Neurofilaments of Kultschitsky cells in human lung

The immunohistochemical localization of three triplet proteins of neurofilaments in normal Kultschitsky cells and tumourlets of the human lung has been studied using avidin-biotin-peroxidase complex (ABC) method. Kultschitsky cells and tumourlets have been stained with antisera against 68 K, 150 K and 200 K dalton components of the neurofilaments, respectively. Ultrastructural observations of human Kultschitsky cells have revealed the presence of bundles of intermediate filaments as well as microtubules and neurosecretory-type granules. In the tumourlets, similarly sized filaments were found, but were relatively scarce. Since intermediate filaments are thought to be specific to differentiated cells and neurofilament proteins are restricted to the neuronal tissues, we conclude that Kultschitsky cells of the lung are of neuronal nature.

[Production and characterization of monoclonal antibody to uterine cervical cancer cell line SKG-IIIa]

By means of an immunization procedure using intact living cells, the established uterine cervical epidermoid cancer cell line SKG-IIIa, a monoclonal antibody (Mab) which reacts with uterine cervical epidermoid cancer cells was obtained. The Mab was of IgG2a subclass. Immunohistochemically the Mab reacted with uterine cervical epidermoid cancer cells (17 out of 25). At the same time, it reacted with a basal layer of normal squamous epithelium, surface mucus secreting cells and parietal cells in stomach and kidney uriniferous tubules. The Mab reacted with the cell surface epitope on HeLa cells to the same extent as on SKG-IIIa cells, but on CCD18-Lu cells (normal diploid) to about one-half as much. The results of an inhibition test using a competitive reaction between Mab and conventional polyclonal antibody indicated that the Mab didn't react with 39 kinds of human serum proteins such as albumin, transferrin, IgG, fibrinogen, lysozyme and some tumor markers. Immunohistochemical staining also revealed that the Mab didn't recognize human blood group substances (A,B,H type, Lewis's a,b type). Treatment of SKG-IIIa cells with a mixture of glycosidases neuraminidase or periodate didn't change the reactivity to the Mab, suggesting that the epitope didn't reside in sugar chains.

Histopathologic and immunohistochemical study of malignant tumors of peripheral nerve sheath (malignant schwannoma)

Histologic and immunochemical analyses were performed on 38 cases and 33 cases of malignant tumors of the peripheral nerve sheath, respectively. The histologic features consisted of either closely packed or loosely arranged interlacing fascicles of slender spindle cells that showed a wavy pattern. Although no characteristic findings indicative of neurogenic differentiation could be confirmed with anti-S-100-protein, a fair number of positive cells were seen in the area where the tumor cells were loosely arranged and displayed a wavy pattern. When anti-neuron-specific enolase (NSE) and anti-neurofilament antibody (68K, 200K) were applied, they were found to be positive in cells differentiating to ganglion cells and in epithelial cells. Since S-100-protein-positive cells indicate a differentiation to Schwann cells and NSE-positive cells and neurofilament-positive cells to nerve cells, it was concluded that immunohistochemistry can serve as an effective supplementary method for the diagnosis of malignant tumors of the peripheral nerve sheath.

[A case of ossifying fibroma of the skull]

A 23-year-old woman was admitted to our hospital because of a soft, painful mass in the right parietal region for a month. Neurological examination revealed no abnormality. Laboratory data including serum Ca, P and alkaline phosphatase were normal. Skull x-ray film showed a partially osteolytic, not well circumscribed lesion in the right frontal, parietal and occipital bone. No remarkable sclerotic area was seen in the lesion. CT scan showed that the lesion was located in the diploë, destroying both inner and outer tables of the bone. Right external carotid angiogram revealed that the lesion is supplied by the branches of superficial temporal artery and middle meningeal artery. 99mTc bone scan showed increased uptake in the lesion. The patient underwent a right parietal craniectomy. The skull bone was invaded by the tumor, which was yellow-brown in color, thickened and fragile. We could easily perforate it through. The tumor didn't invade the dura mater or periosteum. It was extensively removed with an airtome and rongeurs. A cranioplasty was carried out using a plastic resin. The pathological specimen showed that the tumor was mainly composed of mature, regularly-aligned bone and intermingled fibrous tissue. Neither mitosis nor atypical cellular features was seen. These findings were compatible with the diagnosis of ossifying fibroma. The postoperative course was uneventful and the patient was discharged in a good condition. There was no evidence of local recurrence 10 months later. Ossifying fibroma is a rare, benign bone tumor that mainly involves the craniofacial bone. The differential diagnosis of ossifying fibroma versus fibrous dysplasia is difficult. These diseases can be differentiated on combined clinical, radiological and morphological grounds.

