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Tamada S, Edo H, Sakima T, Tanaka R, Shikata K, Nishitani S, Miyamoto M, Takano M, Kuboshima K, Miyai K, Ogata S, Shinmoto H. A case of low-grade endometrial stromal sarcoma presented as an intramyometrial mass mimicking uterine leiomyoma on MRI. BJR Case Rep 2024; 10:uaad012. [PMID: 38352264 PMCID: PMC10860526 DOI: 10.1093/bjrcr/uaad012] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/26/2023] [Accepted: 12/08/2023] [Indexed: 02/16/2024] Open
Abstract
A low-grade endometrial stromal sarcoma (ESS) has a pattern of presenting as an intramyometrial mass and is often misdiagnosed as cellular leiomyoma or degenerative uterine leiomyoma. A low-grade ESS is a malignant tumour that requires total hysterectomy with bilateral salpingo-oophorectomy; while a leiomyoma is a benign tumour and could be acceptable for enucleation. As the treatment strategies differ between a low-grade ESS and leiomyoma, radiologists should be familiar with the characteristic MRI findings of a low-grade ESS. A 51-year-old woman with abnormal uterine bleeding had been observed for 2 years at a previous hospital for a uterine leiomyoma based on MRI findings. A contrast-enhanced MRI demonstrated an intramyometrial mass composed of three components with the hypointense rim on T2-weighted images (T2WI): the first component was a homogeneous solid structure with mild hyperintensity on T2WI with a low apparent diffusion coefficient value; the second component was cystic; the third component was a structure of low signal intensity on T2WI similar to the muscle. Although a degenerative uterine leiomyoma was a differential diagnosis, these MRI findings were suggestive of a low-grade ESS. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and partial omentectomy were performed. The pathological diagnosis was a low-grade ESS. In a low-grade ESS, there are three major patterns of MRI findings: one of these patterns is the less popular but clinically important intramyometrial mass pattern, which can be misdiagnosed as a leiomyoma, and this case conformed to this pattern.
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Affiliation(s)
- Soichiro Tamada
- Department of Radiology, National Defense Medical College, Saitama 359-8513, Japan
| | - Hiromi Edo
- Department of Radiology, National Defense Medical College, Saitama 359-8513, Japan
| | - Taishi Sakima
- Department of Radiology, National Defense Medical College, Saitama 359-8513, Japan
| | - Ryo Tanaka
- Department of Radiology, National Defense Medical College, Saitama 359-8513, Japan
| | - Kohei Shikata
- Department of Radiology, National Defense Medical College, Saitama 359-8513, Japan
| | - Soko Nishitani
- Department of Obstetrics and Gynecology, National Defense Medical College, Saitama 359-8513, Japan
| | - Morikazu Miyamoto
- Department of Obstetrics and Gynecology, National Defense Medical College, Saitama 359-8513, Japan
| | - Masashi Takano
- Department of Obstetrics and Gynecology, National Defense Medical College, Saitama 359-8513, Japan
| | - Keisuke Kuboshima
- Department of Pathology and Laboratory Medicine, National Defense Medical College Hospital, Saitama 359-8513, Japan
| | - Kosuke Miyai
- Department of Pathology and Laboratory Medicine, National Defense Medical College Hospital, Saitama 359-8513, Japan
| | - Sho Ogata
- Department of Pathology and Laboratory Medicine, National Defense Medical College Hospital, Saitama 359-8513, Japan
| | - Hiroshi Shinmoto
- Department of Radiology, National Defense Medical College, Saitama 359-8513, Japan
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Kishimoto N, Miyamoto M, Imauji A, Takada M, Nishitani S, Tanabe R, Ito T, Hada T, Otsuka Y, Takano M. Clinical significance of retained products of conception in placenta previa: a retrospective analysis. BMC Pregnancy Childbirth 2023; 23:481. [PMID: 37391723 DOI: 10.1186/s12884-023-05805-0] [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: 12/30/2022] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Retained products of conception (RPOC) often cause severe postpartum hemorrhage (PPH) but the clinical significance of RPOC in placenta previa is unclear. This study aimed to investigate the clinical significance of RPOC in women with placenta previa. The primary outcome was to evaluate risk factors of RPOC and the secondary outcome was to consider risk factors of severe PPH. METHODS Singleton pregnant women with placenta previa who underwent cesarean section (CS) and placenta removal during the operation at the National Defense Medical College Hospital between January 2004 and December 2021 were identified. A retrospective