[Show abstract][Hide abstract] ABSTRACT: To examine the radiofrequency ablation (RFA) reliability in early breast cancer, we performed RFA followed by delayed surgical resection on 41 patients with invasive or non-invasive breast carcinoma less than 2 cm. MRI scans were obtained before ablation and resection. Excised specimens were examined pathologically by haematoxylin-eosin and nicotinamide adenine dinucleotide-diaphorase staining. 40 patients completed 1 RFA session, which was sufficient to achieve complete tumour cell death. Overall complete ablation rate was 87.8% (36/41). There were no treatment-related complications other than that of a superficial burn in 1 case. After RFA, the tumour was no longer enhanced on MRI in 25/26 (96.2%) cases. Residual cancer, which was suspected on MRI in 1 case, was confirmed pathologically. MRI could be an applicable modality to evaluate therapeutic effect. RFA could be an alternate local treatment option to breast-conserving surgery for early breast cancer.
Breast (Edinburgh, Scotland) 06/2011; 20(5):431-6. · 2.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A 72-year-old woman presented at our hospital with a 1-year history of intermittent right lower abdominal pain. Colonoscopic examination revealed a submucosal tumor with a pitted surface in the terminal ileum. Histopathological diagnosis of the carcinoid tumor was made following biopsy. Blood serotonin and urine 5-hydroxy-indoleacetic acid levels were normal, and carcinoid syndrome was not detected. Enhanced abdominal computed tomography scan and 18F-fluorodeoxyglucose positron emission tomography failed to detect multiple lesions, lymph node swelling or distant metastasis. Laparoscopy-assisted ileocecal resection with lymph node dissection was performed. The resected specimen showed a submucosal tumor with a pitted surface 11 x 11 mm in size, located at the terminal ileum. Histopathological examination revealed a well-differentiated endocrine cell carcinoma with an invasion depth to the muscularis propria. Immunohistochemical analysis showed the tumor cells to be chromogranin A and CD56-positive. The patient had no sign of recurrence for 16 months.
Hiroshima journal of medical sciences 06/2010; 59(2):35-8.
[Show abstract][Hide abstract] ABSTRACT: Vulvar Paget's disease (VPD) is classified into primary and secondary types. Differentiation of these subsets in biopsy specimen is important for appropriate therapy. Expression profile of cytokeratin (CK) 7 and CK20, gross cystic disease fluid protein-15 and uroplakin III has been reported as a differentiation marker of primary and secondary VPD. To examine the role of p63 immunostaining in differential diagnosis between primary VPD and VPD secondary to urothelial carcinoma (VPD-UC), expression of p63 was examined in nine cases of VPD. Paget cells in seven cases of VPD without UC did not express p63. In two cases of VPD associated with UC, Paget cells and UC cells had identical CK expression profile. UC cells were positive for p63 in both cases. In one case, Paget cells were positive for p63 and examination of the resected specimen showed that VPD was secondary to UC. In another case, Paget cells were negative for p63 and this was diagnosed as primary VPD independent of UC. This indicates that p63 is absent in Paget cells in primary VPD and is therefore useful in differentiating primary VPD from VPD-UC.
Pathology International 11/2008; 58(10):648-51. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To predict the response to primary systemic chemotherapy (PSC) involving weekly paclitaxel (PTX) followed by FEC100, we analyzed the therapeutic effects of PSC on 58 cases of stage II - III advanced breast cancer, 2 cases of PD, 4 cases of suspension due to adverse events, and 52 successful cases (89.7%). As for clinical effect, CR was observed in 12 cases (23.1%) and PR in 33 cases (63.5%) and for histological effects, grade 3 (pCR) was observed in 7 cases (13.5%) and grade 2 in 13 cases (25.0%). At the time of completion of 4 courses of PTX, SD was observed in 34 out of 52 cases, but the number of SD decreased to 28 cases on completion of 8 courses of PTX, to 19 cases on completion of 12 courses of PTX, and to 7 cases on completion of 4 courses of FEC. In examining the 7 cases of pCR in whom the histological effect was observed, 3 cases of SD were observed on completion of 4 courses of PTX and 2 cases on completion of 8 courses of PTX. Unless PD is observed during the course of PSC, continuation of therapy would be indicated because of the delayed response.
Gan to kagaku ryoho. Cancer & chemotherapy 10/2008; 35(9):1513-7.
[Show abstract][Hide abstract] ABSTRACT: Certain HMB-45-positive epithelioid cell tumors have recently been categorized under a unified concept: perivascular epithelioid cell tumor (PEComa). In this report, we describe ajejunal PEComa arising in a 32-year-old woman without other tumors or stigmata of tuberous sclerosis. The tumor consisted of nests of epithelioid cells with clear to granular eosinophilic cytoplasm. The nests were separated by thin fibrovascular septa. The tumor cells were positive for HMB-45 and progesterone receptor, and negative for cytokeratin, epithelial membrane antigen, vimentin, desmin, alpha-smooth muscle actin and CD34. RT-PCR analysis failed to reveal fusion transcript ETW/ATF1, which is characteristic of clear cell sarcoma of the soft parts. She developed a recurrent tumor at the pelvic wall and the left ovary at 13 and 25 months after the first operation, respectively. Each tumor was resected surgically, and no additional therapy was performed. We think the tumor of this case is a malignant form of PEComa because of the clinical history of multiple recurrences and the size of the primary tumor. Our case underscores that to make a correct diagnosis, clinical information and immunohistochemical examination are essential.