Cellular differentiation of epithelioid sarcoma. An electron-microscopic, enzyme-histochemical, and immunohistochemical study

For the purpose of clarifying cellular differentiation of epithelioid sarcoma, studies based on various methods were performed. Enzyme histochemical studies showed that epithelioid sarcoma tumor cells have characteristics intermediate between epithelial cells and the large plump cells of synovial sarcoma-incomplete epithelial differentiation. For alkaline phosphatase and adenosine triphosphatase particularly, positive cells and negative cells coexisted, as in the large plump cells of synovial sarcoma. Immunohistochemical studies for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin, and keratin also showed that epithelioid sarcoma tumor cells are very similar to the large plump cells of synovial sarcoma and have incomplete epithelial differentiation. For example, the examinations of serial sections and double staining methods revealed that keratin-positive cells are always vimentin-positive in epithelioid sarcoma and in the monophasic area of synovial sarcoma. Electron-microscopically, bundles of intermediate filaments and filopodia toward the intercellular lumen were observed, as in the monophasic area of synovial sarcoma. The results of enzyme-histochemical and immunohistochemical studies of non-neoplastic synovial lining cells, performed here for the first time, are also discussed.

[Preoperative combination therapy involving local administration of a non-specific immunoactivated preparation (OK-432) and chemotherapeutic preparations for patients with stomach cancer]

OMF therapy, which is a combination therapy consisting of OK-432 administered locally, Mitomycin C and 5-Fluorouracil, was administered to 50 cases of stomach cancer (52 episodes) preoperatively. Judging the criterion for a positive (+) effect as being the existence of degeneration or necrosis in 1/3-1/2 of carcinomas visible within whole fields, the ratio of histological effectiveness shown by this therapy was 75%. As for its effect on metastatic foci of lymph nodes, when 70 case from an n1 group and 8 from an n2 group with metastatic positive lymph nodes, including 17 cases (4 in Stage II and 13 in Stage III) ablated for curing were studied, a greater than positive (+) effect was shown in 51 out of the total of 78. Consequently the effective ratio was 65%. The survival ratio of 16 cases in Stage III on the 48th month calculated by the Kaplan Meier method was 78.6%. The survival time of 50% of 9 cases in Stage IV (absolute non-curing ablation) was 15 months. Tissue samples were examined constantly after local administration of OK-432. Exudation of neutrocytes was shown on the 1st day, and that of histiocytes, lymphocytes and plasmacytes on the 4th day. At this stage, degeneration of the primary focus or necrotizing change was observed. Interstitial reaction peaked on the 14th day, but histiocytes tended to decrease.

Establishment and characterization of a new clonal strain derived from human benign gastric teratoma

Various kinds of cell-types such as squamous epithelial cells, columnar epithelial cells, sarcomatous cells and fibroblast-like cells proliferated in vitro during the initial period of the primary culture from the human benign gastric tridermal teratoma. The fibroblast-like cells designated HOGT clonal strain were established from a single cell of primary cultures. The HOGT clonal strain grew well and 70 serial passages were successively carried out within 17 months. Although the HOGT cells are karyologically normal, when transplanted into the subcutis of nude mice they produced a benign tridermal teratoma. The results obtained from cell culture and heterotransplantation of teratoma strain enabled us to hypothesize that the graft (tridermal teratoma) in mice may arise from a pluripotent stem cell.

Biochemical and immunohistochemical localization of renin in human pituitary

The renin content of human pituitaries obtained at autopsy of eight patients (four males and four females) within 3 hours after death from various diseases was determined. The pituitaries contained a significant amount of renin (5.5 +/- 1.6 mg of angiotensin I/mg of protein/hour). Although much less (1/1000) than that in human kidneys (4.5 micrograms of angiotensin I/mg of protein/hour), this content was about 10 times higher than that in normal plasma (0.5 ng of angiotensin I/mg of protein/hour). More than 50% of the renin activity was inhibited by antihuman renin antibody. These results are the first detection of a significant amount of renin in the human pituitary. No difference in pituitary renin content between males and females was detected; the pituitaries from the two youngest patients showed the highest levels. Immunohistochemical staining showed no positive cells in the intermediate and posterior lobes and many positive cells in the anterior lobe. Serial sections were examined, and renin-containing cells were immunohistochemically identified as polactin-producing cells without distinction as to the sex of the donor. This demonstration of the intracellular presence of immunoreactive renin lends strong support to the idea that renin is not a contaminant of pituitary preparations due to entrapped plasma, but is endogenous to the human pituitary.

