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Free and wedged hepatic venography were carried out in 37 patients with idiopathic portal hypertension (IPH) and the findings compared with those in 88 patients with cirrhosis of the liver. Characteristic changes in IPH included frequent vein-to-vein anastomoses, narrower angles between large veins and their tributaries, smooth and wavy middle-sized to large branches (giving a general "weeping willow" appearance), homogeneous sinusoidal filling, and minimal to absent filling of the portal venous system on wedged retrograde portography. In cirrhosis, by contrast, changes included rare vein-to-vein anastomoses, wide angles between veins and tributaries, irregular stenoses of large veins and branches at various levels, spotty sinusoidal filling, and frequent retrograde flow in the portal venous system. Hepatic venography is helpful in differentiating IPH from cirrhosis.

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We report herein, a rare case of esophageal lipoma and review the Japanese literature on this subject. Lipoma of the alimentary tract is relatively uncommon but that of the esophagus is extremely rare with only 17 cases having been reported in Japan. The majority of these cases occurred in the cervical esophagus with the most serious symptom being regurgitation of the pedunculated tumor which lead to asphyxia and death in one case. Only 2 cases occurred in the thoracic esophagus and these tumors were small in size and resected endoscopically. This is the first reported case of an esophageal lipoma being located in the thoracic esophagus which was resected through a thorocotomy. The clinical features of esophageal lipoma are also described herein.

Background. Seven murine monoclonal antibodies (MoAb) detecting blood group antigens of the Lewis system and their sialylated derivatives were used to define their immunohistochemical distribution in normal and malignant pancreatic tissues. The specific blood group antigens studied included Lewisa (Lea), Lewisb (Leb), Lewisx (Lex), Lewisy (Ley), sialyl‐Lewisa (s‐Lea), sialyllacto‐N‐tetraose (s‐LNT), and sialyl‐Lewisx (s‐Lex). Methods. The expression of these antigens was analyzed by immunoperoxidase technique in pancreatic tissue of patients with (n = 27) and without (n = 19) pancreatic cancer. The genetic background of their secretor status and their Lewis phenotypes were determined by the enzyme‐linked immunosorbent assay using purified salivary glycoprotein and MoAb against eight different blood group–related antigens (Lea, Leb, Lex, Ley, H1, H2, A, B2), and the putative genotypes of the patients were classified as follows: SeLe, Sele, seLe, and sele. Results. The following results were obtained: (1) In normal pancreas, Lea, s‐Lea, s‐LNT, and s‐Lex were expressed in ducts, but their expression was restricted to the luminal side of the cytoplasm (cytoplasmic type with positive polarity). Leb and Ley showed similar patterns of expression in ducts and some parts of the acinus. In contrast, Lex was absent in most cases. (2) Expression of Leb was observed in normal pancreatic ducts in all 46 patients, regardless of their genotypes. Lea and s‐Lea were not expressed in specimens from patients with the seLe and sele saliva phenotypes. (3) In pancreatic cancer, the following antigens were expressed cytoplasmically in the proportion of cases indicated: Lea (78%), Leb (85%), Lex (33%), Ley (44%), s‐Lea (78%), s‐LNT (89%), and s‐Lex (85%). They also were detected in the surrounding stroma. This pattern of expression is distinct from that found in normal pancreatic tissue. Patients with Sele and sele genotypes did not express Lea or s‐Lea, except in one case. (4) Serum levels of carbohydrate antigen 19‐9 (CA 19–9) were not elevated in patients with pancreatic cancer with the Sele and sele genotypes but were elevated in most patients with SeLe and seLe genotypes. Conclusion. The overall findings indicate that Lewis‐related antigens act as pancreatic tissue–related antigens, depending in part on salivary phenotypes of the patient. With proper antigen selection and the determination of secretor status, these anti–blood group MoAb may be of clinical utility in the diagnosis of pancreatic cancer. Cancer 1993; 71:71‐81.