No abstract

From 197'2 to 1985, 40 cases of congenital dilatation of the bile duct (CDBD) were experienced in the department of the authors. Those consisted of 19 cases of anomalous arrangement of the pancreaticobile duct (P-B anomaly), five of bile duct carcinoma, and two of gall bladder carcinoma. In addition, four patients who showed no dilatation of the bile duct in spite of the presence of a P-B anomaly were experienced, and coexistent gall bladder carcinoma was present in three of four cases. The incidence of bile duct carcinoma associated with CDBD is very high. However, coexistent gall bladder carcinoma in CDBD is a new topic, and coexistent intrahepatic bile duct carcinoma in CDBD is extremely rare. This report presents interesting and rare cases of coexistent carcinomas in these anomalies and investigates their carcinogenesis, particularly that of gall bladder carcinoma.Cancer 60:1883-1890, 1987. HE INCIDENCE OF COEXISTENT BILE DUCT carci-T noma in the dilated bile duct of congenital dilitation of the bile duct (CDBD) is very high, but recently coexistent gall bladder carcinoma in CDBD has come into the limelight. Moreover, there are some cases of pancreatico-bile duct (P-B) anomaly without dilatation of the bile duct, even though the former has been considered to be the cause of bile duct dilatation. Among such cases, reports of coexistent gall bladder carcinoma are increasing in Japan. Few reports, however, demonstrate coexistent carcinoma of the intrahepatic bile duct in congenital dilatation of the intrahepatic bile duct.The current report described the study of coexistent carcinoma in CDBD and P-B anomaly relating to the etiology and carcinogenesis of these diseases.From the *Second Department of Pathology, Nagasaki University School of Medicine, Nagasaki, Japan, THamamatsu Medical Center, Hamamatsu. Japan, #Department of Surgery, Ryukyu University School of Medicine, Okin.awa, Japan, and §Nagasaki Citizen's Hospital, Nagasaki, Japan.The authors thank Professor R. Tsuchiya, Department of Surgery, Nagasaki University School of Medicine, for his encouragement and valuable suggestions.Address for reprints: Yasuhiko Sameshima, MD, Second Department of Pathology, Nagasaki University School of Medicine, 12-4 Sakamoto, Nagasaki City, 852, Japan.Accepted for publication April 22. 1987. Case MaterialsFrom April 1972 to December 1981, 36 cases of CDBD were treated in the Surgical Department, Hamamatsu Medical Center, Japan. These consisted of 18 cases of P-B anomaly, four of bile duct carcinoma, and two of gall bladder carcinoma. Four patients who showed no dilatation of the bile duct in spite of the presence of P-B anomaly also were treated, three of which had coexistent gall bladder carcinoma.From April 1982 to December 1985, four cases of CDBD were examined pathologically in the Second Department of Pathology, Nagasaki University School of Medicine, Japan. Among these, there was one case of P-B anomaly and one of coexistent intrahepatic bile duct carcinoma.Among the 40 cases of CDBD and 23 cases of P-B anomaly, ther...

No abstract

In addition to the morphological examination, the measurement of the content of corticosteroids was done in aldosterone-producing adenoma. Histologically, the adenoma consists of four types of cells. The major component of the adenoma was clear-type cells. In this type of cells, the activities of 38hydroxysteroid dehydrogenase and glucose-6-phosphate dehydrogenaee showed weakly positive. The Ane structure was characterized by numerous lipid vacuoles and poor organellae. On the contrary, intermediate-and compact-type cells revealed higher than moderate activities of these enzymes. Moreover, marked development of smooth endoplasmic reticulum and mitochondria was noted. Zona glomerulosa-type cells were observed only in a small part. The content of aldosterone and corticosterone in aldosterone-producing adenoma was signiflcantly larger than those of the other type of adenoma. A tendency of positive correlation between the increase of compact-type cells and content of aldosterone was found. The cell origin of this aldosterone-producing adenoma and functional role of clear-and compact-type cells were also discussed. ACTA PATHOL. JPN. 30: 961-976, 1980. IntraEuctionAldosterone-producing tumors have been shown to have considerable macroscopic and histological characteristics. Such reports, however, were either limited to histological observations alonelo or a t the level of case reports including electron microscopic o b~e r v a t i o n s~~,~~.In the present study, the morphology of aldosterone-producing tumor was studied by histological, enzyme histochemical and electron microscopic methods. At the same time, further analysis was attempted from the viewpoint of functional pathology utilizing quantitative procedure of corticosteroid hormones in the tumor. -~ ___--*:Crr %9& W e BLP, E[B1 S& #ah, I%% FIT All communication and reprint requests to: Prof. Hideo TSUCHIYAMA,

Since CONN first described a case of primary aldosteronism in 1955e), extensive research has been carried out in relation to clinical and biochemical characteristics of this de~ease"*~'.O n the other hand, the details of pathology of the adrenal cortex in aldosteronism have not been fully established")*1e).In this paper the results of histologic and histochemical observations on a series of the adrenals obtained from 10 cases with aldosteronism are reported. Materials and MethodsThe adrenal glands surgically resected from 8 patients and obtained at autopsy from -2 cases with aldosteronism were investigated. From the clinical data, 7 of them were from cues of primary aldosteronism, while 3 others had malignant hypertensive changes and were regarded as those with atypical secondary aldostemism. In 4 cases the cortical admomas of various size were noted ( Table 1). The remaining 6 casu consisted of 2 adenomatous hyperplasia, 1 micronodular and 3 diffuse hyperplrsia of the admarl cortex. Control biopsy specimens were obtained from 5 patients at operaticma for mal stones, tukrculoais and tumors.Each block of tispuea WM embedded in paraffin and carbowax. They wen sectioned at 5 p to 8p.Many sections were stained with following methods: hematoxylin and eosin; GOMORI'S silver stain; oil red 0 and sudan black Bpropylene glycol to demonstrate the general lipids"~18) ;Schultz reaction and Okarnoto-Sonoda-shimarnoto's method to examine cholesterol and their esterslg); Menshik's method and Smith-Betrich's reaction to indicate the presence of phospholipids*1)**'); reaction with neotetrazorium chloride to reveal reducing activity of corticnsteroids8'; Heidenhain's iron hematoxylin-sudan double stain to demonstrate insolubled ketosteroids and stainable granulesl"); Gomori's modified method to reveal acid phosphata~e~).Multiple unfixed and briefly fixed sections, 6 p in thicknecu were cut by cryostat.