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Saka M, Fujimoto M, Mizoguchi K, Tsujimura M, Saeki M, Hirata M, Shibuya S, Odani K, Sakurai T, Yuba Y, Moriyoshi K, Nakajima N, Sumiyoshi S, Kono F, Ono K, Shirase T, Watanabe C, Yoshizawa A, Haga H. Insulin-like Growth Factor II mRNA-binding Protein 3 is a Highly Sensitive Marker for Intravascular Large B-cell Lymphoma: Immunohistochemical Analysis of 152 Pathology Specimens From 88 Patients. Am J Surg Pathol 2024:00000478-990000000-00316. [PMID: 38497417 DOI: 10.1097/pas.0000000000002214] [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: 03/19/2024]
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare type of aggressive extranodal large B-cell lymphoma characterized by the selective growth of lymphoma cells within the lumina of blood vessels, particularly capillaries. IVLBCL lacks mass formation, and its diagnosis can be challenging. We analyzed the utility of insulin-like growth factor II mRNA-binding protein 3 (IMP3) immunohistochemistry for IVLBCL diagnosis in various organs. Double staining with paired box 5 (PAX5) was performed for validation. Overall, 152 pathological specimens (111 positive and 41 negative for IVLBCL) obtained from 88 patients with a diagnosis of IVLBCL were stained for IMP3 and IMP3/PAX5. As negative controls, 40 pathology specimens from 38 patients with no history of IVLBCL or other B-cell lymphomas were stained for IMP3, which comprised 31 benign pathological specimens from 29 patients in whom malignancy was suspected, 7 cases of appendicitis with intravascular and/or intralymphatic lymphoid proliferations, and 2 cases of intravascular natural killer/T-cell lymphoma. All mononuclear cells with cytoplasmic staining were considered positive for IMP3 expression, but expression restricted to germinal center B cells was excluded from evaluation. All 111 IVLBCL pathological specimens were positive for IMP3 and IMP3/PAX5. In addition, 11 of the 41 specimens originally diagnosed as IVLBCL-negative showed IMP3/PAX5 double-positive cells, raising the suspicion of IVLBCL. However, of the 40 negative control samples, IMP3-positive non-germinal center B cells were detected in only 2 samples (P= 0.0131) and no intravascular IMP3-positive B cells suspicious for IVLBCL were identified. Altogether, IMP3 immunohistochemistry is a highly sensitive marker of IVLBCL and can be a helpful adjunct for IVLBCL diagnosis.
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Affiliation(s)
- Manduwa Saka
- Department of Diagnostic Pathology, Kyoto University Hospital
| | | | - Kai Mizoguchi
- Department of Diagnostic Pathology, Kyoto University Hospital
| | | | - Miho Saeki
- Department of Diagnostic Pathology, Kyoto University Hospital
| | - Masahiro Hirata
- Department of Diagnostic Pathology, Kyoto University Hospital
| | | | - Kentaro Odani
- Department of Diagnostic Pathology, Osaka Red Cross Hospital
| | - Takaki Sakurai
- Department of Diagnostic Pathology, Osaka Red Cross Hospital
| | - Yoshiaki Yuba
- Department of Pathology, Medical Research Institute, Kitano Hospital
| | - Koki Moriyoshi
- Department of Diagnostic Pathology, National Hospital Organization Kyoto Medical Center
| | - Naoki Nakajima
- Department of Diagnostic Pathology, Toyooka Hospital, Hyogo
| | | | - Fumihiko Kono
- Department of Diagnostic Pathology, Uji-Tokushukai Medical Center, Kyoto
| | - Kazuo Ono
- Department of Diagnostic Pathology, Japanese Red Cross Wakayama Medical Center, Wakayama
| | | | - Chihiro Watanabe
- Department of Diagnostic Pathology, Takatsuki Red Cross Hospital, Osaka
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology, Kyoto University Hospital
- Department of Diagnostic Pathology, Nara Medical University, Nara
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital
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2
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Ogawa K, Kitabayashi R, Kurokawa M, Okada Y, Uno S, Shibuya S, Okubo K. Metastatic prostate cancer with low PSA levels diagnosed after holmium laser enucleation of the prostate. Int Cancer Conf J 2023; 12:104-108. [PMID: 36896202 PMCID: PMC9989107 DOI: 10.1007/s13691-022-00586-3] [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: 08/08/2022] [Accepted: 11/19/2022] [Indexed: 12/04/2022] Open
Abstract
Holmium laser enucleation of the prostate is a widely accepted surgical treatment method for benign prostate hyperplasia, but its effect on prostate cancer remains unclear. In this study, we report the cases of two patients with metastatic prostate cancer diagnosed during follow-up after holmium laser enucleation of the prostate. Case 1 was a 74 year-old man who underwent holmium laser enucleation of the prostate. Prostate-specific antigen levels declined from 4.3 to 1.5 ng/mL at 1 month after surgery, but after 19 months, they increased to 6.6 ng/mL. Based on pathological and radiological findings, he was diagnosed as having prostate cancer, with Gleason score 5 + 4 with neuroendocrine differentiation, cT3bN1M1a. Case 2 was a 70 year-old man who also underwent holmium laser enucleation of the prostate. Prostate-specific antigen levels declined from 7.2 to 2.9 ng/mL at 6 months after surgery, but after 12 months, they increased to 12 ng/mL. Based on pathological and radiological findings, he was diagnosed as having prostate cancer, with Gleason score 4 + 5 with intraductal carcinoma of the prostate, cT3bN1M1a. This report suggests that advanced prostate cancer may be newly diagnosed after holmium laser enucleation of the prostate. Even if prostate cancer had not been demonstrated in the enucleated specimen, and postoperative PSA levels were below the standard values, physicians should regularly monitor prostate-specific antigen levels after holmium laser enucleation of the prostate, and further examination should be considered keeping in mind prostate cancer progression.
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Affiliation(s)
- Kosuke Ogawa
- Department of Urology, Kyoto Katsura Hospital, 17 Yamada-Hiraocho Nishikyo-Ku, Kyoto, Japan
| | - Ryota Kitabayashi
- Department of Urology, Kyoto Katsura Hospital, 17 Yamada-Hiraocho Nishikyo-Ku, Kyoto, Japan
| | - Masayuki Kurokawa
- Department of Urology, Kyoto Katsura Hospital, 17 Yamada-Hiraocho Nishikyo-Ku, Kyoto, Japan
| | - Yoshiyuki Okada
- Department of Urology, Kyoto Katsura Hospital, 17 Yamada-Hiraocho Nishikyo-Ku, Kyoto, Japan
| | - Shunsuke Uno
- Department of Diagnostic Pathology, Kyoto Katsura Hospital, Nishikyo-Ku, Kyoto, Japan
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kyoto Katsura Hospital, Nishikyo-Ku, Kyoto, Japan
| | - Kazutoshi Okubo
- Department of Urology, Kyoto Katsura Hospital, 17 Yamada-Hiraocho Nishikyo-Ku, Kyoto, Japan
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3
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Watanabe S, Ikeda A, Shibuya S, Aoki K, Okada K, Itokawa Y, Tanaka Y, Fujii S, Kusaka T. [A case of autopsy-confirmed duodenal perforation due to calcium polystyrene sulfonate]. Nihon Shokakibyo Gakkai Zasshi 2023; 120:169-174. [PMID: 36775323 DOI: 10.11405/nisshoshi.120.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A 77-year-old male patient was referred to our hospital because of jaundice. He was diagnosed with alcoholic liver cirrhosis and was admitted to our hospital because of liver failure. After admission, we observed conservative liver disease, but the liver damage did not improve and gradually worsened. Renal function deteriorated during liver failure. Hyperkalemia presented due to renal dysfunction. Hence, calcium polystyrene sulfonate (CPS) was initiated. He died because of liver failure although hyperkalemia improved. An autopsy revealed ulcer perforation with CPS crystals in the duodenum. A basic substance considered a crystal of CPS was found by hematoxylin and eosin staining from the ulcer adjacent to the perforation and the exudate attached to the peritoneum. Furthermore, a large amount of CPS crystals were found in the ascites. A final diagnosis of gastrointestinal perforation peritonitis due to CPS was made. Gastrointestinal perforation due to CPS is presumed as a direct mucosal injury due to the drug, most of which is the sigmoid colon of elderly patients. Upper gastrointestinal tract perforation is extremely rare. We experienced a case of autopsy in which duodenal perforation due to CPS was pathologically confirmed. CPS is a widely used drug for renal disorders, but it has a risk of gastrointestinal injury. Therefore, a potential gastrointestinal mucosal injury should be considered when using CPS.
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Affiliation(s)
- Shunsuke Watanabe
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | - Atsuyuki Ikeda
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | | | - Kentaro Aoki
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | - Keijiro Okada
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | - Yoshio Itokawa
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | - Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital
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4
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Tanaka Y, Fujii S, Okada K, Aoki K, Shibuya S, Kusaka T. Magnifying Narrow-Band Imaging with Acetic Acid Spray for Superficial Non-Ampullary Duodenal Epithelial Tumors Based on the Mucin Phenotype. Digestion 2022; 103:421-427. [PMID: 36265448 DOI: 10.1159/000526236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 03/29/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION This study aimed to identify the characteristics of superficial non-ampullary duodenal epithelial tumors (SNADETs) based on the mucin phenotype using magnifying narrow-band imaging with acetic acid spray (MA-NBI) and evaluate the efficacy of MA-NBI in differentiating gastric-type (G-type) from intestinal-type (I-type) lesions. METHODS We retrospectively identified 59 resected SNADETs in 59 patients who underwent MA-NBI. We evaluated surface patterns using MA-NBI to differentiate G-type from I-type lesions. Surface structures were classified into three patterns: tubular, villous, or oval structures. Lesions displaying a single pattern among the three patterns were classified as monotype, whereas those displaying multiple surface patterns were classified as mixed type. In addition, lesions with disorganized and unclear structures with irregular margins were classified as irregular surface structures. RESULTS In total, 32 (54%), 26 (44%), and 1 (2%) lesions were classified as Vienna category 3, 4, and 5 tumors, respectively, whereas 49 (83%) and 10 (17%) were classified as I- and G-type lesions, respectively. Oval structures were more frequently observed in G-type lesions (70%), whereas tubular structures were more frequently observed in I-type lesions (78%) (p < 0.001). Category 4 and 5 lesions had significantly higher mixed and irregular surface structure rates than category 3 lesions (41 vs. 6%, p = 0.003 and 81 vs. 3%, p < 0.001, respectively). CONCLUSION MA-NBI can distinguish the mucin phenotypes of SNADETs and may facilitate histological grade diagnosis.
