The significance of stromal cells in the esophageal squamous cell carcinoma was studied, using cytological, electronmicroscopical and immunohistochemical methods. The stromata of esophageal cancer were classified into four types by estimating stromal cells around the deepest invasive lesions of carcinoma nodule. The cases with stroma containing predominantly both fibroblasts and lymphocytes (type II or III) were good in prognosis.
Electronmicroscopical examinations showed that cancer stromata were composed of various kinds of cells, such as fibroblasts, macrophages lymphocytes and “fibrohistiocytoid cells”, and cell to cell interaction between cancer cells and various cell types (especially distinct between lymphocytes and fibroblasts) were found.
Immunohistochemically, the cases with abundant ferritin and fibronectin-positive fibroblasts, macrophages and “fibrohistiocytoid cells” around the deepest cancer lesion, had good prognosis. And S-100 positive-Langerhans cells were localized within cancer cell nests and in the stroma neighboring to the tumor nodules. The primary tumors, which were rich in Langerhans cells, had better prognosis. Mast cells were seen in various types of the cancer stroma, but rarely existed in the stroma filled, predominantly, with fibroblasts.
Though lymphocytes had been regarded as one of the most important factors in stromal reactions, our findings lead to a conclusion that various cell types of stromata including fibroblasts, macrophages, “fibrohistiocytoid cells”, Langerhans cells and mast cells, as well as lymphocytes, play cooperatively in cancer immunology.

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Ontogenetic development of monocytic cell series in fetal and bone marrow hematopoiesis of mice was investigated by electron microscopy, ultrastructural peroxidase (PO) cytochemistry, and morphometric analysis. At 10 days of gestation, a few mononuclear cells similar in localization pattern of PO activity to bone marrow promonocytes or monocytes developed in blood islands of the yolk sac and were called fetal promonocytes or monocytes. However, they showed prominent nuclear indentation or lobulation, their PO-positive granules were less in number, and the intensity of PO activity in rough endoplasmic reticula, nuclear envelope and Golgi complexes of the fetal promonocytes was weaker than that of bone marrow promonocytes. In a 3 day-culture of the cell suspensions from the yolk sac, colony-forming cells showed similar ultrastructural and cytochemical features of the fetal promonocytes and monocytes developing in the yolk sac. In the liver anlage, similar fetal promonocytes and monocytes were found in the early stage of hepatic hematopoiesis and subsequently they changed into promonocytes or monocytes seen in bone marrow hematopoiesis. The number and size of PO-positive granules in the fetal promonocytes and monocytes in the colonies growing in culture of the suspensions from the hepatic anlage were intermediate between those in the colonies from the yolk sac and those from the bone marrow.
The above findings indicate that the fetal promonocytes or monocytes first appearing in the yolk sac show incomplete ultrastructural features of bone marrow promonocytes or monocytes and gradually become mature and complete during the stage of hepatic hematopoiesis.

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In lymph follicles of rat popliteal lymph nodes (PLNs), the transition of the localization of PAP (peroxidase-anti-peroxidase complex) trapping area with development of germinal centers was tridimensionally studied to analyze the differentiation of follicular dendritic cells (FDCs). Rats 5 weeks old were injected sheep red blood cells (SRBCs) into foot pads. The PLNs were extirpated at different intervals, at one day before extirpations PAP were injected into foot pads. Detection of PAP in lymph follicles and detail observations were performed in serial paraffin sections and in electron microscopy by immunoperoxidase technique. After the injection of SRBCs, lymph follicles and germinal centers increased in number. In early primary lymph follicles, the PAP trapping area occupied large space, however the ratio of the PAP trapping area occupying in the follicles was decreased with development of germinal centers. The trapping of PAP became weak in which centroblasts had been just appeared in the primary follicles, and then the medullary side of the germinal centers revealed no PAP trapping with further development of germinal centers. In electron microscopical observation, the trapping of PAP in secondary follicles could be found on the surface of cytoplasmic membranes of FDSs, which formed complicated labyrinth structures, in corona and light zone. On long time interval after injection of SRBCs, the germinal centers were atrophic, while cytoplasmic processes of FDCs remained complicated. The differentiation of FDCs is discussed.

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An autopsy case of primary malignant T-cell lymphoma of the central nervous system of a 71-year-old female is presented. The patient was admitted with a diagnosis of brain tumor in December 1985 with a 10-day history of motor weakness of the lower extremities, tendency of somnolence, and urinary incontinence. Neurological findings on admission revealed left hemiparesis, action tremor and Babinski's sign.
However, her general physical examination was unremarkable. A computed tomography [CT] scan without contrast medium, demonstrated isodensity lesions in the right deep frontal lobe extending into the left deep frontal and the right parietal lobes. After the injection of contrast medium, these lesions were homogeneously enhanced. Carotid angiography revealed an avascular space-occupying mass in the right deep frontal lobe. The patient was treated with surgical removal of a right deep frontal tumor followed by combined radiotherapy [a total of 43 Gy] and chemotherapy. Most of the tumor disappeared during radiotherapy [20 Gy] on the CT scan. Following repetitive episodes of remission and exacerbation, the patient expired about 9 months after the onset of symptoms.
The biopsy materials obtained from surgery disclosed diffuse infiltration of large lymphoma cells. Most of lymphoma cells had large, round, clear nuclei with a few irregularly situated nucleoli. Frequently, neoplastic giant cells with bizarre convoluted or lobulated nuclei were found. In immunohistochemical study, some of the lymphoma cells had T-cell markers, such as CD4, CD8 and MT-1. These positive cells had large and convoluted or lobulated nuclei. None of lymphoma cells demonstrated the presence of cytoplasmic immunogloblins of IgG, IgA, IgM, kappa chain and lamda chain, as well as MB-1. Neither glial fibrillary acidic protein [GFAP] nor neuron specific enolase[NSF] were reactive with the lymphoma cells.
At post-mortem examination, the patient had secondary tumors of different type: Grawitz tumor, benign renal cortical adenoma and thyroid multiple adenomas. The occurrence of multiple primary tumor [polyoncogenesis] in the present case appears to be evidence favoring the concept of the loss of immunological surveillance against neoplasms.

