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Kadoya M, Suganuma N, Matsubara Y, Takase H, Kumagai E, Toda S, Yamazaki H, Masudo K, Fujii S, Saito A. Selpercatinib for treating recurrent mixed medullary and follicular cell-derived thyroid carcinoma: a case report. Surg Case Rep 2024; 10:92. [PMID: 38647958 PMCID: PMC11035533 DOI: 10.1186/s40792-024-01898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Mixed medullary and follicular cell-derived thyroid carcinoma (MMFCC) is characterized by the coexistence of follicular and C cell-derived tumour cell populations within the same lesion. Due to its rarity, its etiology and clinical course remain unclear, and treatment for advanced or recurrent cases has not been established. CASE PRESENTATION We report a case of MMFCC treated with selpercatinib. The patient was a 69-year-old male presenting with tumors in the right thyroid lobe and in the upper mediastinum. Fine-needle aspiration (FNA) cytology of the right thyroid lobe tumor revealed a medullary carcinoma; germline RET mutations were not detected. After resection of the right thyroid lobe with central node dissection, rapid intraoperative diagnosis of the mediastinal mass confirmed malignancy, leading to total thyroidectomy with excision of the upper mediastinal tumor. Histologically, the tumor in the right thyroid lobe and the pretracheal lymph node revealed a mixture of medullary and follicular carcinoma components, diagnosed as MMFCC. The mediastinal lymph node exhibited only medullary carcinoma components. At 11 months postoperatively, computed tomography scans showed enlargement of the right supraclavicular and upper mediastinal lymph nodes. FNA cytology of the right supraclavicular lymph node suggested the recurrence of medullary thyroid carcinoma. The gene panel testing (The Oncomine Dx Target Test Multi-CDx system®, Thermo Fisher SCIENTIFIC) of metastatic lymph node revealed RET somatic mutation (M918T). Treatment with selpercatinib was initiated, and both the cervical and mediastinal lymph nodes showed a reduction in size. CONCLUSIONS We report a rare case of selpercatinib use for MMFCC. Since RET mutations may occur frequently in MMFCC, selpercatinib could be effective in treating MMFCC.
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Affiliation(s)
- Mei Kadoya
- Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Nobuyasu Suganuma
- Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Yuka Matsubara
- Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Hiroki Takase
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Eita Kumagai
- Department of Pathology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Soji Toda
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Haruhiko Yamazaki
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Katsuhiko Masudo
- Department of Endocrine Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Satoshi Fujii
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Aya Saito
- Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
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Okubo Y, Toda S, Kadoya M, Sato S, Yoshioka E, Hasegawa C, Ono K, Washimi K, Yokose T, Miyagi Y, Masudo K, Iwasaki H, Hayashi H. Clinicopathological analysis of thyroid carcinomas with the RET and NTRK fusion genes: characterization for genetic analysis. Virchows Arch 2024:10.1007/s00428-024-03777-w. [PMID: 38472412 DOI: 10.1007/s00428-024-03777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024]
Abstract
Thyroid carcinomas exhibit various genetic alterations, including the RET and NTRK fusion genes that are targets for molecular therapies. Thus, detecting fusion genes is crucial for devising effective treatment plans. This study characterized the pathological findings associated with these genes to identify the specimens suitable for genetic analysis. Thyroid carcinoma cases positive for the fusion genes were analyzed using the Oncomine Dx Target Test. Clinicopathological data were collected and assessed. Among the 74 patients tested, 8 had RET and 1 had NTRK3 fusion gene. Specifically, of the RET fusion gene cases, 6 exhibited "BRAF-like" atypia and 2 showed "RAS-like" atypia, while the single case with an NTRK3 fusion gene presented "RAS-like" atypia. Apart from one poorly differentiated thyroid carcinoma, most cases involved papillary thyroid carcinomas (PTCs). Primary tumors showed varied structural patterns and exhibited a high proportion of non-papillary structures. Dysmorphic clear cells were frequently observed. BRAF V600E immunoreactivity was negative in all cases. Interestingly, some cases exhibited similarities to diffuse sclerosing variant of PTC characteristics. While calcification in lymph node metastases was mild, primary tumors typically required hydrochloric acid-based decalcification for tissue preparation. This study highlights the benefits of combining morphological and immunohistochemical analyses for gene detection and posits that lymph node metastases are more suitable for genetic analysis owing to their mild calcification. Our results emphasize the importance of accurate sample processing in diagnosing and treating thyroid carcinomas.
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Affiliation(s)
- Yoichiro Okubo
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan.
| | - Soji Toda
- Department of Endocrine Surgery, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Mei Kadoya
- Department of Endocrine Surgery, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Shinya Sato
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2Asahi-Ku, NakaoYokohama, Kanagawa, 241-8515, Japan
| | - Emi Yoshioka
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Chie Hasegawa
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Kyoko Ono
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Kota Washimi
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Yohei Miyagi
- Department of Pathology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2Asahi-Ku, NakaoYokohama, Kanagawa, 241-8515, Japan
| | - Katsuhiko Masudo
- Department of Endocrine Surgery, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Hiroyuki Iwasaki
- Department of Endocrine Surgery, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
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Toda S, Iwasaki H, Okubo Y, Hayashi H, Kadoya M, Takahashi H, Yokose T, Hiroshima Y, Masudo K. The frequency of mutations in advanced thyroid cancer in Japan: a single-center study. Endocr J 2024; 71:31-37. [PMID: 38044137 DOI: 10.1507/endocrj.ej23-0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
We analyzed the outcomes of genetic testing to study the frequency of mutations in advanced thyroid cancer in Japan. Patients (n = 96) with unresectable or metastatic thyroid carcinoma were included for retrospective chart review. Results of gene panel testing, which was performed between May 2020 and April 2023, were analyzed. The median age of the patients was 73.5 years (range, 17-88); 59 were women, and 39 were men. Overall, 17 patients had anaplastic thyroid carcinoma (ATC), 68 had papillary thyroid carcinoma (PTC), 7 had follicular thyroid carcinoma, and 6 had poorly differentiated thyroid carcinoma (PDTC). Of the 81 patients with differentiated thyroid carcinoma (DTC) and PDTC, 88.9% were radioactive iodine-refractory, and 32.7% of all cases had previously been treated with multiple kinase inhibitors. Of ATC cases, 52.9% had BRAF mutations, and 5.9% had RET fusion. Of PTC cases, 83.1% had BRAF mutations, 9.2% had RET fusion, and 1.5% had NTRK fusion. One case each of ATC and PTC had a tumor mutation burden of ≥10. ATC cases had a significantly higher prevalence of TP53 alterations than the other cases (82.3% vs. 11.8%), whereas the frequencies of TERT promoter mutations were 88.2% in ATC cases and 64.7% in the other cases, albeit without a significant difference. In conclusion, 58.8% of ATC, 93.8% of PTC, and 42.9% of PDTC had genetic alterations linked to therapeutic agents. Active gene panel testing is required to increase treatment options.