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Affiliation(s)
- Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Keijiro Okada
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Kentaro Aoki
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | | | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
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Inada T, Nakakuki T, Nakajima N, Miyake H, Shibuya S, Sakamoto T, Ishikawa M. Skull metastases from extramammary Paget’s disease emerging 8 years after initial treatment with no local progression: illustrative case. Journal of Neurosurgery: Case Lessons 2022; 4:CASE22280. [PMID: 36164671 PMCID: PMC9514261 DOI: 10.3171/case22280] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND
The foci of distant metastasis from extramammary Paget’s disease (EMPD) are the lung, liver, truncal bones, vertebrae, and brain. However, skull metastases have not been reported.
OBSERVATIONS
The authors treated a patient with calvarial and skull base metastases from EMPD who had undergone wide local resection of EMPD 8 years before, and they report his clinical course.
LESSONS
Because EMPD with distant metastasis is fatal, it should be recognized that EMPD can metastasize to the skull even when it seemed to be in remission for several years.
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Affiliation(s)
| | | | | | | | | | | | - Makiko Ishikawa
- Dermatology, Kyoto Katsura Hospital, Kyoto City, Kyoto, Japan
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6
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Beesley MA, Davidson JR, Panariello F, Shibuya S, Scaglioni D, Jones BC, Maksym K, Ogunbiyi O, Sebire NJ, Cacchiarelli D, David AL, De Coppi P, Gerli MFM. COVID-19 and vertical transmission: assessing the expression of ACE2/TMPRSS2 in the human fetus and placenta to assess the risk of SARS-CoV-2 infection. BJOG 2022; 129:256-266. [PMID: 34735736 PMCID: PMC8652560 DOI: 10.1111/1471-0528.16974] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pregnant women have been identified as a potentially at-risk group concerning COVID-19 infection, but little is known regarding the susceptibility of the fetus to infection. Co-expression of ACE2 and TMPRSS2 has been identified as a prerequisite for infection, and expression across different tissues is known to vary between children and adults. However, the expression of these proteins in the fetus is unknown. METHODS We performed a retrospective analysis of a single cell data repository. The data were then validated at both gene and protein level by performing RT-qPCR and two-colour immunohistochemistry on a library of second-trimester human fetal tissues. FINDINGS TMPRSS2 is present at both gene and protein level in the predominantly epithelial fetal tissues analysed. ACE2 is present at significant levels only in the fetal intestine and kidney, and is not expressed in the fetal lung. The placenta also does not co-express the two proteins across the second trimester or at term. INTERPRETATION This dataset indicates that the lungs are unlikely to be a viable route of SARS-CoV2 fetal infection. The fetal kidney, despite presenting both the proteins required for the infection, is anatomically protected from the exposure to the virus. However, the gastrointestinal tract is likely to be susceptible to infection due to its high co-expression of both proteins, as well as its exposure to potentially infected amniotic fluid. TWEETABLE ABSTRACT This work provides detailed mechanistic insight into the relative protection & vulnerabilities of the fetus & placenta to SARS-CoV-2 infection by scRNAseq & protein expression analysis for ACE2 & TMPRSS2. The findings help to explain the low rate of vertical transmission.
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Affiliation(s)
- MA Beesley
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
| | - JR Davidson
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
- EGA Institute for Women’s HealthUniversity College LondonUK
| | - F Panariello
- Telethon Institute of Genetics and Medicine (TIGEM)Armenise/Harvard Laboratory of Integrative GenomicsPozzuoliItaly
| | - S Shibuya
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
| | - D Scaglioni
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
| | - BC Jones
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
| | - K Maksym
- EGA Institute for Women’s HealthUniversity College LondonUK
| | - O Ogunbiyi
- NIHR Great Ormond Street Biomedical Research CentreLondonUK
| | - NJ Sebire
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
- Department of Translational MedicineUniversity of Naples ‘Federico II’NaplesItaly
| | - D Cacchiarelli
- Telethon Institute of Genetics and Medicine (TIGEM)Armenise/Harvard Laboratory of Integrative GenomicsPozzuoliItaly
- Department of Translational MedicineUniversity of Naples ‘Federico II’NaplesItaly
| | - AL David
- EGA Institute for Women’s HealthUniversity College LondonUK
- Fetal Medicine UnitUniversity College London NHS Foundation TrustLondonUK
| | - P De Coppi
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
- NIHR Great Ormond Street Biomedical Research CentreLondonUK
- Great Ormond Street Hospital for ChildrenLondonUK
| | - MFM Gerli
- Great Ormond Street Institute of Child HealthUniversity College LondonUK
- UCL Division of Surgery and Interventional ScienceRoyal Free HospitalLondonUK
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Tanaka Y, Tokubayashi Y, Kikuchi M, Fujii S, Kusaka T, Shibuya S, Kokuryu H. Gastric Cancer with Multiple Lymph Node Enlargement at the Time of the Sarcoidosis Diagnosis. Intern Med 2021; 60:3225-3229. [PMID: 33967139 PMCID: PMC8580756 DOI: 10.2169/internalmedicine.7218-21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
An 80-year-old woman was found to have a 40-mm depressed-type gastric cancer. Computed tomography showed multiple lymph node enlargement, including paraaortic lymph nodes. The extent of lymph node enlargement was significant compared with the depth of the primary lesion. We conducted distal gastrectomy, D2 lymph node dissection, and a paraaortic lymph node biopsy. Microscopically, the tumor was diagnosed as mucosal cancer. In the dissected lymph nodes, noncaseating granuloma was found without metastasis of adenocarcinoma. Immunohistochemical staining using Propionibacterium acnes-specific antibodies showed a large number of P. acnes-positive cells in the granulomas. Finally, the tumor was diagnosed as early-stage gastric cancer and sarcoidosis.
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Affiliation(s)
- Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Yumi Tokubayashi
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Mitsuya Kikuchi
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | | | - Hiroyuki Kokuryu
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
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8
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Uno S, Tanaka Y, Shibuya S, Okada K, Fujii S, Kusaka T, Minamiguchi S, Kushima R, Haga H. Primary pure pancreatic-type acinar cell carcinoma of the stomach. Pathol Int 2021; 71:798-800. [PMID: 34499781 DOI: 10.1111/pin.13164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Shunsuke Uno
- Department of Diagnostic Pathology, Kyoto Katsura Hospital, Nishikyo-ku, Kyoto, Japan.,Department of Diagnostic Pathology, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Nishikyo-ku, Kyoto, Japan
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kyoto Katsura Hospital, Nishikyo-ku, Kyoto, Japan
| | - Keijiro Okada
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Nishikyo-ku, Kyoto, Japan
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Nishikyo-ku, Kyoto, Japan
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Nishikyo-ku, Kyoto, Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
| | - Ryoji Kushima
- Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
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Tanaka Y, Fujii S, Oiwa Y, Kusaka T, Shibuya S, Kokuryu H. Efficacy of Magnifying Narrow Band Imaging with Acetic Acid Spray in Diagnosing Superficial Non-Ampullary Duodenal Epithelial Tumors. Digestion 2021; 102:572-579. [PMID: 32846421 DOI: 10.1159/000509854] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/28/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS The aim of the present study was to evaluate the efficacy of magnifying narrow band imaging with acetic acid spray (MA-NBI) in differentiating category 4/5 lesions from category 3 lesions of superficial non-ampullary duodenal epithelial tumors (SNADETs) as per Vienna Classification and to compare the diagnostic performances of both MA-NBI and magnifying narrow band imaging (M-NBI). METHODS We retrospectively identified 60 resected SNADETs (31 category 3 lesions and 29 category 4/5 lesions) in 60 patients who underwent M-NBI and MA-NBI preoperatively. We evaluated vascular and surface patterns using M-NBI and MA-NBI for characterizing category 3 and 4/5 lesions. The surface pattern was classified as tubular, villous, or mix structure using MA-NBI. In addition, lesions with disorganized and unclear structures with irregular margins that can be clearly recognized by MA-NBI were defined as irregular surface structures. RESULTS For MA-NBI, category 4/5 lesions had a significantly higher mix structure rate and higher irregular surface structure rate than category 3 lesions (62 vs. 16%, p < 0.001, and 86 vs. 19%, p < 0.001, respectively). The diagnostic accuracy of MA-NBI using mix and irregular surface structures for identifying category 4/5 lesions was as follows: sensitivity, 62/86%; specificity, 84/77%; positive predictive value, 78/78%; negative predictive value, 70/86%; and accuracy, 73/82%. The diagnostic accuracy of MA-NBI using irregular surface structure was significantly higher than that of M-NBI (p < 0.05). CONCLUSION MA-NBI may be useful in differentiating between category 3 and category 4/5 lesions of SNADETs.
