The tumor-forming type of multiple myeloma. I. Biological behavior.

A total of 45 cases of multiple myeloma has been followed up clinically during the period from 7 to 80 months. Out of these, six patients (13.3%) were diagnosed to be the tumor-forming type; they developed discrete tumor formation at the disease onset or during clinical observation. Biological behavior of these cases is briefly outlined. Histologically, five cases presented with well or moderately well differentiated plasma cells according to the grading made by Pasmantier and Azar. The remaining one case was poorly differentiated in cell maturity, and with electron and immunofluorescence microscopies, proved to be of plasmacytic nature.</p

Intestinal Nature in Gallbladder Carcinoma with Reference to its Histogenesis

Forty advanced cases of gallbladder carcinoma were examined by the use of histochemical and immunohistological methods, in which attention was focused on intestinal metaplasia seen in and around the lesions. Twenty-nine percent for cases of well-differentiated adenocarcinoma displayed goblet cell-type carcinoma cells within the lesions, while no similar cell was evident in cases of poorly differentiated adenocarcinoma. Ten percent for cases of gallbladder carcinoma included endocrine cells within neoplastic tissues, all of which consisted of well-differentiated adenocarcinoma and mucosal areas adjacent to which also contained similar cells. Mucosal areas in the proximity to foci of well-differentiated adenocarcinoma demonstrated a marked increase in the amount of non-sulfated acid mucin, but no such tendency was discernible around foci of poorly differentiated adenocarcinoma. Lysozyme immunoreactivity was identifiable in a high percent of well-differentiated adenocarcinoma foci and their surrounding mucosal areas, while similar reactivity was rarely present in cases of poorly differentiated adenocarcinoma. It may be suggested from these results that an intimate relationship would exist in between intestinal metaplasia and well-differentiated adenocarcinoma occurring in the gallbladder. It is, however, to be determined whether or not intestinal metaplasia alone would act as a precancerous lesion like adenoma, dysplasia and possibly hyperplastic polyp for the histogenesis of gallbladder carcinomas

微小心筋梗塞を合併した単一冠動脈症の1例

胸痛と心筋逸脱酵素値の上昇より心筋梗塞を合併したと考えられる,Smith 1型の単冠動脈症の1例を経験した.冠動脈造影では右冠動脈を完全に欠除し,左冠動脈には大きな分岐異常はなく,正常走行を示す左前下行枝と,後壁を右下方へ異常に延長した回旋枝で心臓全体が還流されていた.なおこれらの血管には狭窄病変は認められなかった.梗塞を合併した単一冠動脈症の報告はまれであり,その臨床的意義につき文献的考察を加え報告する.Presented case is a 48-year-old patient suffering from single coronary artery of Smith type 1, which was assumed to be associated with a small myocardial infarct as revealed by the presence of anterior chest pain and increased level of serum myocardial enzymes. Coronary angiography disclosed complete defect of the right coronary artery as well as normally branching left coronary artery immediately distal to its ostium, and also suggested that total areas of the heart were perfused only by the left anterior descending and circumflex arteries, the former showing the normal distribution while the latter extending way down to the right side over the posterior aspect of the heart. Stenotic change was by no means presented angiographically in these coronary arteries. A few case of single coronary artery associated with myocardial infarction was reported. We presented a new case without coronary artery stenosis and discussed in detail