Journal of Pathology and Translational Medicine

Volume 6(1); June 1995

Original Article

p 53 Protein Expression in Imprint Cytology of Breast Carcinoma.: Dong Sug Kim, Eun Hi Lee, Ki Kwon Kim, Mi Jin Kim, Soo Jung Lee; Korean J Cytopathol. 1995;6(1):1-9.

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Abstract PDF: This study was carried out to determine the usefulness of imprint cytology for detecting p 53 protein in breast carcinoma. NCL-DO7(Novocastra, U.K.) was used to detect p53 protein immunocytochemically. A total of 33 cases was studied. Immunostaining of imprint cytology with NCL-DO7 was positive in 64%(21\33) and showed relatively high coincident rate (80 %) with immunostaining of formalin-fixed, paraffin - embedded specimen. p 53 protein was related to negative estrogen receptor status, but not to the nuclear grade, lymph node metastasis, or tumor size. The fact that p53 protein expression was not related to nuclear grade might be due to predominance of nuclear grade 3. It was easier to determine the nuclear grade is one of the most important prognostic factors, in imprint cytology than in tissue specimen. p53 protein tended to be stained more strongly in imprint cytology than in tissue.

Etc

Histochemical Studies on Human Endometrium: Jin Kook Choe, Yoo Bock Lee, Dong Sik Kim, Soon O Chung*; Korean J Cytopathol. 1972;6(1):1-15.

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Abstract: The endometrium undergoes marked morphologic and functional changes in very short periods of time, and these are controlled by ovarian hormones. These changes of the endometrium are fundamentally based on biochemical alterations. The endometrium is composed of surface and glandular epithelium, connective tissue and blood vessels, all of which participate in the morphologic alteration during the cyclic changes. Thus, to understand the mechanisms of morphologic alterations and the basis of endometrial function, histochemical studies concerning the localization of specific chemical and enzymatic activity are very important (Mckay, et al., 1956; Levine, 1963). It is the purpose of this report (1) to evaluate histochemical patterns during the normal cyclic Processes of the endometrium, and (2) to search for the histochemical differences in various conditions of endometrium compared with normal endometrium. Material and Methods ; Ninety specimens of endometrium removed by curette were obtained from patients for diagnosis of disease, and sterility at the Department of Gynecology, Yonsei University Medical Center. The histologic criteria of Noyes, et al. (1951) were used to establish the state of each specimen. Of the 25 normal specimens, 9 were proliferative, 14 were secretory, and 2 were menstrual. The 65 abnormal endometriums consisted of 16 with intrauterine pregnancies, 16 with ectopic pregnancies, 25 with hyperplasia, 3 with atypical hyperplasia, 3 with adenocarcinoma, and 2 with endometrial polyp. A portion of each specimen was frozen-sectioned and prepared for the activity of alkaline phosphatase by Gomori’s metal-salt method (1939). The remainder of each specimen was fixed in 10% neutral formalin solution. The paraffin-embedded sections were stained by hematoxylin and eosin, periodic acid-Schiff reaction for glycogen and glycoprotein, alcian blue stain for acid mucopoly-saccharides, and methylgreen pyronin stain for ribonucleic acid.
Result
and Summary ; 1. The PAS positive material, regarded as glycogen, or glycoprotein, underwent cyclic change in surface as well as in glandular epithelium of the normal endometrium. The amount of the material was greater in the secretory endometrium than in the proliferative endometrium and was also large in the endometrium of intra as well as ectopic pregnancies. However, in hyperplasia and adenocarcinoma, the PAS positive material was small in amount as in the proliferative endometrium. 2. The acid mucopolysaccharides which were located chiefly along the brush border of epithelium and in the stroma, revealed its cyclicity, and increased in the secretory endometrium. 3. The most interesting observation relates to the uterine change in hyperplasia and adenocarcinoma of endometrium, where diffuse staining of cytoplasm of the epithelial cells was observed with the acid mucopolysaccharides method. 4. No significant histochemical differences were found in the endometrium between intrauterine pregnancy and ectopic pregnancy. 5. Arias-Stella atypias were observed in 62.5% of ectopic pregnancies and in 31.3% of intrauterine pregnancies. These cells consisted of actively secreting cells, which possibly was due to apocrine secretion. 6. The large quantity of ribonucleic acid granules, which were observed diffusely in the cytoplasm of epithelial cells in proliferative and hyperplastic endometrium, was interpreted as an index of active protein synthesis in these conditions. Those which were concentrated above or near the nuclei of the epithelial cells seemed to be concerned with the secretory function in secretory and pregnant endometrium. 7. The cyclicity of the alkaline phosphatase activity was well demonstrated in the cell membrane of the epithelium, whereas the enzymatic activity in the blood vessels did not show cyclic change. In the proliferative endometrium the epithelial activity was higher than in the secretory or pregnant endometrium but in hyperplasia and adenocarcinoma it varied from gland, or from cell to cell. 8. Estrogen was considered to contribute more to the development of hyperplasia and adenocarcinoma than progesterone because the histochemical findings of these abnormal conditions were more or less similar to those of proliferative endometrium, although irregular findings were also noted in hyperplasia or adenocarcinoma. 9. The staining reactions of the endometrium in the secretory phase of the cycle and in ectopic pregnancy are quantitatively different because they are both under the influence of progesterone. Acknowledgement ; This study was partly supported by the Population Council, New York, N.Y., U.S.A.(Grant No. M69.184 and M71.0136 to Soon O Chung).