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Affiliation(s)
- Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan,
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Yoko Oiwa
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
| | | | - Hiroyuki Kokuryu
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan
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10
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Abstract
An 80-year-old woman presented with a 30-mm protruding lesion-like submucosal tumor with a central depression located at the anterior wall of the upper gastric body. The depressed area had a well-demarcated margin, while the other area was covered by a non-neoplastic mucosa. A biopsy specimen revealed neuroendocrine carcinoma. Endoscopic ultrasonography revealed a heterogeneous mass with a clearly distinguished border in the submucosal layer. The mass had two distinct areas adjacent to each other. In addition, a hypoechoic zone was observed on the margin of the mass. Distal gastrectomy was performed. The final diagnosis was a mixed neuroendocrine-non-neuroendocrine neoplasm arising from the heterotopic gastric gland.
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Affiliation(s)
- Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Yumi Tokubayashi
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | | | - Hiroyuki Kokuryu
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
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11
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Kusumoto K, Yamazaki Y, Kokuryu H, Itokawa Y, Nakai Y, Azechi H, Fujii S, Kusaka T, Nishitai R, Shibuya S. [A case of concomitant pancreatic neuroendocrine neoplasm and intraductal papillary mucinous neoplasm in which preoperative diagnosis was difficult]. Nihon Shokakibyo Gakkai Zasshi 2020; 117:919-924. [PMID: 33041304 DOI: 10.11405/nisshoshi.117.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 75-year-old male patient has been followed-up for mixed-type intraductal papillary mucinous neoplasm (IPMN) in the tail of the pancreas for about 20 years. Upon close examination, he was diagnosed of high-risk stigmata due to a nodule having a contrast effect of 5mm or more in the tumor. Based on this, a distal pancreatectomy was performed. Histopathological analysis revealed concomitant IPMN (low-grade) and pancreatic neuroendocrine neoplasm (PNEN) (G1). This prompted us to report a very rare case of coexisting PNEN and IPMN with an interesting pathological finding that might suggest its pathogenic mechanism.
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Affiliation(s)
- Kiyonori Kusumoto
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Yuki Yamazaki
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Hiroyuki Kokuryu
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Yoshio Itokawa
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Yoshitaka Nakai
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Hidemasa Azechi
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Digestive Center, Kyoto Katsura Hospital
| | - Ryuta Nishitai
- Department of Surgery, Digestive Center, Kyoto Katsura Hospital
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12
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Matsuoka Y, Iemura Y, Fujimoto M, Shibuya S, Yamada A, Fujii S, Kusaka T, Shindo T, Minamiguchi S, Haga H. Upper Gastrointestinal Langerhans Cell Histiocytosis: A Report of 2 Adult Cases and a Literature Review. Int J Surg Pathol 2020; 29:550-556. [PMID: 33034230 DOI: 10.1177/1066896920964566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Langerhans cell histiocytosis (LCH) with primary involvement of the upper gastrointestinal (GI) tract is rare. We report 2 adult cases of localized LCH in the upper-GI tract, including the second reported adult case of esophageal LCH and review 11 previously reported cases. Case 1 involved the esophagus of a 61-year-old man; histiocytosis was detected when endoscopy was performed for an examination of epigastric pain. Case 2 involved the stomach of a 56-year-old woman wherein the lesion was detected during a follow-up endoscopy after Helicobacter pylori infection. Both biopsy specimens exhibited diffuse proliferation of mononuclear cells with nuclear convolution and a background of eosinophilic infiltrate. The cells were immunohistochemically positive for CD1a and langerin, and BRAF V600E mutation was detected in Case 2. Follow-up endoscopy for both cases revealed that the lesions disappeared without any treatment. It is important to avoid misdiagnosing LCH of the upper-GI tract as a malignant neoplasm.
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Affiliation(s)
- Yui Matsuoka
- Kyoto University Hospital, Sakyo-ku, Kyoto, Japan
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13
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Kuroda N, Tsutsui M, Iguchi M, Nobuoka E, Uehara T, Sonobe Y, Morinaga Y, Shibuya S, Oda W, Yanai H, Kawada C, Karashima T, Yamasaki I, Inoue K, Nagashima Y. Fumarate hydratase-deficient renal cell carcinoma: A clinicopathological study of seven cases including hereditary and sporadic forms. Ann Diagn Pathol 2020; 49:151599. [PMID: 32977234 DOI: 10.1016/j.anndiagpath.2020.151599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/03/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 10/23/2022]
Abstract
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) has been incorporated into the recent international histological classification of renal tumors. However, to date, there are limited studies describing the clinicopathological features of fumarate hydratase (FH)-deficient RCC, including the hereditary (HLRCC) and sporadic forms. Herein, we present a clinicopathological study of seven cases with FH-deficient RCC. The age of patients ranged from 26 to 70 years with mean and median age of 51.7 and 57 years, respectively. The follow-up data of all patients were available. One patient was alive without the disease and five patients were alive with active disease. One patient died of the disease. Family history of RCC, or skin or uterine smooth muscle tumor within second degree of kinship was present in four of seven patients. Metastasis was observed in all tumors. Metastatic sites included bone, lungs, liver, peritoneum, ovaries, tonsils, or lymph nodes. Grossly, the cut surface of the tumor usually showed light brown, brown, or whitish color. Microscopically, the cytoplasm of the tumor cells was predominantly eosinophilic and all tumors displayed various architectural patterns such as papillary, tubular, solid, or microcystic patterns. Furthermore, two tumors demonstrated a tubulocystic pattern. Sarcomatoid change and rhabdoid features were seen in five tumors and two tumors, respectively. Large cytomegaloviral (CMV) inclusion-like eosinophilic nucleoli surrounded by a clear halo were identified in all tumors. All tumors showed negative immunohistochemical reaction for FH protein. False positive results of TFE3 protein were observed in three tumors. Furthermore, a germline mutation of FH gene was identified in one patient with family history of the disease. In conclusion, FH-deficient RCC includes hereditary and sporadic forms. Grossly, this tumor is solitary and occurs unilaterally. Histologically, the tumor is characterized by various patterns such as papillary, tubular, solid, tubulocystic, or microcystic, has eosinophilic cytoplasm and CMV-like high-grade nuclei. FH-deficient RCCs frequently metastasize to other anatomic sites. TFE immunoreactivity may occur in some FH-deficient RCCs, and immunohistochemistry can accurately diagnose these tumors and mutational analysis of FH gene.
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Affiliation(s)
- Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi, Japan.
| | - Miho Tsutsui
- Department of Pathology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Mitsuko Iguchi
- Department of Pathology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Emi Nobuoka
- Department of Laboratory Medicine, Shinsyu University, Matsumoto, Japan
| | - Takeshi Uehara
- Department of Laboratory Medicine, Shinsyu University, Matsumoto, Japan
| | - Yuta Sonobe
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yukiko Morinaga
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Wakako Oda
- Department of Pathology, Okayama City Hospital, Okayama, Japan
| | - Hiroyuki Yanai
- Department of Pathology, Okayama University Hospital, Okayama, Japan
| | - Chiaki Kawada
- Department of Urology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Takashi Karashima
- Department of Urology, Kochi Medical School, Kochi University, Nankoku, Japan
| | | | - Keiji Inoue
- Department of Urology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University, Tokyo, Japan
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Abstract
An 80-year-old man was found to have a reddish depressed lesion on the middle thoracic esophagus. The morphology of the lesion had been almost unchanged for 3 years, but it transformed to a 2-cm depressed lesion with elevated margins and an irregular nodular surface. The lesion was resected endoscopically and ultimately diagnosed as a combined neuroendocrine carcinoma and squamous cell carcinoma with submucosal invasion. The patient was additionally treated with chemoradiotherapy but died of the primary disease eight months after the initial treatment. It is important to elucidate the natural history of this disease at an early stage.
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Affiliation(s)
- Yasuyuki Tanaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Daizen Hirata
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Shigehiko Fujii
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
| | - Toshihiro Kusaka
- Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Japan
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15
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Sueyoshi R, Shibuya S, Ochi T, Okawada M, Miyano G, Koga H, Lane GJ, Yamataka A. In prenatally diagnosed CPAM, does the affected lobe influence the timing of symptom onset? Pediatr Surg Int 2019; 35:559-563. [PMID: 30778700 DOI: 10.1007/s00383-019-04460-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Accepted: 02/08/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE We investigated the relationship between the affected lobe and symptom onset in prenatally diagnosed congenital pulmonary airway malformation (CPAM). METHODS 53 CPAM patients diagnosed prenatally were reviewed retrospectively by creating 2 groups according to symptom onset. Group Sneo: (symptomatic during the neonatal period; n = 13) and group S > neo: (symptomatic after the neonatal period; n = 40) were compared for type of CPAM, affected lobes, types of symptoms/infections, treatment, duration of follow-up, and histopathology. Requirement for surgery (Sx) was then used to create three subgroups: Sneo + Sx, S > neo + Sx, and Sx-. RESULTS Some cases had multiple affected lobes. In Sneo, symptoms developed in 55.6%, 50.0%, 0%, 0%, and 36.8% of right upper lobes (RUL), right middle lobes (RML), right lower lobes (RLL), left upper lobes (LUL), and left lower lobes (LLL) diagnosed with CPAM, prenatally. In S > neo, symptoms developed in 0%, 0%, 6.3%, 55.6%, and 33.3% of RUL, RML, RLL, LUL, and LLL diagnosed with CPAM, prenatally. CONCLUSION In prenatally diagnosed CPAM, RUL and RML lesions are more likely to become symptomatic in neonates, and LUL lesions in infants. Surgery is recommended before the onset of respiratory infections after 1 year of age.