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Affiliation(s)
- Soji Toda
- Department of Endocrine Surgery, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Hiroyuki Iwasaki
- Department of Endocrine Surgery, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Yoichiro Okubo
- Department of Pathology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, Kanagawa 221-0855, Japan
| | - Mei Kadoya
- Department of Endocrine Surgery, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Kanagawa 232-0024, Japan
| | - Hiroyuki Takahashi
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Yukihiko Hiroshima
- Department of Cancer Genome Medicine, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
- Research Institute Division of Advanced Cancer Therapeutics, Kanagawa Cancer Center Research Institute, Kanagawa, 241-8515, Japan
| | - Katsuhiko Masudo
- Department of Endocrine Surgery, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
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Toda S, Yamamoto Y, Ookubo Y, Hayashi H, Tsunematsu T, Kadoya M, Masudo K, Iwasaki H. Lenvatinib and selpercatinib successfully treated RET fusion gene-positive papillary thyroid carcinoma cardiac metastases: a case report. Gland Surg 2023; 12:1441-1448. [PMID: 38021198 PMCID: PMC10660185 DOI: 10.21037/gs-23-252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/14/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023]
Abstract
Background Cardiac metastasis from thyroid cancer is rare and has an extremely poor prognosis. Although some patients who undergo heart surgery survive, the therapeutic effectiveness of systemic therapy is limited. Case Description A 53-year-old woman with a history of papillary thyroid carcinoma (PTC) presented with cough and right chest discomfort. She underwent total thyroidectomy, followed by three rounds of radioactive iodine therapy, to treat pulmonary metastasis. Metastases to the lung, chest wall, liver, heart, and lymph nodes were observed on computed tomography. Core needle biopsy of the tumor in the right chest wall revealed the recurrence of PTC. Cardiac metastasis was discovered by echocardiography and cardiac magnetic resonance imaging, and blood test indicated a thyroglobulin level of 851 ng/mL. Based on the presence of cardiac metastasis and strong clinical symptoms, the condition was assumed to be fatal, and lenvatinib was started right away. Three weeks after starting lenvatinib, every metastatic lesion shrank. Once the ERC1-RET fusion gene was identified, we switched to selpercatinib therapy. Ten weeks after starting selpercatinib, every tumor shrank and blood thyroglobulin dropped to 68.1 ng/mL. Initial symptoms such as cough and right chest pain improved. Lenvatinib- and selpercatinib-related adverse effects can be managed with supportive care. Conclusions To the best of our knowledge, this is the first case of successful systemic therapy for cardiac metastasis from PTC. Conventionally, cardiac surgery is the main treatment for cardiac metastasis, but now systemic therapy is also an important alternative.
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Affiliation(s)
- Soji Toda
- Department of Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Yayoi Yamamoto
- Department of Diagnostic and Interventional Radiology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoichiro Ookubo
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan
| | | | - Mei Kadoya
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsuhiko Masudo
- Department of Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Iwasaki
- Department of Endocrine Surgery, Kanagawa Cancer Center, Yokohama, Japan
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Toda S, Kadoya M, Matsui A, Murayama D, Iwasaki H. Hyperthyroidism due to thyrotropin receptor antibody stimulation of metastatic thyroid carcinoma during lenvatinib treatment: a case report. Ann Palliat Med 2021; 11:3571-3577. [DOI: 10.21037/apm-22-276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/08/2022] [Indexed: 11/06/2022]
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Kadoya M, Taira K, Ikenaga C, Uchio N, Kubota A, Mimori T, Kaida K, Tsuji S, Shimizu J. Evaluation for the clinical significance of cancer-association in anti-SRP antibody-positive myopathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kaida K, Kadoya M, Koike H, Iijima M, Takazaki H, Ogata H, Moriguchi K, Shimizu J, Nagata E, Takizawa S, Chiba A, Yamasaki R, Kira J, Sobue G, Ikewaki K. Diagnostic utility of ELISA for anti-neurofascin 155 antibodies in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3535] [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: 11/16/2022]
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Koike H, Kadoya M, Kaida K, Nishi R, Ikeda S, Kawagashira Y, Iijima M, Kato D, Ogata H, Yamasaki R, Matsukawa N, Kira J, Katsuno M, Sobue G. Paranodal axo-glial detachment in chronic inflammatory demyelinating polyneuropathy with anti-neurofascin-155 and anti-contactin-1 antibodies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.226] [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: 11/26/2022]
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Unuma A, Kadoya M, Hida A, Taira K, Uchio N, Ikenaga C, Kubota A, Tsuji S, Shimizu J. Analysis of the risk of cancer among myositis patients without anti-TIF1-γ OR –HMGCR antibodies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.765] [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: 10/18/2022]
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Ogata H, Yamasaki R, Matsushita T, Kadoya M, Kaida K, Matsui M, Kuwabara S, Kusunoki S, Kira J. Proposal of diagnostic criteria for anti-neurofascin 155 antibody-associated neuropathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.374] [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]
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Koiwai K, Shinoda A, Ozawa T, Matsushita H, Fukazawa A, Sakai K, Kadoya M. EP-1811: Aligning the chest with a couch improved reproducibility in radiotherapy for head and neck cancers. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32174-6] [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: 11/17/2022]
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Uchiyama S, Itsubo T, Nakamura K, Fujinaga Y, Sato N, Imaeda T, Kadoya M, Kato H. Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time. Bone Joint J 2013; 95-B:1544-50. [PMID: 24151277 DOI: 10.1302/0301-620x.95b11.31652] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This multicentre prospective clinical trial aimed to determine whether early administration of alendronate (ALN) delays fracture healing after surgical treatment of fractures of the distal radius. The study population comprised 80 patients (four men and 76 women) with a mean age of 70 years (52 to 86) with acute fragility fractures of the distal radius requiring open reduction and internal fixation with a volar locking plate and screws. Two groups of 40 patients each were randomly allocated either to receive once weekly oral ALN administration (35 mg) within a few days after surgery and continued for six months, or oral ALN administration delayed until four months after surgery. Postero-anterior and lateral radiographs of the affected wrist were taken monthly for six months after surgery. No differences between groups was observed with regard to gender (p = 1.0), age (p = 0.916), fracture classification (p = 0.274) or bone mineral density measured at the spine (p = 0.714). The radiographs were assessed by three independent assessors. There were no significant differences in the mean time to complete cortical bridging observed between the ALN group (3.5 months (SE 0.16)) and the no-ALN group (3.1 months (SE 0.15)) (p = 0.068). All the fractures healed in the both groups by the last follow-up. Improvement of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, grip strength, wrist range of movement, and tenderness over the fracture site did not differ between the groups over the six-month period. Based on our results, early administration of ALN after surgery for distal radius fracture did not appear to delay fracture healing times either radiologically or clinically.
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Affiliation(s)
- S Uchiyama
- Shinshu University School of Medicine, Department of Orthopaedic Surgery, Shinshu Society for Surgery of the Upper Extremities, Asahi 3-1-1, Matsumoto 390-8621, Japan
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Watanabe T, Maruyama M, Ito T, Fujinaga Y, Ozaki Y, Maruyama M, Kodama R, Muraki T, Hamano H, Arakura N, Kadoya M, Suzuki S, Komatsu M, Shimojo H, Notohara K, Uchida M, Kawa S. Clinical features of a new disease concept, IgG4-related thyroiditis. Scand J Rheumatol 2013; 42:325-30. [PMID: 23496326 DOI: 10.3109/03009742.2012.761281] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Immunoglobulin (Ig)G4-related disease is a recently proposed systemic disorder that includes autoimmune pancreatitis (AIP), Mikulicz's disease, and various other organ lesions. In the present retrospective study, we examined whether thyroid lesions should also be included in IgG4-related disease (Ig4-RD) under the new term IgG4-related thyroiditis. METHOD We enrolled 114 patients with Ig4-RD, including 92 patients with AIP, 15 patients with Mikulicz's disease, and seven patients with IgG4-related cholangitis, and analysed clinical findings, function, serum values of activity markers, computed tomography (CT) images, and histology of the thyroid gland. RESULTS Among the 22 patients (19%) in our cohort who were found to have hypothyroidism [thyroid stimulating hormone (TSH) > 4 mIU/L], 11 patients had clinical hypothyroidism [free thyroxine (FT4) < 1 ng/dL] and 11 patients had subclinical hypothyroidism (FT4 ≥ 1 ng/dL). Serum concentrations of IgG, IgG4, circulating immune complex (CIC), and β2-microglobulin (β2-MG) were significantly higher in the hypothyroidism group compared with the remaining 92 euthyroid patients, and serum C3 concentration was significantly lower. After prednisolone treatment, TSH values had decreased significantly (p = 0.005) in this group and FT4 values had increased significantly (p = 0.047). CT images showed that the thyroid glands of patients with clinical hypothyroidism had a significantly greater volume than those of the euthyroid and other groups. Pathological analysis of one resected thyroid gland disclosed a focused lesion with infiltration of lymphocytes and IgG4-bearing plasma cells and loss of thyroid follicles. CONCLUSIONS Thyroid lesions associated with hypothyroidism can be considered as a new disease termed IgG4-related thyroiditis. Awareness of this condition should lead to appropriate corticosteroid treatment that may prevent progression to a fibrous state.
