Adult T-cell Leukemia-lymphoma associated with Metastatic Calcification and Acute Pancreatitis under Hypercalcemic Condition

Metastatic calcification due to hypercalcemia in adult Tcell leukemia-lymphoma (ATL) associated with osteolytic change for activation of osteoclasts are reported. These cases of serum calcium were at a high level, 15.1 and 19.4 mg/dl (normal range 8.4-10.4 mg/dl). Metastatic calcification was detected in the tubules of kidneys, in the pulmonary alveolar septa of lungs, in the myocardium, in the muscular layer of stomach, in the lower portion of media of aorta, in the mucosa of stomach, in the tubules of testis, and in the liver by von Kossa\u27s silver nitrate method for calcium. Scattered osteoclasts were seen around the cortex of the bone. ATL cells stained with parathyroid hormone-related protein (PTHrP) by immunohistochemical procedure. Thus, PTHrP is an important bone resorption-stimulating factor of hypercalcemia in ATL. We have investigated the incidence of acute pancreatitis in ATL, and in the other diseases. Of the 317,325 autopsy cases, 632 were ATL; the numbers of the acute pancreatitis cases of them were 1,833 (0.58%) and 25 (4.0%), respectively. The odds ratio from 2 x 2 table is 7.17 and Peason\u27s Chi-square statistics with one degree of freedom is 126, which is highly significant. Therefore, it was suggested that there is a close correlation between acute pancreatitis and hypercalcemia in patients with ATL. We proposed a new theory for the correlation between acute pancreatitis and hypercalcemia in ATL that all the hypercalcemic patiens exhibited high levels of nephrogenous cyclic adenosine monophosphate (NcAMP) stimulating pancreatic secretion in the extralobular ductal system of the pancreas and thus resuling in acute pancreatitis due to occlusion of the pancreatic duct

A Comparative Study of Liver Cell Regenerative Activity between Primary Biliary Cirrhosis, Alcoholic Cirrhosis, Hepatitic Cirrhosis, and Hepatocellular Carcinoma using Figure Analysis

Liver cell regeneration which is a prominent pathological feature in cirrhosis of the liver was examined histopathologically and by figure analysis using immage analyser. Liver cell regenerative changes in liver biopsies of primary biliary cirrhosis (PBC), alcoholic cirrhosis, hepatitic cirrhosis, and hepatocellular carcinoma (HCC) were compared. In PBC, regenerative features of liver cells were mild in degree. In alcoholic cirrhosis, regenerative liver cells were less prominent than in hepatitic cirrhosis. In hepatitic cirrhosis, regenerative liver cell nodules were well developed, showing remarkable pleomorphism of liver cell nuclei and expansive arrangement of liver cell cords. Cellular and structural atypia were observed in some parts of regenerative nodules. These results suggest that a possibility of occurring HCC is much more prominent in hepatitic cirrhosis than in PBC or alcoholic cirrhosis, because developement of liver cell regeneration is most remarkable in hepatitic cirrhosis

T-cell Rich B-cell Cross-reacting Nasopharyngeal Carcinoma

Immunohistochemical analysis was carried out to examine infiltration of lymphocytes in the tumor nests of nasopharyngeal carcinoma (NPC) using 38 biopsy cases obtained from southern China. These cases were divided into 3 groups according to their prominent pattern associated with the cell and the tissue differentiation using the World Health Organaization (WHO) classification as follows: (i) 6 cases of squamous cell carcinoma (16%), (ii) 25 cases of differentiated non-keratinizing carcinoma (66%), (ii) 7 cases of undifferentiated carcinoma (18%). All tumor tissues reacted diffusely with MB-1, however, these did not react with L26 (CD20), 4KB5 (CD45R), MT-1, and leukocyte common antigen (LCA). In the tumor nests, normal lymphocytes were observed in squamous cell carcinoma type (50%), differentiated non-keratinizing carcinoma type (72%), and undifferentiated carcinoma type (86%). Therefore, it is suggested that a large number of infiltrating non-neoplastic T-cells may be related to good prognosis. T-cell-rich B-cell lymphomas (TCRBCLs) are recently described as unusual non-Hodgkin\u27s lymphomas associated with predominance of reactive T-cells. Therefore, the mechanism of T-cell lymphocyte infiltration adjacent to the tumor cell is considered that these T-cell infiltrates may be the passive response to cytokine secretion by the tumor cells

Histopathological Difference of Nasopharyngeal Carcinoma in Southern China and Japan

