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Ohta Y, Norose T, Ohike N, Takiguchi S, Murayama M, Kobayashi S, Shiokawa A, Nagao T. A case of secretory carcinoma of the parotid gland provides cytological clues for the differential diagnosis of this disease. Cytopathology 2018; 29:375-379. [PMID: 29656485 DOI: 10.1111/cyt.12548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Y Ohta
- Department of Pathology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - T Norose
- Department of Pathology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - N Ohike
- Department of Pathology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - S Takiguchi
- Department of Otolaryngology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - M Murayama
- Department of Otolaryngology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - S Kobayashi
- Department of Otolaryngology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - A Shiokawa
- Department of Pathology, Showa University School of Medicine, Tokyo, Japan
| | - T Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
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Shibata H, Ohike N, Norose T, Isobe T, Suzuki R, Imai H, Shiokawa A, Aoki T, Murakami M, Mizukami H, Tanaka JI, Takimoto M. Mucinous Cystic Neoplasms Lined by Abundant Mucinous Epithelium Frequently Involve KRAS Mutations and Malignant Progression. Anticancer Res 2017; 37:7063-7068. [PMID: 29187496 DOI: 10.21873/anticanres.12178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/03/2017] [Accepted: 10/12/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pancreatic and hepatic mucinous cyst neoplasms (MCNs) have a malignant potential, but indolent MCNs are not uncommon. MATERIALS AND METHODS The pathological and genetic characteristics of resected MCNs (n=15) categorized by the amount of mucin of the lining epithelium were investigated. RESULTS MCNs were divided into two groups: (i) a rich (r)-MCN group (n=6), in which more than half of the epithelium was lined by abundant mucinous epithelium; and (ii) a poor (p)-MCN group (n=9), which consisted of the remaining cases. Three patients in the r-MCN group showed invasive carcinoma or high-grade dysplasia, whereas all patients in the p-MCN group showed low-grade dysplasia. Mutations of Kirsten rat sarcoma viral oncogene homolog (KRAS) were more frequent in the r-MCN group (83%) (p-MCN; 11%, p<0.05). CONCLUSION Mucinous MCNs more frequently have KRAS mutations and higher risk of malignant progression.
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Affiliation(s)
- Hideki Shibata
- Department of Pathology, Showa University Hospital, Tokyo, Japan .,Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan.,Division of General and Gastroenterological Surgery, Department of Surgery, Showa University Hospital, Tokyo, Japan
| | - Nobuyuki Ohike
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Tomoko Norose
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Tomohide Isobe
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Reika Suzuki
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Hideyuki Imai
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Akira Shiokawa
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Takeshi Aoki
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University Hospital, Tokyo, Japan
| | - Masahiko Murakami
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University Hospital, Tokyo, Japan
| | - Hiroki Mizukami
- Department of Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Jun-Ichi Tanaka
- Department of Gastroenterological Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan
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Okamoto S, Komura M, Terao Y, Kurisaki-Arakawa A, Hayashi T, Saito T, Togo S, Shiokawa A, Mitani K, Kobayashi E, Kumasaka T, Takahashi K, Seyama K. Pneumothorax caused by cystic and nodular lung metastases from a malignant uterine perivascular epithelioid cell tumor (PEComa). Respir Med Case Rep 2017; 22:77-82. [PMID: 28706850 PMCID: PMC5496452 DOI: 10.1016/j.rmcr.2017.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 06/20/2017] [Indexed: 12/03/2022] Open
Abstract
Perivascular epithelioid cell tumors (PEComas) are mesenchymal neoplasms with immunoreactivity for both melanocytic and smooth muscle markers. PEComas occur at multiple sites, and malignant PEComas can undergo metastasis, recurrence and aggressive clinical courses. Although the lung is a common metastatic site of PEComas, they usually appear as multiple nodules but rarely become cystic or cavitary. Here, we describe a female patient whose lungs manifested multiple cystic, cavity-like and nodular metastases 3 years after the resection of uterine tumors tentatively diagnosed as epithelioid smooth muscle tumors with uncertain malignant potential. This patient's subsequent pneumothorax necessitated video-assisted thoracoscopic surgery, and examination of her resected lung specimens eventually led to correcting the diagnosis, i.e., to a PEComa harboring tuberous sclerosis complex 1 (TSC1) loss-of-heterozygosity that originated in the uterus and then metastasized to the lungs. The administration of a gonadotropin-releasing hormone analogue later stabilized her clinical course. To the best of our knowledge, the present case is the first in the literature that associates PEComas with a TSC1 abnormality. Additionally, the pulmonary manifestations, including imaging appearance and pneumothorax, somewhat resembled those of lymphangioleiomyomatosis, a representative disease belonging to the PEComa family. Although PEComas are rare, clinicians, radiologists and pathologists should become aware of this disease entity, especially in the combined clinical setting of multiple cystic, cavity-like, nodular lesions on computed tomography of the chest and a past history of the tumor in the female reproductive system.
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Key Words
- CAPUs, clinically aggressive PEComas of the uterine corpus
- CT, computed tomography
- Cystic lung disease
- ESS, endometrial stromal sarcoma
- GnRH, gonadotropin-releasing hormone analogue
- HPF, high-power fields
- LAM, lymphangioleiomyomatosis
- LOH, loss of heterozygosity
- Loss of heterozygosity
- Multiple lung nodules
- PEComa
- PEComa, perivascular epithelioid cell tumor
- PEComa-NOS, PEComa not otherwise specified
- Pneumothorax
- Pulmonary metastasis
- TFE3, transcription factor E3
- TSC, tuberous sclerosis complex
- mTOR, mammalian target of rapamycin
- α-SMA, α-smooth muscle actin
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Affiliation(s)
- Shouichi Okamoto
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
| | - Moegi Komura
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Yasuhisa Terao
- Department of Gynecology and Obstetrics, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Aiko Kurisaki-Arakawa
- Department of Human Pathology, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Takuo Hayashi
- Department of Human Pathology, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
| | - Tsuyoshi Saito
- Department of Human Pathology, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Shinsaku Togo
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Akira Shiokawa
- Department of Clinical Diagnostic Pathology, Showa University Fujigaoka Hospital, 1-30, Fujigaoka Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan
| | - Keiko Mitani
- Department of Human Pathology, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
| | - Etsuko Kobayashi
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
| | - Toshio Kumasaka
- Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
| | - Kazuhisa Takahashi
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Kuniaki Seyama
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
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Ohta Y, Hirota Y, Kohno Y, Kishimoto K, Norose T, Ohike N, Takimoto M, Shiokawa A, Ota H. Cytology of low-grade cribriform cystadenocarcinoma in salivary glands: Cytological and immunohistochemical distinctions from other salivary gland neoplasms. Diagn Cytopathol 2015; 44:241-5. [DOI: 10.1002/dc.23411] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/14/2015] [Accepted: 11/24/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Yoshiki Ohta
- Department of Clinico-Diagnostic Pathology; Showa University Fujigaoka Hospital; Kanagawa Japan
| | - Yuko Hirota
- Department of Clinico-Diagnostic Pathology; Showa University Koto-Toyosu Hospital; Tokyo Japan
| | - Yohko Kohno
- Division of Pathology; Department of Oral Diagnostic Sciences, Showa University School of Dentistry; Tokyo Japan
| | - Koji Kishimoto
- Department of Clinico-Diagnostic Pathology; Showa University Fujigaoka Hospital; Kanagawa Japan
| | - Tomoko Norose
- Department of Clinico-Diagnostic Pathology; Showa University Fujigaoka Hospital; Kanagawa Japan
| | - Nobuyuki Ohike
- Department of Clinico-Diagnostic Pathology; Showa University Fujigaoka Hospital; Kanagawa Japan
| | - Masafumi Takimoto
- Department of Pathology; Clinico-Diagnostic Pathology, Showa University School of Medicine; Tokyo Japan
| | - Akira Shiokawa
- Department of Pathology; Clinico-Diagnostic Pathology, Showa University School of Medicine; Tokyo Japan
| | - Hidekazu Ota
- Department of Pathology; Clinico-Diagnostic Pathology, Showa University School of Medicine; Tokyo Japan
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Omatsu M, Kunimura T, Mikogami T, Shiokawa A, Nagai T, Masunaga A, Kitami A, Suzuki T, Kadokura M. Difference in distribution profiles between CD163+ tumor-associated macrophages and S100+ dendritic cells in thymic epithelial tumors. Diagn Pathol 2014; 9:215. [PMID: 25499804 PMCID: PMC4302590 DOI: 10.1186/s13000-014-0215-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/26/2014] [Indexed: 12/23/2022] Open
Abstract
Background In a number of human malignancies, tumor-associated macrophages (TAMs) are closely involved in tumor progression. On the other hand, dendritic cells (DCs) that infiltrate tumor tissues are involved in tumor suppression. However, there have been very few reports on the distribution profiles of TAMs and DCs in thymic epithelial tumors. We examined the difference in the distribution profiles between TAMs and DCs in thymoma and thymic carcinoma. Methods We examined 69 samples of surgically resected thymic epithelial tumors, namely, 16 thymic carcinomas and 53 thymomas, in which we immunohistochemically evaluated the presence of TAMs using CD68 and CD163 as markers and DCs using S100 as the marker in tumor tissue samples in comparison with normal thymic tissues. Results The percentage of samples with a large number of CD68+ TAMs was not significantly different between thymic carcinoma and thymoma (7/16 versus 16/53, p = 0.904). However, the percentage of sample with a large number of CD163+ TAMs was significantly higher in thymic carcinoma than in thymoma (15/16 versus 34/53, p = 0.024). In contrast, the percentage of samples with a large number of S100+ DCs was significantly lower in thymic carcinoma than in thymoma (2/16 versus 23/53, p = 0.021). Conclusions To the best of our knowledge, we are the first to show a high percentage of CD163+ TAMs and a low percentage of S100+ DCs in thymic carcinoma samples, and our findings may provide an idea for future targeted therapeutic strategies for thymic carcinoma using antibodies that inhibit monocyte differentiation to TAMs, thereby skewing TAMs differentiation toward DCs. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_215
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Affiliation(s)
- Mutsuko Omatsu
- Department of Clinico-diagnostic Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Toshiaki Kunimura
- Department of Clinico-diagnostic Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Tetsuya Mikogami
- Department of Clinico-diagnostic Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Akira Shiokawa
- Department of Clinico-diagnostic Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
| | - Tomoko Nagai
- Department of Clinico-diagnostic Pathology, Showa University School of Medicine, Tokyo, Japan.