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Affiliation(s)
- T Watanabe
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
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Kadoya M, Hashimoto M, Kubota A, Shimizu J, Tsuji S. P2.49 Sensitivity and specificity of major histocompatibility complex expression on sarcoplasmic membrane for diagnosis of idiopathic inflammatory myopathies. Neuromuscul Disord 2010. [DOI: 10.1016/j.nmd.2010.07.121] [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: 11/24/2022]
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15
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Ishino H, Kawahito Y, Hamaguchi M, Takeuchi N, Tokunaga D, Hojo T, Wada M, Yamamoto A, Kadoya M, Tsubouchi Y, Kohno M, Nakada H. Expression of Tn and sialyl Tn antigens in synovial tissues in rheumatoid arthritis. Clin Exp Rheumatol 2010; 28:246-249. [PMID: 20483047] [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] [Received: 05/27/2009] [Accepted: 11/12/2009] [Indexed: 05/29/2023]
Abstract
OBJECTIVES The carbohydrate chains represented by mucins (MUCs) are expressed by a variety of normal and malignant secretory epithelial cells and induce a variety of immunoreactions. Tn and sialyl Tn antigens are tumour-associated carbohydrate antigens which are borne on the core proteins of mucins. The purpose of this study is to investigate the existence of tumour-associated carbohydrate antigens in rheumatoid arthritis (RA). METHODS . We examined the expression of Tn and sialyl Tn antigens in synovial tissues from RA and osteoarthritis (OA) patients by immunohistochemistry. In addition, mucins from synovial fluid (SF) from RA patients are purified by gel filtration and density gradient ultracentrifugation and the existence of these antigens examined by dot and Western blotting. RESULTS We found that Tn and sialyl Tn antigens were strongly expressed in synovial cells and infiltrating mononuclear cells on the sublining layer and lymphoid follicles in synovial tissues in RA compared with those in osteoarthritis. Tn and sialyl Tn antigens were detected in purified mucins of SF from RA patients. CONCLUSIONS Tumour-like synovial hyperplasia cells expressed Tn and sialyl Tn antigens. This finding suggests that the mucins exhibiting with abnormal glycosylation may be in part responsible for synovial hyperplasia, leading to the joint destruction in the pathogenesis of RA.
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Affiliation(s)
- H Ishino
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Kobayashi T, Arai Y, Takeuchi Y, Nakajima Y, Shioyama Y, Sone M, Tanigawa N, Matsui O, Kadoya M, Inaba Y. Phase I/II clinical study of percutaneous vertebroplasty (PVP) as palliation for painful malignant vertebral compression fractures (PMVCF): JIVROSG-0202. Ann Oncol 2009; 20:1943-7. [DOI: 10.1093/annonc/mdp242] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Koiwai K, Shikama N, Sasaki S, Shinoda A, Kadoya M. Risk Factors for Severe Dysphagia after Concurrent Chemoradiotherapy for Head and Neck Cancers. Jpn J Clin Oncol 2009; 39:413-7. [DOI: 10.1093/jjco/hyp033] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fukushima K, Kurozumi M, Kadoya M, Ikeda S. Portal-systemic encephalopathy in a non-cirrhotic patient. Case Reports 2009; 2009:bcr2007121822. [DOI: 10.1136/bcr.2007.121822] [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: 11/04/2022] Open
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Affiliation(s)
- K Fukushima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto 390-8621, Japan.
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Arai Y, Kobayashi K, Takeuchi Y, Nakajima Y, Shioyama Y, Sone M, Tanigawa N, Matsui O, Kadoya M, Inaba Y. Phase I/II study of percutaneous vertebroplasty (PVP) for painful malignant vertebral compression fracture(PMVCF): JIVROSG- 0202. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9118 Backgrounds: This multi-center prospective study was conducted to evaluate the safety and efficacy of PVP, a new treatment modality for PMVCF, using techniques of interventional radiology. Methods: Enrolled patients (pts) had PMVCF by primary or metastatic tumor; restricted activities by PMVCF; tumor not exposed into spinal canal; adequate hematologic, hepatic, renal and cardiac functions; 0–3 ECOG performance status (PS); estimated prognosis over 4 weeks; and written consent. In phase I, 9 pts were enrolled; in phase II, 24 pts. Safety and efficacy were evaluated by NCI-CTC Ver. 2 and Visual Analogue Scale (VAS) at week 1 after PVP, respectively. By VAS score decreases, efficacy was classified into significantly effective (SE: =5 or reached 0–2), moderately effective (ME: 2–4), or not effective (NE: <2 or increase). Response rate was the ratio of pts with SE or ME in total pts. PVP was performed by insertion of 14–16 G bone biopsy needle into fractured vertebral body (FVB) using fluoroscopy or CT guidance, injection of bone cement (BC) under real time imaging observation, and discontinuation of BC injection at its distribution to adequate area of FVB or into extra bone space. Results: Procedures were completed in all 33 patients with 42 PMVCF. PS of pts was 0 in 1, 1 in 7, 2 in 12 and 3 in 13. In 30 days after PVP, 2 patients died of primary disease progression, but no major adverse reaction (>Grade 2) was observed. Response rate was 73% (56–85% in 95% CI) (61% (n=20) with SE; 12% (n=4) with ME; 27% (n=9) with NE), and increased to 83% at week 4. Median to PVP effect was 1 day (mean: 2.4). Median pain controlled survival was 73 days. Conclusion: For PMVCF, PVP is a safe and effective treatment modality with immediate responses. A phase III trial comparing PVP and standard radiation therapy is planned to evaluate PVP as the front line treatment. No significant financial relationships to disclose.
