Primary giant cell malignant fibrous histocytoma of the lung: a case report.

A rare case of malignant fibrous histiocytoma of giant cell type originating in the lung of a 46-year-old woman is presented. The patient complained of having a cough that had lasted for a few weeks. A chest X-ray photograph showed a tumor shadow on the left lung. Histological and cytological examination of the biopsy specimen revealed that the tumor was a kind of sarcoma. An operative procedure was selected because of tumor invasion into the trunk of the left pulmonary artery, which was discovered on computed tomography examination, and because metastatic tumor was excluded clinically. The tumor was almost encapsulated and 6 x 6 x 6 cm in size; however, it also showed invasion into the pulmonary artery and bronchial lumen. A histological survey of the tumor showed a wide range of patterns such as fibrous, pleomorphic, fascicular and osteoclast-like giant cell figures; however, the osteoclast-like giant cell area was predominant. Immunohistochemically, the tumor cells were positive for vimentin, CD68 for histiocytic marker and alpha1-antichymotrypsin, and negative for keratin, epithelial membrane antigen, S-100 protein, MT-1, desmin, myoglobin and lysosome. No primary tumor was found clinically in any part of the patient's body at 2 and 4 months after operation. Consequently, she was diagnosed as having primary giant cell malignant fibrous histiocytoma of the lung.

The capacity of dog lung to release prostaglandin I2 as a biochemical parameter for evaluating lung damage during preservation.

The release of prostaglandin I2 (PGI2) from the vasculature is thought to reflect damage to the vessels. Basal and bradykinin (BK)-stimulated release of PGI2 from isolated dog lungs after 6-hr preservation were investigated to evaluate lung damage after preservation. Maximal PGI2 release induced by BK decreased significantly after preservation at 24 degrees C (room temperature), but not after hypothermic preservation at 4 degrees C, although basal PGI2 release without BK stimulation did not change in either group of lungs after preservation. The function of allotransplanted lungs assessed by arterial oxygen tension was impaired by preservation at room temperature but not by hypothermic preservation. No differences were observed by light microscopy in either group in the pulmonary tissues, including the pulmonary artery, after preservation. In summary, damage to the lung after preservation may be reflected by the maximal PGI2 release from the lung after BK infusion. Therefore the maximal PGI2 releasing capacity induced by BK may be a useful biochemical parameter for estimating the viability of preserved lungs.

Co-carcinogenic effect of chrysotile and amosite asbestos with benzo(a)pyrene in the lung of hamsters.

To clarify co-carcinogenic effects of chrysotile (Chry) and amosite (Amo) asbestos with benzo(a)pyrene (Bap), 0.2 mg UICC (International Union against Cancer) standard reference sample of asbestos and 0.4 mg Bap were applied intratracheally once a week for 6 weeks. Eighteen and 24 months after the last instillation the number of tumors was examined. The Chry + Bap group yielded 37 tumors including 16 carcinomas in 12 animals, and the Amo + Bap group yielded 30 tumors including 11 carcinomas in 12 animals. Tumor-bearing animals were 100% in the Chry + Bap group and 92% in the Amo + Bap group, and carcinoma-bearing animals were 83% and 67%, respectively. The animals injected with Chry, Amo, and Bap alone developed no tumors. The number of tumors and carcinomas and the frequency of the tumor- or carcinoma-bearing animals in Chry + Bap and Amo + Bap were significantly higher than those of the groups injected independently. The number of tumors or the frequency of tumor-bearing animals was higher in Chry + Bap than in Amo + Bap; however, these differences were not significant. These results indicate that both Chry and Amo play an important role in the genesis of bronchogenic carcinoma.

Comparison of the pulmonary responses to chrysotile and amosite asbestos administered intratracheally. I) Early phase of cellular reactions.

To clarify whether serpentine and amphibole asbestos have different effects on the lung, UICC chrysotile and amosite asbestos were injected intratracheally into hamster lung, and the lungs were examined at 30 min, 1, 4, 8, and 24 h, and 2 and 4 days after asbestos application by light and scanning electron microscopy. A leukocyte and macrophage reaction appeared at 4 h and increased up to 2 days, and the cell reaction was stronger and more prolonged after application of chrysotile than after application of amosite asbestos. Furthermore, chrysotile induced more prominent cell (leukocytes or/and macrophages) necrosis and alveolar wall thickening. These findings indicate that chrysotile asbestos induces more stronger cell reactions in the alveolar wall, and is more noxious than amosite.

[A clinicopathological study of thymomas, with special reference to evaluation of malignant grade by morphometric analysis].