| | - Atsuko Masunaga
- Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
| | - Akihiko Kitami
- Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
| | - Takashi Suzuki
- Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
| | - Mitsutaka Kadokura
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
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Omatsu M, Kunimura T, Mikogami T, Shiokawa A, Masunaga A, Nagai T, Kitami A, Suzuki T, Kadokura M. Cyclin-dependent kinase inhibitors, p16 and p27, demonstrate different expression patterns in thymoma and thymic carcinoma. Gen Thorac Cardiovasc Surg 2014; 62:678-84. [PMID: 24938902 DOI: 10.1007/s11748-014-0437-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/05/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The role of cell cycle inhibitors in tumorigenesis has been proven in various neoplasms; however, their roles in thymic tumors are still unclear. We examined the expression of cell cycle inhibitors such as those of the Cip/Kip family (p21, p27, and p57) and the INK-4/ARF family (p16 and p14) in thymoma and thymic carcinoma. METHODS Samples from 41 thymoma and 14 thymic carcinoma patients, and 34 normal thymic tissue samples were prepared for the study. Immunohistochemical analysis using antibodies to p21, p27, p57, p16, and p14 was carried out, and the positivity for these inhibitors in each group was estimated in terms of their subcellular location and percentage of cells showing positive staining. RESULTS Nuclear p27 showed a stepwise decrease (p < 0.0001), and the cytoplasmic p27 showed a stepwise increase (p < 0.0001) in expression level with the increase in malignancy. p16 in both the nucleus and cytoplasm showed a stepwise increase (p < 0.0001) in expression level with the increase in malignancy. However, as for p21, p57, and p14, there was almost no nuclear or cytoplasmic expression in each group. CONCLUSIONS Our findings suggest that low nuclear and high cytoplasmic p27 expression levels, and high nuclear and cytoplasmic p16 expression levels may correlate with the increase in thymic malignancy.
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Affiliation(s)
- Mutsuko Omatsu
- Department of Clinico-diagnostic Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan,
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Ohta Y, Sasaki Y, Saito M, Kushima M, Takimoto M, Shiokawa A, Ota H. Claudin-4 as a marker for distinguishing malignant mesothelioma from lung carcinoma and serous adenocarcinoma. Int J Surg Pathol 2013; 21:493-501. [PMID: 23775021 DOI: 10.1177/1066896913491320] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We compared claudin-4 with Ber-EP4 and carcinoembryonic antigen as markers to distinguish mesothelioma from lung adenocarcinoma, poorly differentiated lung squamous cell carcinoma, and serous adenocarcinoma of the uterus or ovary. All mesothelioma specimens were negative for claudin-4, but 3 of 18 specimens were focally positive for Ber-EP4. In contrast, lung adenocarcinoma including poorly differentiated adenocarcinoma was highly positive for claudin-4, but expression of Ber-EP4 and carcinoembryonic antigen varied widely. Claudin-4 in poorly differentiated squamous cell carcinoma had a lower positive expression rate than in adenocarcinoma. Granular claudin-4 immunoreactivity was conspicuous in poorly differentiated squamous cell carcinoma; this immunoreactive pattern was also observed in mesothelioma. Claudin-4 was thus considered very useful marker for distinguishing mesothelioma and adenocarcinoma, even if histological specimens are small, as in biopsies that contain limited numbers of tumor cells. However, it should be mentioned that claudin-4 has a limit in discrimination between squamous cell carcinoma from mesothelioma.
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Ohta Y, Kunimura T, Omatsu M, Shiokawa A, Kushima M, Ota H. Mixed mucin-producing and squamous differentiated tumor of the uterine cervix: a report of a case as adenosquamous carcinoma in situ. J Obstet Gynaecol Res 2013; 39:420-3. [PMID: 23294292 DOI: 10.1111/j.1447-0756.2012.01904.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report a non-invasive mixed mucin-producing and squamous differentiated tumor of the uterine cervix. This tumor was composed of two cell types: mucin-producing cells and non-mucin-producing cells. These cells were intimately mixed with each other, and showed intraepithelial spreading. The mucin-producing cells showed signet-ring or columnar shapes, and were localized to the lower-to-upper epithelial layer. The non-mucin-producing cells had eosinophilic cytoplasms with a monotonous appearance through the epithelium. Mitosis was sometimes observed in both cell types. Immunohistochemically, both cell types were positive for p16(INK4A) . The non-mucin-producing cells were positive for p63 and 34βE12, suggesting squamous differentiation. Although most mucin-producing cells were p63(-) , a few of them were p63(+) and many 34βE12 immunoreactive cells were found in the mucin-producing cells. This tumor was adenosquamous carcinoma in situ.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology Second Department of Pathology, Showa University, Tokyo, Japan.
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Omatsu M, Kunimura T, Mikogami T, Hamatani S, Shiokawa A, Masunaga A, Kitami A, Suzuki T, Kadokura M, Morohoshi T. Immunohistochemical analysis of thymic carcinoma focusing on the possibility of molecular targeted and hormonal therapies. Gen Thorac Cardiovasc Surg 2012; 60:803-10. [PMID: 23054618 DOI: 10.1007/s11748-012-0160-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/18/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Thymic carcinoma is a rare mediastinal malignant tumor, and in many patients, the tumor is detected in an inoperable advanced stage. Even when chemotherapy is administered to such patients, the patients show a poor response. We investigated new biomarkers of therapeutic molecular targets. METHODS This study included 44 patients diagnosed and treated for primary thymic epithelial tumors at Showa University Northern Yokohama Hospital, Showa University Hospital, and Showa University Fujigaoka Hospital from 2003 to 2011. We investigated new biomarkers of therapeutic molecular targets, such as the peroxisome proliferator-activated receptor γ (PPARγ), insulin-like growth factor 1 receptor (IGF1R), epidermal growth factor receptor (EGFR), estrogen receptor (ER), progesterone receptor (PgR), androgen receptor (AR), human epidermal growth factor type 2 (HER2)/neu, CD44, and L-type amino acid transporter 1 (LAT1), in thymic tumors. RESULT Immunohistochemical analysis showed that the PPARγ positivity rate in thymic carcinoma was 32 %, which was significantly higher than that in thymoma (4 %). The IGF1R positivity rate in thymic carcinoma was 73 %, which was significantly higher than that in thymoma (27 %). CONCLUSION Therefore, by examining the expressions of PPARγ and IGF1R, it would be possible to identify therapy-responsive patients and to improve results of thymic carcinoma treatment.
