HEPATOCELLULAR CARCINOMA PRESENTING EXTRAHEPATIC OBSTRUCTIVE JAUNDICE DUE TO BILE DUCT INVASION-CLINICOPATHOLOGICAL STUDY OF TWO CASES

Two rare cases of autopsy and surgery presenting extrahepatic biliary obstruction due to intrabile-duct growth of hepatocellular carcinoma were reported. Clinically obstructive jaundice was predominant in comparison with the other symptoms in both cases. In one autopsy case, hepatocellular carcinoma developed in the right lobe of the cirrhotic liver (posthepatitic). It involved the secondary branch of the right hepatic duct and grew into the common hepatic duct. In the other case of surgical operation, hepatocellular carcinoma, which developed in the posterior portion of the right lobe of the cirrhotic liver (posthepatitic), destroyed the posterior wall of the bifurcation of the bilateral hepatic duct and obstructed the common hepatic duct due to the intraductal cancer growth. From the site of the bile duct invasion or permeation by the tumor, two cases were classified into the peripheral (the former case) and proximal (the latter case) types, respectively. Furthermore, as far as obstructive jaundice is clinically concerned, the possibility should be kept in mind that hepatocellular carcinoma may proliferate into the large bile ducts, apart from that of cholangiocarcinoma or cholelithiasis

EXPERIMENTAL STUDY ON THE DRAINAGE OF SO-CALLED INTRAVENOUS FAT PIGMENT FROM THE LIVER. LONG-TERM OBSERVATION WITH HISTOLOGIC, ENZYME-HISTOCHEMICAL AND ELECTRON MICROSCOPIC ANALYSIS

The drainage and decrease of so-called intravenous fat pigment (i.v. fat pigment), which was a lipoid-pigment complex and deposited in the reticuloendothelial system after repeated infusions of Intrafat (intravenous fat emulsion), was observed in the liver of the rabbit by histological, histochemical and electron microscopic methods. As a result, the i.v. fat pigment was mainly found in Kupffer cells immediately after the repeated injections of Intrafat. After then, depending on the period when no injection were given, it decreased gradually and disappeared finally from Kupffer cells. On the other hand, in the interstitium of Glisson s sheath, many phagocytes, extremely swollen and laden with i.v. fat pigment, appeared during the postinfusion period. Furthermore, these phagocytes laden with i.v. fat pigment were found in Glisson’s sheath for a long period, although they showed a tendency of decrease Histochemical and electron microscopic characteristics, quite similar to those of Kupffer cells, suggested that these phagocytes corresponded to the extremely swollen histiocytes or macrophages having some role in the drainage or the metabolism of the i.v. fat pigment

ARGYROPHIL CELLS IN ADENOMAS OF FAMILIAL POLYPOSIS COLI

The presence of argyrophil cell was demonstrated in the adenomas of familial polyposis coli (FPC) with the Sevier Munger method. Ususlly, argyrophil cells were distributed sparsely near the base of the crypts, rather close to the normal mucosa. But, adenomas with severe or moderate dysplasia did not contain argyrophil cells. The frequency of argyrophil cells in the adenoma was remarkably higher in the sigmoid than in the ascending colon. Because this phenomenon was found both in the non-adenomatous mucosal crypts of FPC and of normal control cases, it is conceivable that the appearance of the argyrophil cells in the adenomas of FPC is affected by the structural arrangement of the original non-tumorous mucosa, as a background. Furthermore, a tendency, that many argyrophil cells were located within the adenomas, was observed in one of the seven families examined. It showed that the argyrophil cell which is thought to be one of the elements constituting the adenoma might actively participate in the growth of the adenoma