To determine the factors influencing the extent and recurrence of thymoma, 31 cases of thymoma who had undergone complete resection were analyzed clinicopathologically with special reference to the nuclear area of epithelial cells. The mean tumor size and incidence of recurrence of stage III thymomas were significantly larger and higher than those of stage I thymomas. The nuclear area of epithelial cells of stage III thymomas (72.9 +/- 29.2 micron 2) was significantly larger than that of stage I thymomas (48.4 +/- 13.2 micron 2) or stage II thymomas (49.4 +/- 11.6 micron 2). The nuclear area of thymomas with recurrence (70.2 +/- 21.5 micron 2) was significantly larger than that of those without recurrence (50.2 +/- 12.8 micron 2). In 16 cases who were followed up for 5 years or more, the nuclear areas were over 50 micron 2 in all thymomas with recurrence, while in 8 of 11 thymomas without recurrence it was under 50 microns 2. These results indicated that the tumor size and nuclear area increased step-wisely in association with the advance of clinical stage and that the incidence of recurrence was related to not only clinical stage but also nuclear area. Thymomas with large nuclear area (over 50 microns 2) are considered to be a high-risk group of recurrence and should be carefully followed up.

Morphologic aspects and morphogenesis of blood cysts on canine cardiac valves.

We investigated retrospectively the morphologic aspects of blood cysts of the atrioventricular valve in eight Beagle dogs and clarified the morphogenesis of the lesions. Study of serial sections revealed that the cysts communicate with the blood vessels; however, they showed no connection with the valve surface. Immunohistochemically, the thin endothelium of the lesions showed positive staining for factor VIII-related antigen. Histologic studies of a variety of sizes of blood cysts revealed four basic stages of blood cyst formation: 1) initially, the involved blood vessel undergoes only a slight enlargement that is not grossly detectable; 2) next, the vessel becomes moderately or markedly dilated and contains a large number of erythrocytes. The changes of this stage are macroscopically detectable; and 3) then, blood flow is arrested partly in the cystic lesion, followed by degeneration and necrosis of the cyst. At this third stage, fibrous tissue or dense collagenous connective tissue is usually seen surrounding the cyst; 4) and finally, metaplastic bone is formed within the lesion. Colloidal carbon infusion into the valves of normal canine hearts revealed the presence of an extensive, dense arrangement of blood vessels in the septal leaflet of the tricuspid valve, which usually is the recognized site to develop blood cysts.

Morphological rejection phases and cytotoxic activity in peripheral blood lymphocytes in canine lung allo-transplantation.

The relationship between the morphological changes in allografted lungs and the cytotoxicity of recipient peripheral blood lymphocytes was studied. Left lung allotransplantations were performed in 14 adult mongrel dogs. Four dogs were treated with cyclosporin A (20 mg/kg/day po.) and four were treated with FK-506 (0.1 mg/kg/day im.) for 10 days. Six dogs were not given any immunosuppressive drugs. Cytotoxicity was measured with the 51Cr release assay in which the donor skin fibroblasts were used as target cells. The histological changes of the grafted lungs were classified into three grades: grade 0; no abnormal findings, grade I; perivascular and peribronchial mononuclear cell infiltration, and grade II; edema, hemorrhage and a fibrin-like substance in the alveolar space in addition to the findings of grade I. The grafted lungs of the dogs with elevated cytotoxicity showed the histological findings of grade II (8 of the 14 dogs) and significantly higher cytotoxicity (44.1 +/- 25.7 per cent) were seen in these dogs than in those with grade 0 (2.0 +/- 3.9 per cent) or grade I (2.6 +/- 1.9 per cent). It is therefore considered that the cytotoxicity against donor skin fibroblasts in recipient peripheral blood lymphocytes is associated with morphological rejection phases in allografted lungs.

Analysis of the core of ferruginous bodies and the relationship between body type and core characteristics.

The cores of 164 ferruginous bodies from seven non-primary asbestos workers were analyzed by the carbon planchet method to elucidate the nature of the core mineral and the relationship between ferruginous body type and the core characteristics. One hundred and sixty-two cores, except for two talcs, were all amphibole group asbestos. Amosite and anthophyllite fibers were all finer than 0.9 micron and mainly less than 0.5 micron in diameter and had tendency to form type I asbestos bodies. On the other hand, tremolite and actinolite fibers constituted non-beaded club-like type II or type IV bodies and tended to have a larger diameter than that of amosite or anthophyllite fibers (p less than 0.005). These results suggest that the type of asbestos body depends fundamentally on the core diameter (width) rather than the type of asbestos, although the core diameter was correlated with asbestos type. For the analysis and evaluation of ferruginous body cores, which are completely coated, it is necessary to denude the ferruginous coating. This study suggested the usefulness of the carbon planchet method with Dodson's method.

Co-carcinogenic effect of asbestos and benzo(a)pyrene in the lung of hamster.

Epidemiological reports indicate that occupational asbestos exposure and smoking habit make increase the incidence of lung carcinomas greatly. To elucidate the synergetic effect of smoking and asbestos exposure, hamsters were injected intratracheally with asbestos and benzo(a)pyrene(Bap), which is contained in cigarette smoke, singly or in combination. Tumor was not induced in the hamsters injected with asbestos or Bap alone except epithelial hyperplasia. On the other hand, 7 tumors out of 34 animals were found in groups injected with both asbestos and Bap from 12 months to 19 months after injection. Two of them were carcinomas. This result seemed to indicate synergetic effect of asbestos and Bap in causing carcinoma of the lung.

Human fetal lung changes associated with maternal smoking during pregnancy.