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Affiliation(s)
- Mutsuko Omatsu
- Department of Clinical Diagnostic Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, 224-8503, Japan.
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Ohta Y, Suzuki T, Kojima T, Mikogami T, Omatsu M, Hamatani S, Shiokawa A, Kushima M, Ota H. High-grade endometrial stromal sarcoma with smooth muscle and skeletal muscle differentiation: Report of a case with cytomorphologic and immunocytologic analysis. Diagn Cytopathol 2010; 39:301-5. [DOI: 10.1002/dc.21431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 04/05/2010] [Indexed: 02/01/2023]
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Tajiri T, Inagaki T, Ohike N, Omatsu M, Kasugai H, Kunimura T, Shiokawa A, Mitsuya T, Morohoshi T. Intraductal oncocytic papillary carcinoma of the pancreas showing numerous hyaline globules in the lumen. Pathol Int 2010; 60:48-54. [PMID: 20055952 DOI: 10.1111/j.1440-1827.2009.02474.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Two cases of intraductal oncocytic papillary carcinoma (IOPC) treated surgically were analyzed on light microscopy and immunohistochemistry: that of a 61-year-old man and that of a 55-year-old man. There were no clinical symptoms in either case. Pancreatic abnormalities were discovered incidentally on CT. Various clinical examinations were carried out, and the preoperative diagnosis was intraductal papillary mucinous carcinoma (IPMC) in both cases. Surgery was performed. Macroscopic observation of tissue cross-sections indicated multilocular cystic mass containing polypoid lesions encapsulated by the dilated pancreatic duct. Histologically, the cyst walls were lined by columnar epithelial cells with complex papillary projections associated with oxyphilic cytoplasm, and they were strongly immunoreactive with anti-mitochondrial antibody in the cytoplasm. Electron microscopy showed numerous mitochondria in the cytoplasm. IOPC was diagnosed. Interestingly, amorphous hyaline globules were produced from the oxyphilic cells, which exhibited a bud-like appearance. The hyaline globules were not positive for mucin staining. No case of IPMC with hyaline globules has been reported to date. The production of hyaline globules may be related to oncocytic differentiation. It is suggested that hyaline globules should be regarded as a characteristic of IOPC.
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Affiliation(s)
- Takuma Tajiri
- Department of Diagnostic Pathology, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan.
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Ohta Y, Suzuki T, Tonoike T, Hamatani S, Ohike N, Shiokawa A, Kushima M, Ota H. Two cases of intracranial germinoma showing a cell arrangement mimicking carcinoma. Diagn Cytopathol 2010; 38:132-136. [PMID: 20073098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Tumors of germ cell origin uncommonly arise in extragonadal sites. We report two cases of intracranial germinoma, in which it was necessary to distinguish between intracranial germinoma and metastatic carcinoma in cytological specimens. Cytologically, not only single tumor cells or loosely connective tumor cells but also closely packed clusters of cells and pair cells were recognized. Immunocytochemically, almost all tumor cells were immunoreactive for M2A, placental alkaline phosphatase, and c-kit. Closely packed clusters were also immunoreactive for pan-cytokeratin. Therefore, Cytopathologists should be aware that tumor cell clusters, mimicking carcinoma might appear in cytological specimens of intracranial germinomas. Although immunocytochemical analysis assists in correct diagnosis, some cell clusters showing cytokeratin immunoreactivity does not become the basis for the diagnosis of metastatic carcinoma. A panel of antibodies including D2-40, PLAP, and c-kit should be used.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology, Showa University Northern Yokohama Hospital, Kanagawa 227-8503, Japan.
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Saka R, Gomi A, Sugiyama A, Ohashi Y, Ohike N, Shiokawa A, Sanada Y, Toki A. Ectopic pancreas as a cause of jejunal obstruction in a neonate. J Pediatr Surg 2009; 44:856-8. [PMID: 19361655 DOI: 10.1016/j.jpedsurg.2009.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 01/19/2009] [Accepted: 01/19/2009] [Indexed: 11/28/2022]
Abstract
This report describes a case of symptomatic ectopic pancreas in the jejunum. A review of the literature revealed no other case of ectopic pancreas manifesting as jejunal stenosis during the neonatal period. Ectopic pancreas should be excised in consideration of the potential late complications.
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Affiliation(s)
- Ryuta Saka
- Children's Medical Center, Showa University Northern Yokohama Hospital, Kanagawa 224-8503, Japan.
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14
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Ohta Y, Suzuki T, Tonoike T, Hamatani S, Ohike N, Shiokawa A, Kushima M, Ota H. Two cases of intracranial germinoma showing a cell arrangement mimicking carcinoma. Diagn Cytopathol 2009. [DOI: 10.1002/dc.21183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Ohta Y, Suzuki T, Hamatani S, Shiokawa A, Kushima M, Ota H. Lobular endocervical glandular hyperplasia might become a precursor of adenocarcinoma with pyloric gland features. Pathol Res Pract 2008; 204:683-7. [DOI: 10.1016/j.prp.2008.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Revised: 10/23/2007] [Accepted: 02/19/2008] [Indexed: 11/30/2022]
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16
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Ohta Y, Hamatani S, Suzuki T, Ikeda K, Kiyokawa K, Shiokawa A, Kushima M, Ota H. Clear cell adenocarcinoma arising from a giant cystic adenomyosis: a case report with immunohistochemical analysis of laminin-5 gamma2 chain and p53 overexpression. Pathol Res Pract 2008; 204:677-82. [PMID: 18467037 DOI: 10.1016/j.prp.2008.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Revised: 02/15/2008] [Accepted: 02/19/2008] [Indexed: 11/28/2022]
Abstract
We report a case of a clear cell adenocarcinoma arising from a giant cystic adenomyosis, with immunohistochemical analysis of p53 and laminin-5 gamma2 chain overexpression. Microscopically, not only clear cell adenocarcinoma showing myometrial invasion but also single-layered clear cell adenocarcinoma cells lining the cyst wall were observed. Transition from these single-layered tumor cells to papillary proliferative lesions of various degrees was recognized. Moreover, these tumor cells were continuous with minimal atypical cells. Although the tumor cells within the uterus showed a low positive cell ratio for p53, the metastatic foci showed a remarkable p53 overexpression. Laminin-5 gamma2 chain expression was low in papillary proliferation and high in myometrial invasion and metastatic foci. The single-layered tumor cells showing non-invasive proliferation also contained laminin-5 gamma2 chain-positive cells. When non-invasive tumor cells were considered to be at an early stage in tumor progression, some tumor cells had already acquired an invasive feature. p53 overexpression was not related to expression of the laminin-5 gamma2 chain.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan.
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17
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Ohta Y, Suzuki T, Ikeda K, Saito K, Shiokawa A, Mitsuya T, Kushima M, Ota H. A case of dysgerminoma of the ovary with early carcinomatous features. Histopathology 2007; 51:269-71. [PMID: 17593215 DOI: 10.1111/j.1365-2559.2007.02742.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Kadokura M, Kamio Y, Kitami A, Nakjima H, Fujisawa H, Kushihashi T, Shiokawa A. A surgical case of pulmonary adenocarcinoma complicated with pulmonary infarction presenting as an intrapulmonary metastasis. J Cardiovasc Surg (Torino) 2007; 48:389-92. [PMID: 17505446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Pulmonary adenocarcinoma complicated with a pulmonary infarction presenting as an intrapulmonary metastasis is relatively rare. We present a case of pulmonary infarction manifesting as intrapulmonary metastases of lung cancer. A previously healthy 59-year-old woman was admitted to our hospital on May 16, 2002 for evaluation of multiple abnormal radiographic shadows in the right lower lung field. Laboratory tests showed no abnormalities except for a slight elevation of carcinoembryonic antigens. Computed tomography of the chest revealed a hilar mass lesion with parenchymal lesions in the periphery of the right lower lobe, highly suspected to be a pulmonary adenocarcinoma with intrapulmonary metastases. A diagnosis of pulmonary adenocarcinoma was confirmed by a transbronchial brushing examination. A right middle and lower bilobectomy with mediastinal lymph node dissection was needed by hilum lymphadenopathy and a lower lobe invasion of the main tumor. Histopathological findings of the resected specimens revealed poorly differentiated adenocarcinoma of the lung with N1 (#11i) disease and multiple pulmonary infarctions with coagulation necrosis and recanalization. Pulmonary infarctions are demonstrated on chest x-rays as round or polygonal in shape, and located at the periphery of the same lobe as the primary tumor. Computed tomography is more sensitive than conventional radiography in the detection of pulmonary infarction. Our case suggests that pulmonary infarction associated with lung cancer should be considered as one important cause of peripheral pulmonary nodules.