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Affiliation(s)
- R Sueyoshi
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan.
| | - S Shibuya
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
| | - T Ochi
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
| | - M Okawada
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
| | - G Miyano
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
| | - H Koga
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
| | - G J Lane
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
| | - A Yamataka
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan
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16
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Miyazaki Y, Teramoto Y, Shibuya S, Goto T, Okasho K, Mizuno K, Uegaki M, Yoshikawa T, Akamatsu S, Kobayashi T, Ogawa O, Inoue T. Consecutive Prostate Cancer Specimens Revealed Increased Aldo⁻Keto Reductase Family 1 Member C3 Expression with Progression to Castration-Resistant Prostate Cancer. J Clin Med 2019; 8:jcm8050601. [PMID: 31052459 PMCID: PMC6571723 DOI: 10.3390/jcm8050601] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/27/2019] [Revised: 04/23/2019] [Accepted: 04/26/2019] [Indexed: 01/03/2023] Open
Abstract
Aldo-keto reductase family 1 member C3 (AKR1C3) is an enzyme in the steroidogenesis pathway, especially in formation of testosterone and dihydrotestosterone, and is believed to have a key role in promoting prostate cancer (PCa) progression, particularly in castration-resistant prostate cancer (CRPC). This study aims to compare the expression level of AKR1C3 between benign prostatic epithelium and cancer cells, and among hormone-naïve prostate cancer (HNPC) and CRPC from the same patients, to understand the role of AKR1C3 in PCa progression. Correlation of AKR1C3 immunohistochemical expression between benign and cancerous epithelia in 134 patient specimens was analyzed. Additionally, correlation between AKR1C3 expression and prostate-specific antigen (PSA) progression-free survival (PFS) after radical prostatectomy was analyzed. Furthermore, we evaluated the consecutive prostate samples derived from 11 patients both in the hormone-naïve and castration-resistant states. AKR1C3 immunostaining of cancer epithelium was significantly stronger than that of the benign epithelia in patients with localized HNPC (p < 0.0001). High AKR1C3 expression was an independent factor of poor PSA PFS (p = 0.032). Moreover, AKR1C3 immunostaining was significantly stronger in CRPC tissues than in HNPC tissues in the same patients (p = 0.0234). Our findings demonstrate that AKR1C3 is crucial in PCa progression.
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Affiliation(s)
- Yu Miyazaki
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Yuki Teramoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto 606-8507, Japan.
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto 606-8507, Japan.
| | - Takayuki Goto
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Kosuke Okasho
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Kei Mizuno
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Masayuki Uegaki
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Takeshi Yoshikawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Shusuke Akamatsu
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Takashi Kobayashi
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
| | - Takahiro Inoue
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan.
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Tabata R, Tabata C, Yamamoto N, Shibuya S, Yasumizu R, Kojima M. Progressive peripheral CD8+ T lymphocytosis complicated by pure red cell aplasia following immunosuppressive therapy for thymoma-associated myasthenia gravis. Int Immunopharmacol 2018; 63:14-18. [DOI: 10.1016/j.intimp.2018.07.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/12/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
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18
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Funada S, Kita Y, Okada Y, Kobayashi T, Teramoto Y, Shibuya S, Saito R, Murakami K, Matsumoto K, Yang F, Dimitrov DS, Inoue T, Ogawa O. Bladder urothelial carcinoma producing insulin-like growth factor II: A case report. IJU Case Rep 2018; 1:9-12. [PMID: 32743354 PMCID: PMC7292130 DOI: 10.1002/iju5.12018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/25/2018] [Accepted: 07/25/2018] [Indexed: 01/06/2023] Open
Abstract
Introduction Non-islet cell tumor hypoglycemia is a rare paraneoplastic syndrome associated with tumors. Although it mainly occurs in solid tumors of mesenchymal and epithelial origin, but rarely also in hematopoietic and neuroendocrine origin. Case presentation We describe a 65-year-old man with a muscle-invasive bladder urothelial carcinoma, which rapidly progressed against systemic chemotherapy consisting of gemcitabine and cisplatin. Notably, the patient developed hypoglycemia at the terminal stage of the disease. Pathological diagnosis was giant cell urothelial carcinoma, which was strongly positive for insulin-like growth factor-II in immunohistochemistry. We established patient-derived xenograft from insulin-like growth factor-II producing bladder urothelial carcinoma that caused non-islet cell tumor hypoglycemia. Although we evaluated the efficacy of the neutralizing antibody, there was no statistically significant inhibitory effect on tumor growth. Conclusion To the best of our knowledge, this is the first report of insulin-like growth factor-II-producing urothelial carcinoma that have been recapitulated in a patient-derived xenograft model.
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Affiliation(s)
- Satoshi Funada
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuki Kita
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yoshiyuki Okada
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Takashi Kobayashi
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuki Teramoto
- Department ofDiagnostic Pathology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Shinsuke Shibuya
- Department ofDiagnostic Pathology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Ryoichi Saito
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Kaoru Murakami
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Keiyu Matsumoto
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Feng Yang
- Cancer and Inflammation Program Center for Cancer Research National Cancer Institute Frederick Maryland USA
| | - Dimiter S Dimitrov
- Cancer and Inflammation Program Center for Cancer Research National Cancer Institute Frederick Maryland USA
| | - Takahiro Inoue
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Osamu Ogawa
- Department of Urology Kyoto University Graduate School of Medicine Kyoto Japan
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19
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Kato T, Sugimoto M, Yamashita M, Miyauchi Y, Hirama H, Tsunemori H, Ueda N, Imachi H, Shibuya S, Kushida Y, Kakehi Y. Retroperitoneal liposarcoma excreting insulin-like growth factor 2 that induced severe hypoglycemia. Int J Urol 2016; 24:162-165. [PMID: 28012446 DOI: 10.1111/iju.13276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 07/12/2016] [Accepted: 11/24/2016] [Indexed: 11/28/2022]
Abstract
Insulin-like growth factor 2 is overexpressed in various cancers, and is associated with a poor prognosis. Also, it is known that insulin-like growth factor 2 is an etiology of non-islet cell tumor hypoglycemia. In this report, we describe a case of unexpected hypoglycemia caused by a dedifferentiated liposarcoma producing insulin-like growth factor 2. A large mass in the retroperitoneum was detected in a 61-year-old man who complained of appetite loss. Despite having no history of diabetes mellitus, hypoglycemia suddenly occurred after admission, but oral glucose therapy was ineffective. After total parenteral nutrition, tumor resection was attempted, but failed as a result of rigid adhesion to the surrounding organs. The patient died of the disease 21 days after surgery. Pathological diagnosis at autopsy revealed dedifferentiated liposarcoma, and immunohistochemical staining showed that the tumor excreted insulin-like growth factor 2. The possibility of an insulin-like growth factor 2-producing tumor should be taken into consideration when we encounter a patient with spontaneous hypoglycemia resistant to glucose substitution therapy.
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Affiliation(s)
- Takuma Kato
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Mikio Sugimoto
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Motoki Yamashita
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Yasuyuki Miyauchi
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Hiromi Hirama
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Hiroyuki Tsunemori
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Nobufumi Ueda
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Hitomi Imachi
- Department of Endocrinology and Metabolism, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Yoshio Kushida
- Department of Diagnostic Pathology, Kagawa University Faculty of Medicine, Kagawa, Japan
| | - Yoshiyuki Kakehi
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan
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20
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Arakaki R, Yamasaki T, Kanno T, Shibasaki N, Sakamoto H, Utsunomiya N, Sumiyoshi T, Shibuya S, Tsuruyama T, Nakamura E, Ogawa O, Kamba T. CCL2 as a potential therapeutic target for clear cell renal cell carcinoma. Cancer Med 2016; 5:2920-2933. [PMID: 27666332 PMCID: PMC5083746 DOI: 10.1002/cam4.886] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 02/26/2016] [Revised: 07/07/2016] [Accepted: 08/01/2016] [Indexed: 12/21/2022] Open
Abstract
We previously reported that the pVHL‐atypical PKC‐JunB pathway contributed to promotion of cell invasiveness and angiogenesis in clear cell renal cell carcinoma (ccRCC), and we detected chemokine (C‐C motif) ligand‐2 (CCL2) as one of downstream effectors of JunB. CCL2 plays a critical role in tumorigenesis in other types of cancer, but its role in ccRCC remains unclear. In this study, we investigated the roles and therapeutic potential of CCL2 in ccRCC. Immunohistochemical analysis of CCL2 expression for ccRCC specimens showed that upregulation of CCL2 expression correlated with clinical stage, overall survival, and macrophage infiltration. For functional analysis of CCL2 in ccRCC cells, we generated subclones of WT8 cells that overexpressed CCL2 and subclones 786‐O cells in which CCL2 expression was knocked down. Although CCL2 expression did not affect cell proliferation in vitro, CCL2 overexpression enhanced and CCL2 knockdown suppressed tumor growth, angiogenesis, and macrophage infiltration in vivo. We then depleted macrophages from tumor xenografts by administration of clodronate liposomes to confirm the role of macrophages in ccRCC. Depletion of macrophages suppressed tumor growth and angiogenesis. To examine the effect of inhibiting CCL2 activity in ccRCC, we administered CCL2 neutralizing antibody to primary RCC xenografts established from patient surgical specimens. Inhibition of CCL2 activity resulted in significant suppression of tumor growth, angiogenesis, and macrophage infiltration. These results suggest that CCL2 is involved in angiogenesis and macrophage infiltration in ccRCC, and that CCL2 could be a potential therapeutic target for ccRCC.