Pathology - Research and Practice 02/2003; 199(1):47-50. · 1.21 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We report an interesting case of pleomorphic adenoma (PA) with extensive adenoid cystic carcinoma (ACC)-like cribriform areas of parotid gland along with a discussion of the differential diagnosis. The patient was a 62-year-old-female who presented with a 5-month history of a slow-growing painless mass in the left preauricular region. Pathological examination of the excised mass revealed a well-encapsulated tumor consisting of typical PA areas and extensive ACC-like cribriform areas. The transition between both areas was frequently observed. There was no clinical or histological evidence of a longstanding PA, such as prominent hyalinization with dystrophic calcification. Immunohistochemically, the neoplastic myoepithelial cells of the PA areas showed frequent expression of vimentin and S-100 protein, along with occasional positivity for glial fibrillary acidic protein and alpha-smooth muscle actin. The immunoreactivity of the neoplastic myoepithelial/basal cells forming cribriform nests was essentially identical to that of the PA areas. The difference of immunoreactivity of the basal/myoepithelial cells between PA and ACC may have some discriminatory advantage. In addition, the low proliferative activity observed in the entire tumor suggested that the cribriform nests resembling ACC are also the component of PA.
Pathology International 02/2003; 53(1):30-4. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A case of ovarian immature teratoma with rhabdomyosarcomatous recurrence in a 6-year-old girl is described. The primary tumor consisted of a dermoid cyst and a solid nodule composed of mature and immature mesenchymal tissue. The most immature mesenchymal cells showed no distinctive differentiation except for focal rhabdomyoblastic differentiation. The primary tumor was diagnosed as immature teratoma, grade 2, stage IIa. Despite left oophorectomy and excision of uterine serosal implants, chemotherapy, and radiation, four intrapelvic recurrences developed within 3 years. Although the primary tumor contained only a few rhabdomyoblasts, the recurrent tumors became increasingly rhabdomyosarcomatous. The patient died of systemic disease 3 years after presentation. This case and previous reports indicate that the prognosis of patients with ovarian immature teratoma with rhabdomyosarcomatous recurrence is poor and similar to that of primary ovarian rhabdomyosarcoma.
International Journal of Gynecological Pathology 02/2002; 21(1):82-5. · 1.41 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An autopsy case of vascular dementia, clinically resembling Creutzfeldt-Jakob disease, is reported. A 74-year-old woman showed progressive dementia, transient myoclonus of the right upper arm, diffuse periodic synchronous discharges on electroencephalography, and brain atrophy on computed tomography. The duration of the illness was 17 months. Neuropathologic findings were numerous small necrotic foci in the middle and lower layers of the cerebral cortex, myelin pallor of the cerebral white matter, and fibrous thickening of the arterial and arteriolar walls in the cerebrum and cerebellum (both cortex and white matter). Vascular dementia was diagnosed. On the basis of these features, it is considered that such neuropathologic changes caused Creutzfeldt-Jakob-like symptoms, such as dementia and periodic synchronous discharges.
[Show abstract][Hide abstract] ABSTRACT: An autopsy case of progressive supranuclear palsy (PSP) with degeneration of the fronto-pontine tracts of the midbrain and pons, and without grumose degeneration of the dentate nucleus is reported. A 72-year-old woman was suffering from dysarthria and gait disturbance. Moderate dementia was noted and gradually worsened. Pyramidal and extrapyramidal signs and cerebellar ataxia were not observed. Eye movements were fully preserved. Brain CT showed cerebellar atrophy. Three years later, she was unable to stand or move, and became mutistic. At the age of 75, she died suddenly. The duration of her illness was approximately 4 years. Clinical diagnosis was LCCA (late cortical cerebellar atrophy). Neuropathological examination revealed gliosis of the deep layers of the cerebral cortex around the precentral gyrus, fronto-pontine tracts degeneration (posterior part of the anterior crus, genu and anterior part of the posterior crus of the internal capsule, cerebral peduncles of the midbrain, pontine base and pyramis of the medulla oblongata). Also, atrophy of the pons and marked degeneration of the superior colliculi and substantia nigra were observed. Neurofibrillary tangles (NFTs) and glial fibrillary tangles (GFTs) were found in the subcortical nuclei. These findings were almost consistent with PSP. However, the following differed from those of previously reported typical PSP cases: firstly, mild gliosis in the reticular formation of the midbrain; secondly, few NFTs in the pontine nuclei and superior colliculi and; thirdly, no grumose degeneration in the dentate nucleus. In addition, clinical symptoms of the present case are not consistent with PSP. Therefore, we concluded this case to be an atypical PSP both clinically and neuropathologically.
Nō to shinkei = Brain and nerve 12/1996; 48(11):1037-45.
[Show abstract][Hide abstract] ABSTRACT: We present the case of an 8-year-old girl with a ganglioneuroma in the left cerebellopontine angle region. The tumor originated
from the sensory root of the trigeminal nerve. Histopathologically, it was composed of neoplastic ganglion cells and Schwann
cells, leading us to the diagnosis of ganglioneuroma. Intracranial ganglioneuroma is very rare. To our knowledge, this is
the first report of a trigeminal ganglioneuroma. The nature and origin of this tumor are discussed and the literature reviewed.