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Affiliation(s)
- Y. Arai
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - K. Kobayashi
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - Y. Takeuchi
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - Y. Nakajima
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - Y. Shioyama
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - M. Sone
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - N. Tanigawa
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - O. Matsui
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - M. Kadoya
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
| | - Y. Inaba
- Natl Cancer Center, Tokyo, Japan; Ishikawa Prefectural Central Hospital, Kanazawa, Japan; Kyoto 1st Red Cross Hospital, Kyoto, Japan; St. Marianna University, Kawasaki, Japan; Ibaraki Prefectural Central Hospital & Cencer Cent, Ibaraki, Japan; Iwate Medical University, Morioka, Japan; Kansai Medical University, Hirakata, Japan; Kanazawa University, Kanazawa, Japan; Shinshu University, Matsumoto, Japan; Aichi Cancer Center, Nagoya, Japan
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Mega S, Miyamoto M, Li L, Kadoya M, Takahashi R, Hase R, Kaneko H, Shichinohe T, Kawarada Y, Itoh T, Morikawa T, Kondo S. Immunohistochemical analysis of nuclear survivin expression in esophageal squamous cell carcinoma. Dis Esophagus 2006; 19:355-9. [PMID: 16984532 DOI: 10.1111/j.1442-2050.2006.00604.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 12/11/2022]
Abstract
Despite advances in the treatment of esophageal carcinoma, the prognosis for this disease remains poor. Therefore, it is important to obtain a better understanding of the molecular basis of esophageal carcinogenesis. The purpose of this study was to clarify the roles of survivin in esophageal squamous cell carcinoma (ESCC). One hundred 22 ESCC surgical specimens resected from 1989 to 1999 were examined. Survivin expression was assessed by immunohistochemistry. Tumor cells were considered survivin-positive if the immunoreactivity was confined to the nucleus, and a scoring method was applied. Survivin-positive immunostaining was detected in 68 patients (56%). There was a significant association between survivin expression and pN (P = 0.0472). Moreover, the overall survival rate was worse in patients with survivin-positive tumors than in patients with survivin-negative tumors (P = 0.0189). The overexpression of survivin was associated with the overall survival rate and poor prognosis in patients with ESCC. Survivin may be targeted during cancer therapy because of its selective expression in malignant tissue.
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Affiliation(s)
- S Mega
- Surgical Oncology, Cancer Medicine, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
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22
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Nishifuji K, Ueda Y, Sano A, Kadoya M, Kamei K, Sekiguchi M, Nishimura K, Iwasaki T. Interdigital involvement in a case of primary cutaneous canine histoplasmosis in Japan. ACTA ACUST UNITED AC 2006; 52:478-80. [PMID: 16268961 DOI: 10.1111/j.1439-0442.2005.00763.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 5-year-old male Siberian husky bred outdoor in Tokyo had a swollen paw with interdigital granulomatous lesions in the left hindlimb. The dog had no apparent pulmonary or gastrointestinal involvement. Histopathological analysis of the skin lesions demonstrated yeast-like organisms predominantly within macrophages. Sequence analysis of fungal ribosome RNA gene isolated from a paraffin sample revealed a 100% homology with the teleomorph of Histoplasma capsulatum. The present case may support the concept of primary cutaneous canine histoplasmosis as an endemic phenotype recognized in Japan.
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Affiliation(s)
- K Nishifuji
- Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo160-8582
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Aoki-Ota M, Ota T, Kadoya M, Sekiguchi M, Momoi Y, Amagai M, Iwasaki T. FC-19 Autoantibodies against extracellular domains of desmocollin 1 are not involved in canine pemphigus foliaceus. Vet Dermatol 2004. [DOI: 10.1111/j.1365-3164.2004.411_19.x] [Citation(s) in RCA: 4] [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] [Indexed: 11/30/2022]
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Kadoya M, Momoi Y, Iwasaki T. FC-51 Comparison of intradermal test and antigen-specific IgE test in 22 cases of feline allergic dermatitis. Vet Dermatol 2004. [DOI: 10.1111/j.1365-3164.2004.411_51.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
In this report, we present CT and MRI findings of a case of a schwannoma that developed in the floor of the oral cavity. A 49-year-old woman visited our hospital with a painless swelling in the oral floor. CT and MRI revealed a well circumscribed oval mass in the sublingual space, which showed cystic degeneration in most of the lesion. In addition, a thickened wall that strongly enhanced after injection of contrast medium and formation of fluid level were observed in the mass. The mass was removed and was histopathologically diagnosed as schwannoma. Only a few cases of schwannoma in the oral floor have been reported. However, when the characteristic findings are observed on CT and MRI, schwannoma should be added to the differential diagnosis.
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Affiliation(s)
- R Kawakami
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621 Japan.
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Gabata T, Sanada J, Kobayashi S, Terayama N, Kadoya M, Matsui O. Tumor-associated focal chronic pancreatitis from invasion of the pancreatic duct by common bile duct carcinoma: radiologic-pathologic correlation. Abdom Imaging 2003; 28:378-80. [PMID: 12719908 DOI: 10.1007/s00261-002-0049-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report a case of tumor-associated focal chronic pancreatitis of the uncinate process of the pancreas. The chronic pancreatitis was secondary to stenosis of the main pancreatic duct from invasion by a common bile duct carcinoma. A feature distinguishing the chronic pancreatitis from pancreatic carcinoma was the localized dilatation of pancreatic duct branches evident in the focal lesion of the uncinate process.
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Affiliation(s)
- T Gabata
- Department of Radiology, Kanazawa University, Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa City, Ishikawa, 920-8641, Japan
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Gabata T, Matsui O, Sanada J, Kadoya M, Ohmura K, Minato H. Cystic duct remnant carcinoma with widespread invasion along the extrahepatic bile duct wall: dynamic CT findings. Abdom Imaging 2003; 28:79-82. [PMID: 12483391 DOI: 10.1007/s00261-001-0159-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a case of remnant cystic duct carcinoma with widespread invasion along the common bile duct wall. Thin-slice dynamic computed tomography showed circumferential wall thickening of the extrahepatic bile duct (from the common hepatic duct to the intrapancreatic common bile duct) and the remnant cystic duct. Pathologically, the extrahepatic bile duct wall was thickened due to submucosal tumor infiltration by cystic duct papillary adenocarcinoma.
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Affiliation(s)
- T Gabata
- Department of Radiology, Kanazawa University, School of Medicine, 13-1 Takara-machi, Kanazawa City, Ishikawa 920-8641, Japan
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Kurokawa T, Okushiba S, Kadoya M, Miyamoto D, Kurashima Y, Kitagami H, Ikeda J, Sunaga M, Shinzato Y, Ozawa T, Kondo S, Katoh H. Selective occlusion with fibrin glue under fistuloscopy: seven cases of postoperative management for intractable complex fistulas. Endoscopy 2002; 34:220-2. [PMID: 11870573 DOI: 10.1055/s-2002-20294] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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
BACKGROUND AND STUDY AIM Fistula occlusion is not achieved in some fistulas with complex branches. To obtain early fistula closure in such cases, we insert a double-lumen catheter into each fistula branch, with the aid of a guide wire positioned using a small-caliber endoscope, and attempt selective infusion of fibrin glue. PATIENTS AND METHODS Following removal of foreign bodies and necrotic granulation, we applied the selective occlusion method under fistuloscopic control to seven intractable external fistulas with complex branches, in which fistula closure had not been obtained by a simple occlusion method (SOM). All the fistulas were complex with more than two branches. RESULTS Fistula occlusion was obtained within 2 weeks in six of the seven patients, and there has been no sign of recurrence over a follow-up period of 4 - 59 months (average 29.8 months). CONCLUSION Selective occlusion under fistuloscopy is highly effective for intractable external fistulas with complex branches.
