Pathohistological Diagnosis Research Articles

A CASE OF APPENDICEAL MUCOCELE WHOLE-CIRCUMFERENTIALLY COVERED WITH CALCIFICATION

A case of appendiceal mucocele whole-circumferentially covered with calcification was experienced. A 78-yearold female was admitted to the hospital because of a mass in the right lower quadrant which was pointed out elsewhere CT scan showed the tumor with caltification in ileocecal region. Ovarian tumor was suspected and operation was performed. The tumor was originated in the appendix and no abnormality was found in the ovary. Ileocecal excision was performed. The tumor was filled with white jelly-like substance. The pathohistological diagnosis was mucinous cystadenoma.

さい性癌の１例

A report is presented on a rare case of primary branchiogenic carcinoma proposed by Martin H in 1950.Case ReportA 73-year-old male with a nodular swelling in the right middle neck was referred on September 28, 1988. The swelling was 4cm in diameter and could be palpated at the anterior margin of right sternocleidomastoid muscle. No findings of malignant tumor could be observed in the head and neck region. Incision biopsy was performed and a diagnosis was no malignancy. Cytology led to the pathohistological diagnosis of squamous cell carcinoma. The cervical nodular swelling was clinically diagnosed tentatively as branchiogenic carcinoma. As the tumor increased in size to 6cm in diameter, preoperative radiotherapy of 60Co of 40 Gy was commenced together with hyperthermotherapy.The skin of the neck 2cm from the radiant ulcer was extensively resected and right radical neck dissection was performed. The right deltopectoral flap was elevated and the skin defect was repaired. Local recurrence and distant metastasis could not be detected and the primary lesion continued to be unknown, and the course was satisfactory. However, after a lapse of 5 years and 3 weeks following diagnosis, the patient expired due to myocardial infarction.

Ｃａｓｔｌｅｍａｎリンパ腫（Ｈ‐Ｖ ｔｙｐｅ）例

We recently treated a 16-year-old male patient with Castleman's lymphoma (hyalinevascular type) of the neck. The tumor was in the upper lateral cervical area, was surgically removed under general anesthesia. The pathohistological diagnosis was hyaline-vascular type of Castleman's lymphoma. In general, the hyaline-vascular type of Castleman's lymphoma has a good prognosis.The pathogenesis of Castleman's lymphoma is not known, but immunohistological studies suggests that it is a lymph node hamartoma.Although Castleman's lymphoma occurs most frequently in the mediastinum, it may occur in the head and neck region. In Japan there have been only 61 reports including this case. We must consider entity in the differential diagnosis of head neck masses.

A CASE REPORT OF APPENDICEAL MUCOCELE

We report a case of appendiceal mucocele which could be diagnosed preoperatively. A 40-year-old man was admitted to our hospital complaining of a palpable mass in the right lower part of the abdomen. Abdominal plain roentgenogram, barium enema, ultrasonogram and computed tomogram revealed calcified tumor in the ileocaecal region. The diagnosis of appendiceal mucocele was made and laparotomy was performed. The tumor coincided with the location of the appendix, ileocecal excision being carried out. The excised tumor had partially uneven wall, and was filled with gelatin-like substance. The pathohistological diagnosis was mucinous cystadenoma, borderline malignancy.Appendiceal mucocele is rare and difficult to be diagnosed preoperatively. We discussed the way of preoperative diagnosis and surgical procedures for appendiceal mucocele.

A CASE REPORT OF GRANULOMATOUS APPENDICITIS

We report a case of granulomatous appendicitis which was pathohistologically diagnosed. A 28-year-old woman complaining of ileocecalalgia was admitted to our hospital. A mass was palpated in the ileocecal region. Ultrasonography and barium meal roentgenography of the small intestine showed an ileocecal tumor, and laparotomy was performed. The tumor, sizing 4.0×3.0×2.0 cm, was hard and originated from the appendix. Mesenteric lymph nodes were swollen. Right hemicolectomy was carried out on a suspicion of malignancy. The cross section of the tumor was yellowish white. The pathohistological diagnosis was granulomatous appendicitis.We pointed out the differential diagnosis between the granulomatous appendicitis and Crohn's disease, and also discussed the infectious disease in the ileocecal region due to Yersinia pseudotuberculosis.

