To investigate the microvascular changes in primary pulmonary hypertension, the lungs of 24 Sprague-Dawley rats were treated by an intraperitoneal injection of 2% monocrotaline(MCT) solution and then examined with scanning electron microscopy(SEM) after microvascular corrosion casting. Histologic examination revealed significant medial thickening in the small to medium-sized pulmonary arteries. Scanning electron microscopic findings of the normal lungs showed two kinds of microvascular structures. One showed a well-fortned three-dimensional basket structure of uniform flat-tubular alveolar capillaries, which were connected to each other in a T or Y shape or at right angles. The other revealed a two-dimensional reticular sheet of round tubular branches mainly in the bronchial artery-supplying regions. The MCT-treated groups(remodelling) showed apparent changes in both kinds of microvasculatures in comparison to the normal group but the more prominent change was found in Lbe bronchial artery microvasculature showing the dense thick encasement around large pulmonary arteries. Alveolar microvasculature of the pulmonary artery revealed individually enlarged angular appearance, with generally deformed alveolar architecture. Quantitatively, the significant enlargement of diameter and intercapillary distance appeared in both microvasculatures of MCT-induced rat lungs, but the density was increased only in the bronchial artery microvasculature. In conclusion, our three-dimensional microvascular study of the MCT-treated rat lungs demonstrates a new morphologic finding of vascular remodeling in primary puhnonary hypertension, which is thought to play an important vascular role in the pathogenesis in addition to interstitial fibrosis.
Rats ; Animals

Beta-2-microglubulin(beta 2m), the invariable light chain of the histocompatibility antigen is present on the surfaces of most human nucleated cells. It has proved to be reduced or disappeared on the cell surfaces of variable skin cancers. Patterns of beta 2m stainability in normal uterus and of the loss in several cervical epithelial lesions were examined by immunohistochemical staining using rat monoclonal and rabbit polyclonal anti-beta 2m, repectively on fresh tissues of 13 cases and formalin-fixed paraffin-embedded tissues of 23 cases. To know patterns of loss of beta 2m stainability and measure its extent and degree, only fixed tissues were examined. Fresh uterine tissue showed beta 2m stainability present on the cell membranes of squamous epithelium, endocervical gland, and capillary endothelium. Of these, squamous epithelium of uterine cervix revealed most characteristic lace-like staining along the cell outlines. Paraffin-embedded 23 cases were classified as group I (6 normal conrol and metaplasia), II (5 mild and moderate dysplasia), III (6 severe dysplasia and carcinome in situ), and IV ( 6 microinvasive and invasive squamous cell carcinoma). Group 2-4 showed reduced beta 2m stainability when compared to group 1 that exhibited the similar stainability as fresh normal cervical epithelium. The reduction or less proved to be statistically significant(p-value<0.001) in group 3 and 4 except for group 2. In spite of being invasive cases, a few disclosed beta 2m positive cells mainly in well-differentiated areas. In sum, ABC immunohistochemical staining of beta 2m showed the tendency tend to decrease or disappear in uterine cervical epithelial lesions with premalignant or malignant change and rather to appear in some well-differentiated areas of malignant lesions.
Humans ; Rabbits ; Rats ; Animals

Aqueductal forking was first described by Russell (l949) as a cause of aqueductal obstruction and a form of congenital malformation with simple stenosis, it is a relatively common cause of congenital hydrocephalus not associated with spina bifida or meningomyelocele. Pathologically it is characterized by two distinct channels separated by non-gliotic brain tissue. We describe variable clinicopathologic findings of 3 autopsy cases showing hydrocephaly due to aqueductal atresia with forking case 1 was a 35-week-old female showing Potter's syndrome, dextrocardia, and skeletal anomaly. case 2 was a 29-week-old male abortus with micrognathia, simian crease, club feet, and minor defects of visceral organs. Case 3 was a 32-week-old female abortus with associated anomalies such as a low-set ear, ectopic thymus and thyroid, and Meckel's diverticulum. On serial sections of brain stems of all 3 cases, were seen variably shaped and atretic lumina of aqueducts with distinct two channe1s and intervening brain tissues of normal cellularity.
Female ; Male ; Humans

Fine needle aspiration cytology of three cases of pulmonary hamartoma is presented. Case 1 was in a 67-year-old man with a 7 cm-sized left lung mass. Case 2 and 3 were in 47 and 53 year old females and consisted of 3 cm and 2 cm-sized right lung nodules, respectively. Fine needle aspiration of the masses revealed several fragments of irregularly shaped mature hyaline cartilage or fibromyxoid mesenchyme and sheets of benign epithelial cells in scanty to acellular background. Also scattered were inflammatory cells including lymphocytes, neutrophils and histiocytes and mature fat cells. These features were diagnostic for pulmonary hamartoma and case 1 was histologically confirmed by following surgical excision of the mass. Differential diagnoses about pulmonary hamartoma in the respect of conditions capable of producing cartilage on fine needle aspiration, were discussed.
Female ; Male ; Humans ; Diagnosis, Differential ; Hamartoma

