An extremely unique case of a liver tumor occurring in a 70-year-old man is documented in this article. The primary tumor was well encapsulated by a thick, connective capsule and was histologically composed of two distinct elements, i.e., a common hepatocellular carcinoma (HCC) and a rhabdomyosarcoma. Metastasis of HCC was only seen in the left adrenal gland, whereas intrahepatic metastatic foci as well as tumor thrombi occluding the portal vein branches were composed exclusively of rhabdomyosarcoma. The possibility that the rhabdomyoblastic component might have come from the preexisting HCC by way of metaplastic proliferation is discussed. Case ReportA 70-year-old Japanese man was admitted to the Chiba Workmen's Compensation Hospital on February 8, 1986 because of hypertension (1 90/98 mmHg), pretibial pitting edema, and proteinuria (570 mg/dl). He also had loss of appetite, diarrhea, and abdominal pain for several days. There was a 3-year history of diabetes mellitus for which he was not treated, and laboratory data exhibited a high level (1 94 mg/dl) of fasting blood sugar. The value of creatinine clearance was 10 to 20 ml/minute, and a radionuclide renogram revealed a marked decrease in bilateral renal excretion. This oligunc patient was treated for chronic renal failure and diabetes mellitus.From the

A rare case of a colon carcinoma that developed in a 50‐year‐old woman is documented. Histologically, the removed tumor was composed of two distinctive elements, i.e., well‐differentiated papillary adenocarcinoma and choriocarcinoma. It was strongly suggested that the latter malignancy derived from the pre‐existing colonic carcinoma through metaplastic proliferation. A very high human chorionic gonadotropin level was noted in the patienťs serum obtained at the preoperative stage. Autopsy materials revealed that metastatic foci in the liver, lungs, and lymph nodes were exclusively composed of choriocarcinoma.

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A case of peliosis hepatis in a 52‐year old woman with unusual involvement of the spleen and lymph nodes is described. The initial sign was intraperitoneal hemorrhage from the splenic lesion, recessitating splenectomy. The hepatic lesion, which was first noticed during the operation, rapidly progressed and eventually resulted in hepatic rupture with fatal intraperitoneal hemorrhage. Serial sections treated by silver impregnation revealed degeneration and dissolution of the fine reticulin framework in the involved organs, suggesting the possible morphogenesis of the peliotic lesion. The patient had no history of any underlying disorders or of medication with steroids. Acta Pathol. Jpn. 32: 212∼215, 1989.

One hundred twenty-nine cases of breast carcinoma were examined in order to clarify the occurrence of lobular involvement with regard to stromal invasion. Lobular involvement was clearly recognized in 56 cases (43%) having discernible portions of intraductal carcinoma components. The process of lobular involvement was first recognizable as an extension of a few carcinoma cells from intralobular ducts into the acinar lumina. Progressive accumulation of the carcinoma cells resulted in marked swelling and distortion of the involved lobules. During the process, perilobular myoepithelial cells (actin-positive cells) were stretched and disappeared. Subsequently, breaks in the basement membranes were also observed, resulting in stromal invasion of carcinoma cells. The lobular involvement was classified into common and round varieties, possibly reflecting different growth activities of the carcinoma cells. The stromal invasion was initiated by peripheral budding or focal necrosis of the involved lobules. The latter pattern was often observed in comedo carcinoma. It was thus revealed that in breast carcinomas the terminal ductal-lobular units are quite often involved and can become sites of extraductal invasion. Acta Pathol Jpn 41 : 227-232, 1991.