The second autopsy case of microlithiasis alveolaris pulmonum in our country was discussed. This case had no familial back‐ground or genetic predisposition for the disease and followed an almost asymptomatic course for 13 years since abnormal shadow of chest was revealed radio‐logically.
Of interest in this case in the deposition observed microscopically of the same substance in alveolar walls or in the interstitium as the ground substance of intra‐alveolar microlith, which was probably responsible for the irregular elastosis.
In order to clarify the present state of opportunistic fungal infections increasing in incidence in autopsy cases, all autopsy cases from 1966 to 1975 reported in the Annual of Pathological Autopsy Cases in Japan were reviewed. Of the total 233,130 autopsy cases, mycoses were present in 4,340 (1.86%). The incidence of mycoses has strikingly increased during the recent five-year period. In Japan, the mycoses most frequently occurring in autopsy cases were candidiasis (32.28%), aspergillosis (23.08%), cryptococcosis (9.63%), and mucormycosis (2.90%). These occurred more frequently in younger persons and were most commonly secondary and deep-seated infections (95.78%). Among the primary diseases associated with mycoses, aplastic anemia (14.36%), leukemia (9.89%), malignant lymphoma (5.73%), multiple myeloma (4.68%), and systemic lupus erythematosus (4.62%) were most frequent. The incidence of the primary diseases associated with mycoses is increasing extraordinarily, and this seems to be strongly related to the modern therapy of using high doses of anticancer or immunosuppressive agents.
This report presents the first autopsy case in Japan of idiopathic retroperitoneal fibrosis which had developed in a 71‐year‐old man. The clinical course was of extremely long duration of more than 10 years. Malignancy was suspected on biopsy, and at one stage chylous ascites developed. The cause of this retroperitoneal fibrosis could not be determined, but it is considered that the vicious circle of inflammatory processes such as cellulitis and lymphangitis in the retroperitoneum and lymphedema as well as lymphorrhage attributable to mechanical lymphatic obstruction brought about the retroperitoneal fibrosis.
Chronic granulomatous disease (CGD) is based on the dysfunction of phagocytes and characterized by a comparatively uniform granulomatous lesion caused by organisms which do not produce hydrogen peroxide and which are catalase-positive. This report describes two autopsy cases in children, a nine year-two month-old boy and a ten month-old girl, with the clinical manifestations and autopsy findings of CGD and a brief review of all autopsy cases consistent with CGD reported in Japan. In these cases, in addition to the usual CGD lesions, there was a markedly different type of granuloma due to Aspergillus sp., which consisted of multinuclear giant cells alone, or a caseous center surrounded by giant cells. This peculiar type of aspergillosis may correspond to a primary infection, described as pseudotuberculosis aspergillina. It appears that in some CGD patients, macrophages may function normally and sometimes be more activated by these infections than in the normal body. The histochemical and electron microscopic examination of the present cases and a review of the previous cases suggest that the yellowish brown pigment found seems to resemble a ceroid. It is a product of the degradation of leukocytes and tissue elements with subsequent accumulation in phagocytic histiocytes and is not necessarily peculiar to CGD.
Acute rheumatic carditis, in which numerous Aschoff bodies are found, has rarely been reported in Japan, and the origin of the Aschoff cell remains to be established. However, Murphy's opinion of myogenic origin is widely accepted.Such an autopsy case, in which the diagram of distribution of Aschoff body is scrutinized upon the whole of the heart.Clinically, a 16-year-old girl was admitted to the Shinshu University Hospital on 20 June, 1958, because of sighing dyspnea and slight fever. At the age of 11, she complained of pain and swelling of both knee joints. Later, she was diagnosed as suffering from heart failure because of palpitation, fatigue, sighing respiration and hematuria, or at some time as nephritis. In June, 1958, she was given the possible diagnosis of subacute bacterial endocarditis or rheumatic fever. At the time of admission to the Shinshu University Hospital, she had slight edema, oliguria and fever. At that time, albuminuria, anemia and leukocytosis were observed, and marked systolic murmurs were audible all over the precordial area. She recovered gradually by treatment, but on 6 August, 1958, she became suddenly comatous and died soon afterwards .
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