Pulmonary impairment in the offspring of smoking mothers is well documented by epidemiologic studies. The morphologic bases for the functional impairment are largely unexplored. We studied 17 infant lungs obtained at autopsy, ten from smoking (group 1) and seven from nonsmoking (group 2) mothers, by light (LM), transmission (TEM), and scanning electron microscopy (SEM). By LM, the alveolar mean linear intercept was similar in both groups; the total lung volume and alveolar surface area increased with the increase in gestational age in all lungs studied. By SEM, the sizes of the neuroepithelial bodies (NEB) were larger in group 1 than in group 2. By SEM and TEM, ciliated cells were increased, but the amount of dense core granules was decreased, in the NEB of the smoking group. Maternal smoking during pregnancy appears to alter the size and cellular composition of fetal NEB. The detailed mechanisms of the alteration in NEB and their implications are unclear from this study and needed further clarification.

Physical and microchemical alterations of chrysotile and amosite asbestos in the hamster lung.

The physical and microchemical alterations of chrysotile and amosite asbestos (Union International Contre le Cancer standard samples) in the hamster lung and in vitro following acid treatments were studied by scanning electron microscopy (SEM) and x-ray energy-dispersive spectrometry (XEDS). Following intratracheal instillation, the ratio of short chrysotile fibers (less than 5 microns in length) decreased initially from 38% to 13% in the hamster lung, but increased again to 56% 2 years after the instillation. The majority of these new short chrysotile fibers had diameters less than 0.05 micron. Contrary to this, short amosite fibers (less than 5 microns in length) decreased from 41% initially to 4% 2 yr after instillating into the hamster lung. The diameters of amosite fibers appeared much less altered than that of chrysotile during the same time period. After 2 yr in the hamster lung, 33% of chrysotile and 68% of amosite found were asbestos bodies. The Si/Mg ratios of chrysotile fibers with diameters less than 0.2 micron were significantly higher than those with diameters between 0.2 and 0.6 micron in all groups: this relationship was reversed in all amosite groups. The Si/Mg ratios of the instillated and acid-treated chrysotile fibers were both higher than that of the same-sized control fibers. Acid treatments of chrysotile fibers in asbestos bodies from the hamster lung further altered their Si/Mg ratio. The Si/Mg ratios of the instillated amosite fibers were lower than that of the same-sized control fibers, but the difference between them disappeared following acid treatments. The hamster lung disposed of both chrysotile and amosite fibers smaller than 5 microns efficiently. Chrysotile and its asbestos bodies appeared to lose Mg ions and to fragment continuously in the hamster lung, and also in vitro with acid treatments. Amosite appeared also to fragment but lose more silicon than magnesium ions, at a much slower rate than that of chrysotile, presumably from the difference in their basic structures.

Nicotine-induced neuroepithelial cell changes in young rabbits: a preliminary communication.

Nicotine, 1 mg/kg body weight/day, was injected subcutaneously in 3 female rabbits during gestational and lactating periods, and the lungs of the offspring were studied by scanning and transmission electron microscopy (SEM and TEM) on days 5, 10, and 25 postpartum. Three other female rabbits served as controls. The size and number of neuroepithelial bodies (NEB) as estimated by SEM were larger in the experimental group than in the control group, especially on days 5 and 25. Moreover, the NEB in the nicotine-exposed groups showed loss of normal boundaries and derangement of cells and granules by TEM. Neural components also became prominent. These findings suggest that chronic maternal exposure to nicotine may directly, or, through the neural route, indirectly induce hyperplasia and dysplasia of the NEB in the offspring of rabbits. Because NEB are suspected to regulate regional bronchial and vascular smooth muscle cells, such alterations may be similar to respiratory functional impairments found in infants of mothers who smoke.

Extraction of ferruginous bodies from lung tissue obtained at surgery and autopsy. Special reference to carcinoma of lung.

Ferruginous bodies were extracted quantitatively from 508 patients; operated 242 with lung cancer and 94 with non-lung cancer, and autopsy 51 from hepatomas, 42 from stomach cancers, and 79 from non-cancer diseases. The bodies were divided morphologically into 4 types; 2 types may be from asbestos and the other 2 types from carbon and silicate which were very rarely found. The incidence of the bodies was the highest in hepatoma 96.8, followed by lung cancer 90.8%, non-lung cancer 80%, stomach cancer 76.2%, and non-cancer 74.2% in the years 1975-1981. Distribution of count of asbestos bodies was characteristic in patients with lung cancer, i.e. the cases who had asbestos bodies above 100/5 g of wet lung were found in 36 of 242 patients with lung cancer (14.8%) who were all smokers and 15 of 266 patients with the other diseases (5.6%) with significant difference between the two groups. Moreover, out of 14 patients who had the bodies above 300/5 g of wet lung, 9 were patients with lung cancer and also smoked heavily, and remaining 5 patients with diseases other than lung cancer consisted of 2 heavy smokers, a moderate and a mild smoker, and a non-smoker. These evidences may suggest the existence of some relation between occurrence of lung cancer and low degree of asbestos exposure with addition of smoking.