Original Articles

DNA Ploidy in Anaplastic Carcinoma of the Thyroid Gland by Image Analysis.: Ji Shin Lee, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; Korean J Cytopathol. 1995;6(1):10-17.

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Abstract PDF: Anaplastic carcinoma of the thyroid gland is one of the most malignant tumors. Recently, DNA ploidy measured by flow cytometry and image analysis has been suggested as an additional useful indicator of tumor behavior. Studies on the occurrence and clinical significance of DNA aneuploidy in anaplastic carcinoma of the thyroid are rare. In this study, the pattern of DNA ploidy was measured by image analysis on Papanicolaou stained slides in four cases of anaplastic carcinoma and also measured by flow cytometry using paraffin blocks in two cases. In all cases of anaplastic carcinoma. DNA aneuploidy was found by image analaysis. By flow cytometry, one case had a diploid peak and the other case had an arieuploid peak. According to the above results, we conclude that anaplastic carcinoma of the thyroid glands have a high incidence of DNA aneuploidy and image analysis using Papanicolaou stained slides is a useful method in detecting DNA aneuploidy.

Cytologic Findings of Breast Carcinoma in Fine Needle Aspiration: Comparison with Histologic Findings, Stage and Lymph Node Metastasis.: Hee Jin Chang, Duck Hwan Kim, Sung Sook Paeng, Sung Eun Yang, Jin Hee Sohn, Jung Il Suh, Hyo Sook Park; Korean J Cytopathol. 1995;6(1):18-26.

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Abstract PDF: In order compare cytologic findings of breast carcinoma in fine needle aspiration cytology (FANC) with histologic findings and prognostic factors including histologic grading, lymph node metastasis and stage, 79 cases of infiltrating ductal carcinoma diagnosed by FANC and confirmed by histology were analysed. We especially attempted to correlate nuclear grade, cellularity and smear pattern with histologic grade, type, status of lymph node metastasis and stage. The results are as follwos : 2. Individual cell pattern was more frequently identified in high histologic grade and scirrhous or solid-tubular type than in low histolgic grade and papillotubular type. 3. Cellularity increased with higher histologic grade and lymph node metastsis. However cellularity was low in scirrhous type. 4. There is no relationship between nuclear grade and histologic type, between smear pattern and lymph node metastasis or stage, and between cellularity and stage. These results suggest that cytologic findings of breast carcinoma such as nuclear grade, cellularity and smear pattern are indicative of histologic findings in relation to histolgic grade and type. Especially, nuclear grade of FANC may yield valuable prognostic information.