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Affiliation(s)
- M Kadokura
- Department of Respiratory Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
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19
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Inoue H, Sasajima K, Kaga M, Sugaya S, Sato Y, Wada Y, Inui M, Satodate H, Kudo SE, Kimura S, Hamatani S, Shiokawa A. Endoscopic in vivo evaluation of tissue atypia in the esophagus using a newly designed integrated endocytoscope: a pilot trial. Endoscopy 2006; 38:891-5. [PMID: 16981105 DOI: 10.1055/s-2006-944667] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS A newly designed magnifying endoscope featuring an endocytoscopy function provided by ultrahigh magnification was evaluated in a pilot study in patients with various types of benign and malignant pathology in the esophagus. PATIENTS AND METHODS Seventy-five consecutive patients were included in the study from 15 March to 21 December 2005. Twenty-nine patients with specific esophageal lesions that had been detected by regular or narrow-band imaging, or both, were further evaluated using endocytoscopy, followed by tissue biopsy or resection. During the endocytoscopic examinations, the esophageal mucosa was stained with 0.5 % methylene blue. The endocytoscopic findings were graded from 1 to 5 in an endocytoscopic atypia (ECA) classification. The final histopathological diagnoses based on biopsies or resected specimens were as follows: category 1 in the Vienna classification, n = 4; category 2, n = 6; category 3, n = 1; category 4, n = 10; and category 5, n = 7. The endocytoscopic diagnoses were compared with the histopathological diagnoses. RESULTS Clear endocytoscopic images were obtained in all cases. In definitely malignant lesions, the cell nuclei had an enlarged and irregularly arranged appearance (grade ECA 5). The positive predictive value for malignancy (grades ECA 4 and 5) was 94 %; the false-negative rate was 16.7 %, and the false-positive rate was 6.3 %. The overall accuracy of endocytoscopy for differentiating between nonmalignant tissue (categories 1 - 3 in the Vienna classification) and malignant tissue (categories 4 and 5) was 82 %. CONCLUSIONS These preliminary results suggest that incorporating endocytoscopy facilities into a standard endoscope may be helpful in characterizing tissue in a variety of esophageal lesions. The potential clinical impact of this method in relation to other gastrointestinal organs requires further study.
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Affiliation(s)
- H Inoue
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
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20
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Ogata H, Koiwa F, Takahashi J, Takahashi K, Shiokawa A, Kitanosono T, Kinugasa E, Taguchi S. Cystic β2-microglobulin amyloidoma in a patient on long-term hemodialysis. Clin Exp Nephrol 2006; 10:159-61. [PMID: 16791406 DOI: 10.1007/s10157-006-0409-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Accepted: 01/24/2006] [Indexed: 10/24/2022]
Abstract
We report a patient with beta2 microglobulin amyloidosis (beta2M) in whom cystic tumors were seen in the bilateral axillary region. The patient was a 68-year-old woman who had been on hemodialysis for more than 20 years because of IgA nephropathy. Computed tomography-guided biopsy was performed to confirm the diagnosis. Congo red staining, beta2M immunohistochemistry, and electron microscopy examination of the biopsied sample showed extended beta2M deposits in the cystic tumor. beta2M-related amyloidosis in patients with long-term dialysis commonly presents as osteoarticular disease, although a soft-tissue pseudotumor, known as amyloidoma, has been reported. This is the first report in the English-language literature of amyloidosis presenting as bilateral axillary cystic tumors.
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Affiliation(s)
- Hiroaki Ogata
- Department of Internal Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki, Yokohama 224-8503, Japan.
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21
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Kadokura M, Kamio Y, Kitami A, Nakajima H, Fujisawa H, Kushihashi T, Shiokawa A. Pulmonary adenocarcinoma complicated with pulmonary infarction presented as intrapulmonary metastases: a report of a case. Ann Thorac Cardiovasc Surg 2006; 12:189-93. [PMID: 16823332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Pulmonary adenocarcinoma complicated with a pulmonary infarction presenting as an intrapulmonary metastasis is relatively rare. We present a case of pulmonary infarction manifesting as intrapulmonary metastases of lung cancer. A previously healthy 59-year-old woman was admitted to our hospital for evaluation of abnormal shadows in the right lower lung field. Laboratory tests showed no abnormalities except for a slight elevation of carcinoembryonic antigens (CEAs). Computed tomography (CT) of the chest revealed a hilar mass lesion with parenchymal lesions in the periphery of the right lower lobe, highly suspected to be a pulmonary adenocarcinoma with intrapulmonary metastases. A diagnosis of pulmonary adenocarcinoma was confirmed by a transbronchial brushing examination. A right middle and lower bilobectomy with mediastinal lymph node dissection was due to hilar lymphadenopathy and a lower lobe invasion of the main tumor. Histopathological findings of the resected specimens revealed poorly differentiated adenocarcinoma of the lung with N1 (number 11i and 12 l) disease and multiple pulmonary infarctions with coagulation necrosis and recanalization. Our case suggests that pulmonary infarction associated with lung cancer should be considered as one important cause of peripheral pulmonary nodules.
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Affiliation(s)
- Mitsutaka Kadokura
- Division of Chest Surgery, First Department of Surgery, Showa University School of Medicine, Tokyo, Japan
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22
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Sasajima K, Kudo SE, Inoue H, Takeuchi T, Kashida H, Hidaka E, Kawachi H, Sakashita M, Tanaka J, Shiokawa A. Real-time in vivo virtual histology of colorectal lesions when using the endocytoscopy system. Gastrointest Endosc 2006; 63:1010-7. [PMID: 16733118 DOI: 10.1016/j.gie.2006.01.021] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2004] [Accepted: 01/02/2006] [Indexed: 02/07/2023]
Abstract
BACKGROUND The histological findings of GI lesions are based on light-microscopic examination of H&E-stained thin-slice specimens. Recently, a concept of optical biopsy has been advocated. A study of the observation of colorectal lesions using endocytoscopy to obtain real-time histological images in vivo during endoscopy was performed. DESIGN Prospective study. AIM To evaluate the usefulness of optical biopsy of colorectal lesions with the endocytoscopy (E-C) system. PATIENTS The subjects were 113 consecutive patients who underwent a complete colonic examination, from April 2003 to March 2004, performed by a single colonoscopist. SETTING Digestive Disease Center of Showa University Northern Yokohama Hospital. RESULTS With E-C, it was possible to observe lesions at the cellular level and evaluate cellular atypia in addition to structural atypia in vivo. The correlation was statistically significant between the endocytoscopic diagnosis and the histological diagnosis. LIMITATIONS The endocytoscope had to be touched to the target colonic glands. CONCLUSIONS It was possible to distinguish neoplastic from non-neoplastic lesions, and also possible to distinguish invasive cancer from adenoma. "Ultra-high" magnifying endoscopy, the E-C system, provides real-time histological images in vivo, which correspond well with those of H&E-stained microscopic images.
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Affiliation(s)
- Keita Sasajima
- Digestive Disease Center, Department of Pathology, Showa University Northern Yokohama Hospital, Chigasaki-chuo 35-1, Tsuzuki-ku, Yokohama 224-8503, Japan
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23
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Nagata K, Endo S, Hidaka E, Tanaka JI, Kudo SE, Shiokawa A. Laparoscopic sentinel node mapping for colorectal cancer using infrared ray laparoscopy. Anticancer Res 2006; 26:2307-11. [PMID: 16821607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Sentinel lymph node (SN) mapping by dye injection on conventional laparoscopy (CL) is often precluded by the presence of mesenteric adipose tissue in patients with colorectal cancer. SN mapping on CL was compared with that on infrared ray laparoscopy (IRL) during laparoscopy-assisted colectomy (LAC). PATIENTS AND METHODS Forty-eight patients with colorectal cancer who underwent LAC were enrolled. The tumor was identified by intra-operative fluoroscopy with marking clips. The tumor was stained intra-operatively by peritumoral injection of indocyanine green dye. SNs were observed by CL and by IRL. RESULTS In all 48 patients, dye injection and tumor localization during LAC were successful. The identification of SNs on IRL was approximately five times better than that on CL. There were no false-negative cases in T1 and T2 disease by IRL. CONCLUSION SN mapping on IRL is superior to that on CL. SN mapping by IRL might be feasible for T1 and T2 tumors.
