Association of the hepatoid and choriocarcinomatous components in adenocarcinoma of the stomach is extremely unusual and raises a possibility of new approach understand the histogenesis of gastric hepatoid adenocarcinoma. This paper describes a Borrmann type III adenocarcinoma of the stomach with both choriocarcinomatous and hepatoid components in composite tumor pattern in a 50-year-old man. Tubular arrangement of differentiated embryonalcarcinoma was encountered in choricarcinomatous and hepatoid areas, which showed strong immunoreactivity to beta-HCG and AFP, respectively. The findings suggest that gastric adenocarcinoma may have a potential of differentiation toward embryonal carcinoma. from which both choriocarcinoma and hepatoid variant of gastric adenocarcinoma may develop by retrodifferentiation.
Adenocarcinoma

As flow cytometric analysis using paraffin-embedded tissue was developed by Hedley et al in 1983, retrospective study with large amount of archival material was possible. Many literatures reported that the result of paraffin embedded tissue was compatible with that of fresh tissue. We compared the DNA histograms of 26 cases of colorectal adenocarcinoma in which the analysis was done in both fresh and paraffin-embedded tissues. Aneuploidy in fresh and paraffin-embed-ded tissues was 73.0% and 50.0%, respectively. The concordance rate of fresh and paraffin-em-bedded tissues was 76.8% and six interpreters were agreed in 73.0% of the cases. Because flow cytometric DNA analysis using fresh tissues can detect more aneuploid population than in paraffin-embedded tissue, the former is strongly recommeded in DNA ploidy study. Also careful observation using standard criteria may improve the interpretation of DNA histogram.
Adenocarcinoma

No abstract available.
Adenocarcinoma

No abstract available.
Adenocarcinoma*

Obstructive colitis is an ulceroinflammatory lesion of the large intestine at a distance proximal to the obstructing or potentially obstructing lesion of any etiology. It has been suggested that a rise in the intraluminal pressure related to the obstruction results in a fall in the intramural blood flow with subsequent ischemic necrosis. We examined 7 cases of surgically resected obstructive colitis associated with distal constrictive adenocarcinoma of the large intestine. Two cases of the obstructive colitis were radiologically suspected prior to surgery either as a separate tumor mass or diverticulosis, and another case was suggested to be a tumor seeding by colonoscopy. Grossly, five cases presented with single or multiple, shallow, well-demarcated ulcerative lesions, and the remaining two were featured with a segmental ulcerative lesion the with pseudopolypoid area. The ulceroinflammatory lesions were separated from the distal obstructive carcinoma by a skipped zone of relatively normal mucosa measuring 4-43 cm. The proximal colon to the obstructive lesions were obviously dilated except in one case. Microscopically, mucosa and submucosa were replaced by granulation tissue, and showed inflammatory cell infiltration and fibrin exudates. Muscle coat often accompanied ischemic contraction. Fissuring was noted in one case. The recognition of these lesions prior to or during surgery is stressed based on the morphological features corresponding to an ischemic change in the proximal mucosa to the primary obstructive lesion.
Adenocarcinoma

No abstract available.
Adenocarcinoma*

Primary gallbladder carcinoma is generally assumed as uncommon but dismal malignancy. Only sporadic studies about pathologic features of the gallbladder carcinoma have drawn pathologists attention especially in association with cholelithiasis. Currently, we have focused much on the role of metaplastic changes in diseased gallbladders including cholecystitis with or without cholelithiasis, and raised its implication in the development of benign or malignant neoplasm. The authors reviewed 34 cholecystectomy cases with primary gallbladder carcinoma, and their histologic findings were analyzed with reference to the association of metaplastic changes both in tumor and adjacent nonneoplastic mucosal epithelium. Association with gallstones and metaplastic changes in the surrounding nontumorous mucosa is more frequent in intestinal typen than in non-intestinal type (P<0.05). Gallstones may play a role of irritant stimuli to the gallbladder mucosa which can be eventually reconstructed with more resistant cell type. And the subsequent increase in absorptive capacity and accumulation of carcinogenic substance may result in malignant transformation of (reserve) cells in replication zone. At this time we can assume that association of cholelithiasis and presence of metaplastic changes are in parallel relationshop in intestinal type adenocarcinoma. Intestinal type adenocarcinomas are usually papillary (72.7%) especially in superficial portion, but deeper area also shows infiltrative growth focally. This finding is comparable to intestinal type gastric carcinoma which represents frequently a polypoid and papillary growth pattern. With these results, as in the gastric carcinoma it is strongly supported that intestinal metaplasia may play a major role as a precancerous lesion in a minor group of the gallbladder adenocarcinoma. Controlled prospective study on biological behavior of intestinal type adenocarcinoma should be followed with more cumulative cases.
Adenocarcinoma