Etc

The Difference of Host Response (Proliferation of Small Round Cells) to Transplanted Ehrlich Carcinoma Growth between in the Non-immune and the Immune Mice: Soo Young Lee, Young Che Kim; Korean J Cytopathol. 1972;6(1):19-25.

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Abstract: It has been generally accepted that Ehrlich carcinoma is not strain-specific. However, Park (1968) of our laboratory reported that the intracranially implanted tumor of Ehrlich carcinoma did not show any necrosis till the mouse was killed 2 weeks after tumor inoculation and that in the subcutaneous transplantation of the same tumor, the same tumor tissue showed marked necrosis even 1 week after the inoculation. And Seu (1968) reported that in the tumor growth of intrahepatic, intrarenal and intratesticular implantation necrosis was conformed 1 week following the tumor transplantation except in the testis. Rho and Kim (1971) also reported that in the immune (UV-killed tumor vaccine inoculated) mice, the tumor growth became retarded in comparison with the non-immune mice, and central necrosis began to appear 12 hours after tumor inoculation whereas in the non-immune mice necrosis appeared far lately in the form of central necrosis in the tumor, which was often combined with cellular necrosis in the immune mice later, and on the other hand, the infiltration of small round cells was stronger in the immune mice in comparison with the non-immune ones. In this work, an attempt was made to observe autoradiographically the proliferation rates of small round cells of the host to tumor growth in both non-immune and immune (UV-killed tumor vaccine inoculated) mice. The results were as follows: 1. In the immune mice, the tumor growth became retarded in comparison with the non-immune mice. 2. In the immune mice, the proliferation of small round cells around the tumor mass was distinct in comparison with the non-immune ones.

Original Article

Cytologic Features of Soft Tissue Lesions.: Soon Ae Oak, Gyung Yub Gong, Ghee Young Choe, Jur Yung Hch, Eun Sil Yu, In Chul Lee; Korean J Cytopathol. 1995;6(1):27-35.

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Abstract PDF: We reviewed 93 cases of fine needle aspiration of skin\subcutaneous and soft tissue lesions with histologic confirmation. On the basis of the most prominent cytologic features, morphologic classification of the aspirates was done. Neoplastic lesions of soft tissue were categorized as ; round cell, spindle cell, polygonal cell, well-differentiated and myxoid tumor. This classification is convenient to recognize and categorize most soft tissue tumors.

Etcs

Studies on the Blastogenesis of PHA Stimulated Lymphocytes: Sang-In Kim, Kui-Nyung Yi; Korean J Cytopathol. 1972;6(1):27-32.

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Abstract: Studies on the blastogenesis of PHA stimulated lymphocytes of the cord blood of newborns, and the vencus bloods of the 2∼6 month old normal infants, normal adults and chromic lympoid leukemia patients of the Koreans and Israeli were performed. The results are summerized as follows: 1) Lymphocytes from cord blood of newborns showed slightly higher transformation rate while the infants showed significantly low comparing with that of normal adults. 2) Sex difference in transformation rate is not significant. 3) Mean values of transformation rates in Koreans are slightly higher than that of Israeli, however the Koreans disclosed more individual variations. 4) 3H-thymidine incorporation rate in 2∼6 month old infants is markedly low while the blast-transformation rate is relatively high, indicating that the DNA synthesis rate of PHA stimulated lymphocytes in this age group is very low comparing that of newborns and adults.

Histogenesis of Primary Non-teratoid Squamous Cell Carcinoma of Ovary -An Experimental Study-: Hee Yong Park; Korean J Cytopathol. 1972;6(1):35-47.