Alveolar soft part sarcoma. An elaboration of a three-dimensional configuration of the crystalloids by digital image processing

As an initial step to elucidate the nature of the unique characteristics of the crystalloids of alveolar soft part sarcoma, a three-dimensional model of the crystalloids was prepared by digital image analysis of electron micrographs by computer. It was revealed that occult periodicities are present at two intervals, 60 A and 380 A, in the filamentous structure of the crystalloid; and it was also revealed by the observation of each cross-section that two globular substances with a diameter of 60 A are arranged in a dumbbell pattern in each filamentous structure. The model prepared based on these data showed the double strands crossing each other at intervals of 380 A, each of which consists of successive arrangement of the globular substances with a diameter of 60 A. This structure is clearly similar to that of actin. The similarities and differences between these results and the well-known studies of the organization of naturally occurring actin bundles are discussed.

Generalized neonatal herpes virus infection (cytomegalovirus or herpes virus type 1). Comparative examination of loci attacked by two viruses

Two autopsy cases, a 5-minute-old male infant with congenital cytomegalovirus (CMV) infection and a 10-day-old female infant with herpes simplex virus type 1 (HSV-1) infection, were presented. CMV antibody titer detectable by immunofluorescence (IF) technique was significantly high in the sera of both infant and mother in the CMV case. In another HSV-1 case, we have succeeded in HSV-1 isolation from autopsy liver and subsequent serological identification of the isolated virus, including a detection of high HSV-1 antibody titer in the mother's serum by IF. On light and electron microscopes, these two cases respectively showed typical findings as the severest form of each viral infection. As one of the marked differences between the two cases, the thymus in the HSV-1 case showed remarkable involution with a complete disappearance of thymic cortical lymphocytes. However, the CMV case exhibited an existence of intact thymus without viral injuries. Similar distinguishable differences between the two cases were observed also in the bone marrow. It additionally seems to be unique that cytomegalic inclusion bodies were disclosed fairly well in the submaxillary glands and rarely in the renal tubules even in the case with HSV-1.

[Preoperative immunochemotherapy for gastric cancer combined with perifocal administration of OK-432]

OMF treatment consisting of perifocal administration of OK-432 associated with MMC and 5-FU was applied for 37 lesions of 35 cases including 2 with multiple cancer. The results obtained were as follows lesions. Macroscopical efficacy was rated as "good" in 12 lesions (32.4%), "fair" in 24 lesions (64.9%) and "poor" in 1 case. Histological efficacy was assessed as "++" for 10 lesions (27%), and "+" for 16 lesions (43.2%). Taking "+" or higher histologically as "effective", the efficacy rate was approximately 71%. Efficacy rate for metastatic lymph nodes was approximately 61% in patients who underwent a curative operation. Patients who received non-curative operation showed a certain efficacy to some extent. Twenty-one cases were judged as "S2" at operation. 11 cases as "se", and another 10 cases as 2 cases of "ss beta" and 8 cases of "pm" Histologically . Seven cases of "pm" were considered either as "good" or Histological efficacy as "++" in terms of macroscopical efficacy.

Histogenesis of clear cell sarcoma of tendons and aponeuroses. An electron-microscopic, biochemical, enzyme histochemical, and immunohistochemical study

For the purpose of clarifying the histogenesis of clear cell sarcoma of tendons and aponeuroses (CCS) as well as the problem of whether or not CCS is a heterogeneous group of neoplasms, studies based on various methods were performed. Analysis of glycosaminoglycans gave the same results for amelanotic CCS and synovial sarcoma, and the DOPA reaction gave the same negative results for amelanotic CCS and synovial sarcoma. However, the DOPA reaction was also negative in an amelanotic recurrent tumor of a melanotic CCS, and electron-microscopic studies revealed a close resemblance between amelanotic CCS and melanotic CCS. Further, enzyme histochemical studies showed definite differences between synovial sarcoma and amelanotic CCS but gave identical results for amelanotic and melanotic CCS. Immunohistochemical studies revealed the presence of S-100 protein in all CCS cases, both amelanotic and melanotic. These results indicate that CCS is not a heterogeneous group of neoplasms, and that both amelanotic and melanotic CCS are of neural crest origin.

Immunoperoxidase demonstration of a new muscle protein (Z-protein) in myogenic tumors as a diagnostic aid

Z-protein, a new muscle protein with a molecular weight of 55,000 daltons recently discovered in Japan, is an excellent marker for muscle differentiation in paraffin sections. Positive staining by a peroxidase-antiperoxidase technique for detection of intracellular Z-protein was observed in 2 of 2 cardiac rhabdomyomas, 5 of 5 leiomyomas, 9 of 10 leiomyosarcomas, and in 15 of 18 rhabdomyosarcomas including 5 of 5 of the pleomorphic type, 7 of 9 of the embryonal type, and 3 of 4 of the alveolar type. Other types of tumors (77 cases) that sometimes mimic myogenic tumors on histologic examination gave negative results. The immunoperoxidase method for detection of intracellular Z-protein is of use in distinguishing myogenic tumors from other types of tumors.