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Affiliation(s)
- Koichi Nagata
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama 224-8503, Japan.
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24
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Shiozawa E, Takimoto M, Makino R, Adachi D, Saito B, Yamochi-Onizuka T, Yamochi T, Shimozuma J, Maeda T, Kohno Y, Kawakami K, Nakamaki T, Tomoyasu S, Shiokawa A, Ota H. Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. Leuk Res 2006; 30:859-67. [PMID: 16406514 DOI: 10.1016/j.leukres.2005.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Revised: 11/08/2005] [Accepted: 11/15/2005] [Indexed: 01/07/2023]
Abstract
PURPOSE The aim of the study was to analyze the methylation status of the promoter regions of p15 and p16 and to assess the prognostic significance of promoter hypermethylation in diffuse large B-cell lymphoma (DLBCL). EXPERIMENTAL DESIGN DLBCL was diagnosed by morphology and immunohistochemical analysis according to the World Health Organization (WHO) classification. The methylation status of CpG islands in the p15 and p16 promoters was analyzed by methylation-specific polymerase chain reaction in 49 DLBCLs. RESULTS Hypermethylation of the p15 and p16 promoters was detected in 20 (41%) and 22 (45%) of the 49 DLBCLs, respectively. Among all patients with DLBCL, there was no significant difference in the overall survival between those with hypermethylated and unmethylated p15 (P=0.442) or between those with hypermethylated and unmethylated p16 (P=0.468). Therefore, methylation was analyzed in combination with evaluation of clinical features using the international prognostic index (IPI). In the high-intermediate-risk and high-risk groups, patients with hypermethylated p16 had significantly lower survival rates than those of patients in the same risk group with unmethylated p16 (P=0.010). CONCLUSIONS Our results suggest that hypermethylation of the p16 promoter indicates a poor prognosis in high-intermediate-risk and high-risk DLBCL patients, and may be a useful marker for selection of appropriate treatment when used in conjunction with the IPI.
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Affiliation(s)
- Eisuke Shiozawa
- Second Department of Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo 142-8555, Japan.
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25
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Inoue H, Kudo SE, Shiokawa A. Technology insight: Laser-scanning confocal microscopy and endocytoscopy for cellular observation of the gastrointestinal tract. ACTA ACUST UNITED AC 2005; 2:31-7. [PMID: 16265098 DOI: 10.1038/ncpgasthep0072] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2004] [Accepted: 11/26/2004] [Indexed: 02/06/2023]
Abstract
Recent advances in endoscopic imaging technology have enabled the visualization of early-stage cancer and its precursors in the gastrointestinal tract. Chromoendoscopy, magnifying endoscopy, endoscopic optical coherent tomography, spectroscopy, and various combinations of these technologies, are all important for the recognition of small and unclear lesions. To observe cancer cells in vivo, two types of ultra-high magnifying endoscope--'laser-scanning confocal endoscopy series' and 'contact endoscopy series'--that have a maximum of more than 1,000x magnifying power have been developed. These endoscopes can generate high-quality images of both living cancer cells and normal cells in the gastrointestinal tract, with a quality comparable to that possible with conventional cytology. These novel imaging technologies may make in vivo histological diagnosis by virtual histology possible.
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Affiliation(s)
- Haruhiro Inoue
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokahama, Japan.
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26
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Kojima M, Shiokawa A, Ohike N, Ohta Y, Kato H, Iwaku K, Hayasi R, Morohoshi T. Clinical significance of nuclear morphometry at the invasive front of T1 colorectal cancer and relation to expression of VEGF-A and VEGF-C. Oncology 2005; 68:230-8. [PMID: 16015039 DOI: 10.1159/000086779] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2004] [Accepted: 07/05/2004] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To better understand the metastatic potential of T1 colorectal cancer, we investigated variations in nuclear morphometry and expression of angiogenic factors in cancer cells at the invasive front. Sixty-five patients who had undergone curative resection were entered. METHODS Nuclear shape factor, area, width, and proportion of cells with large nucleoli in all cells were determined in two high-power magnification areas at the invasive front of the tumor. We then performed the Ward method for cluster analysis. A dendrogram revealed that cases fell into two clusters: cluster A with high atypical nuclei and cluster B with low atypical nuclei. Expression of vascular endothelial growth factor-A (VEGF-A) and -C were evaluated immunohistochemically at the invasive front of the tumor. RESULTS Nuclear atypia, and VEGF-C expression were associated significantly with lymph node metastasis by univariate analysis. Nuclear atypia was independently and significantly associated with lymph node metastasis by multivariate analysis. Whereas VEGF-A expression was associated with nuclear atypia, VEGF-C expression was not showed. Nuclear atypia, strong VEGF-A or -C expressions were not associated with the depth of invasion. CONCLUSION Nuclear morphometry and expression of angiogenic factors at the invasive front are useful prognostic markers of lymph node metastasis, even cases with slight invasion.
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Affiliation(s)
- Motohiro Kojima
- First Department of Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, Japan.
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Abstract
A solid pattern of tumor cells with a clear cytoplasm is common to both ovarian clear cell carcinoma (OvCCC) and renal clear cell carcinoma (RCCC). This study examined the possible differential expression of CD10 and cytokeratins (CK7, CK20, 34betaE12, and CAM5.2) between these two types. An immunohistochemical technique using peroxidase-labeled amino acid polymers was used to test formalin-fixed and paraffin-embedded tissues. In OvCCC, 6 of 29 cases were positive for CD10, and all cases had expression of CK7, 34betaE12, and CAM5.2. In contrast, all 24 RCCC cases had CD10 and CAM5.2 immunoreactivity, but none had any staining for 34betaE12. CK7 was only expressed in nine cases. No CK20 positivity was observed in any sample from either tumor type. Localization of CD10 expression was different in OvCCC versus RCCC. Although positive staining for 34betaE12 strongly suggests OvCCC, sometimes only a few cells may be stained. Therefore, 34betaE12-negative biopsies also should be evaluated for CD10 and CK7 immunoreactivity to enable histologic and cytologic differential diagnosis.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology, Showa University Northern Yokohama Hospital, Kanagawa 227-8503, Japan
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28
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Abstract
BACKGROUND In the field of colorectal cancer, the presence of a nonstructural pattern in magnifying colonoscopy means that cancer involves the submucosal layer. Since en bloc EMR was developed, differentiation between mucosal and submucosal cancer is a critical issue in the management of gastric cancer. In this study, we evaluated the clinical meaning of a nonstructural pattern in magnifying gastroscopy. METHODS Between April 2002 and July 2003, 59 patients with 50 cancers and 11 adenomas were enrolled in this study. A cancerous lesion was subclassified into a differentiated-type group or a undifferentiated-type group according to histologic type. Before treatment, magnifying endoscopic observation was performed. After EMR or surgical intervention, resected specimens were observed by using stereomicroscopy. In both in vivo magnifying endoscopic and in vitro stereomicroscopic observations, the presence of a nonstructural pattern on the lesion was investigated. Compared with histologic findings, the clinical meaning of the presence of a nonstructural pattern on the gastric neoplastic lesion was evaluated. RESULTS A nonstructural pattern could not be confirmed in any adenomas and in 29 of 31 mucosal differentiated cancers. However, in 9 of 11 submucosal cancers, a nonstructural pattern could be identified. CONCLUSIONS The presence of a nonstructural pattern appeared to be a useful marker to not proceed with EMR of gastric cancer.
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Affiliation(s)
- Tatsuya Yoshida
- Departement of Surgery, Kudanzaka Hospital, Chiyodao-ku, Tokyo 102-0074, Japan
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29
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Abstract
It is now possible to perform microscopic imaging of living cells from both normal mucosa and malignant tissue in the gastrointestinal tract. Endocytoscopy is a catheter-type contact endoscope that has more than 1000-fold magnifying power and can pass through the working channel of the straight-view endoscope. In esophageal cells, the nucleus, cell body, and even the nucleolus were clearly distinguished with high-resolution images comparable with those of conventional cytology. This novel technology has the potential to provide histologic diagnoses during endoscopic examinations, similar to those obtained currently by conventional histology techniques.
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Affiliation(s)
- Haruhiro Inoue
- Digestive Disease Center and Department of Pathology, Showa University Northern Yokohama Hospital, Japan.