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Abstract: Squamous cell carcinoma arising in dermoid cyst or cystic teratoma of ovary occurs rarely in women; its incidence is low and varies from 1.7% to 3%. A non-teratomatous squamous cell carcinoma of ovary is even rarer. Only one or two authentic cases are reported in the literature. Human ovarian squamous cell carcinoma is usually found in benign cystic teratomas which undergo malignant transformation. According to E. R. Novak, histogenesis of teratoma is inadequately established and their relationship to other tumors such as struma ovarii, seromucinous cystadenomata, dysgerminoma and embryonal carcinoma is not clear. Black and Benitez reported a most unusual case of non-teratomatous squamous cell carcinoma in situ of ovary in a 35-year-old woman of Mongolian descent, who was operated on for a large cystic ovary measuring 8.2×6.3×3.4 cm. Three cysts were found on section; one of them was lined by squamous cell carcinoma in situ, and the remaining two were lined by flattened cuboidal epithelium. This certainly indicates that squamous cell carcinoma may haute a non-teratomatous origin in ovary. Black and Benitez suggested that perhaps an atypical squamous metaplasia of the endocervical like epithelium of an ovarian cyst could conceivably progress to an in situ carcinoma. Another case of a primary cystic squamous cell carcinoma was reported to have originated in the areas of squamous metaplasia in a mucinous cystadenoma. Therefore it is quite possible that the Black’s case may well be of the same histogenesis as the case cited above, although in this case the original cyst may have been lined by follicular cells and the latter undergone squamous metaplasia progressing to carcinoma. Since there is a growing evidence in recent years that granulosa cells are mobile as well as derived from the ovarian stroma, it is conceivable that many hormone-producing tumors of ovary also take their origin in the stroma, which is, as R.A. Willis puts it and others concur, not a mere supportive tissue but an undifferentiated blastema that is highly plastic and capable of wide range of metaplastic transformation. Some form of malignant Brenner tumors look very much like primary squamous cell carcinoma of ovary and Shay and Janovski suggested to classify the tumor as epidermoid, adenocarcino matous and mixed type. There are numerous studies and reports on histogenesis and hormonal activity of granulosatheca cell tumor, Brenner tumor, and serous cystadenocarcinoma. Review of the literature makes us believe more strongly that all these tumors, be .it feminizing or musculinizing, are closely related to each other and of the same stromal origin. The current report of an experimental study of mouse ovarian cell cultures and tumors which they induced is presented to support the view that many of these tumors are akin to one another and of common origin in bipotential ovarian cells. The ovarian epithelial and stromal cells were shown to undergo an interchangeable type of differentiation. Knowledge of the conditions under which this ability becomes manifested and of the mechanisms in altering cell differentiation may lead to a better understanding of histogenesis of ovarian tumors, including origin of such unusual type of ovrarian neoplasm as squamous cell carcinoma. An in vitro method of growing epithelial cell cultures isolated from explanted ovary of mouse led to the development of cell lines with tumorigenic properties. Among various neoplasms such as granulosa cell carcinoma and sarcomatoid tumors produced by inoculation of isologous mice, a squamous cell carcinoma was also observed. The description of the method by which this unusual tumor was unexpectedly produced and the demonstration of the usefulness of an in vitro analytical approach to studies of differentiation of various types of ovarian cells and of histogenesis of ovarian tumors are the main objectives of this report.

Original Articles

Fine Needle Aspiration Cytology of Parasitic Infestation in Soft Tissue.: Kyeong Mee Park, Ill Hyang Ko; Korean J Cytopathol. 1995;6(1):36-40.

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Abstract PDF: In the past, parasitic diseases were a major problem in public health in Korea. In recent years, however, nematodiasis that used be prevalent are no longer a serious problem. Instead some cestodiasis, particularly cysticercosis and sparganosis have become comparatively more important in recent years. Parasitic infestation of soft tissue is presented as a subcutaneous nodule or mass with nonspecific clinical manifestations.

Metastatic Carcinoma in Lymph Nodes of Neck: Analysis of 221 Cases Diagnosed by Fine Needle Aspiration Cytology.: Duck Hwan Kim, Youn Ju Kim, Seung Eun Yang, Sung Suk Paeng, Hee Jin Chang, Jin Hee Sohn, Jung Il Suh; Korean J Cytopathol. 1995;6(1):41-47.

