The cytologic heterogeneity of the tumor cells in gastric signet ring cell carcinoma was studied with 13 surgically early gastric carcinoma specimens by means of histochemical stainings on mucin(periodic acid Schiff-alcian blue at pH 2.5, paradoxical concanavalin A, high iron diamine) and electron microscopy. Of the 13 cases of early gastric cell carcinomas, 6 were mucosal type and 7 were submucosal type. Eleven cases consisted of mixture of gastric and intestinal type signet ring cells and the remaining 2 of the mucosal type were entirely made of gastric type. The colonic goblet cell type was found in 4 of the submucosal type. Within the mucosa the tumor cells showed a layering phenomenon; type A signet ring cells were distributed at the central zone and type B and C at the superficial or deeper zone. Each type of signet ring cell showed variable mucin histochemical stainability of gastric and/or intestinal nature. Above finding strongly suggest that the variable phenotypes of signet ring cells result from a heterogeneity of cytoplasmic mucin as well as different stages of differentiation of signet ring carcinoma cells.

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Child* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

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Osteotomy*

We report a case of colonic type-papillary adenocarcinoma of appendiceal origin in a 73-year-old male patient. The patient presented with right lower quadrant mass and was operated for a preoperative diagnosis of inflammatory small bowel mass. The mid one-third of the appendix showed a 3.5x3.3 cm sized, broad-based, intraluminal papillary mass. Microscopically, it was a well differentiated papillary adenocarcinoma and revealed a strong immunoreactivity to carcinoembryonic antigen. Tumor desmoplasia and acute inflammatory change were prominent.
Male ; Humans ; Adenocarcinoma

We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
Cysts

We evaluated the accuracy of a noninvasive method for estimating right ventricular systolic pressures in patients with atrial septal defect and tricuspid regurgitation defected by two-dimensional and Doppler ultrasound. Of 54 patients with atrial septal defect, 24(44%) had jets of tricuspid regurgitation. By use of the maximum velocity(V) of the regurgitatant jet recorded by continuous wave Doppler ultrasound and the Bernoulli equation, we predicted right ventricular systolic pressure(RVP) calculated by the equation of RVP=4V2+10 proposed by Tei et al.The values correlated well with catheterization values(r=0.851, standerd error of estimate=4mmHg). In addition the relation between the Lt to Rt shunt amount and the severity of tricuspid regurgitation was assessed. The severity of tricuspid regurgitation graded on a four-pointscali by pulsed Doppler and two-dimensional echocardiography correlated with Qp/Qs ratio calculated by the Fick's method(p<0.05).
Catheterization ; Catheters ; Echocardiography ; Heart Septal Defects, Atrial* ; Humans ; Tricuspid Valve Insufficiency* ; Ultrasonography