analysis was performed to examine the frequency and risk factors of RPOC and the association of RPOC with severe PPH in pregnant women with placenta previa. RESULTS This study included 335 pregnant women. Among these, 24 (7.2%) pregnant women developed RPOC. Pregnant women with prior CS (Odds Ratio (OR) 5.98; 95% Confidence Interval (CI) 2.35-15.20, p < 0.01), major previa (OR 3.15; 95% CI 1.19-8.32, p < 0.01), and placenta accreta spectrum (PAS) (OR 92.7; 95% CI 18.39-467.22, p < 0.01) were more frequent in the RPOC group. Multivariate analysis revealed that prior CS (OR 10.70; 95% CI 3.47-33.00, p < 0.01,) and PAS (OR 140.32; 95% CI 23.84-825.79, p < 0.01) were risk factors for RPOC. In pregnant women who have placenta previa with RPOC or without RPOC, the ratio of severe PPH were 58.3% and 4.5%, respectively (p < 0.01). Furthermore, the occurrence of prior CS (OR 9.23; 95% CI 4.02-21.20, p < 0.01), major previa (OR 11.35; 95% CI 3.35-38.38, p < 0.01), placenta at the anterior wall (OR 3.44; 95% CI 1.40-8.44, p = 0.01), PAS (OR 16.47; 95% CI 4.66-58.26, p < 0.01), and RPOC (OR 29.70; 95% CI 11.23-78.55, p < 0.01) was more in pregnant women with severe PPH. In the multivariate analysis for severe PPH, prior CS (OR 4.71; 95% CI 1.29-17.13, p = 0.02), major previa (OR 7.50; 95% CI 1.98-28.43, p < 0.01), and RPOC (OR 13.26; 95% CI 3.61-48.63, p < 0.01) were identified as risk factors. CONCLUSIONS Prior CS and PAS were identified as risk factors for RPOC in placenta previa and RPOC is closely associated with severe PPH. Therefore, a new strategy for RPOC in placenta previa is needed.
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Affiliation(s)
- Naohisa Kishimoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Morikazu Miyamoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Akari Imauji
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Minori Takada
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Soko Nishitani
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Risa Tanabe
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Tsubasa Ito
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Taira Hada
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Yuka Otsuka
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Masashi Takano
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
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Hada T, Miyamoto M, Ohtsuka Y, Suminokura J, Ito T, Kishimoto N, Nishitani S, Takada M, Imauji A, Tanabe R, Takano M. Genetic analysis for mucinous ovarian carcinoma with infiltrative and expansile invasion and mucinous borderline tumor: a retrospective analysis. Diagn Pathol 2023; 18:49. [PMID: 37081552 PMCID: PMC10120221 DOI: 10.1186/s13000-023-01340-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/21/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Mucinous carcinoma (MC) is a histological subtype of ovarian cancer that has a worse prognosis at advanced stages than the most prevalent histological subtype, high-grade serous carcinomas. Invasive patterns have been recognized as prognostic factors for MCs. MCs with infiltrative invasion were more aggressive than those with expansile invasion. MC with an expansile pattern exhibited behavior similar to mucinous borderline tumors (MBT). However, genomic analysis of invasive patterns is insufficient. This study aimed to compare genetic information between groups with MC and infiltrative invasion (Group A) and those with MC with expansile invasion or MBT (Group B). METHODS Ten cases each of MC with infiltrative invasion, MC with expansile invasion, and MBT between 2005 and 2020 were identified. Deoxyribonucleic acid (DNA) extraction from formalin-fixed paraffin-embedded tissues was performed, and cases with DNA fragmentation or the possibility of DNA fragmentation were excluded. Mutant base candidates and tumor mutation burden (TMB) values (mutations/megabase) were calculated. RESULTS After assessing the quality of purified DNA, seven cases of MC with infiltrative invasion, five cases of MC with expansile invasion, and three cases of MBT were included. More patients in group A experienced recurrence or progression (p < 0.01) and died of disease (p = 0.03). Moreover, the TMB value was statistically higher in group A than in group B (p = 0.049). There were no statistical differences in the incidence of the mutations of KRAS, TP53, and CREBBP. KRAS, TP53, and CREBBP mutations were discovered in 8/15 (53.3%), 6/15 (40.0%), and 5/15 (33.3%) cases, respectively. CONCLUSIONS Genetic analysis revealed that Group A had higher TMB than Group B. Therefore, this result might be useful for future treatment.