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30
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Shiozawa E, Shiokawa A, Shibata M, Nakada T, Yamochi-Onizuka T, Saito B, Takaba E, Iijima M, Takimoto M, Ota H. Autopsy case of CD4/CD8 cutaneous T-cell lymphoma presenting disseminated pagetoid reticulosis with aggressive granulomatous invasion to the lungs and pancreas. Pathol Int 2005; 55:32-9. [PMID: 15660701 DOI: 10.1111/j.1440-1827.2005.01785.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pagetoid reticulosis is a rare cutaneous T-cell lymphoma with striking epidermotropism similar to that present in Paget's disease. There are two forms of pagetoid reticulosis: localized and disseminated. Reported herein is an autopsy case of disseminated pagetoid reticulosis with CD4(-)/CD8(-) phenotype T cells and massive invasion of the lungs and pancreas. The abnormal cells in the epidermis expressed a protein derived from a rearranged T-cell receptor beta gene, and this feature was used to confirm the monoclonality of these cells by polymerase chain reaction. At present, the World Health Organization (WHO) classification system considers pagetoid reticulosis to be an indolent form of primary cutaneous T-cell lymphoma and a variant of mycosis fungoides/Sezary syndrome with prominent epidermotropism. Some differences have been observed between pagetoid reticulosis and mycosis fungoides in terms of clinical course, tumor cell phenotype, and genetic findings; and these differences are highlighted in the present case. The relation between disseminated pagetoid reticulosis, CD4(-)/CD8(-) cutaneous T-cell lymphoma, and gammadelta T-cell lymphoma, including whether pagetoid reticulosis is a variant of mycosis fungoides, remains unclear.
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Affiliation(s)
- Eisuke Shiozawa
- Second Department of Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
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31
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Kadokura M, Kamio Y, Kitami A, Nakajima H, Kushihashi T, Shiokawa A, Nonaka M. [Completion pneumonectomy 9 years after middle lobectomy for adenocarcinoma]. Kyobu Geka 2005; 58:361-5. [PMID: 15881232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Completion pneumonectomy (CP) is a difficult operation in which the surgeon must use techniques such as intrapericardial ligation of the pulmonary vessels. We report herein a case of CP for a patient with recurrent lung cancer. A 63-year-old man was admitted to our hospital for evaluation of abnormal shadows in the right lung field in October 2002. Right middle lobectomy with mediastinal lymph node dissection had been performed in February 1993. Computed tomography (CT) revealed a hilar mass in the right upper lobe the day after admission. Bronchofiberscopic cytology revealed squamous cell carcinoma. Right completion pneumonectomy was performed on suspicion of metachronous multiple lung cancers 4 days later. Histopathologically, resected specimens represented adenosquamous carcinoma similar to the prior lesion from the middle lobe, and examination revealed that the tumor represented a recurrence following middle lobectomy. The patient remains well as of 19 months postoperatively.
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Affiliation(s)
- Mitsutaka Kadokura
- Division of Chest Surgery, Department of Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
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32
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Abstract
BACKGROUND Cytologic diagnosis of adenoma malignum is not easy. A case of adenoma malignum was diagnosed cytologically. CASE A 45-year-old woman was suspected of having adenoma malignum. Her chief complaint was a mucoid cervical discharge. Transvaginal ultrasound examination showed multiple cervical cysts, and peculiar clusters of cervical columnar cells showing a channellike structure were observed cytologically. Cytologic analysis detected tumor cells with increased euchromatin and stretched nuclear membranes with distinct eosinophilic nucleoli. Intranuclear cytoplasmic inclusion bodies and lobate or budlike nuclei were also observed. Immunohistochemically, both HIK-1083 and carcinoembryonic antigen (CEA) were positive in the histologic specimens, although only a few glands were positive for CEA. On 3-dimensional reconstruction of normal cervical tissue, glands showing similar calibers and straight lines also had a "weeping willow-shaped" growing pattern. In the adenoma malignum there were large and small glands showing a cumuliform pattern, and cystic dilation with discontinuity and fusion of glands could be seen. CONCLUSION The nuclear findings mentioned above were thought to be diagnostic characteristics of adenoma malignum. Three-dimensional reconstruction seems to be a method that can aid in the diagnosis of adenoma malignum.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology, Northern Yokohama Hospital, Showa University, Kanagawa, Japan
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33
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Wakamura K, Kadokura M, Kamio Y, Kitami A, Nakajima H, Kushihashi T, Shiokawa A. [Aneurysmal bone cyst arising in the rib; report of a case]. Kyobu Geka 2005; 58:82-5. [PMID: 15678973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We experienced with a relatively rare case of an aneurysmal bone cyst (ABC) arising in the left rib. A 34-year-old female, had experienced chest discomfort on the left anterior side and pain for 1 year. A chest X-ray suggested a left chest wall tumor involving the ribs. Computed tomography (CT), magnetic resonance imaging (MRI) and a bone scintigram revealed an expansive tumor of the anterior portion of the left 4th rib involving the 3rd and 5th rib with "blow out appearance" and "fluid-fluid level". Wide excision of the tumor and adjacent muscle tissue was performed with an antero-axillary incision. Chest wall reconstruction was performed with prolene mesh (140 x 90 mm). The resected specimen showed an encapsulated bony mass (75 x 60 x 35 mm) with multiple blood-filled spaces. Histopathological diagnosis was an ABC originating in the left 4th rib. She has been doing well with no evidence of recurrence 12 months postoperatively.
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Affiliation(s)
- Kunihiko Wakamura
- Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
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Abstract
We report a case of adenomyoma of the uterus that was cytologically difficult to distinguish from leiomyosarcoma. Examination of a uterine cervical smear revealed numerous spindle cells that were present in cell clusters or as isolated cells. These cells contained nuclei that were oval-shaped/elongated with nucleoli and delicate wispy cytoplasm. Large and bizarre nuclei were also identified. Based on these cytological findings leiomyosarcoma was considered: however, this diagnosis remained uncertain because of the absence of mitosis and/or necrotic substance. Histologically, we recognized leiomyomatous smooth muscle cells growing in a solid pattern and intermingled with endometrial-type glands. Moreover, bizarre smooth muscle cells were observed in the surface layer of the tumor. These observations suggest that for a diagnosis of uterine leiomyosarcoma the presence of mitosis and/or necrosis is important in addition to nuclear atypia.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology, Showa University Northern Yokohama Hospital, Kanagawa, Japan.
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35
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Wada Y, Kadokura M, Kamio Y, Kitami A, Nakajima H, Inoue H, Shiokawa A. [Esophageal gastrointestinal stromal tumor surrounding the middle esophagus with dysphagia for 8 years; report of a case]. Kyobu Geka 2004; 57:1250-3. [PMID: 15609668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
In September 2002, a 24-year-old woman complaining dysphagia with an abnormal shadow in a chest X-ray was admitted to our hospital. Endoscopic ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) showed a hypo-echoic, low-density mass surrounding the middle esophagus. Bronchofiberscopy and gastrofiberscopy showed compression from the outside of bronchus and esophagus. No ulcer formation was found. Transbronchial aspiration biopsy and esophageal biopsy showed no malignancy. After 14 cm thoractomy, extirpation of the tumor was performed. The solid tumor was 10.5 x 3.0 x 2.5 cm in dimension, and the cut surface of the tumor was light yellow. Immunohistochemically, the tumor cells were positive for c-kit, SMA, CD34, and S-100. Histopathologically, the tumor was diagnosed as gastrointestinal stromal tumor (GIST), combined smooth muscle-neural type. A postoperative upper gastrointestinal tract barium study showed no stenosis. She is doing well without evidence of tumor recurrence at 12 months postoperatively. Although GIST is the most common mensenchymal tumor of the human gastrointestinal tract, this case is reported because the GIST arising from the middle esophagus is very rare.
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Affiliation(s)
- Yoshiki Wada
- Department of Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
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36
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Satodate H, Inoue H, Fukami N, Shiokawa A, Kudo SE. Squamous reepithelialization after circumferential endoscopic mucosal resection of superficial carcinoma arising in Barrett's esophagus. Endoscopy 2004; 36:909-12. [PMID: 15452789 DOI: 10.1055/s-2004-825830] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Recent reports on the results of endoscopic ablation of Barrett's mucosa have been promising, particularly when total mucosal ablation is coupled with aggressive acid-suppression treatment using high-dose proton-pump inhibitor therapy. There is also a considerable literature on reepithelialization after ablative treatments in Barrett's esophagus. This report describes a case of multifocal superficial adenocarcinoma arising in Barrett's mucosa that was successfully treated with total circumferential endoscopic mucosal resection, with a subsequent follow-up of more than 2 years. This is the first report describing the process of squamous reepithelialization after endoscopic mucosal resection in Barrett's esophagus.