Neoplasms presenting at birth or within the first month of life are defined as congenital tumors. The principal components of this congenital tumors are neuroblastoma, leukemia, brain tumors and sarcomas. The neuroblastoma is the most common accounting for 15~50% of all tumors in this group. It most often presents with an abdominal mass due to adrenal-retroperitoneal primary or hepatomegaly resulting from extensive metastasis. Most often the primary site is adrenal but other loci include the retroperitoneum, mediastinum, pelvis, etc. This 2-day-old female presented with hepatomegaly and a left adrenal mass at birth, first detected by ultrasonography. On the first day, she suffered from hematemesis and bradycardia. She died on the second day. Postmortem examination revealed massive metastatic tumor nodules in the liver and a well-demarcated round mass, 4 cm, in the left adrenal, with necrosis and hemorrhage. Microscopic findings revealed largely undifferentiated neuroblastoma with focal neuronal differentiation and areas of necrosis and calcification in the background of fine fibrovascular stroma. Other metastatic foci were detected in the right adrenal and pituitary gland.
Female ; Humans ; Neoplasm Metastasis ; Neuroblastoma

Lymphoid lesions of the orbit and conjunctiva may be divided histologically into three groups: monomorphous and cytologically atypical malignant lymphomas, benign reactive follicular hyperplasia or inflammatory pseudotumor, and borderline lymphoid lesions mainly composed of small, non-atypical lymphocytes with or without evidence of plasmacytic differentiation or germinal centers which are difficult to clarify its nature by histologic criteria alone. From 1984 to 1992 at Seoul National University Hospital, 20 cases of orbital lymphoid infiltrates were reviewed to find out histopathologic characteristics of malignant lymphomas and try to classify them properly. Also, we sought histologic findings helpful for differential diagnosis between malignant and borderline cases. Histologic examination of malignant lesions usually revealed the features of low-grade B cell lymphomas of mucosa-associated lymphoid tissue(MALT) origin, which predominantly consist of centrocyte-like(CCL) cells. Among 13 primary orbital lymphomas, six cases were classified as MALT lymphomas of Isaacson, six were more apt to be the type of immunocytoma by kiel classification, and remaining one showed mixed pattern of both types in areas. The one case of malignant lymphoma with diffuse large cell type was confirmed by secondary involvement of intestinal lymphoma. Five cases were confirmed by immunoglobulin k-light chain monoclonality on flow cytometry and immunofluorescence study. The histologic findings such as Dutcher bodies, hemosiderin, deposits and polykaryocytes tended to be more frequently encountered in malignant lymphoma rather than indeterminate lesions and were thought to be helpful ones in making differential diagnosis between malignant and benign lesions. With above findings, we assume that the principal neoplastic cells in the low grade lymphoma arising in the orbit and conjunctiva are CCL cells, which might be originated from the localized memory B cells, and also several kinds of B lymphocytes in on-going differentiation stages such as medium-sized monocytoid B cell, lymphoplasmacytoid cell, plasma cell, and mature small lymphocyte also contribute to the tumor progression.
Diagnosis, Differential

Cellular blue nevus is an benign variant of blue nevus group, characterized by cellular islands composed of closely aggregated spindle cells with little or no melanin. The other variants include atypical and malignant blue nevus which often had the difficulties in the differential diagnosis from the malignant melanoma. A 4-year-old boy presented with hemispheric scalp nodule, which has been slowly grown since birth, measuring 3.5x3x1.5 cm. The surface showed geographic black pigmentation without hairs, hemorrhage, and ulceration. The excised mass disclosed homogeneoulsy dark black, glistening, and muddy cut surface. Histological examination revealed exuberant melanocytic proliferation with both spindle and dendritic components. Heavily pigment ed spindle cells, melanophages, focal necrosis, and vacuolated epithelioid cells were unusually noted in our case and diagnosed as cellular blue nevus. Electron microscopy disclosed largely mature melanosomes in tumor cells and melanophages. During about 16 months since operation, he has been relatively well with no evidence of disease.
Diagnosis, Differential