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Affiliation(s)
- Ryuichiro Arakaki
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshinari Yamasaki
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toru Kanno
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noboru Shibasaki
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiromasa Sakamoto
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriaki Utsunomiya
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Sumiyoshi
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tatsuaki Tsuruyama
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Eijiro Nakamura
- Laboratory for Malignancy Control Research/Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Osamu Ogawa
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomi Kamba
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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21
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Sato Y, Mii A, Hamazaki Y, Fujita H, Nakata H, Masuda K, Nishiyama S, Shibuya S, Haga H, Ogawa O, Shimizu A, Narumiya S, Kaisho T, Arita M, Yanagisawa M, Miyasaka M, Sharma K, Minato N, Kawamoto H, Yanagita M. Heterogeneous fibroblasts underlie age-dependent tertiary lymphoid tissues in the kidney. JCI Insight 2016; 1:e87680. [PMID: 27699223 PMCID: PMC5033938 DOI: 10.1172/jci.insight.87680] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [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] [Received: 03/22/2016] [Accepted: 06/13/2016] [Indexed: 12/16/2022] Open
Abstract
Acute kidney injury (AKI) is a common clinical condition defined as a rapid decline in kidney function. AKI is a global health burden, estimated to cause 2 million deaths annually worldwide. Unlike AKI in the young, which is reversible, AKI in the elderly often leads to end-stage renal disease, and the mechanism that prevents kidney repair in the elderly is unclear. Here we demonstrate that aged but not young mice developed multiple tertiary lymphoid tissues (TLTs) in the kidney after AKI. TLT size was associated with impaired renal function and increased expression of proinflammatory cytokines and homeostatic chemokines, indicating a possible contribution of TLTs to sustained inflammation after injury. Notably, resident fibroblasts from a single lineage diversified into p75 neurotrophin receptor+ (p75NTR+) fibroblasts and homeostatic chemokine-producing fibroblasts inside TLTs, and retinoic acid-producing fibroblasts around TLTs. Deletion of CD4+ cells as well as late administration of dexamethasone abolished TLTs and improved renal outcomes. Importantly, aged but not young human kidneys also formed TLTs that had cellular and molecular components similar to those of mouse TLTs. Therefore, the inhibition of TLT formation may offer a novel therapeutic strategy for AKI in the elderly.
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Affiliation(s)
| | | | | | | | | | - Kyoko Masuda
- Department of Immunology, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | | | | | | | | | - Akira Shimizu
- Department of Experimental Therapeutics, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan
| | - Shuh Narumiya
- Medical Innovation Center, Graduate School of Medicine
| | - Tsuneyasu Kaisho
- Department of Immunology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - Makoto Arita
- Laboratory for Metabolomics, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Masashi Yanagisawa
- Department of Molecular Genetics, Howard Hughes Medical Institute, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- International Institute for Integrative Sleep Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masayuki Miyasaka
- Institute for Academic Initiatives, Osaka University, Osaka, Japan
- MediCity Research Laboratory, University of Turku, Turku, Finland
| | - Kumar Sharma
- Center for Renal Translational Medicine and Institute of Metabolomic Medicine, Department of Medicine, University of California San Diego, Veteran’s Administration San Diego Health Care System, La Jolla, California, USA
| | | | - Hiroshi Kawamoto
- Department of Immunology, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
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22
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Nishino H, Hatano E, Seo S, Shibuya S, Anazawa T, Iida T, Masui T, Taura K, Haga H, Uemoto S. Histological features of mixed neuroendocrine carcinoma and hepatocellular carcinoma in the liver: a case report and literature review. Clin J Gastroenterol 2016; 9:272-9. [PMID: 27384317 DOI: 10.1007/s12328-016-0669-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/22/2016] [Indexed: 12/14/2022]
Abstract
Primary hepatic neuroendocrine carcinoma (NEC) is rare, and its origin, clinical features, diagnosis and treatment have not been clarified. Primary mixed NEC and hepatocellular carcinoma (HCC) is even rarer and is divided into either combined type or collision type. We report a patient with the combined type of mixed NEC and HCC. A 72-year-old male was diagnosed with HCC and underwent hepatectomy because of the presence of two tumors in his liver. Histological examination demonstrated that one of the tumors had both NEC and HCC components. The transitional zone was noted in the immunohistological examination, and the tumor was determined to be the combined type of primary mixed NEC and HCC. This was the first description of an HCC component being found in an NEC-dominant area in a primary mixed NEC and HCC tumor. Three weeks after hepatectomy, an abdominal computed tomography scan showed extensive regional and para-aortic lymphadenopathy, and early relapse was suspected in the patient. The patient died 3 months after the operation despite treatment with combination chemotherapy. This report describes an unfavorable case and summarizes all the primary mixed NEC and HCC tumor cases that have been previously reported.
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MESH Headings
- Aged
- Carcinoma, Hepatocellular/diagnostic imaging
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/surgery
- Carcinoma, Neuroendocrine/diagnostic imaging
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/surgery
- Hepatectomy/methods
- Humans
- Liver Neoplasms/diagnostic imaging
- Liver Neoplasms/pathology
- Liver Neoplasms/surgery
- Magnetic Resonance Imaging
- Male
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Positron Emission Tomography Computed Tomography
- Tomography, X-Ray Computed
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Affiliation(s)
- Hiroto Nishino
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Etsuro Hatano
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Satoru Seo
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takayuki Anazawa
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Taku Iida
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Toshihiko Masui
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kojiro Taura
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shinji Uemoto
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Randhawa JS, Yoshino H, Kobayashi T, Kofuji S, Finley K, Majd N, Malhotra A, Wise-Draper T, Yamasaki T, Shibuya S, Ogawa O, Okumura K, Sasaki A. Dynamic role of GTP-energy metabolism in metastasis of renal cell carcinomas: Prognosis and therapeutic applications. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e16107] [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)
| | | | | | | | | | | | | | | | | | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Osamu Ogawa
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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24
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Sunada T, Kobayashi T, Furuta A, Shibuya S, Okada Y, Negoro H, Terada N, Yamasaki T, Matsui Y, Inoue T, Kamba T, Ogawa O. Large Retroperitoneal Mass Diagnosed as Adrenal Chronic Expanding Hematoma. Urology 2015; 86:e17-9. [DOI: 10.1016/j.urology.2015.06.043] [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] [Received: 04/16/2015] [Revised: 06/21/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
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25
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Shibayama T, Okamoto T, Nakashima Y, Kato T, Sakurai T, Minamiguchi S, Kataoka TR, Shibuya S, Yoshizawa A, Toguchida J, Haga H. Screening of BCOR-CCNB3 sarcoma using immunohistochemistry for CCNB3: A clinicopathological report of three pediatric cases. Pathol Int 2015; 65:410-4. [DOI: 10.1111/pin.12319] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 05/07/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Takahiro Shibayama
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takeshi Okamoto
- Department of Orthopedic Surgery; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Yasuaki Nakashima
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takaaki Kato
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Takaki Sakurai
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Tatsuki R. Kataoka
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
| | - Junya Toguchida
- Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application; Kyoto University; Kyoto Japan
| | - Hironori Haga
- Department of Diagnostic Pathology; Kyoto University Graduate School of Medicine; Kyoto Japan
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26
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Hayashi T, Haba R, Kushida Y, Katsuki N, Shibuya S, Kadota K, Matsunaga T, Miyake K, Tamiya T. Pilomyxoid astrocytoma of the pineal region: cytopathological features and differential diagnostic considerations by intraoperative smear preparation. Diagn Cytopathol 2014; 43:121-4. [PMID: 24578310 DOI: 10.1002/dc.23133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 08/27/2013] [Revised: 01/14/2014] [Accepted: 02/16/2014] [Indexed: 11/08/2022]
Abstract
Pilomyxoid astrocytoma (PMA) is a recently identified type of pilocytic astrocytoma (PA) with shorter progression-free and overall survival, higher rate of recurrence, and higher risk of leptomeningeal spread compared to pilocytic tumors (WHO grade 2 designation). A case is presented here in which intraoperative imprint smears of a pineal region tumor in a 14-year-old girl revealed cytologic monomorphism, elongated cells with bland nuclei embedded in a myxoid background. The tumor cells possessed uniformly round nuclei with a smooth nuclear outline, fine granular chromatin, and small nucleoli. Slender cytoplasmic fibrillary processes and angiocentric arrangement were observed but Rosenthal fibers or eosinophilic granular bodies were absent. A cytologic diagnosis of PMA of the pineal region was suggested by intraoperative smear preparation. Histology and immunohistochemical results confirmed the final diagnosis. This report shows that smear preparation can be trustworthy for the intraoperative diagnosis of PMA, helping to determine the appropriate neurosurgical procedure and therapeutic implications.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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27
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Bando K, Shibuya S, Matsunaga T. Cytopathologic characteristics and differential diagnostic considerations of osteolytic myxopapillary ependymoma. Diagn Cytopathol 2013; 42:778-83. [PMID: 23913845 DOI: 10.1002/dc.23033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 01/13/2013] [Revised: 04/12/2013] [Accepted: 06/11/2013] [Indexed: 11/09/2022]
Abstract
Myxopapillary ependymoma (MPE) is a rare variant of conventional ependymoma found predominantly in the sacrococcygeal region in young adults and characterized by its distinct epithelial and stromal components (WHO grade I designation). MPE with extensive osteolysis is extremely uncommon and only up to 40 cases have been documented. A case is presented here in which imprint smears of a sacral tumor in an 18-year-old man revealed complex papillary structures, small loose clusters, or cord-like structures of bland tumor cells embedded in a myxoid or mucinous background. The tumor cells possessed uniformly round nuclei with a smooth nuclear outline, fine granular chromatin, and small nucleoli. Slender cytoplasmic fibrillary processes and occasional intracytoplasmic vacuoles were observed. A cytologic diagnosis of a MPE was suggested and histochemical and immunohistochemical studies were conducted on formalin-fixed, paraffin-embedded material. Immunohistochemically, the tumor cells showed diffuse and strong membranous and cytoplasmic staining for cytokeratin AE1/AE3, glial fibrillary protein, and S-100 protein, but negative for epithelial membrane antigen, pan-neuroendocrine markers (i.e., NSE, chromogranin A, synaptophysin), or brachyury. The proliferative index with MIB-1 was around 10%. The diagnosis of osteolytic MPE was confirmed based on cytopathologic, histopathological, immunohistochemical results, radiologic findings, and the location of the tumor. We demonstrated here the cytopathological features of osteolytic MPE with emphasis on differential diagnostic considerations.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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28
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Okazoe H, Zhang X, Liu D, Shibuya S, Ueda N, Sugimoto M, Kakehi Y. Expression and role of GPR87 in urothelial carcinoma of the bladder. Int J Mol Sci 2013; 14:12367-79. [PMID: 23752273 PMCID: PMC3709790 DOI: 10.3390/ijms140612367] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/01/2013] [Accepted: 06/03/2013] [Indexed: 11/16/2022] Open
Abstract
The orphan GPR87 has recently been matched with its ligand LPA, which is a lipid mediator with multiple physiological functions, including cancer cell proliferation. This study aimed to clarify the role of GPR87 in urothelial carcinoma of the bladder. GPR87 expression was assessed in seven human bladder cancer cell lines. A replication-deficient recombinant adenoviral vector expressing shRNA targeting GPR87 (Ad-shGPR87), was constructed. Gene silencing was carried out using Ad-shGPR87. Immunohistochemical analysis was performed for transurethral resection of bladder tumor samples from 71 patients with non-muscle-invasive bladder cancer. We observed GPR87 expression in five of the seven cell lines, and silencing GPR87 gene expression significantly reduced cell viability. GPR87 expression was positive in 38 (54%) of 71 tumors. Ki-67 index was associated with positive GPR87 staining status (p < 0.0001). Patients with GPR87-positive tumors had shorter intravesical recurrence-free survival than those with GPR87-negative tumors (p = 0.010). Multivariate analysis revealed that GPR87 staining status was an independent prognostic parameter for intravesical recurrence (p = 0.041). Progression from non-muscle-invasive to muscle-invasive tumor was more frequently observed in patients with GPR87-positive tumors, although this trend did not reach statistical significance (p = 0.056). These results warrant further prospective studies to clarify the role of GPR87 expression in intravesical recurrence and progression in bladder cancer.