Estrogen and progesterone receptors exist in the epithelial and stromal cells of the endometrium. Proliferative disorders of the endometrium may be associated with autocrine and paracrine actions of estrogen and progesterone in epithelial and stromal cells. This study was performed to evaluate the differences estrogen and progesterone receptor(ER/PR) expression in the epithelial and stromal cells of endometrial hyperplasias and adenocarcinomas using immunohistochemical methods. Immunohistochemical analysis of proliferating cell nuclear antigen(PCNA) was done to evaluate a possible correlation between PCNA and hormone receptor expression. Evaluation was based on samples from 31 simple hyperplasias, 30 complex hyperplasias, and 32 adenocarcinomas. The immunohistochemical expression of ER, PR and PCNA in epithelial and stromal cells were examined according to a scoring system based on the percentage of positive cells and the staining intensity. The results were as follows; 1) The expression of ER and PR in epithelial cells showed a graded, significant decreases in simple hyperplasia, complex hyperplasia and endometrial carcinoma, in that order(ER: P=0.008, PR: P= 0.026). 2) PR expression in the stromal cells showed a significant decrease between hyperplasia and adenocarcinoma(P=0.003). The difference in ER expression was not significant. 3) In stromal cells, the decrease in PR expression was more prominent than the decrease in ER expression when complex hyperplasia was compared to simple hyperplasia. 4) The PCNA expression in simple and complex hyperplasia and adenocarcinoma was not higher than the expression of PCNA in nomal proliferative endometrium. There was no significant difference in PCNA expression between simple and complex hyperplasia and adenocarcinoma(P=0.073). 5) A negative correlation between PCNA and ER/PR expression was not demonstrated in simple and complex hyperplasia, or in adenocarcinoma. Endometrial hyperplasia and adenocarcinoma are probably related to a paracrine action of estrogen and progesterone in epithelial and stromal cells. A progressive loss of PR expression in stromal cells may induce abnormal proliferation of endometrium due to a disrupted hormonal balance.
Adenocarcinoma

No abstract available.
Adenocarcinoma*

Pulmonary adenocarcinoma of fetal type is a very uncommon tumor of the lung which simulates an early stage of lung differentiation. This is a primitive appearing epithelial tumor similar to the epithelial component of pulmonary blastoma but lacking the sarcomatous features. Since the report of Kradin et al, 8 more cases have been reported by a variety of name. These tumors are composed of glycogen-rich, non-ciliated tubular epithelial cells forming irregularly shaped tubules or arranged in a papillary pattern. A very remarkable findings of this tumor is the presence of endocrine cells which is confirmed by argyrophilia, immunohistochemistry or electron microscopy. We experienced a case of this tumor which showed hepatocytoid differentiation in addition to the characteristic histologic findings. Immunohistochemical studies performed on a resected tumor tissue showed immunoreactivity for alpha-fetoprotein, neuron-specific enolase and somatostatin, and endocrine type granules were found ultrastructurally. Although this tumor seems to have a relation with pulmonary blastoma in its histology, immunohistochemistry and ontogeny, a distinction between these should be attained because the average survival of the former group is longer as 23 months, while that of the latter is only 4 months.
Adenocarcinoma