Optic nerve gliomas manifest either as a solitary form or a component of von Recklinghausen's neurofibromatosis. The reported incidence of coexistence with neurofibromatosis varies from 12% to 70%. Usually there are no significant cytological differences between the gliomas that accomapny the disease and those that are deemed to be solitary manifestations. The only possible difference between them is the apparently more common association, with the former, of extensive arachnoid hyperplasia and of a more florid local gliomatous infiltration into the leptomeninges, altogether resulting in perineural thickening. Our cases were 8 and 6 years old girls, respectively, presented with slowly progressive proptosis for 4 years and visual disturbance for 2.5 months. There were multiple cafe au lait spots on their trunks, and case 2 showed Lisch nodules in the iris. MRI of brain revealed unilateral optic nerve thickening with involvement of chiasm or multiple intracranial lesions. Resection of optic nerve tumor was performed. Microscopically, variable degree of tumorous change was seen. Most typically enlarged area was composed of intraneural and perineural portions surrounded by a layer of intact dura. Intraneural tumor revealed proliferation of elongated, spindle-shaped pilocytic astrocytes in intertrabecular spaces and distention of the pial septa with fibrovascular thickening. Another segment had areas with reactive gliosis. Perineural tissue was considerably thickened and, associated with proliferation of meningothelial cells and fibroblasts intermingled with astrocytes and Rosenthal fibers. There were increase of the optic nerve diameter and distention of the overlying dura. Foci of arachnoid cell hyperplasia were noted in both cases, although differed in degree. Immunohistochemically, the tumor cells expressed glial fibrillary acidic protein in intraneural and perineural portions particularly in case 2.
Incidence

Adenosquamous carcinoma originating in the stomach is relatively rare, and the occurrence of such tumor is interesting with respect to its histogenesis. We describe three cases of gastric adenosquamous carcinoma in a 39-year-old man, a 58-year-old woman and a 52-year-old man. They were grossly classified as Borrmann type III or II, revealing no difference from usual advanced gastric adenocarcinomas. Microscopically three cases showed well or moderately differentiated squamous cell carcinoma component occupying large areas of the tumors. Areas of transition from glandular to squamous epithelium were frequently observed. Metastatic foci in the regional lymph nodes also were consisted of two elements. On immunohistochemical study, CEA immunoreactivity was found not only in adenocarcinoma component but also in squamous cell components, in comparison to cytokeratin which was detected only in squamous areas. The immunohistochemical findings of CEA reactivity in both components, and the presence of microscopic transitional zones support the hypothesis of squamous metaplasia occurring in an already existing adenocarcinoma in the development of adenosquamous carcinoma of the stomach.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

PURPOSE: The objectives of this study are to elucidate the level of p21(WAF1/CIP1) expression in non-small cell lung carcinomas (NSCLCs) and to investigate the relationship between the p21(WAF1/CIP1) expression and clinicopathologic features; p53 overexpression; and proliferative activity measured by Ki-67 expression. MATERIALS AND METHODS: The expressions of p21(WAF1/CIP1), p53, and Ki-67 proteins were analyzed by immunohistochemistry in 45 formalin-fixed and paraffin-embedded NSCLC specimens. 43 patients underwent curative resections and 2 patients had bronchoscopic biopsy specimens only. The correlations between p21(WAF1/CIP1) immunoexpression and p53 status; Ki-67 proliferative activity; and clinicopathologic parameters were analyzed statistically by chi-square or Fisher's exact test. RESULTS: p21(WAF1/CIP1) expression in the carcinoma cells was found in 28 (62%) of 45 cases. There was no significant correlation between p21(WAF1/CIP1) expression and abnormal accumulation of p53 protein. In 16 (36%) of 45 cases, p21(WAF1/CIP1) was expressed inde pendently of p53 overexpressions. p21WAF1/CIP1 expression was not associated with patient sex, smoking history, pathological stage, tumor size, histological grade or type. However, p21WAF1/CIP1 immunoreactivity was significantly higher in older individuals over 59 years and tended to occur more intensely in the more highly differentiated portion of the squamous carcinoma. Also, a positive correlation between p21WAF1/CIP1 and Ki-67 expression was observed. CONCLUSIONS: The present findings overall suggest that aberrations in the relationship between p21(WAF1/CIP1) and p53 expressions may be important in the development of NSCLCs; that a p53-independent pathway may be substantially involved in the induction of p21(WAF1/CIP1) expression in NSCLCs; and that the proliferative activity of lung cancers might be dependent on positive control of the cell cycle by p21(WAF1/CIP1).
Biopsy ; Carcinoma, Squamous Cell ; Cell Cycle ; Humans ; Immunohistochemistry ; Lung Neoplasms ; Lung* ; Phosphotransferases* ; Smoke ; Smoking