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Affiliation(s)
- Homare Okazoe
- Department of Urology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mails: (H.O.); (X.Z.); (N.U.); (M.S.)
| | - Xia Zhang
- Department of Urology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mails: (H.O.); (X.Z.); (N.U.); (M.S.)
| | - Dage Liu
- Department of General Thoracic Surgery, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mail:
| | - Shinsuke Shibuya
- Department of Diagnostic Pathology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mail:
| | - Nobufumi Ueda
- Department of Urology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mails: (H.O.); (X.Z.); (N.U.); (M.S.)
| | - Mikio Sugimoto
- Department of Urology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mails: (H.O.); (X.Z.); (N.U.); (M.S.)
| | - Yoshiyuki Kakehi
- Department of Urology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; E-Mails: (H.O.); (X.Z.); (N.U.); (M.S.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-87-891-2202; Fax: +81-87-891-2203
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Sugimoto M, Hirama H, Hayashida Y, Shibuya S, Ueda N, Kakehi Y. Cellular intermingling between adrenal gland and liver: an infrequent cause of incomplete resection at right adrenalectomy. J Endourol 2013; 27:804-8. [PMID: 23339404 DOI: 10.1089/end.2012.0708] [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] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To assess the incidence of difficulty in complete dissection between the right adrenal gland and the liver at the time of laparoscopic surgery for adrenal tumor and to elucidate its cause histopathologically. PATIENTS AND METHODS Thirty-six patients underwent laparoscopic right adrenalectomy between 2004 and 2011 at our institution. Two reviewers independently assessed difficulty in dissection for the 36 nonedited video records of laparoscopic right adrenalectomy in blinded fashion. Twenty-seven records were evaluable for the judgment of difficulty in dissection between the lower surface of the liver and the right adrenal gland. On the other hand, the gross and microscopic relationship between the right adrenal gland and the surface of the liver was investigated in 32 cadavers. RESULTS Incomplete resection of the adrenal gland was found in 11 of 27 (40.7%) patients. Difficulties in dissection because of adhesions between the liver and the adrenal gland were apparently recognized in 5 of 27 (18.5%) patients. Pathologic assessment for cadavers revealed that capsules between these two organs are partially fused in 10 of 32 (31.3%) cases. Histopathologically, intermingling of parenchymal cells (infiltration through the fibrous capsules) was observed in nine (28.1%) cases. CONCLUSIONS The tight adhesion between the lower surface of the liver and the adrenal gland because of intermingling of parenchymal cells of both organs is a major cause of incomplete resection of right adrenalectomy. Surgeons have to keep this fact in mind during right adrenalectomy to avoid unnecessary adverse events.
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Affiliation(s)
- Mikio Sugimoto
- Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan.
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30
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Sugimoto M, Hirama H, Hayashida Y, Shibuya S, Ueda N, Kakehi Y. 41 CELLULAR INTERMINGLING BETWEEN ADRENAL GLAND AND LIVER: AN INFREQUENT CAUSE OF INCOMPLETE RESECTION AT RIGHT ADRENALECTOMY. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.1417] [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: 11/16/2022]
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31
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Takahashi T, Kansaku K, Wada M, Shibuya S, Kitazawa S. Neural Correlates of Tactile Temporal-Order Judgment in Humans: an fMRI Study. Cereb Cortex 2012; 23:1952-64. [DOI: 10.1093/cercor/bhs179] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Miyai Y, Shibuya S, Sasaki M, Bando K, Matsunaga T, Hata T. Cytopathologic characteristics of the primary strumal carcinoid tumor of the ovary: a case report with emphasis on differential diagnostic considerations. Diagn Cytopathol 2011; 41:812-6. [PMID: 22144175 DOI: 10.1002/dc.22811] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 08/12/2011] [Accepted: 10/31/2011] [Indexed: 11/10/2022]
Abstract
Primary strumal carcinoid tumor of the ovary (SCTO) is an extremely rare entity, though the survival rate is excellent if the disease is confined to one ovary. A case is presented here in which intraoperative squash smears in a 45-year-old woman with a left adnexal mass revealed dispersed or small clusters of neoplastic cells forming loosely cohesive gland-like structures with abundant cytoplasm. The nuclear chromatin was finely granular with a "salt and pepper" appearance and occasional tiny nucleoli. The position of the nucleus presented a vaguely plasmacytoid appearance. Small fragments of thyroidal colloid-like structures were also identified. A cytopathologic diagnosis of a SCTO was suggested. Further evaluation and immunohistochemical studies were conducted on formalin-fixed, paraffin-embedded material. Cords or nests of uniform cells with abundant cytoplasm, and eccentric nuclei with coarse chromatin and occasional colloidal tissue were identified on H&E sections. The tumor cells showed diffuse and strong cytoplasmic staining for chromogranin A, synaptophysin, CD56, and vimentin but were negative for calretinin, α-inhibin or CDX2. The proliferative index with MIB-1 was around 3%. Thyroidal colloid-like structures were immunoreactive for thyroglobulin and TTF-1 stains. The diagnosis of primary SCTO was confirmed based on cytopathologic, histopathological, and immunohistochemical results, and the location of the tumor. Awareness of the cytopathological findings of SCTO can assist in diagnosing this rare entity correctly.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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33
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Bando K, Miyai Y, Shibuya S, Matsunaga T. Cytopathologic characteristics and differential diagnostic considerations of neuroglial heterotopia of the retropharyngeal space. Diagn Cytopathol 2011; 39:857-61. [PMID: 21994200 DOI: 10.1002/dc.21575] [Citation(s) in RCA: 3] [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] [Received: 09/13/2010] [Accepted: 09/22/2010] [Indexed: 11/06/2022]
Abstract
Neuroglial heterotopias (NGH) are rare congenital head and neck lesions composed of differentiated neuroectodermal tissue and representing developmental heterotopias rather than true neoplasms. The case of a male neonate with respiratory distress and early feeding problems depicting a retropharyngeal space mass which in the intraoperative squash smears revealed glial cells with multiple cytoplasmic processes is reported here. Small clusters of cuboidal epithelial cells with rosette-like ependymal structures and cuboidal cells arranged in sheets or branching folds suggestive of choroid plexus cells were also identified. Through this cytological approach a cytologic diagnosis of a NGH or low-grade astrocytoma was suggested. Further evaluation and immunohistochemical studies were conducted on formalin-fixed, paraffin-embedded material. Glial cells, ependymal structures and choroid plexus were identified on H&E sections. Immunohistochemically, the glial cells showed diffuse and strong cytoplasmic staining for glial fibrillary acidic protein (GFAP) and S-100 protein and focal immunoreactivity for synaptophysin and neurofilament. The proliferative index with MIB-1 was around 4%. The diagnosis of NGH of the retropharyngeal space was confirmed based on the clinical, cytopathologic, histopathology, immunohistochemical results, and the location of the tumor. We demonstrated here for the first time the cytopathological features of NGH of the retropharyngeal space with emphasis on differential diagnostic considerations.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Miyai Y, Bando K, Shibuya S, Matsunaga T, Yokomise H. Cytopathologic findings and differential diagnostic considerations of primary clear cell carcinoma of the lung. Diagn Cytopathol 2011; 41:550-4. [DOI: 10.1002/dc.21827] [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: 06/06/2011] [Accepted: 08/09/2011] [Indexed: 11/09/2022]
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35
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Hayashi T, Haba R, Tanizawa J, Katsuki N, Kadota K, Miyai Y, Bando K, Shibuya S, Nakano M, Kushida Y. Cytopathologic features and differential diagnostic considerations of primary lymphoepithelioma-like carcinoma of the lung. Diagn Cytopathol 2011; 40:820-5. [PMID: 21433005 DOI: 10.1002/dc.21670] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 01/22/2011] [Indexed: 11/11/2022]
Abstract
Primary lymphoepithelioma-like carcinoma (LELC) of the lung is an extremely rare disease that occurs more commonly in Asians, and is composed of undifferentiated carcinoma with prominent lymphoid stroma. LELC is reported to be closely associated with Epstein-Barr virus (EBV) infection. A case is presented here in which bronchial brushing smears in a 70-year-old man, revealed large clusters of neoplastic cells with scant cytoplasm. The nuclei were large, hyperchromatic, of irregular contour and with prominent nucleoli. Also identified were prominent intratumoral lymphoid infiltration and brisk mitotic figures. We detected EBV-coded small RNA in situ hybridization in smears. A cytologic diagnosis of a LELC was suggested. Further evaluation and immunohistochemical studies were conducted on formalin-fixed, paraffin-embedded material. Cords or nests of large neoplastic cells with enlarged nuclei and prominent nucleoli with marked lymphoid infiltration and lymphoid stroma were identified on H&E sections. Immunohistochemically, the tumor cells showed diffuse and strong membranous staining for CK(AE1/AE3), CK5/6, CK34βE12, Napsin A and Bcl-2 but were negative for CK7, CK14, CK20, EMA, TTF-1, chromogranin A, synaptophysin and CD56. The proliferative index with MIB-1 was around 60%, and the p53 positive cells around 20%. The diagnosis of primary LELC of the lung was confirmed based on cytopathologic, histopathologic, immunohistochemical and EBER results, and a detailed systemic examination to exclude possible extrapulmonary (nasopharyngeal) origin. We report the cytopathological features of LELC of the lung and demonstrate here for the first time the positivity of the EBER with RNA-ISH method in smears with emphasis on differential diagnostic considerations.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa Prefecture, Japan.