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Affiliation(s)
- Taira Hada
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Morikazu Miyamoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Yuka Ohtsuka
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Jin Suminokura
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Tsubasa Ito
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Naohisa Kishimoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Soko Nishitani
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Minori Takada
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Akari Imauji
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Risa Tanabe
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Masashi Takano
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa, Saitama, 359-8513, Japan
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Nishitani S, Kuwamoto S, Takahira A, Miyamura T, Shinohara K. Maternal Prefrontal Cortex Activation by Newborn Infant Odors. Chem Senses 2014; 39:195-202. [DOI: 10.1093/chemse/bjt068] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Shinohara K, Nishitani S. S52-4 Neural correlates of maternal love, paternal love and children's love for their parents. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)60314-8] [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: 11/25/2022]
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So K, Moriya T, Nishitani S, Takahashi H, Shinohara K. The olfactory conditioning in the early postnatal period stimulated neural stem/progenitor cells in the subventricular zone and increased neurogenesis in the olfactory bulb of rats. Neuroscience 2007; 151:120-8. [PMID: 18093744 DOI: 10.1016/j.neuroscience.2007.07.051] [Citation(s) in RCA: 14] [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] [Received: 01/09/2007] [Revised: 07/03/2007] [Accepted: 07/26/2007] [Indexed: 11/18/2022]
Abstract
The olfactory memory acquired during the early postnatal period is known to be maintained for a long period, however, its neural mechanism remains to be clarified. In the present study, we examined the effect of olfactory conditioning during the early postnatal period on neurogenesis in the olfactory bulb of rats. Using the bromodeoxyuridine-pulse chase method, we found that the olfactory conditioning, which was a paired presentation of citral odor (conditioned stimulus) and foot shock (unconditioned stimulus) in rat pups on postnatal day 11, stimulated the proliferation of neural stem/progenitor cells in the anterior subventricular zone (aSVZ), but not in the olfactory bulb, at 24 h after the conditioning. However, the number of newborn cells in the olfactory bulb was increased at 2 weeks, but not 8 weeks, after such conditioning. Neither the exposure of a citral odor alone nor foot shock alone affected the proliferation of neural stem/progenitor cells in the aSVZ at 24 h after and the number of newborn cells in the olfactory bulb at 2 weeks after. The majority of newborn cells in the olfactory bulb of either the conditioned rats or the unconditioned rats expressed the neural marker NeuN, thus indicating that the olfactory conditioning stimulated neurogenesis in the olfactory bulb. These results suggest that olfactory conditioning during the early postnatal period temporally stimulates neurogenesis in the olfactory bulb of rats.
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Affiliation(s)
- K So
- Department of Neurobiology and Behavior, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
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Kurokawa T, Asada S, Nishitani S, Hazeki O. Age-related changes in manganese superoxide dismutase activity in the cerebral cortex of senescence-accelerated prone and resistant mouse. Neurosci Lett 2001; 298:135-8. [PMID: 11163296 DOI: 10.1016/s0304-3940(00)01755-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this paper, we showed that the oxidative stress in brain of senescence-accelerated prone mouse 8 (SAMP8) at earlier stages was increased compared with that of senescence-accelerated resistant mouse 1 (SAMR1) irrespective of the breeding conditions. Furthermore, we found that manganese superoxide dismutase (Mn-SOD) activity in the cerebral cortex of 10-week-old SAMP8 was decreased by about 50% compared with that in age-matched SAMR1. These results indicate that the decrease of Mn-SOD activity may be involved in the increased oxidative stress in the brain of SAMP8 at younger stages. However, there was no difference in the expression of this protein between the two strains at 10 weeks of age, suggesting that Mn-SOD protein in SAMP8 was post-translationally modified to reduce its enzymatic activity.
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Affiliation(s)
- T Kurokawa
- Department of Physiological Chemistry, Faculty of Medicine, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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Tsubata T, Nomura T, Nishitani S. [B lymphocyte antigen CD40 and its ligand, CD40L]. Seikagaku 1995; 67:51-5. [PMID: 7535832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- T Tsubata
- Department of Medical Chemistry, Faculty of Medicine, Kyoto University
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