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Affiliation(s)
- T Kurokawa
- Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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Abstract
We assessed the prognostic importance of magnetic resonance (MR) findings in locally advanced papillary thyroid cancer. MR findings, clinical data, and pathologic (and surgical) data for 66 patients, including 51 women and 15 men with a mean age of 57 years, who had primary surgery for papillary thyroid cancers were correlated with prognosis. Mean follow-up was 27.5 months (range, 5-117 months). Recurrence was seen in 18 patients (27%). In univariate analyses, age of 60 years or more (p = 0.0066), male gender (p = 0.0373), six MR findings (tumor size of > or = 4 cm ([p = 0.0002], ill-defined margins ([p < 0.0001], tumor extension of the trachea [p = 0.0337], carotoid artery [p = 0.0028]), esophagus [p < 0.0001], and lymph nodes [p = 0.0005]), and three pathologic findings (tumor extension of soft tissues [p = 0.0288], carotid artery [p = 0.0013], and esophagus [p < 0.0001]) had a significant adverse effect on disease-free survival. In multivariate analyses, tumor size (p = 0.0169) and nodal metastasis (p = 0.0393) determined on MR imaging and pathologic esophageal invasion (p = 0.0016) were the only significant independent variables. Esophageal invasion was accurately diagnosed with MR imaging (94% accuracy). MR findings may contain prognostic importance of locally advanced papillary thyroid cancer.
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Affiliation(s)
- S Takashima
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan.
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Terayama N, Matsui O, Gabata T, Kobayashi S, Sanada J, Ueda K, Kadoya M, Kawamori Y. Accumulation of iodized oil within the nonneoplastic liver adjacent to hepatocellular carcinoma via the drainage routes of the tumor after transcatheter arterial embolization. Cardiovasc Intervent Radiol 2001; 24:383-7. [PMID: 11907744 DOI: 10.1007/s00270-001-0070-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [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: 10/28/2022]
Abstract
PURPOSE After transcatheter arterial embolization (TAE) with iodized oil (Lipiodol), a relatively dense accumulation of Lipiodol is often seen in the nontumorous liver adjacent to a hypervascular hepatocellular carcinoma (HCC) nodule. We compared this phenomenon with the findings obtained with single-level dynamic CT during hepatic arteriography (SLDCTHA) and presumed its possible mechanism. METHODS Fifty-six patients with HCC underwent hepatic angiography including SLDCTHA followed by segmental or subsegmental TAE with a mixture of an anticancer drug and Lipiodol. We compared the drainage area of the HCC depicted on SLDCTHA with the Lipiodol accumulation in the nontumorous liver adjacent to the HCC on CT after TAE (LpCT). RESULTS In 26 of the 56 patients, a definite corona enhancement around the HCC, suggesting the drainage of blood from the tumor into the surrounding liver parenchyma, was seen on the late phase of SLDCTHA. In 17 of these 26 patients (65.4%), LpCT showed a more intense accumulation of Lipiodol in the nontumorous liver adjacent to the HCC that corresponded to the drainage area revealed on SLDCTHA. CONCLUSION The drainage of blood from the HCC was considered to be a possible mechanism of the accumulation of Lipiodol in the nontumorous liver adjacent to the HCC.
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Affiliation(s)
- N Terayama
- Department of Radiology, Kanazawa University School of Medicine, Japan.
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Kuwatsuru R, Kadoya M, Ohtomo K, Tanimoto A, Hirohashi S, Murakami T, Tanaka Y, Yoshikawa K, Katayama H. Comparison of gadobenate dimeglumine with gadopentetate dimeglumine for magnetic resonance imaging of liver tumors. Invest Radiol 2001; 36:632-41. [PMID: 11606840 DOI: 10.1097/00004424-200111000-00002] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES To compare gadobenate dimeglumine (Gd-BOPTA) with gadopentetate dimeglumine (Gd-DTPA) for magnetic resonance imaging of the liver. METHODS The contrast agent Gd-BOPTA or Gd-DTPA was administered at a dose of 0.1 mmol/kg to 257 patients suspected of having malignant liver tumors. Dynamic phase images, spin-echo images obtained within 10 minutes of injection, and delayed images obtained 40 to 120 minutes after injection were acquired. All postcontrast images were compared with unenhanced T1-weighted and T2-weighted images obtained immediately before injection. A full safety assessment was performed. RESULTS The contrast efficacy for dynamic phase imaging was moderately or markedly improved in 90.9% (110/121) and 87.9% (109/124) of patients for Gd-BOPTA and Gd-DTPA, respectively. At 40 to 120 minutes after injection, the cor- responding improvements were 21.7% (26/120) and 11.6% (14/121) for spin-echo sequences and 44.5% (53/119) and 19.0% (23/121) for breath-hold gradient-echo sequences, respectively. The differences at 40 to 120 minutes after injection were statistically significant (P < 0.02). Increased information at 40 to 120 minutes after injection compared with information acquired within 10 minutes of injection was available for 24.0% (29/121) of patients with Gd-BOPTA and for 14.5% (18/124) of patients with Gd-DTPA (P < 0.03). Adverse events were seen in 4.7% (6/128) and 1.6% (2/127) of patients receiving Gd-BOPTA and Gd-DTPA, respectively. The difference was not statistically significant. CONCLUSIONS The efficacy of Gd-BOPTA is equivalent to that of Gd-DTPA for liver imaging during the dynamic phase and superior during the delayed (40-120 minutes) phase of contrast enhancement. Both agents are safe for use in magnetic resonance imaging of the liver.
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Affiliation(s)
- R Kuwatsuru
- Department of Radiology, Juntendo University School of Medicine, 3-1-3 Bunkyo-ku Hongo, Tokyo 113.8431, Japan.
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Kawashima H, Tawara M, Suzuki M, Matsui O, Kadoya M. Effectiveness of dynamic MRI for diagnosing pericicatricial minimal residual breast cancer following excisional biopsy. Eur J Radiol 2001; 40:2-9. [PMID: 11673001 DOI: 10.1016/s0720-048x(01)00358-8] [Citation(s) in RCA: 11] [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: 11/24/2022]
Abstract
The purpose of this study was to investigate the effectiveness of dynamic MRI for diagnosing pericicatricial minimal residual breast cancer following excisional biopsy. Twenty-six patients who underwent excisional biopsy of a tumor or calcified lesion of the breast underwent gadolinium-enhanced dynamic MRI by the fat-saturated 2D fast spoiled gradient echo (SPGR) sequence (group 1), 24 patients by the spectral IR enhanced 3D fast gradient echo (Efgre3d) sequence (group 2). Pericicatricial residual cancer was confirmed histologically in 29 of the 50 patients. The overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MRI for residual cancer diagnosis was 66, 81, 72, 83 and 63%. A nodular, thick and discontinuous enhanced rim around the scar is indicative of a residual tumor. However, false-positive findings due to granulation or proliferative fibrocystic change remain limitations.
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Affiliation(s)
- H Kawashima
- Department of Radiology, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.
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Oguchi K, Murase S, Kaneko T, Takizawa M, Kadoya M. [Preliminary experience of wireless teleradiology system using Personal Handyphone System]. Nihon Igaku Hoshasen Gakkai Zasshi 2001; 61:686-7. [PMID: 11729679] [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: 02/22/2023]
Abstract
We investigated the potential of the wireless teleradiology system, using a Personal Handyphone System(PHS) and hand-held personal computer. To provide and interpret CT images, an internet web system was used. It took 5.5 seconds to transmit a single CT image of 28 KB. Therefore, about 2 minutes was required to brawse a series of brain examinations(20 CT images). Although transmission speed needs to be increased, our system makes it possible to perform imaging diagnosis anywhere and is especially useful in emergency situations.
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Affiliation(s)
- K Oguchi
- Department of Radiology, National Chushin Matsumoto Hospital
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Kobayashi S, Matsui O, Kadoya M, Gabata T, Sanada J, Terayama N. Right posterior-superior subsegmental hepatic artery originating from the right inferior adrenal artery. Cardiovasc Intervent Radiol 2001; 24:271-3. [PMID: 11779018 DOI: 10.1007/s00270-001-0021-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 12/01/2022]
Affiliation(s)
- S Kobayashi
- Department of Radiology, Kanazawa University School of Medicine, Japan.
