A 47-year-old Japanese woman in whom obstructive jaundice had already been diagnosed, was found to have a dome-shaped elevated tumor approximately 3 cm in diameter located in the area very close to the papilla of Vater on endoscopical and radiographical investigations. Histopathologically, the resected tumor was composed mainly of solid nests of atypical argyrophilic cells, and partially of an area of well differentiated tubular adenocarcinoma, showing mutual transition in the mucosal layer. Both immunohistochemical and ultrastructural analyses confirmed the difference in character of tumor cells between these two areas: neuroendocrine cell carcinoma and tubular adenocarcinoma of common type in the intestine. To the best of our knowledge, this is only the third case reported to be a coexisting malignant carcinoid tumor and adenocarcinoma arising in the periampullary region.

A rare case of recurrent cervical cancer presenting multiple metastases to the small intestine is reported. A 69‐year‐old Japanese woman with a past history of early‐stage (Ia) cervical cancer 13 years previously suffered sudden onset of panperitonitis caused by perforation of the small intestine. In the perforated lesion, squamous cell carcinoma, which was histologically similar to that of the primary lesion, was observed, and was diagnosed as a late recurrence of the cervical cancer. Perforation of the small intestine caused by tumor metastasis, especially metastasis from cervical cancer, rerely occurs. Furthermore, recurrence of an early cervical cancer presenting 13 years after hysterectomy is extremely rare. The present case draws attention to the possibility of late recurrence of cervical cancer, even in cases treated at the early‐stage. ACTA PATHOL JPN 38: 225–234, 1988.

A 59-year-old Japanese man who had recently noticed a gradual enlargement in a nodule located in the left anterior part of his neck was admitted for surgical treatment. The histopathological features of the resected tumor were consistent with a typical lymphoepithelial cyst, however, the inner surface epithelium of the cyst showed histological transition to mucoepidermoid carcinoma, which was partially invading the cyst wall. Despite clinical efforts in a systemic search, no primary lesions which could have metastasized were found. The patient hasn't shown any evidence of recurrence since his tumor resection over 2 years ago. Besides this rare case report, a review of the English literature reveals 22 cases of possible branchiogenic carcinoma over the last 10 years, including 21 cases whose histological features were of squamous cell carcinoma and 1 whose histological features revealed mucoepidermoid carcinoma. The present case is thus only the second proven case of low-grade mucoepidermoid carcinoma arising within a branchiogenic cyst.

The lymph node cells from 11 strains of rats, differing in the genotype of the major histocompatibility complex of the rat (RTI), were examined on the basis of their proliferative response to the cell wall antigen of Streptococcus mutans. The 11 rat strains fell into three groups: high, intermediate, and low responders. To demonstrate the influence of the major histocompatibility complex on immune responsiveness to S. mutans, further experiments were performed using the RTJ-congenic rat strains WKAH.1L(LEW), WKAH. 1AV1(ACI), and WKAH.1J(LEJ), which differ only in the genotype of the RTJ region. Although the background genes of each strain were of WKAH origin, WKAH.lL(LEW) and WKAH.1AV1(ACI) rats showed a low response whereas WKAH.1J(LEJ) rats showed a moderate response to the S. mutans cell wall antigen. The results indicate that the immune response is controlled by the class II gene(s) in RTI. Furthermore, the RTL.D locus products were shown to play an important role in the restriction molecule, since a monoclonal antibody, HOK7, directed to the RT1 .Dklocus products reduced the proliferative response of lymph node cells.

A rare autopsy case of primary squamous cell carcinoma of the thyroid gland is reported herein. A 61-year-old Japanese woman with a swelling of the left neck underwent surgery and the resulting tumor was histopathologically diagnosed as pure squamous cell carcinoma of the thyroid gland. She had had the nodule for 20 years, and it was histologically diagnosed as having been a well-encapsulated, follicular adenoma. Histopathological observation of the resected glands also revealed the coexistence of pure squamous cell carcinoma, which presumably originated from the adenoma. Postoperatively, an esophagotracheal fistula formed due to local invasion of the tumor cells. The patient's state gradually deteriorated and she died of severe bronchopneumonia and renal dysfunction, 4 months after the operation. Autopsy revealed no distant metastases, but severe septicemia caused by bacterial infection affecting the systemic organs was found, which presumably resulted in multiple organ failure.