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Affiliation(s)
- H Satodate
- Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama 224-8503, Japan.
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37
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Kojima M, Kunimura T, Inagaki T, Hayashi R, Morohoshi T, Shiokawa A, Ohta Y, Ohike N. A fibrolamellar carcinoma of the liver with a marked solid component. J Gastroenterol 2004; 39:905-7. [PMID: 15565414 DOI: 10.1007/s00535-003-1410-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2003] [Accepted: 12/19/2003] [Indexed: 02/04/2023]
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Kojima M, Shiokawa A, Ohike N, Tamegai Y, Kato H, Morohoshi T. Relation of E-cadherin and beta-catenin expression to pit pattern in colorectal cancer. Oncol Rep 2004; 12:533-8. [PMID: 15289833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
To investigate the usefulness of pit pattern to estimate depth of submucosal invasion and the mechanism of change in pit pattern by tumor character in colorectal cancer, we investigated the relation between pit pattern and immuno-histochemical E-cadherin and beta-catenin expression. Fifty-seven colorectal tumors including 37 submucosal invasive carcinomas, 10 high-grade adenomas and 10 cases of advanced carcinomas invading into the muscularis propria were divided into a non-VN and VN group according to a modification of the Kudo classification system. In addition, distance between the invasive front and muscularis mucosae was measured, and histological and immunohistochemical expression of E-cadherin and beta-catenin in the superficial portion and invasive portion were examined. Many tumors with deep invasion were classified in the VN group. Among the submucosal invasive carcinomas in the VN group, there was a significantly higher number with deep invasion than with slight invasion. All submucosal invasive cancers with lymphatic invasion also had deep submucosal invasion. Immunohistochemical analysis revealed significant loss of normal membrano-cytoplasmic beta-catenin expression in the superficial area of cancers in the VN group. Submucosal carcinoma with deep invasion also had significant loss of membrano-cytoplasmic expression of beta-catenin in the superficial area. Pit pattern is useful not only to predict tumor character but also to estimate depth of invasion. Change in pit pattern may be associated with abnormality of beta-catenin expression.
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Affiliation(s)
- Motohiro Kojima
- First Department of Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
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Kojima M, Shiokawa A, Ohike N, Tamegai Y, Kato H, Morohoshi T. Relation of E-cadherin and β-catenin expression to pit pattern in colorectal cancer. Oncol Rep 2004. [DOI: 10.3892/or.12.3.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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40
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Ohike N, Nakashima M, Shiokawa A, Morohoshi T, Maass N, Miki Y, Nagasaki K. Prognostic significance of tumor suppressor gene maspin in pulmonary adenocarcinoma. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- N. Ohike
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
| | - M. Nakashima
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
| | - A. Shiokawa
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
| | - T. Morohoshi
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
| | - N. Maass
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
| | - Y. Miki
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
| | - K. Nagasaki
- Showa University Northern Yokohama Hospital, Yokohama-shi, Kanagawa, Japan; Showa University, First Department of Pathology, Shinagawa-ku, Tokyo, Japan; University of Kiel, Dept of Obstetrics & Gynecology, Kiel, Germany; Genome Center, Cancer Institute, Tokyo, Japan; Gene Expression, Genome Center, Cancer Institute, Toshima-ku, Tokyo, Japan
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41
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Inoue H, Kazawa T, Sato Y, Satodate H, Sasajima K, Kudo SE, Shiokawa A. In vivo observation of living cancer cells in the esophagus, stomach, and colon using catheter-type contact endoscope, "Endo-Cytoscopy system". Gastrointest Endosc Clin N Am 2004; 14:589-94, x-xi. [PMID: 15261204 DOI: 10.1016/j.giec.2004.03.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A catheter-type endomicroscope has been developed with a maximum magnifying power of 1100 times. Living cancer cells in the esophagus, stomach, and colon were successfully observed in high-resolution images. The "Endo-Cytoscopy system" (prototype,Olympus Optical, Co., Tokyo, Japan) is a catheter-based probe capable of passage through the accessory channel of the endoscope(GIF-1T, Olympus). Methylene blue solution was used for vital staining of the in vivo gastrointestinal mucosa. Living cells in both normal mucosa and malignant tissue were clearly demonstrated in luminal organs. In particular, the nucleus, cell body, and nucleolus were clearly demonstrated with high-quality images similar to those of conventional cytology. This novel technology has the potential to provide an in vivo histologic diagnosis via "optical biopsy" and virtual histology.
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Affiliation(s)
- Haruhiro Inoue
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Chigasaki Chuo 35-1, Tsuzuki-ku, Yokohama 224-8503, Japan.
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42
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Abstract
Recent advances in endoscopic imaging technology have enabled the visualization of cellular-level microstructures of early-stage cancer and its precursors. Chromoendoscopy, magnifying endoscopy, endoscopic optical coherent tomography (EOCT) spectroscopy, and various combinations of these technologies, are all important for the recognition of small and unclear lesions. In order to observe cancer cells in vivo two types of ultra-high magnifying endoscope--'laser-scanning confocal laser-scanning endoscopy series' and 'contact endoscopy series'--that have a maximum of >1,000 times magnifying power have been developed. The use of these endoscopes has allowed the generation of high quality images of both living cancer cells and normal cells in the gastrointestinal tract. In particular, clear images of cells and their nuclei, equivalent to the high quality that is possible with conventional cytology, have been produced. These novel imaging technologies may make in vivo histological diagnosis by virtual histology possible.
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Affiliation(s)
- Haruhiro Inoue
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
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43
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Sakashita M, Inoue H, Kashida H, Tanaka J, Cho JY, Satodate H, Hidaka E, Yoshida T, Fukami N, Tamegai Y, Shiokawa A, Kudo S. Virtual histology of colorectal lesions using laser-scanning confocal microscopy. Endoscopy 2003; 35:1033-8. [PMID: 14648417 DOI: 10.1055/s-2003-44595] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Histological examination of gastrointestinal lesions is currently based on light-microscopic examination of thin-slice specimens, with hematoxylin and eosin staining. A study of the use of laser-scanning confocal microscopy (LCM) to obtain immediate microscopic images of untreated specimens for examining colorectal lesions was carried out. A probe-type LCM prototype endomicroscope that can be passed through the working channel of an endoscope has also been developed. MATERIALS AND METHODS The study materials consisted of colorectal lesions resected either endoscopically or surgically at Showa University Northern Yokohama Hospital. One hundred untreated specimens were examined using LCM. The histopathological findings in the lesions were seven cases of normal colonic mucosa, five hyperplastic polyps, 68 adenomas with low-grade dysplasia, 10 adenomas with high-grade dysplasia, and 10 adenocarcinomas. An argon laser beam with a wavelength of 488 nm was used for the LCM study. Observation of the resected normal colonic mucosa (in vitro) and the rectal mucosa of a healthy volunteer (in vivo) was possible using the endomicroscope. The LCM images for each specimen were compared with the hematoxylin-eosin-stained histopathological cross-sections. RESULTS The LCM images corresponded well with the conventional hematoxylin-eosin light-microscopic images. The nuclei were not visualized in normal mucosa or hyperplastic polyps. In adenomas with high-grade dysplasia and carcinomas, nuclei were more often visible than in adenomas with low-grade dysplasia. The rate of visualization of nuclei was significantly different ( P < 0.01) between these two groups (60.0 % vs. 10.3 %). In LCM images using endomicroscope, it was possible to recognize the orifices of the colonic glands and goblet cells both in vitro and in vivo. CONCLUSIONS Laser-scanning confocal microscopy provides immediate images that correspond well with those of hematoxylin-eosin staining. An improved probe-type LCM endomicroscope is being developed which should provide better histological images of colorectal lesions in vivo.