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Gabata T, Kadoya M, Matsui O, Ueda K, Kawamori Y, Terayama N, Sanada J, Kobayashi S. Peritumoral spared area in fatty liver: correlation between opposed-phase gradient-echo MR imaging and CT arteriography. Abdom Imaging 2001; 26:384-9. [PMID: 11441550 DOI: 10.1007/s002610000178] [Citation(s) in RCA: 23] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND The purpose of the present study was to evaluate the magnetic resonance findings of a spared area of fatty liver caused by hepatic tumors and clarify the etiology of this phenomenon by computed tomographic (CT) arteriography. METHODS Six patients with hepatic tumors (metastases from colon cancer, n = 3; breast cancer, n = 2; hepatocellular carcinoma, n = 1) were examined. In-phase (IP) and opposed-phase (OP) T1-weighted spoiled gradient-echo images were obtained. CT during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) were also performed. Pathologic confirmation was obtained in three patients with metastases from colon cancer. RESULTS In all six patients, peritumoral ringlike or wedge-shaped hyperintense areas in relation to the tumor and the surrounding steatotic liver parenchyma were clearly visualized on OP images alone. This area appeared as a perfusion defect on CTAP and ringlike or wedge-shaped enhancement on CTHA. Pathologically, the peritumoral hyperintense areas on OP images were compatible with the spared area of fatty liver. CONCLUSION A peritumoral spared area can be demonstrated with OP images. The etiology of the phenomenon is correlated with decreased portal flow and increased arterial flow in the peritumoral hepatic parenchyma.
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Affiliation(s)
- T Gabata
- Department of Radiology, Kanazawa University, School of Medicine, 13-1 Takara-machi, Kanazawa City, Ishikawa, Japan 920-8641
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Shikama N, Oguchi M, Sasaki S, Shinoda A, Nishikawa A, Arakawa K, Koiwai K, Mochizuki K, Yamada A, Watanabe T, Kadoya M. Evaluation of central nervous system involvement in nasal lymphomas. Nihon Igaku Hoshasen Gakkai Zasshi 2001; 61:342-6. [PMID: 11496414] [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: 02/21/2023]
Abstract
OBJECTIVES To clarify the usefulness of evaluating central nervous system (CNS) involvement in patients with nasal lymphomas at the initial staging procedure, and of CNS prophylaxis for patients with clinical stage I/II. PATIENTS AND METHODS We retrospectively reviewed 43 patients with nasal lymphomas who had been treated from 1973 through 1999. The staging procedure included mainly computed tomography (CT), ultrasonography, gallium scintigraphy, upper gastrointestinal study, magnetic resonance (MR) imaging, and bone marrow biopsy. Forty-two patients received radiotherapy, and 25 patients received chemotherapy. All 38 patients with stage I/II were not subjected to CNS prophylaxis. RESULTS Four patients demonstrated CNS involvement at the staging procedure. MR imaging demonstrated the tumor had directly infiltrated the skull base in 3 patients, but CT demonstrated CNS infiltration in only one patient. In another patient, cerebrospinal fluid (CSF) cytologic analyses demonstrated CNS involvement, but MR imaging and CT did not. These 4 patients complained of frontonasal pain and/or cerebral nerve dysfunction. No patient with stage I/II developed CNS relapse. CONCLUSIONS MR imaging and CSF cytologic analyses should be performed at the initial staging of nasal lymphomas, especially in patients with frontonasal pain and/or cerebral nerve dysfunction. Patients with stage I/II might not need CNS prophylaxis.
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Affiliation(s)
- N Shikama
- Department of Radiology, Shinshu University, School of Medicine, Naoto Shikama
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Gabata T, Kadoya M, Matsui O, Kobayashi T, Kawamori Y, Sanada J, Terayama N, Kobayashi S. Dynamic CT of hepatic abscesses: significance of transient segmental enhancement. AJR Am J Roentgenol 2001; 176:675-9. [PMID: 11222204 DOI: 10.2214/ajr.176.3.1760675] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate dynamic CT findings of hepatic abscesses, especially segmental hepatic enhancement, and to clarify the cause. MATERIALS AND METHODS Twenty-four abscesses in eight patients were examined by early (30 sec) and late phase (90 sec) dynamic CT. Patients underwent abscess drainage (n = 1), hepatic resection (n = 2), or antibiotic therapy (n = 5). CT during arterial portography and CT during hepatic arteriography were performed in one patient. We retrospectively observed the frequency and changes of segmental hepatic enhancement on dynamic CT and determined its cause using radiologic and pathologic correlation. RESULTS Sixteen abscesses (67%) showed transient segmental hepatic enhancement and three abscesses showed only segmental hepatic enhancement in the early phase. Four abscesses in one patient who underwent CT during arterial portography and CT during hepatic arteriography showed a segmental perfusion defect on CT during arterial portography and segmental enhancement on CT during hepatic arteriography. On follow-up dynamic CT performed 10-17 days after the initial CT, segmental hepatic enhancement surrounding hepatic abscesses decreased or disappeared in all abscesses. Pathologic examination of two patients showed marked inflammatory cell infiltration with stenosis of portal venules within the portal tracts surrounding hepatic abscesses without definite inflammation in the liver parenchyma. CONCLUSION Segmental hepatic enhancement on dynamic CT is frequently associated with hepatic abscesses and may be caused by decreased portal flow resulting from inflammation of the portal tracts.
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Affiliation(s)
- T Gabata
- Department of Radiology, Kanazawa University, School of Medicine, 13-1 Takara-machi, Kanazawa City, Ishikawa, 920-8641 Japan
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Okai T, Minamoto T, Ohtsubo K, Takahashi Y, Kitagata H, Kadoya M, Oda Y, Sawabu N. Presacral ganglioneuroma arising in an elderly man with persistent constipation. Abdom Imaging 2001; 26:215-7. [PMID: 11178704 DOI: 10.1007/s002610000133] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Presacral ganglioneuroma in a 70-year-old man with persistent constipation and its features on computed tomography, magnetic resonance, and endoscopic ultrasonography are presented. Barium enema study and laparotomy showed that constipation was caused mainly by extrinsic compression from this tumor. Computed tomography, magnetic resonance, endoscopic ultrasonographic features such as well-defined solid tumor with a cystic component and punctate calcifications may facilitate early diagnosis of this rare tumor.
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Affiliation(s)
- T Okai
- Department of Internal Medicine and Medical Oncology, Cancer Research Institute, Kanazawa University, 4-86 Yoneizumi, Kanazawa 921-8044, Japan
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40
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Kobayashi S, Matsui O, Kadoya M, Yoshikawa J, Gabata T, Kawamori Y, Sanada J, Terayama N. CT arteriographic confirmation of focal hepatic fatty infiltration adjacent to the falciform ligament associated with drainage of inferior vein of Sappey: a case report. Radiat Med 2001; 19:51-4. [PMID: 11305620] [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: 02/19/2023]
Abstract
We experienced a case of focal fatty infiltration in the anteromedial edge of the medial segment of the liver adjacent to the falciform ligament associated with advanced esophageal cancer. By using CT during selective right internal thoracic arteriography, we confirmed that the inferior vein of Sappey drained into the area of focal fatty infiltration. This is the first case to directly establish the relationship between drainage of the inferior vein of Sappey and occurrence of focal fatty infiltration of the liver.