Primary malignant fibrous histiocytoma of the lung

The authors interpret a case-report on malignant fibrotic lung histiocytoma diagnosed in a 69 year old female. The patient was admitted for examination because of suspicion of tumor. None of the usual pulmonology tests (sputum cytology, fiberoscopy, bronchus-brush-cytology) could reveal the origin of the change. Upper-lobe resection was done because of the round shadow on the X-ray image of the upper lobe. The pathohistological diagnosis was malignant fibrotic histiocytoma. Combined cytostatic treatment was administered on this patient--after the surgery. She was sinking gradually and died 4.5 months after the resection.

Importance of immunoenzyme histochemical reaction in diagnosis of disseminated intravascular coagulation in human and animal material.

Renal tissues from 208 human necropsies were observed histologically for disseminated intravascular coagulation (DIC). The tissues were stained with hematoxylin-eosin, Mallory's phosphotungstic acid hematoxylin (PTAH) and cationic ferric hydroxide colloid stabilized with cacodylate (Fe-Cac), and tested by immunoenzyme histochemical (IEH) reaction for fibrin-related materials (FRMs). The use of the IEH method increased FRM recognition, and FRMs were detected in a total of 80 cases (38.5%). In 26 cases diagnosed clinically as DIC, FRMs were shown in 23 of the cases (88.5%). Thus, 57 patients with FRMs were clinically asymptomatic. In rats with DIC induced by endotoxin injection, glomerulus FRM was effluxed into the tubulus through the Bowman's capsule and was excreted into urine. The electric charge was reduced on the endothelial surface of the glomerular capillaries in both human and rat DIC. Under the scanning electron microscopy, the endothelial surface appeared coarse in the glomerular capillary and fibrin degradation was present. Our conclusions are: (a) PTAH is non-specific for FRMs, (b) IEH aids the pathohistological diagnosis of DIC, especially in asymptomatic forms including the compensated DIC state, (c) FRMs in tubuli suggest DIC, and (d) DIC is possibly initiated by a reduction in the capillary electric surface charge.

A CASE REPORT OF MACROGLOBULINEMIA WITH GASTRIC CANCER

A case of macroglobulinemia with gastric cancer is reported.The patient was a 72-year-old man. The diagnosis of macroglobulinemia was established on the basis of an increase in serum monoclonal IgM (3110mg/dl) and a reduction of other serum immunoglobulins.The patient was treated with bestrabucil, and serum IgM gradually decreased. In January 1987, epigastric pain appeared, and a gastroendoscopic examination revealed gastric cancer of Borrmann I in the posterior wall of the antrum.The pathohistological diagnosis obtained by biopsy was tubular adenocarcinoma. Surgery was not performed because CT showed a multiple low density area in the liver. The patient died in September 1987.

Influence of unilateral adrenalectomy on renin-angiotensin-aldosterone system in primary aldosteronism.

In a study of 14 patients (11 Japanese and 3 white North Americans) with aldosterone-producing tumor carried out within 2 to 4 weeks after unilateral adrenalectomy, both plasma renin activity (PRA) and plasma aldosterone concentration (PAC) increased almost normally with short-term sodium depletion and upright posture. Aldosterone excretion rate (AER) also increased significantly with sodium depletion, and was normally suppressed by sodium loading. Highly significant correlations were observed between PRA and PAC (r=0.89, p < 0.001) or AER (r=0.88, p < 0.001) ater operation, whereas there had been no such correlation before operation. Either physiological or laboratory findings were normalized or markedly improved in all cases although pathohistological diagnosis was made as adenomatous hyperplasia in 10 out of 11. These results indicate that within 4 weeks of operation PRA and the remaining adrenal gland can almost normally respond to stimuli such as sodium depletion and upright posture regardless of the amount of spironolactone given preoperatively.

The Incidence of Metastases in Cancer of the Larynx and Hypopharynx based on the Pathohistological Diagnosis

The incidence of distant and lymphnode metastases on 193 autopsied cases of the laryngeal cancer and 48 autopsied cases of the hypopharyngeal cases are obserbed.Distant metastases are obserbed 72 cases (37.3%) in laryngeal cancer and 14 cases (29.1%) in hypopharyngeal cancer.And metastases into lung is most frequent and in turn in bone, liver, kidney, pleura relatively high metastases is obserbed.The incidence of lymphnode metastases are 86 cases (44.5%) in laryngeal cancer and are 19 cases (39.5%) in hypopharyngeal cancer.And metastases into cervical lymphnodes are most frequent and as the distant lymphnode metastases, the pulmonal and tracheo bronchial lymphnodes are relatively frequent obserbed.

Statistical observation of malignant tumors in the oto-rhino-laryngeal region, based on pathohistological diagnosis

Statistical observation of malignant tumors in the oto-rhino-laryngeal region, based on pathohistological diagnosis