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Affiliation(s)
- M Sakashita
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
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Inoue H, Cho JY, Satodate H, Sakashita M, Hidaka E, Fukami S, Kazawa T, Yoshida T, Shiokawa A, Kudo S. Development of virtual histology and virtual biopsy using laser-scanning confocal microscopy. Scand J Gastroenterol 2003:37-9. [PMID: 12797680 DOI: 10.1080/00855910310001485] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The aim of this project is to acquire a direct image of histology from in vivo gastrointestinal mucosa. In other words, the task of 'endo-microscope' is to observe the cellular architecture of tissue in vivo during routine endoscopic examination. As the first step to completing this study, resected fresh specimens from the oesophagus. stomach and colon were examined by laser-scanning confocal microscopy (LCM) (Fluoview, Olympus, Tokyo). Fresh untreated mucosal specimens obtained by endoscopic pinch biopsy, polypectomy or endoscopic mucosal resection were collected and placed in normal saline and examined by LCM, collecting the reflective light of a 488-nm wavelength argon laser beam. As the second step, a probe-type LCM 'endo-microscope' was designed and applied to observe the human oral-cavity mucosa. The probe has 4.5-mm outer diameter and 20-cm length, which enables easy access to oral cavity mucosa. The estimated special resolution of the probe is 1-5 microm. A real-time microscopic image directly from ex vivo fresh specimens was acquired. The acquired LCM images corresponded well with the conventional H-E light microscopic images. Cell wall, nucleus and cytoplasm were simultaneously visualized by LCM scanning. This novel method enables serial imaginary microscopic sections on fresh specimens. In addition, a probe-type LCM 'endo-microscope' was designed and was applied to observe human oral cavity mucosa. Virtual histological images from the living oral squamous cell were successfully obtained. LCM images from ex vivo fresh specimens demonstrated the features of the H-E staining histological image. In the next step to accomplish our project, we developed a LCM probe with 4.5-mm outer diameter to obtain a virtual image of human oral cavity mucosa.
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Affiliation(s)
- H Inoue
- Digestive Disease Center, Dept. of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan
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45
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Satodate H, Inoue H, Yoshida T, Usui S, Iwashita M, Fukami N, Shiokawa A, Kudo SE. Circumferential EMR of carcinoma arising in Barrett's esophagus: case report. Gastrointest Endosc 2003; 58:288-92. [PMID: 12872107 DOI: 10.1067/mge.2003.361] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Hitoshi Satodate
- Digestive Disease Center, Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama, Japan
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Abstract
A case of low-grade endometrial stromal sarcoma with extensive epithelial-like element (ELE) is reported. This tumor was composed of classical endometrial stromal sarcoma (CESS) showing diffuse proliferation, and ELE occupying approximately 72% of the tumor mass. On immunohistochemistry, ELE was negative for sex-cord differentiation markers, and was positive for myogenic markers used in our investigation, and had a particularly prominent positivity for alpha-smooth muscle actin within the ELE. Therefore, it was considered that ELE showed no true sex cord feature, but smooth muscle differentiation. Moreover, ELE was also positive for CD10, suggesting that it was derived from CESS. It has been reported that there is a distinct clinical behavior between endometrial stromal tumors with abundant ELE and those with limited ELE. In the present case, the Ki-67 labeling index was markedly higher in CESS than in ELE. Therefore, a difference in cell proliferative activity between ELE and CESS might underlie a different clinical prognosis.
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Affiliation(s)
- Yoshiki Ohta
- Department of Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, Kanagawa 224-8503, Japan.
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47
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Matsuyama TA, Inoue S, Kobayashi Y, Saito T, Tanno K, Sakai T, Otsuka T, Shiokawa A, Katagiri T, Ota H. Histopathologic exploration of intra-hisian conduction disturbances. J Cardiovasc Electrophysiol 2002; 13:257-64. [PMID: 11942594 DOI: 10.1046/j.1540-8167.2002.00257.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The length of the His bundle and the precise location of injury responsible for split His potentials have not been fully established in patients with intra-Hisian block. We conducted an autopsy study comparing histologic findings in intra-Hisian block versus control hearts. METHODS AND RESULTS We studied hearts from 4 intra-Hisian block patients (age 66 to 93 years, mean 79.5) and hearts from 14 patients without AV conduction abnormalities (control). All intra-Hisian block patients underwent electrophysiologic evaluation; 3 patients demonstrated intra-Hisian block and 1 showed no His potential. Autopsies were performed when each patient died. After the heart was fixed in formaldehyde, the AV septal junctional area was removed en bloc and serially sectioned into 7-microm thick slices. For study purposes, we considered the three segments of the His bundle separately: the penetrating bundle, the nonbranching bundle, and the branching bundle. The actual length of each segment was calculated from the number of respective serial sections, and the lesion was reconstructed within the conduction axis. Intra-Hisian block hearts were heavier than control hearts (mean weight 389 vs 301 g; P < 0.05). The lesion was situated in the nonbranching bundle in 3 hearts and in the penetrating bundle in 1 heart. Mean compact node length was 3.8 mm in intra-Hisian block hearts and 3.3 mm in control hearts. The penetrating bundle was 2.1 and 2.1 mm, the nonbranching bundle was 3.5 and 1.9 mm, and the branching bundle was 4.5 and 4.6 mm in intra-Hisian block and control hearts, respectively. CONCLUSION Most lesions were observed in the nonbranching bundle adjacent to the junction between the central fibrous body and ventricular septum. This segment was longer in intra-Hisian block hearts than in control hearts.
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Affiliation(s)
- Taka-Aki Matsuyama
- Second Department of Pathology, Showa University School of Medicine, Tokyo, Japan.
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Kato S, Shiokawa A, Fukushima H, Numaga J, Kitano S, Hori S, Kaiya T, Oshika T. Glycemic control and lens transparency in patients with type 1 diabetes mellitus. Am J Ophthalmol 2001; 131:301-4. [PMID: 11239860 DOI: 10.1016/s0002-9394(00)00804-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To assess quantitatively the cumulative effect of hyperglycemia on lens transparency in patients with juvenile type 1 diabetes mellitus. METHODS Subjects were 30 patients (30 eyes) with type 1 diabetes mellitus who had well-documented records on the duration of diabetes mellitus and condition of glycemic control from the onset. They were 35 years of age or younger (mean, 26.0 years), had a history of type 1 diabetes mellitus at least 5 years (mean, 8.4 years), had corrected visual acuity of 20/20 or better, and showed no clinically apparent cataract on slit-lamp examination. Twenty-one eyes of 21 subjects served as age-matched normal controls. They were 35 years of age or younger (mean, 25.7 years), had no diabetes mellitus, had corrected visual acuity of 20/20 or better, and showed no signs of cataract on slit-lamp examination. The degree of lens opacity was quantified using the anterior eye segment analysis system based on the Scheimpflug principle. An index was created to represent the cumulative effect of long-term glycemic control (hyperglycemic accumulation) by multiplying the average hemoglobin A(1c) value and the number of months from the onset. RESULTS The patients with diabetes mellitus exhibited significantly greater degree of lens opacity than the normal controls (P =.017, Mann-Whitney U-test). Among the patients with diabetes mellitus, the lens opacity was greater in eyes with retinopathy than those without retinopathy (P =.011). Multiple regression analysis revealed that only the index of hyperglycemic accumulation significantly correlated with the degree of lens opacity (P =.042). CONCLUSION Accumulated effect of hyperglycemia is related to the lens transparency in patients with diabetes.
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Affiliation(s)
- S Kato
- Department of Ophthalmology, School of Medicine, University of Tokyo, 3-28-5 Mejirodai, Bunkyo-ku, Tokyo, 112-8688 Japan.
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Matsuyama T, Inoue S, Kobayashi Y, Saito T, Tanno K, Sakai T, Otsuka T, Shiokawa A, Ota H, Yoshida H, Katagiri T. Histopathological exploration of intra-hisian conduction disturbances. Europace 2001. [DOI: 10.1016/eupace/2.supplement_1.a101-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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50
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Gotoh N, Morita H, Ishikawa H, Shiokawa A, Takimoto M, Yoshimura H. [A case of the old injured vena cava superior found during the operation of lung cancer]. Kyobu Geka 1997; 50:811-5. [PMID: 9259148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We operated a 78-year-old male with lung cancer and unstable angina pectoris. During the operation of right upper lobe, a mass, with size of 2 cm in diameter was detected on the right postero-lateral side of the superior vena cava, and was resected. Postoperative pathological examination suggested that the mass resulted from an injury made by a Swan-Ganz catheter used before operation. Thus, as insertion of a Swan-Ganz catheter through the right subclavian vein may involve risk, so we concluded that the right internal jugular vein or femoral vein may be preferable as a route of first choice for insertion.
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Affiliation(s)
- N Gotoh
- Department of Thoracic Surgery, Kawasaki Kyodo Hospital, Japan
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