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Affiliation(s)
- S Kobayashi
- Department of Radiology, Kanazawa University School of Medicine, Japan
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Gabata T, Kadoya M, Mori A, Kobayashi S, Sanada J, Matsui O. MR imaging of focal splenic extramedullary hematopoiesis in polycythemia vera: case report. Abdom Imaging 2000; 25:514-6. [PMID: 10931988 DOI: 10.1007/s002610000045] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We report a case with focal mass-like lesion of the spleen in polycythemia vera. Magnetic resonance imaging of the lesion showed homogeneous hyperintensity on T2-weighted images, with progressive enhancement on dynamic magnetic resonance images after bolus injection of gadolinium. The magnetic resonance features of focal splenic extramedullary hematopoiesis have not been previously reported.
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Affiliation(s)
- T Gabata
- Department of Radiology, Kanazawa University, School of Medicine, 13-1, Takara-machi, Kanazawa City, 920-8641, Japan
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42
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Gabata T, Kadoya M, Matsui O, Kobayashi T, Sanada J, Mori A. Intrahepatic biliary calculi: correlation of unusual MR findings with pathologic findings. Abdom Imaging 2000; 25:266-8. [PMID: 10823448 DOI: 10.1007/s002610000030] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We report a case of intrahepatic biliary calculi. A localized dilated intrahepatic duct of the left lateral segment of the liver was filled with material that showed marked hyperintensity on T1- and T2-weighted magnetic resonance (MR) images. These MR findings are unusual for intrahepatic stones. Pathologically, the stones were muddy bilirubin calculi, the chemical and physical characteristics of which are surmised to have been the cause of the unusual MR findings.
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Affiliation(s)
- T Gabata
- Department of Radiology, Kanazawa University, School of Medicine, Ishikawa, Japan
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43
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Kawashima H, Matsui O, Suzuki M, Kadoya M, Tawara M, Nonomura A, Noguchi M, Takashima T. Breast cancer in dense breast: detection with contrast-enhanced dynamic MR imaging. J Magn Reson Imaging 2000; 11:233-43. [PMID: 10739554 DOI: 10.1002/(sici)1522-2586(200003)11:3<233::aid-jmri1>3.0.co;2-x] [Citation(s) in RCA: 24] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of this study was to identify contrast enhancement patterns of dense breast parenchyma and to investigate the ability of dynamic magnetic resonance imaging (MRI) to detect cancer in the dense breast. Thirty-two patients with breast cancer in dense breast underwent gadolinium-enhanced dynamic MRI. The detectability of cancer by dynamic MRI, mammography, and physical examination was compared. Two parenchymal enhancement patterns could be identified. One was increasingly multiple patchy enhancement found predominantly in the periphery (type A), and the other was faint enhancement without any nodular opacification (type B). Type A was thought to reflect severe proliferative fibrocystic change (PFC). For both patterns, the detection rate of primary cancers by dynamic MRI was found to be superior to that by other modalities. Dynamic MRI also could detect multifocal cancers, which could not be found with other modalities, although the detectability of these small cancers might be reduced in patients with severe PFC.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Scirrhous/diagnosis
- Adenocarcinoma, Scirrhous/pathology
- Adult
- Aged
- Breast/pathology
- Breast Neoplasms/diagnosis
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/diagnosis
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Contrast Media
- Female
- Fibrocystic Breast Disease/diagnosis
- Fibrocystic Breast Disease/pathology
- Gadolinium DTPA
- Humans
- Image Enhancement
- Magnetic Resonance Imaging
- Mammography
- Middle Aged
- Predictive Value of Tests
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Affiliation(s)
- H Kawashima
- Department of Radiology, Kanazawa University School of Medicine, Ishikawa, Japan
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44
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Kobayashi K, Matsui O, Yoshikawa J, Kadoya M, Kawamori Y, Takashima T. Right hepatic arterial supply to the posterior aspect of segment IV of the liver: analysis by CT during hepatic arteriography. Abdom Imaging 1999; 24:591-3. [PMID: 10525814 DOI: 10.1007/s002619900570] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the frequency of the right hepatic arterial supply to the posterior aspect of segment IV (PASIV) of the liver shown on computed tomography (CT) during hepatic arteriography (CTHA). MATERIALS AND METHODS Seventy-four patients who underwent CTHA from the right and/or left hepatic artery were studied. The right arterial supply to the PASIV was determined when the PASIV was stained on CT during right hepatic arteriography without any opacified arteries originating from the right hepatic artery and distributing to segment IV through the left hepatic hilum or when no staining was seen in the PASIV on CT during left hepatic arteriography. The frequency of the right hepatic arterial supply to the PASIV demonstrated on CTHA was analyzed. RESULTS In six of 74 patients (8%), the PASIV was supplied from the right hepatic artery. CONCLUSION This PASIV was supplied by the right hepatic artery in a significant proportion of cases.
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Affiliation(s)
- K Kobayashi
- Department of Radiology, Tonami General Hospital, 1-61 Shintomicho, Tonami 939-1395, Japan
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45
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Kuwatsuru R, Kadoya M, Ohtomo K, Tanimoto A, Hirohashi S, Murakami T, Tanaka Y, Yoshikawa K, Katayama H. Clinical late phase II trials of MultiHance (Gd-BOPTA) for the magnetic resonance imaging of liver tumors in Japan. J Comput Assist Tomogr 1999; 23 Suppl 1:S65-74. [PMID: 10608400 DOI: 10.1097/00004728-199911001-00010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/26/2022]
Abstract
OBJECTIVE The purpose of the study was to evaluate the safety and efficacy of Gd-BOPTA for liver imaging and to determine the most appropriate clinical dose to administer. METHODS Gd-BOPTA was administered at a dose of 0.05 (group A), 0.1 (group B), or 0.2 (group C) mmol/kg to 201 patients suspected of having malignant liver tumors who had been referred for magnetic resonance imaging. Dynamic phase images (T1-weighted gradient echo sequences obtained during breath-hold), images obtained within 10 min of Gd-BOPTA injection (spin echo images) and delayed images obtained at 40-120 min after Gd-BOPTA injection (T1-weighted spin echo and gradient echo sequences during breathhold) were acquired. All post-contrast images were compared with pre-contrast images (T1- and T2-weighted sequences) obtained immediately prior to Gd-BOPTA administration. Safety was assessed in terms of the incidence of adverse events. RESULTS The contrast efficacy for the dynamic study was classified as ( ) in 39.7% (27/68), 55.4% (36/65), and 47.0% (31/66) for groups A, B, and C, respectively. The contrast efficacy within 10 min of the injection was classified as ( ) in 7.6% (5/66), 16.9% (11/65), and 12.5% (8/64) for groups A, B, and C, respectively. The contrast efficacy at 40-120 min post-injection was classified as ( ) in 4.4% (3/68), 21.5% (14/65), and 20.0% (13/65) for groups A, B, and C, respectively with significant differences noted between groups A and B and groups A and C. As regards safety, the overall incidence of adverse reactions was 3.5% (7/199). CONCLUSION Gd-BOPTA is a safe and efficacious contrast agent for use in both dynamic phase imaging and delayed (40-120 min) static imaging. A dose of 0.1 mmol/kg Gd-BOPTA appears to be the ideal dose for use in liver imaging in Japan.