Cytologic and biologic studies of endometrioid carcinoma of the ovary

The cytologic findings in an ovarian endometrioid carcinoma were investigated, and biologic characterization was performed. Cytologic findings from the ascitic fluid revealed characteristics of adenocarcinoma, such as fine cytoplasm, anisochromasia and prominent nucleoli; findings characteristic of endometrioid carcinoma of the ovary were not found, though a cluster of carcinoma cells on imprinted smears was similar to that of endometrial carcinoma cells. A morphologic comparison between the cells from the ascitic fluid and cells cultured from the ovarian endometrioid carcinoma showed their similarity. Biologic characterization showed a modal chromosome number of 103, a 74.4-hour population doubling time of the cell line and 0 plating efficiency. Heterotransplantation was achieved in one of the four hamsters (25%).

Alveolar soft-part sarcoma. A review on its histogenesis and further studies based on electron microscopy, immunohistochemistry, and biochemistry

To date, the histogenesis of alveolar soft part sarcoma has been considered to be of paraganglioma origin, striated muscle cell origin, or as a malignant granular cell myoblastoma, neural neoplasm, or renin-producing tumor. Further studies for these existing theories were performed based on various methods. The negative formaldehyde-induced fluorescence and the immunohistochemical absence of neuron-specific enolase were against the paraganglioma theory. The immunohistochemical absence of myelin proteins (P2 protein and PO protein) and S-100 protein were against the malignant granular cell myoblastoma and neural neoplasm theory. Furthermore, there was a totally negative immunohistochemical finding for renin in the tumor cells, and the biochemical relationship of the tumor and renin was completely negated. The contradiction in a well-known report that the components of crystals were considered to be Z-band materials such as tropomyosin was referred to based on recent myological data. Concurrently, the absence of tropomyosin was immunohistochemically demonstrated. Hence, the issues on the histogenesis of alveolar soft part sarcoma and the identity of the characteristic crystalloids remain open for discussion.

[Case of gastrin-producing carcinoid, adenocarcinoma and xanthoma of the stomach]

A rare case with gastrin-producing carcinoid, adenocarcinoma and xanthoma of the stomach is presented. A 69-year-old male underwent total gastrectomy with splenectomy and distal pancreatectomy. The histological type of the carcinoid was poorly differentiated (type D), and argyrophil cell carcinoma. Immunoperoxidase staining of the carcinoid was positive for gastrin and negative for glucagon, somatostatin or insulin. The histological findings of the carcinoma were tub 2, medullary, INF alpha, se, ly 2, v 1, ow(-), aw(-), n 1. Histologically, the xanthoma consisted of foamy macrophages accumulated in the lamina propria.

Immunohistochemical localization of S-100 protein and peripheral nerve myelin proteins (P2 protein, P0 protein) in granular cell tumors

The presence and distribution of nervous-system-specific protein (S-100 protein), peripheral nerve myelin proteins (P2 protein and P0 protein) that have not been given any attention in the field of tumor pathology, and striated muscle-related proteins (myoglobin and myosin) were studied in 18 cases of granular cell tumor by the peroxidase-antiperoxidase method. The granular cells of all cases were negatively stained with anti-striated-muscle-related protein antiserums. On the other hand, they were positively stained with anti-S-100 protein, P2 protein, and P0 protein antiserums. The distribution of P2 protein and P0 protein corresponded with that of characteristic PAS-positive granules on serial sections. Angular bodies in the interstitial cells were also positively stained with anti-P2 protein antiserum and anti-P0 protein antiserum. These results further support the hypothesis that the granular cell tumor is derived from Schwann cells and also suggest that myelin proteins are major core proteins of the characteristic granules and angular bodies of interstitial cells. The biologic significance of these results in relation to myelinogenesis is also discussed.

Primary leiomyosarcoma of bone. An immunohistochemical and ultrastructural study

Primary leiomyosarcoma of bone is extremely rare. A 60-year-old woman had a mass in the right femur that was studied immunohistochemically and by electron microscopy. Human smooth-muscle actomyosin was detected in tumor cells, but human skeletal-muscle myoglobin and lysozyme (muramidase) were not. Electron microscopy of the tumor showed findings suggestive of a smooth-muscle origin, such as myofilaments, dense bodies, pinocytotic vesicles, and basement membrane. The results were diagnostic of leiomyosarcoma rather than rhabdomyosarcoma, fibrosarcoma, or malignant fibrous histiocytoma, which are similar neoplasms. We believe that ours is the first case of primary leiomyosarcoma of the bone proved by immunohistochemistry.