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36
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Kadota K, Haba R, Katsuki N, Hayashi T, Miyai Y, Bando K, Shibuya S, Kushida Y. Cytological findings of mixed squamous cell and glandular papilloma in the lung. Diagn Cytopathol 2010; 38:913-7. [DOI: 10.1002/dc.21334] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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37
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Igarashi K, Shibuya S, Sano H, Takahashi M, Hasegawa M, Ichimura S, Satomi K, Ohki Y. P31-17 Analysis of the target-reaching movement in patients with cervical myelopathy. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)61184-4] [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: 11/29/2022]
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38
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Miyai Y, Bando K, Shibuya S, Funamoto Y, Kakehi Y. Cytopathological features of warty (condylomatous) carcinoma of the penis: a case report and distinction from other verruciform penile tumors. Diagn Cytopathol 2010; 38:841-5. [PMID: 20301209 DOI: 10.1002/dc.21341] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Warty (condylomatous) carcinoma (WC) is a rare specific variant of invasive squamous cell carcinoma that shows hybrid features of condyloma with invasive cell carcinoma. As compared with conventional squamous cell carcinoma, WC tends to run a less aggressive clinical course. A case is presented here in which squash smears of a penile foreskin tumor in a 65-year-old male revealed small cohesive clusters and sheets of tumor cells in papillary configurations. The neoplastic cells were polygonal to elongated and contained oval nuclei, coarse chromatin pattern, and distinct nucleoli. Nuclear pleomorphism and loss of nuclear polarity were observed. Characteristically, there were also many koilocytes demonstrating mild to moderate nuclear atypia and perinuclear cytoplasmic halos. A cytologic diagnosis of a verruciform penile tumor was suggested. Histologic examination of the tumor showed a hyper-parakeratotic arborizing papillomatous growth with thin fibrovascular cores and the tips were variably rounded or tapered. Obvious koilocytic cytopathic change, nuclear pleomorphism, and focal stromal invasion were observed. Immunohistochemically, the tumor cells showed diffuse and strong membranous staining for cytokeratin (AE1/AE3) while the MIB-1 and p53 immunoreactive cells were confined to the basal areas of the papillae. No lymphovascular invasion was detected in D2-40 or elastic Van-Gieson stains. On the basis of the overall features, we confirmed a final diagnosis of penile WC. We demonstrated here for the first time the cytopathological features of penile WC with emphasis on differential diagnostic considerations.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
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39
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Bando K, Miyai Y, Shibuya S, Funamoto Y, Shindo A, Miyake K, Tamiya T. Cytopathologic features of orbital intraosseous chordoid meningioma: Report of a case and distinction from other myxoid/mucoid tumors. Diagn Cytopathol 2010; 38:818-21. [DOI: 10.1002/dc.21326] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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40
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Kadota K, Haba R, Katsuki N, Chujo K, Okada S, Nakamura H, Hayashi T, Miyai Y, Bando K, Shibuya S, Kushida Y. Bronchial brushing cytology of a pulmonary fetal adenocarcinoma with a poorly differentiated component. Cytopathology 2009; 21:349-51. [PMID: 20015256 DOI: 10.1111/j.1365-2303.2009.00724.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Kadota K, Kushida Y, Miyai Y, Katsuki N, Hayashi T, Bando K, Shibuya S, Haba R. Epidermoid cyst in an intrapancreatic accessory spleen: three case reports and review of the literatures. Pathol Oncol Res 2009; 16:435-42. [PMID: 19949910 DOI: 10.1007/s12253-009-9229-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [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: 07/27/2009] [Accepted: 11/16/2009] [Indexed: 01/19/2023]
Abstract
The development of an epidermoid cyst in an intrapancreatic accessory spleen is an extremely rare lesion, with only 17 cases being reported in the English literature. All such cases were located in the pancreatic tail, some of which showed carbohydrate antigen 19-9 (CA19-9) immunoreactivity in the lining of the epithelium. A few of them indicated an elevation of the serum CA19-9 level. Here we report three cases of an epidermoid cyst in an intrapancreatic accessory spleen. Cases 1 and 2 were 57-year-old and 70-year-old women, while case 3 was a 37-year-old man. All three cases were asymptomatic. Serum CA19-9 levels showed within normal limits (case 1), slightly elevated (case 2), and clearly elevated (case 3). They underwent a distal pancreatectomy with splenectomy (cases 1 and 2) and without splenectomy (case 3). Grossly, the surgical specimen was a well-demarcated, multiple (case 1) or solitary (cases 2 and 3) cystic mass in the pancreatic tail. A high level of fluid CA 19-9 was detected in case 1. Microscopically, the cystic walls were lined with squamous and cuboidal epithelium, which were surrounded by normal splenic tissue and hyalinized fibrous tissue. The lining squamous epithelium was revealed as nonkeratinizing (Cases 1 and 2) or keratinizing (Case 3). Immunohistochemically, CA19-9 was positive in the monolayer and surface layer of the cuboidal epithelium, but negative for the keratinizing squamous epithelium. As for the histogenesis, it is suggested that the cystic lining of the epithelium may derive from the pancreatic duct which protrudes into the accessory spleen.
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Affiliation(s)
- Kyuichi Kadota
- Department of Diagnostic Pathology, University Hospital, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kagawa, Japan.
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Shirai T, Ikegami M, Fujimoto S, Souda H, Tanabe M, Tongu H, Noda A, Noda K, Fujimoto T, Iwata S, Shibuya S, Smirnov A, Meshkov I, Fadil H, Grieser M. One-dimensional beam ordering of protons in a storage ring. Phys Rev Lett 2007; 98:204801. [PMID: 17677703 DOI: 10.1103/physrevlett.98.204801] [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] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 02/25/2007] [Indexed: 05/16/2023]
Abstract
The ordering of protons has been observed at a new storage ring, S-LSR, at Kyoto University. Abrupt jumps in the momentum spread and the Schottky noise power were observed for protons for the first time at a particle number of approximately 2000, upon applying electron cooling with electron currents of 25, 50, and 100 mA. The transition temperature was 0.17 and 1 meV in the longitudinal and transverse directions, respectively. The transverse temperature of the proton beam was much below that of electrons at the transition, which played an essential role in the ordering of protons.
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Affiliation(s)
- T Shirai
- Institute for Chemical Research, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan.
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Chikamori F, Kuniyoshi N, Kawashima T, Shibuya S, Takase Y. Percutaneous transhepatic obliteration for isolated gastric varices with gastropericardiac shunt: case report. ACTA ACUST UNITED AC 2006; 31:249-52. [PMID: 16245014 DOI: 10.1007/s00261-005-0372-y] [Citation(s) in RCA: 5] [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: 10/25/2022]
Abstract
Management of isolated gastric varices with a gastropericardiac shunt (GPS) has not yet been established. We were able to control a case of isolated gastric varices with a GPS by percutaneous transhepatic obliteration (PTO) using a microcatheter. In this case, the main blood drainage route was not a gastrorenal shunt, so transvenous retrograde obliteration could not be performed and PTO using the microcatheter was applied. Percutaneous transhepatic splenic venography revealed that the gastric varices came from the posterior gastric vein and the main drainage route was a GPS. Gastric varices and their blood supply were superselectively embolized using platinum microcoils and absolute ethanol. Portal venous pressure did not change after PTO because the route from the left gastric vein to the azygos venous system was preserved. Computed tomography 7 days after PTO revealed that the gastric varices were completely obliterated by the thrombi. Plasma ammonia level, arterial ketone body ratio, and indocyanine green retention rate at 15 min were improved. We conclude that PTO using a microcatheter is a rational, effective, and safe therapy for isolated gastric varices with a GPS.
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Affiliation(s)
- F Chikamori
- Tsukuba Portal Hypertension Study Group, Kuniyoshi Hospital, 1-3-4 Kamimachi, Kochi City, Kochi 780-0901, Japan.