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Affiliation(s)
- R Kuwatsuru
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
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Ueda F, Suzuki M, Fujinaga Y, Kadoya M, Takashima T. In vivo anatomical analysis of arterial contact with trigeminal nerve: detection with three-dimensional spoiled grass imaging. Br J Radiol 1999; 72:838-45. [PMID: 10645189 DOI: 10.1259/bjr.72.861.10645189] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/05/2022] Open
Abstract
The purpose of this study was to review the normal in vivo neurovascular relationship between the trigeminal nerve and surrounding arteries without the use of volunteers. 290 nerves in 145 cases were reviewed during a 1-year period. Axial source images and multiplanar reconstructed (MPR) images were used to determine the neurovascular contact and direction of contact. Multiplanar volume reformation (MPVR) was used to identify the contact vessels and to demonstrate the relationship between the nerve and arteries. Vascular contact was found in 29% of the 290 nerves (83 nerves). The arteries involved were the superior cerebellar artery (SCA) or the anterior inferior cerebellar artery (AICA). Vascular contact with two arteries was found in 3%. Of the 286 asymptomatic nerves, the nerve was located between the two vessels in 3% and compression was seen in 1%. Three points of vascular contact by the two arteries were identified in one asymptomatic nerve. The direction of contact between the SCA and the nerve was superior (38%), superomedial (32%) or medial (15%) in most cases. The direction of contact between the AICA and the nerve was inferior, inferolateral or lateral in all cases. Vascular contact at the root entry zone (REZ) was noted in 90%. Four nerves were affected by trigeminal neuralgia, one of which touched an artery and two were compressed. It was concluded that arterial contact can be assessed without difficulty but evaluation of vascular compression is not easy.
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Affiliation(s)
- F Ueda
- Department of Radiology, Kanazawa University School of Medicine, Japan
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47
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Tanimoto A, Kuwatsuru R, Kadoya M, Ohtomo K, Hirohashi S, Murakami T, Hiramatsu K, Yoshikawa K, Katayama H. Evaluation of gadobenate dimeglumine in hepatocellular carcinoma: results from phase II and phase III clinical trials in Japan. J Magn Reson Imaging 1999; 10:450-60. [PMID: 10508308 DOI: 10.1002/(sici)1522-2586(199909)10:3<450::aid-jmri29>3.0.co;2-k] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [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: 12/11/2022] Open
Abstract
To evaluate the clinical efficacy of gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance imaging for hepatocellular carcinoma (HCC), we reviewed the results of clinical phase II and III trials in Japan. Gd-BOPTA was administered at a dose of 0.1 mmol/kg to 139 patients who were suspected to have HCC. Dynamic phase images [breath-hold T1-weighted gradient echo (GRE)], spin-echo (SE) images obtained within 10 minutes of injection, and delayed breath-hold GRE images obtained 40-120 minutes after injection were evaluated. All post-contrast images were compared with T1- and T2-weighted pre-contrast images. The contrast efficacy for the dynamic study was classified as ( ) or (++) in 92.1% (128/139), in 43.1% (59/137) with SE within 10 minutes of injection, and in 43.2% (60/139) with breath-hold GRE at delayed phase. The increase in lesion-liver contrast-to-noise ratio was best at the arterial phase of dynamic breath-hold GRE. Liver signal-to-noise ratio showed a mean 52.3% increase in delayed phase. Additional information at delayed phase compared with images acquired within 10 minutes of injection (including the dynamic study) was classified as ( ) or (++) in 28.1% (39/139). With regard to safety, the overall incidence of adverse reactions was 5.0% (7/141) of the patients who were suspected to have HCC, all of whom recovered within 12 hours without any sequelae. No clinically important changes were observed in the blood and urine laboratory tests. It was concluded that Gd-BOPTA was well tolerated and effective in both dynamic study and delayed static imaging for the diagnosis of HCC.
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Affiliation(s)
- A Tanimoto
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo 160-8582, Japan.
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Hayashi M, Matsui O, Ueda K, Kawamori Y, Kadoya M, Yoshikawa J, Gabata T, Takashima T, Nonomura A, Nakanuma Y. Correlation between the blood supply and grade of malignancy of hepatocellular nodules associated with liver cirrhosis: evaluation by CT during intraarterial injection of contrast medium. AJR Am J Roentgenol 1999; 172:969-76. [PMID: 10587130 DOI: 10.2214/ajr.172.4.10587130] [Citation(s) in RCA: 245] [Impact Index Per Article: 9.8] [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: 02/07/2023]
Abstract
OBJECTIVE The purpose of this study is to evaluate the correlation between the intranodular blood supply revealed by CT during intraarterial injection of contrast medium, mainly using helical CT, and the grade of malignancy of hepatocellular nodules associated with liver cirrhosis as classified by the International Working Party of the World Congress of Gastroenterology. SUBJECTS AND METHODS We studied 201 histologically proven nodules (101 resected and 100 biopsied nodules), including 47 low-grade dysplastic nodules (low-DNs), 56 high-grade dysplastic nodules (high-DNs), 24 well-differentiated hepatocellular carcinomas (wd-HCCs), and 74 moderately or poorly differentiated HCCs (mp-HCCs), in 139 cirrhotic patients. Findings on CT during arterial portography (n = 201) and CT during hepatic arteriography (n = 74) were reviewed and compared with the histologic diagnosis. RESULTS CT findings were classified into four types relative to the surrounding liver: type A (isodense), type B (slightly hypodense), type C (partially hypodense), and type D (markedly hypodense) on CT during arterial portography and type I (isodense), type II (hypodense), type III (partially hyperdense), and type IV (hyperdense) on CT during hepatic arteriography. On CT during arterial portography, the distributions of each type were low-DN (n = 47 [A, n = 36; B, n = 8; C, n = 3]), high-DN (n = 56 [A, n = 18; B, n = 20; C, n = 10; D, n = 8]), wd-HCC (n = 24; [B, n = 4; C, n = 13; D, n = 7]), and mp-HCC (n = 74 [D, n = 74]). On CT during hepatic arteriography, the distributions were low-DN (n = 26 [I, n = 18; II, n = 7; III, n = 1]), high-DN (n = 19 [I, n = 6; II, n = 7; III, n = 4; IV, n = 2]), wd-HCC (n = 15 [I, n = 1; III, n = 8; IV, n = 6]), and mp-HCC (n = 14 [IV, n = 14]). We found a statistically significant correlation between the four types and the grade of malignancy of these nodules. CONCLUSION Findings on CT during arterial portography and CT during hepatic arteriography correlated positively with histologic grading when overlap in appearance between dysplastic nodules and HCCs occurred. The concept revealed in this study can apply to diagnoses made on the basis of Doppler sonography, dynamic CT, and MR imaging.
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Affiliation(s)
- M Hayashi
- Department of Radiology, Kanazawa University School of Medicine, Japan
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49
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Affiliation(s)
- T Komatsu
- Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara-machi, Kanazawa 920, Japan
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Yoon KH, Matsui O, Kadoya M, Yoshigawa J, Gabata T, Arai K. Pseudolesion in segments II and III of the liver on CT during arterial portography caused by aberrant right gastric venous drainage. J Comput Assist Tomogr 1999; 23:306-9. [PMID: 10096343 DOI: 10.1097/00004728-199903000-00024] [Citation(s) in RCA: 24] [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] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We report three cases of pseudolesions caused by aberrant right gastric venous drainage (AGVD) in segment II/III of the liver as demonstrated on CT during arterial portography (CTAP). On CTAP, the lesions were seen as wedge-shaped perfusion defects, and on hepatic arteriography, AGVD directed to the area with the perfusion defect was visible in all three cases. When a perfusion defect is detected at the edge of segments II/III at CTAP, a pseudolesion caused by AGVD should be suspected.
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Affiliation(s)
- K H Yoon
- Department of Radiology, Kanazawa University School of Medicine, Japan
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