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Abstract PDF: Two hundreds and twenty one consecutive patients with enlarged lymph nodes of neck areas were diagnosed as metastatic carcinoma by fine needle aspiration. The metastatic carcinomas were most frequent in the supraclavicular lymph nodes(p<0.05). As a primary site, lung, stomach, upper respiratory tract and breast were common sites in descending order of frequency. In overall cytologic types, squamous cell carcinoma was the most common in males(43%) while adenocarcinoma was the most common in females(72%) (p<0.05). While carcinomas of the esophagogastro -intestinal tract showed a tendency to metastasis to the left supraclavicular lymph nodes, the metastatic carcinomas of lung and breast usually metastasized to the same side primary cancers with predilection for the supraclavicular lymph nodes. The submandibular lymph nodes were frequently involved by the carcinoma of upper and lower respiratory tract, in which squamous cell carcinoma is the most prevalent cytologic type. diagnosis by fine needle aspiration cytology is the first step in the workup of patients with nodal enlargement suspicious for malignancy, particularly in metastatic carcinoma.

Case Report

Fine Needle Aspiration Cytology of Kimura's Lymphadenitis with Characteristic Warthin-Finkeldey Type Polykaryocytes: A Case Report.: Yeon Mee Kim, Hye Je Cho; Korean J Cytopathol. 1995;6(1):48-53.

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Abstract PDF: Kimura's disease is a chronic inflammatory disorder of unknown etiology, presenting usually as a painless subcutaneous swelling in the head and neck region or in the lymph nodes. We experienced a case of Kimura's lymphadenitis with characteristic Warthin-Finkeldey type polykaryocytes by fine needle aspiration cytology. The patient was a 10 - year old male, with two enlarged lymph nodes in the postauricular area. Fine needle aspiration cytology from the lymph nodes disclosed hypercellular smears with some scattered eosinophils and polykaryocytes in a polymorphous lymphoid background. There were also fragmented vessel walls and activated endothelial cell clusters in the slightly necrotic background. The Warthin-Finkeldey type polykaryocytes had three to thirty nuclei and prominent nucleoli with ill defined cytoplasmic borders. Their nuclei were arranged in grapevine or ring shaped clusters. As these polykaryocytes could also be found in lymph nodes and extranodal tissues of both reactive and neoplastic lymphoid disorders, polykaryocytes themselves are clinically nonspecific. However, the morphologic features of the Warthin-Finkeldey type giant cells are quite different from the foreign body type or Langhans' type giant cells. When the characteristic cytologic features of Kimura's disease such as significant number of eosinophils in a background of lymphoid cells asd proliferation of vessels and endothelial cells are also observed in the smear, it is possible to suggest this diagnosis in the appropriate clinical setting.

Etc

Primary Squamous-Cell Carcinoma of the Corpus uteri Arising in Adenomyosis -Report of A Case-: Hee-Yong Park, Tai-Sik Hwang*; Korean J Cytopathol. 1972;6(1):51-56.

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Abstract: The development of carcinoma in adenomyosis has rarely been reported (5), whereas the occurrence of malignant changes in foci of external endometriosis has been noted more frequently(1). Sampson(7) postulated certain rigid criteria which may be modified to apply to carcinoma developing in adenomyosis. These are : 1. The absence of carcinoma in the normally situated endometrium and elsewhere in the pelvis. 2. The carcinoma must actually be seen to arise from the epithelium of areas of adenomyosis and not to be invading it from some other sources. 3. The endometrial stromal cells must surround the aberrent glands to support the diagnosis of adenomyosis. In none of the cases reported by Coleman Rosenthal(1) was noted squamous component in the developing carcinomas. It seems extremely rare to see primary squamous cell carcinoma originating in adenomyosis. Certain prerequisities for the diagnosis of primary squamous cell carcinoma of the corpus uteri are the following as claimed by Peris et al. (6): It is essential that there be no evidence, past or present, of squamous cell carcinoma of the uterine cervix. In the presence of a coincidental adenocarcinoma of the endometrium, squamous epithelium from the uterine corpus must be carefully studied to rule out adenoacanthoma. The author recently has encountered a seemingly authentic case of primary squamous cell carcinoma of the uterine corpus arising in adenomyosis with direct invasion of the rectosigmoid colon causing intestinal obstruction. Because this represents a rare gynecological disorder, the case is being presented.

