No abstract

We report on a rare primary undifferentiated carcinoma of the bladder producing alpha-fetoprotein in a woman. Definitive features included an aggressive, invasive and rapidly growing tumor with a hepatoid carcinomatous lesion on histological examination. Histopathological findings suggested that the multipotent transitional cell induces production of alpha-fetoprotein. The association of an aggressive tumor with the ability to produce this antigen suggests a possible benefit in measuring serum alpha-fetoprotein levels and examining histological sections for its expression in primary undifferentiated carcinoma of the bladder. Further study may indicate radical cystectomy when the resected specimen produces alpha-fetoprotein, particularly if tumors appear to be aggressive and highly vascularized as in our case.

A 29-year-old female was admitted because of thrombocytopenia and an abdominal mass which was palpated 5 finger breadths below the left costal margin. A computed tomographic scan of the abdomen revealed splenomegaly with a large calcified cystic lesion. The spleen was removed and the pathological examination disclosed that the cyst was monolocular and the wall was of mesothelial origin. (Internal Medicine 32: 672-674, 1993)

Cyclin D1 overexpression is remarkably frequent in several human carcinomas and is believed to be a critical event in oncogenesis. We examined cyclin D1 expression, p53 expression, and the Ki-67 labeling index by immunostaining in human gallbladder mucosa in conditions varying from normal to malignant tissue. We also examined K-ras codon 12 mutations in these tissues with a two-step polymerase chain reaction. Nuclear cyclin D1 overexpression was observed in 48% of carcinomas occurring independently of adenoma, but not in adenomas, carcinomas arising in adenomas, or nonneoplastic lesions. Cytoplasmic cyclin D1 overexpression was observed in about 15% of abnormal specimens, irrespective of the type of epithelial abnormality. Carcinomas showing nuclear cyclin D1 overexpression had significantly higher Ki-67 labeling indexes than those with no overexpression. Moderately to poorly differentiated adenocarcinomas showed a higher incidence of nuclear cyclin D1 overexpression than papillary to well differentiated carcinomas. Specimens with cyclin D1 overexpression showed a high incidence of lymph permeation, venous permeation, and lymph node metastasis. We conclude that nuclear cyclin D1 overexpression is a critical event importantly associated with cell proliferation and invasive growth in gallbladder carcinogenesis, and that cyclin D1 immunostaining may become a useful marker for evaluating gallbladder carcinomas.

A case of marginal zone B cell lymphoma of MALT type arising in the uvula and breast is reported. The patient, a 30-year-old woman who delivered a child and lactated in 1997, was suffering from Sjögren syndrome (SS). She was diagnosed with MALT lymphoma after a biopsy of the right breast and uvula. To investigate the relationship of the delivery, lactation and MALT lymphoma, we examined the immunohistochemical analysis of hormone receptors. As a result, lymphoid cells of the breast were stained with anti-progesterone receptor antibodies in the cytoplasm. Consequently, the MALT lymphoma of the uvula appeared to be associated with SS. Moreover, hormones such as progesterone may have influenced the breast involvement of MALT lymphoma in our case.