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Chikamori F, Kuniyoshi N, Kagiyama S, Kawashima T, Shibuya S, Takase Y. Role of percutaneous transhepatic obliteration for special types of varices with portal hypertension. ACTA ACUST UNITED AC 2006; 32:92-5. [PMID: 16802200 DOI: 10.1007/s00261-006-9007-1] [Citation(s) in RCA: 15] [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: 10/24/2022]
Abstract
The treatment of special types of varices with portal hypertension has not yet been established. We were able to control 13 cases of special types of varices by percutaneous transhepatic obliteration (PTO). These 13 cases consisted of 2 esophagojejunal varices after total gastrectomy for gastric cancer, 1 stoma varices after abdominoperineal excision for rectal cancer, 2 mesenteric varices with encephalopathy, 1 gastric variceal rupture, 1 gastrorenal and gastroazygos shunt with encephalopathy, 3 giant bar-type esophageal varices, 2 isolated gastric varices with gastropericardiac shunts, and 1 isolated gastric varices with gastrophrenic shunt. The special types of varices were successfully embolized in all cases and there were no complications. We conclude that the PTO is still an effective and safe treatment for special types of varices with portal hypertension.
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Affiliation(s)
- F Chikamori
- Department of Surgery, Kuniyoshi Hospital, 1-3-4 Kamimachi, Kochi City, Kochi 780-0901, Japan.
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Wakayama Y, Inoue M, Kojima H, Jimi T, Yamashita S, Kumagai T, Shibuya S, Hara H, Oniki H. Altered alpha1-syntrophin expression in myofibers with Duchenne and Fukuyama muscular dystrophies. Histol Histopathol 2006; 21:23-34. [PMID: 16267784 DOI: 10.14670/hh-21.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Alpha1-syntrophin, a scaffolding adapter and modular protein, is a cytoplasmic component of the dystrophin glycoprotein complex. This study investigated immunohistochemically the expression of alpha1-syntrophin in Duchenne and Fukuyama muscular dystrophies (DMD and FCMD, respectively). Biopsied muscles of five DMD, five FCMD, five normal controls and five disease controls (three myotonic and two facioscapulohumeral dystrophies) were analyzed. Immunoblot analysis showed that anti-alpha1-syntrophin antibody had a decreased reaction in both DMD and FCMD muscle extracts. Biopsied muscle sections and their serial sections were immunostained with rabbit anti-alpha1-syntrophin and rabbit anti-muscle-specific beta-spectrin antibodies, respectively. Immunoreactive patterns of sarcolemma were classified into (i) a continuously positive immunostaining pattern, (ii) a partially positive immunostaining pattern, (iii) a negative immunostaining pattern and (iv) a faint but entire surface positive immunostaining pattern. The group mean percentages of alpha1-syntrophin and beta-spectrin immunonegative myofibers in the DMD group were 39.3% and 10.8%, respectively, while those in the FCMD group were 45.5% and 10.4%, respectively. These values were statistically significant compared with those of disease control and normal control muscles. Thus we found that dystrophin-deficient DMD muscles contained significant numbers of alpha1-syntrophin-positive fibers and significant numbers of alpha1-syntrophin-negative fibers were present in dystrophin-positive muscles of severe muscular dystrophy such as FCMD. Alpha-dystrobrevin immunoreactivity was tested in DMD muscles and appreciable amounts of alpha-dystrobrevin that binds to syntrophin were found in DMD muscle membranes.
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Affiliation(s)
- Y Wakayama
- Department of Neurology, Showa University Fujigaoka Hospital, Yokohama, Japan.
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Shiga Y, Miyazawa K, Sato S, Fukushima R, Shibuya S, Sato Y, Konno H, Doh-ura K, Mugikura S, Tamura H, Higano S, Takahashi S, Itoyama Y. Diffusion-weighted MRI abnormalities as an early diagnostic marker for Creutzfeldt-Jakob disease. Neurology 2005; 63:443-9. [PMID: 15304574 DOI: 10.1212/01.wnl.0000134555.59460.5d] [Citation(s) in RCA: 207] [Impact Index Per Article: 10.9] [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: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the usefulness of diffusion-weighted MRI (DWI) for the early diagnosis of Creutzfeldt-Jakob disease (CJD). METHODS Thirty-six consecutive patients (age 56 to 82 years) were enrolled, and 26 were examined by DWI. Nine were definite based on the World Health Organization criteria, and 27 were probable. The percentages of DWI abnormalities, periodic sharp wave complexes (PSWCs) on the EEG, detection of CSF 14-3-3 protein, and increase of CSF neuron-specific enolase (>25 ng/mL) on the first examination were compared. For DWI, 32 patients (age 31 to 84 years) who showed progressive dementia or impaired consciousness served as disease controls. RESULTS The percentage of DWI abnormalities was 92.3%, of PSWCs 50.0%, of 14-3-3 protein detection 84.0%, and of NSE increase 73.3%. Two of the 32 control subjects were falsely positive on DWI. The sensitivity of DWI was 92.3% (95% CI 74.8 to 99.5%) and specificity 93.8% (95% CI 79.2 to 99.2%). In 17 patients who did not show PSWCs on the first EEG, abnormal DWI findings were still clearly detected. Four patients who were negative for 14-3-3 protein also showed DWI abnormalities. DWI abnormalities were detected as early as at 3 weeks of symptom duration in four patients in whom PSWCs were not yet evident. CONCLUSIONS DWI can detect characteristic lesions in the majority of patients with CJD regardless of the presence of PSWCs. DWI was the most sensitive test for the early clinical diagnosis of CJD; consideration should be given to its inclusion in the clinical diagnostic criteria of CJD.
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Affiliation(s)
- Y Shiga
- Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
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Abstract
The authors describe the clinical features of Creutzfeldt-Jakob disease (CJD) with the causative point mutation at codon 180. The symptoms never started with visual or cerebellar involvement. The patients showed slower progression of the disease compared with sporadic CJD. They never showed periodic sharp and wave complexes in EEG. MRI demonstrated remarkable high-intensity areas with swelling in the cerebral cortex except for the medial occipital and cerebellar cortices. These characteristic MRI findings are an important clue for an accurate premortem diagnosis.
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Affiliation(s)
- K Jin
- Department of Neurology, Tohoku University School of Medicine, Sendai, Japan
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Ohnishi T, Shibuya S, Nemoto I, Koike S, Takizawa H, Suzuki T, Watanabe S. Evidence from mucin core protein expression that some Paget's disease on areola can be of extramammary-like histogenesis and part of multisite disease. Br J Dermatol 2004; 151:688-92. [PMID: 15377360 DOI: 10.1111/j.1365-2133.2004.06087.x] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Triple extramammary Paget's disease, which consists ordinarily of bilateral axillary and genital lesions, is uncommon. Triple extramammary Paget's disease involving other sites has never been reported, although solitary extramammary Paget's disease can occur at various sites around the body. Erythematous plaques on the areola, axilla and genitalia of a 91-year-old man were surgically removed under the clinical diagnosis of multiple extramammary Paget's disease. Histology revealed that all three lesions consisted of intraepidermal nests of Paget cells and other isolated Paget cells scattered in the epidermis. Although adnexal invasion was observed in the genital lesion, neither intraductal invasion nor underlying breast carcinoma was detected in the areolar lesion. Immunohistochemically, the Paget cells in all lesions expressed simple epithelial cytokeratins (CK8, 18 and 19), mucin (MUC)1 and MUC5AC, but neither CK20 nor MUC2. From the histological findings, the present case was interpreted as triple extramammary Paget's disease rather than synchronous mammary and extramammary Paget's disease. Furthermore, the mucin core protein expression pattern, which was identical to that observed in extramammary Paget's disease, supported the above interpretation.
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Affiliation(s)
- T Ohnishi
- Department of Dermatology, Teikyo University School of Medicine, 11-1 Kaga-2, Itabashi-ku, Tokyo 173-8605, Japan.
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Luic M, Koellner G, Yokomatsu T, Shibuya S, Bzowska A. Binary complex of calf spleen purine nucleoside phosphorylase with a potent multisubstrate analogue inhibitor. Acta Crystallogr A 2004. [DOI: 10.1107/s0108767304096643] [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: 11/10/2022] Open
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Imamura H, Shibuya S, Uchida K, Teshima K, Masuda R, Miyamoto N. Effect of moderate exercise on excess post-exercise oxygen consumption and catecholamines in young women. J Sports Med Phys Fitness 2004; 44:23-9. [PMID: 15181386] [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: 04/29/2023]
Abstract
AIM The purpose of this study was to examine the effects of moderate exercise on the magnitude and duration of excess post-exercise oxygen consumption (EPOC) and catecholamine concentrations in 7 young women. METHODS The subjects performed 30 or 60 minutes of exercise (30-ME and 60-ME, respectively) on separate days at an intensity of 60% of maximal oxygen uptake on a cycle ergometer. The glucose, epinephrine and norepinephrine in the plasma, and free fatty acids and glycerol in the serum were measured at the end of the 60 min of the rest period before each exercise, immediately after the performance of each exercise and 30 min, 1, 2 and 24 h time points after each exercise. RESULTS EPOC lasted for 46.1+/-25.4 and 116.1+/-79.8 min after the 30- and 60-ME, respectively. Corresponding total EPOC were 2636+/-1125 and 5208+/-1880 ml, respectively. The mean differences were statistically significant (p<0.05 each). The serum free fatty acids significantly increased immediately after the 60-ME. The serum glycerol was significantly increased immediately after the 30-ME and was also significantly increased immediately after and 30 min time point after the 60-ME. The plasma epinephrine and norepinephrine significantly increased immediately after the 30- and 60-ME, respectively. The plasma epinephrine at the 30 min time point after the 60-ME significantly correlated with the magnitude (r=0.955) and duration (r=0.897) of EPOC. Norepinephrine at the 30 min time point after the 60-ME also significantly correlated with the magnitude (r=0.774) of EPOC. CONCLUSION The results indicate that longer duration exercise results in a greater and longer EPOC, and the plasma catecholamines may possibly contribute to EPOC in young women. Although, the overall magnitude of EPOC is small, if exercise frequency and compliance are strong, some long term benefits may accrue.
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Affiliation(s)
- H Imamura
- Laboratory of Nutrition and Exercise Physiology, Department of Food and Nutrition, Nakamura Gakuen University, Fukuoka, Japan.
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