Case Reports

Fine Needle Aspiration Cytology of Endodermal Sinus Tumor of the Ovary: A Case Report.: Jin Man Kim, Dae Young Kang; Korean J Cytopathol. 1995;6(1):54-57.

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Abstract PDF: We report a case of fine needle aspiration cytology of endodermal sinus tumor of the ovary. A 13-year-old girl complained of abdominal mass and pain. The abdominal sonography revealed a well-demarcated huge mass, which was solid and multiseptated. Percutaneous fine needle aspiration was performed from the mass. The smears revealed moderate cellularity, which was arranged in sheets or clumps of pleomorphic malignant cells on mucoid background. The valuable characteristic features of tumor cells were papillary configuration, vacuolated cytoplasm and intracellular and extracellular hyaline globules. The diagnosis was confirmed later by histologic study of surgical resection of the specimen.

Percutaneous Fine Needle Aspiration Cytology of Adrenal Cortical Carcinoma: A Case Report.: Myoung Ja Jeong, Ho Lee, Myoung Jae Kang, Dong Geun Lee, Ho Yeul Choi, Sang Ho Kim; Korean J Cytopathol. 1995;6(1):58-61.

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Abstract PDF: Fine needle aspiration(FNA) biopsy has become the procedure of choice for initial diagnosis of adrenal masses. However, there have been relatively few reports discussing the FNA cytologic features of adrenal cortical carcinoma. Recently, we experienced a case of FNA cytology of bilateral adrenal cortical carcinoma in a 61-year old man. The smear revealed loosely cohesive pleomorphic tumor cells with hemorrhagic and necrotic background. The tumor cells showed oval to spindle hyperchromatic nuclei and prominent nucleoli with frequent mitotic figures. The cytoplasm of tumor cells was relatively abundant and sometimes vacuolated. These cytologic findings were interpreted as an adrenal cortical carcinoma, undifferentiated pattern.

Etc

Ultrastructural Changes of Rat Liver Cells Induced by Yellow Phosphorus: Sung Ho Kim; Korean J Cytopathol. 1972;6(1):59-73.