Histopathological analysis was carried out to examine the characteristics of nasopharyngeal carcinoma (NPC) using 38 biopsy cases obtained from southern China and 34 cases obtained from Japan. These cases were divided into three groups according to their predominant pattern associated with the cell and the tissue differentiation using the World Health Organization (WHO) histological classification of tumors as follows: (i) squamous cell carcinoma; 6 Chinese cases and 5 Japanese cases, (ii) differentiated nonkeratinizing carcinoma; 25 Chinese cases and 7 Japanese cases, (iii) undifferentiated carcinoma; 7 Chinese cases and 22 Japanese cases. The age of Chinese patients ranged from 21 to 80 years with a mean of 46 years and Japanese patients ranged from 17 to 89 years with a mean of 53.8 years. The male to female ratio was 2.7:1.0 in China and 1.8:1.0 in Japan. The most common histological type of NPC in China was differentiated non-keratinizing carcinoma, however, it was undifferentiated carcinoma in Japan. The mechanism of cancer arising from the nasopharynx may be quite different between Chinese and Japanese cases. The Chinese NPC cases were considered as continuity shift from normal epithelium to differentiated nonkeratinizing carcinoma, to undifferentiated carcinoma sequence. On the other hand, the Japanese cases were considered discontinuity shift. Therefore, in Chinese cases, NPC formation mechanism may be that EBV infection and chemical carcinogens can act synergistically in the enhancement of both viral replication and malignant transformation. It is suggested that some Japanese cases are associated with Epstein- Barr virus infection, although, mechanism of formation of NPC in Japanese cases is not yet clear

Proliferating Cell Nuclear Antigen (PCNA), Nucleolar Organizer Regions (AgNORs), and Mitotic Indeces in Nasopharyngeal Carcinoma

Proliferative activity of nasopharyngeal carcinoma (NPC) using 20 biopsy cases obtained from southern China were analyzed by immunolabelling with the monoclonal antibody of proliferating cell nuclear antigen (PCNA), the numbers of interphase silver stained nucleolar organizer regions (AgNORs), and mitotic indices. Nucleolar organizer regions (NORs) are loops of ribosomal DNA (rDNA) occurring in the nucleoli of cells, which transcribe to ribosomal RNA (rRNA) and ultimately direct ribosome and protein formation. PCNA is a nuclear protein synthesized in the nucleus late in G1 phase, peaking during S phase and subsiding during G2 and M phases of the cell cycle. These may indicate that PCNA and AgNORs are present at different stages of the cell cycle. The authors found that 28% of differentiated non-keratinizing carcinoma type of NPC and 18% of undifferentiated carcinoma type of NPC were positively stained by PCNA. The mean AgNOR counts for differentiated non-keratinizing carcinoma type of NPC, and undifferentiated carcinoma type of NPC were 1.8 and 1.2, respectively. The mean mitotic counts for differentiated non-keratinizing carcinoma type of NPC and undifferentiated carcinoma type of NPC were 3.4 and 2.1, respectively. Therefore, it is suggested that PCNA labelling immunoreactivity may be correlated with AgNORs score and mitotic indeces, thus in NPC, these number and size have been regarded as markers of cell proliferative ability

Immunohistochemical Investigation of Nasopharyngeal Carcinoma Using Keratin, EMA, Laminin, Fibronectin, Collagen Type IV, Laminin Receptor, and Laminin/Collagen Receptor Antibodies

Immunohistochemical investigation was carried out to examine the characteristics of nasopharyngeal carcinoma (NPC) using 12 biopsy cases obtained from southern China. These cases were divided into three groups according to their predominant pattern associated with the cell and the tissue differentiation using the World Health Organization (WHO) classification as follows: (i) 4 cases with squamous cell carcinoma, (ii) 4 cases with differentiated nonkeratinizing carcinoma, (iii) 4 cases with undifferentiated carcinoma. These three types of NPC cases were reacted with keratin and epithelial membrane antigen (EMA). All neoplastic tissues were stained with keratin stronger than EMA. Squamous cell carcinoma and differentiated non-keratinizing carcinoma cases were diffusely stained strongly positive by immunoperoxidase for keratin. On the other hand, most of undifferentiated carcinoma cases were weakly or negatively reacted with keratin immunohistochemistry, and a part of tumor cytoplasms were stained strongly positive by keratin immunoreaction. For EMA immunoperoxidase method, squamous cell carcinoma cases were diffusely positive and most of differentiated non-keratinizing carcinoma and undifferentiated carcinoma cases were partly positive. However, none of NPC cases reacted with immunoreactivity for laminin 200, laminin 400, fibronectin, collagen, laminin receptor, and laminin/collagen receptor. Therefore, immunohistochemical characteristics of NPC showed epithelial cell origin, arising from squamous cells in nasopharynx

Histochemical and Immunohistochemical Studies on the Relationship Between Severe Iron Accumulation and Liver Cell Injury

Histochemical and immunohistochemical analysis was carried out to determine the relationship between iron accumulation and hepatic cirrhosis, using 10 autopsy cases of. severe iron accumulation in the hepatocytes obtained from Kenya, including cases of Bantu siderosis. These severe iron accumulation specimens were divided into two groups ; one group consists of five cases with cirrhosis with or without hepatocellular carcinoma, and the other five cases with non-cirrhosis. All cirrhosis cases included hepatitis B surface antigen. Chronic infection caused by hepatitis B virus may lead to necrosis of the liver cells, resulting in the formation of hepatic fibrosis or cirrhosis. On the other hand, none of the non-cirrhosis cases include hepatitis B virus. This finding indicates that iron accumulation does not lead to cellular injury. Therefore, it is suggested that chronic iron toxicity is not recognized in Bantu siderosis. The reached conclusion is that there is no correlation between iron accumulation and hepatic fibrosis or cirrhosis