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Localizations of lactoferrin and lysozyme in the peripheral blood cells and bone marrow cells obtained from normal volunteers were investigated by an electron microscopic immunogold double stainings. Both lactoferrin and lysozyme were present in the same granules of neutrophils. Mast cell granules and some phagolysosomes of bone marrow reticulum cells also showed similar double stainabilities. In contrast, monocyte granules and eosinophil granules contained exclusively lysozyme. Neither lactoferrin nor lysozyme was observed in blastoid cells, megakaryocytes, platelets, erythroblasts, red blood cells, plasma cells, lymphocytes and basophils.
The electron microscopic immunogold double stainings are useful for detecting a couple of antigens on a single cell.

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A 76-year-old man was admitted to our hospital because of generalized lymphadenopathy and skin rash in February, 1983. Laboratory examinations showed pancytopenia, hypocellular marrow, polyclonal hypergammaglobulinemia and predominant helper/inducer T lymphocyte in peripheral blood and in lymph node. Histological finding of the cervical lymph node was immunoblastic lymphadenopathy. After four months, subjective symptoms and laboratory findings were spontaneously improved following the stop of Eviprostat. In February, 1985, he was re-admitted because of generalized lymphadenopathy. Biopsy of the inguinal lymph node revealed malignant lymphoma, diffuse, large, clear cell type. Several courses of CHOP therapy (cyclophosphamide, adriamycin, vincristine, prednisolone) resulted in the improvement of generalized lymphadenopathy. In October, 1985, generalized lymphadenopathy re-appeared, and skin tumor of the back was developed in December. Immunohistological examination of biopsied skin tumor showed malignant lymphoma, diffuse, medium-sized, B cell type. He was treated with CHOP therapy, but died in January 1986. We reported a case of immunoblastic lymphadenopathy terminating in B cell lymphoma through the phase of clear cell lymphoma, and discussed the mechanism of malignant evolution.

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A case of IBL like T cell lymphoma with monoclonal increasing IgM and κ-light chain in the serum was reported.
58 yrs female, who had been suffered from heart failure, admitted for the lymphadenopathy and general fatigue with fever. Leucopenia with small amount of atypical lymphocytes and hyperviscousity of blood were detectable. Serum analysis showed the monoclonal elevation of IgM-κ(M-protein) remarkably and slight dinturbance of liver function. Urinary Bence-Jones protein was detected. Lymph node biopsy revealed the disappearance of normal structure and the proliferation of atypical lymphoids with pale cells which characterize IBL like T cell lymphoma. Immunocytochemistry disclosed the pale cells bearing T cell markers (MT1, CD5, CD8 & CD4) and moderate distribution of IgM positive lymphoids and plasma cells. On November 1987, tonsil was swelling and was biopsied. Specimen showed the infiltration of atypical lymphoids and pale cells. Bone marrow biopsy showed moderate proliferation of lymph-plasmacytoid cells and formation of lymphoid germinal center. Clinical data and symptoms suggested the macroglobulinemia.
Additional lymph node biopsy was carried out on December 1987, and specimen also revealed IBL like T cell lymphoma. Monoclonal increasing of IgM-has been still remained. The patient is fortunately alive and well irrespective of no-recieving of therapy for lymphoma. IBL like T cell lymphoma is characterized with polyclonal hypergammaglobulinemia. The present case representing as IBL like T cell lymphoma histologically, however, showed monoclonal gammopathy which was macroglobulinemia clinically. It is difficult to define the pathogenesis whether IBL like T cell lymphoma induce the macroglobulinemia or the two kinds of the diseases occur simultenously and independently.

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Macrophages (Mφ) obtained from the pelvic cavity of 30 patients with various gynecological diseases were investigated enzyme-cytochemically to examine stimulatory conditions of the cavity. Resident Mφ, exudate Mφ, exudate-resident Mφ and peroxidase (PO)-negative Mφ were distinguished in the human peritoneal Mφ populations as in animal species. In many cases of the present series, PO-negative Mφ predominated in human peritoneal Mφ population, and resident Mφ were present in a few cases. These results indicate that the peritoneal cavity of woman may be stimulated persistently by unknown local factors. Exudate Mφ were more numerous in the peritoneal cavity of patients with ovarian carcinoma than in that of other patients. In patients with endometrial carcinoma, cervical carcinoma and benign ovarian tumor, Mφ, especially exudate ones, were few in number.
From these results, ultrastructural PO-cytochemistry of human peritoneal Mφ is considered to be useful for analyzing stimulatory state of the peritoneal cavity in the patients with various gynecological diseases.

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