Following a simple cholecystectomy, a 63-year-old woman with gallstones was histologically diagnosed as having minute squamous cell carcinoma of the gallbladder. A laparotomy revealed a small, firm nodule that appeared to be an adenoma, which was palpated in the fundus of the gallbladder. The resected gallbladder contained 37 small stones and a small and firm mass (0.4 x 0.4 x 0.3 cm in size) on the mucosal side. Histologically, a pure type of well-differentiated squamous cell carcinoma of the gallbladder was diagnosed. To our knowledge, this is the first case of a minute and pure type of squamous cell carcinoma in the gallbladder. This case may have implications for the histogenesis of squamous cell carcinoma of the gallbladder.

A small-cell carcinoma of the extrahepatic bile duct in a 69-year-old woman is herein reported. A tumor measuring approximately 3 cm in diameter was located at the confluence of the common bile duct, cystic duct, and common hepatic duct. Histopathologically, the tumor was small-cell neuroendocrine carcinoma without any gland formation or differentiation to squamous cell carcinoma. Tumor cells were immunoreactive for epithelial markers such as epithelial membrane antigen and cytokeratin and for the neuroendocrine markers such as neuron-specific enolase, chromogranin A, and synaptophysin. Although the carcinomas in more than half of the reported cases have been reported to be associated with well-to-moderately differentiated squamous or glandular components, seven cases, including our case, showed the carcinomas without squamous or glandular components. According to the review of 16 previously reported cases and our case of small-cell carcinoma of the extrahepatic bile ducts, there is no significant difference in the clinicopathological findings, namely, age, sex, site of carcinoma, and prognosis between the cases with or without squamous or glandular components. No CD34-positive multipotent adult progenitor cells, which might be the origin of the small-cell carcinoma, were detected in the bile duct epithelium in our case.

No abstract

A 45-year-old womanwas admitted because of hypertension and hypokalemia. Primary amenorrhea from birth was noted. Plasma renin activity (PRA), 17a-hydroxyprogesterone and androgen levels were low, but progesterone, 1 1 -deoxycorticosterone, corticosterone and adrenocorticotropic hormone (ACTH)were elevated, resulting in a diagnosis of 17oc-hydroxylase deficiency. Abdominal magnetic resonance imaging revealed a round mass in the left adrenal region, the specimen of which was diagnosed as myelolipoma. After removal of the tumor, the blood pressure, serum potassium and hormonelevels were unchanged, indicating an adrenal non-functioning tumor. Excessive ACTH secretion over a long period maystimulate the development of adrenal myelolipoma. (Internal Medicine 40: 920-923, 2001)

Systemic sclerosis (SSc) is a generalized disorder characterized by fibrosis and vascular obliteration in the skin, lung, gastrointestinal tract, and kidney. One of its two subsets is a stable, limited cutaneous group (lSSc). Pulmonary involvement in scleroderma is common, and several types of pulmonary disorders are associated with SSc. Bronchiolitis obliterans organizing pneumonia (BOOP) is a rare finding in lung disorders associated with SSc. We describe a case of lSSc with BOOP that was responsive to steroid therapy. Of interest is that the lung disorders appeared in different periods and areas. It might be important to diagnose abnormal shadows in lung fields before treatment of patients with SSc.