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Abstract: Yellow Phosphorus, one of the allotropic forms of elemental phosphorus, is highly toxic to human being but yellow phosphorus-containing roach poisons and other chemical substances are still available. When sufficient quantities have been ingested, acute hemorrhagic inflammation of the esophagus and stomach is induced and followed by fatty degeneration of the liver, kidneys, heart, and the voluntary muscles, but liver damage is considered as the most significant one since cirrhosis or acute yellow atrophy of the liver can occur and death may result from these causes (LaDue et al., 1944; Goodman and Gilman, 1965; Harrison et al., 1966). The morphologic changes of the liver induced by yellow phosphorus had been rather well established with light microscopic studies and fatty degeneration and necrosis at the peripheries of lobules of the liver have been accepted as a characteristic findings of phosphorus intoxication (Popper and Schaffner, 1957; Robbins, 1967). The ultrastructural changes at the early stage of intoxication, however, not fully established yet because previous studies on the ultrastructural changes of the phosphorus-intoxicated rat liver are extremely variable in result and not reproducible(Jézéquel, 1958; Ghoshal et at., 1969; Ganote and Otis, 1969). The mechanism of fatty degeneration is still controversial. Recently, however, a very interesting speculation was postulated by Choshal et al. (1969, 1971) explaining that lipoperoxidation theory, which was very attractive in case of carbon tetrachloride poisoning, was consistent with mechanism of yellow phosphorus intoxication in morphological aspects. The purpose of this paper is to describe the ultrastructural changes in the liver cells of the yellow phosphorus intoxicated rat on the early stage and to discuss the possibility of lipoperoxidation mechanism by studying the effect of DL-alpha-tocopherol, a very powerful antioxidant. Materials and Methods ; Thirty two adult albino rats weighing around 200 gm. each were used regardless of their sex. The animals were divided into three groups as follows: Group Ⅰ: control animals. Group Ⅱ: yellow phosphorus treated animals. Group Ⅲ: vitamin E and phosphorus treated animals. Phosphorus was suspended in olive oil (0.5% mixture w/v) and administered into peritoneal cavities in the amount of 0.75mg. per 100gm of body weight. DL-alpha-tocopherol (Tofaxin, made by Wintrop-Steams Co.) was injected intramuscularly in a dosage of 10 mg. per 100 gm. of body weight daily for 3 days prior to yellow phosphorus treatment and at time of yellow phosphorus injection. The control animals received olive oil only with the same volume with animals of group Ⅱ or Ⅲ. At intervals of 6, 12, 24 and 48 hours after the administration of yellow phosphorus, the animals were killed. The liver and other organs were examined grossly and the specimens for the light and electron microscopic examination were obtained immediately from the liver. Specimens for the light microscopic examinations were fixed in 10% neutral formalin and embedded in paraffin. Sections of 6 micron thick were made and stained with hematoxylin-eosin for studies of overall histologic change and periodic acid Schiff reaction for glycogen. Frozen sections were also made and stained with oil red O for demonstration of fat. Specimens for the electron microscopic examinations were cut in 1 mm3 size and fixed in 6% glutaraldehyde in phosphate buffer pH 7.4 for 2 hours at 4℃ and post fixation was followed in 1% osmium tetraoxide in phosphate buffer at pH 7, 4 for 2 hours. They were embedded in Epon 812 and cut into 400-500Å thickness with glass knife. After staining with uranyl acetate and lead hydroxide, observation was made with Hitachi model HU 11-E electron microscope.
Result
and Discussion ; In the liver of control rats, no stainable fat was demonstrated by oil red O method, but in group Ⅱ, fatty metamorphosis was demonstrable at 6 hours after administration of yellow phosphorus and involved almost the entire lobule except some hepatic parenchymal cells adjacent to central vein. It advanced in degree through 12th hour and reached its peak at 24th hour and maintained this until the 48th hour. Scattered parenchymal cell necrosis and round cell infiltrations were also noted but did not reveal any zonal character. In group Ⅲ, the fatty metamorphosis did not occur at the 6th hour but at 12th hour mild changes were noted which also advanced with time. Vitamin E failed to prevent inflammation and necrosis. PAS positive material was mildly decreased in the liver throughout the experimental periods as compared with the control liver. The most significant ultrastructural changes were found in rough endoplasmic reticulum and were very distinctive. The rough endoplasmic reticulum was markedly hyperplastic and arranged in parallel fashion occupying large areas of cytoplasmic spaces. The studded ribosome was intact and free ribosome was not increased. Polysome formation, however, was not demonstrable. These changes were noted at the 6th hour and maintained these patterns until 24 hours after phosphorus injection but markedly decreased in degree at 48th hour. The fat globules were identified at 6th hour not in the cisternae but in cytoplasm and these findings were considered as evidences of difference between carbon tetrachloride and yellow phosphorus intoxication. In group Ⅲ, the same morphologic changes took place except the absence of fat globule at 6th hour. The smooth endoplasmic reticulum, lysosome, mitochondria, microbody, Golgi complex and nucleus were not significantly altered in their morphologic characters in both groups Ⅱ and Ⅲ. In summary, the fatty changes induced by yellow phosphorus were not confined to the periphery of the hepatic lobule but involved in almost the entire lobules even in the early stage. The most significant and quite distinctive ultrastructural changes were early hyperplasia of the rough endoplasmic reticulum and their parallel arrangement. Vitamin E failed to prevent the toxic effect of yellow phosphorus completely and the lipoperoxidation theory seems not to be convincing in cases of fellow phosphorus poisoning.

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