-
[show abstract]
[hide abstract]
ABSTRACT: Perineuriomas are uncommon benign peripheral nerve sheath tumors that include soft tissue, sclerosing, reticular, and intraneural variants. Soft tissue perineuriomas arise in a wide anatomic distribution and mostly in patients older than 20 years of age. We report an atypical perineurioma in a 7-year-old girl. The tumor, located in the tongue, was uniformly hypercellular. The tumor cells were spindle-shaped with a slender, elongated, bipolar, wavy cytoplasmic process formation and wavy elongated nuclei, and the architecture was composed of predominantly short fascicles with areas exhibiting a vague storiform pattern. Although the tumor cells generally appeared bland, the tumor showed worrisome features including an infiltrative pattern and occasional mitotic figures. Psammoma bodies were observed in the periphery of the tumor. Immunohistochemically, the cells were positive for epithelial membrane antigen, vimentin, claudin-1, and GLUT-1, but negative for S-100 protein, CD34, and type IV collagen. The authors document a case of soft tissue perineurioma with atypical histological features that occurred in the tongue of a child.
Pathology International 12/2010; 60(12):787-91. · 1.62 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Cystic nephroma is a relatively rare and benign renal lesion of uncertain etiology. Approximately 200 cases have been described, but only a few cases of cystic nephroma with prominent renal pelvis involvement have been reported. Here, we report an unusual case of cystic nephroma that protruded into the renal pelvis. A 45-year-old woman hospitalized because of a right renal mass detected on clinical examination. The diagnosis of a malignant or benign lesion was not clear. A right nephroureterectomy was performed. The characteristics of the resected specimen were consistent with those of cystic nephroma. Macroscopic examination revealed that the giant lesion originated from the upper renal pelvis and extended into the renal pelvis. The patient is currently free from disease at eight months after the surgery. In general, this tumor arises from the renal parenchyma. To our knowledge, this is the fifth case report on cystic nephroma with prominent renal pelvis involvement.
Hinyokika kiyo. Acta urologica Japonica 10/2010; 56(10):577-80.
-
[show abstract]
[hide abstract]
ABSTRACT: The objective of our study was to compare T2-weighted magnetic resonance imaging (T2WI), combined T2-weighted and dynamic imaging (Dynamic), and combined T2-weighted and diffusion-weighted imaging (DWI) in the identification of the site of prostate cancer.
Before radical prostatectomy, 85 patients with prostate cancer underwent magnetic resonance imaging using a 1.5-T endorectal coil; we excluded 3 patients treated with neoadjuvant hormonal therapy. The sites of prostate cancer in 82 patients were predicted by T2WI alone, T2WI + Dynamic, and T2WI + DWI, and the results were compared with the step-section analysis of radical prostatectomy specimens. The peripheral zone (PZ) and the transition zone (TZ) of the prostate were divided into left and right halves. Only tumors with a diameter of more than 5 mm were considered significant.
The sensitivity, specificity, positive predictive value (PPV), and the area under the receiver operating characteristic (ROC) curve (Az) for the prediction of the site of prostate cancer in the PZ of the prostate were as follows: 42%, 94%, 93%, and 0.76 for T2WI alone; 48%, 96%, 96%, and 0.78 for T2WI + Dynamic; and 50%, 96%, 96%, and 0.81 for T2WI + DWI. The sensitivity, specificity, PPV, and Az for the prediction of the site of prostate cancer in the TZ of the prostate were as follows: 31%, 92%, 76%, and 0.66 for T2WI alone; 46%, 82%, 67%, and 0.65 for T2WI + Dynamic; and 48%, 94%, 85%, and 0.71 for T2WI + DWI.
The Az value for the prediction of prostate cancer in the PZ and those in the TZ of the prostate was the highest for the combined T2WI and DWI approach.
Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 05/2010; 101(4):603-8.
-
[show abstract]
[hide abstract]
ABSTRACT: Segmental infarction of the testis represents a rare entity in that there have been fewer than 40 cases documented in the literature. Like global infarction, segmental infarction of the testis can masquerade as a mass lesion or torsion of the testis. Reported herein is a very rare case of segmental testicular infarction due to atheroembolism in a 58-year-old man. The patient presented with severe left testicular pain and underwent left high orchiectomy on the clinical diagnosis of testicular torsion. The testis had a segmental hemorrhagic necrosis around which many cholesterol emboli were observed. This is the first report to describe cholesterol embolism-associated segmental testicular infarction.
Pathology International 12/2008; 58(11):745-8. · 1.62 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We report a case of paratesticular rhabdomyosarcoma in a 16-year-old male. The patient with a mass in the right scrotum was at first diagnosed with testicular tumor. Right orchiectomy revealed paratesticular rhabdomyosarcoma. Para-aortic lymph node metastasis was pointed out by abdominal computed tomography. Although he received multidrug chemotherapy consisting of vincristine, adriamycin, cyclophosphamide, cisplatin, and actinomycin-D (IRS-III regimen 35 and IRS-IV regimen) without radiotherapy, he died twenty-one months after the operation.
Hinyokika kiyo. Acta urologica Japonica 06/2008; 54(6):431-3.
-
[show abstract]
[hide abstract]
ABSTRACT: We report three cases of small cell carcinoma of the urinary bladder. Case 1: A 69-year-old man showed microscopic hematuria during follow up of prostate cancer of stage D2. The patient was diagnosed with small cell carcinoma of the urinary bladder at the stage of pT2N0M0. Complete remission was achieved by three courses of chemotherapy consisting of irinotecan and carboplatin. The patient was died by prostate cancer 16 months after the chemotherapy. Case 2: An 83-year-old woman presented with macroscopic hematuria. The patient was diagnosed with small cell carcinoma of the urinary bladder at the stage of pT2N0M0 and partial cystectomy was performed. The patient has been alive without any evidence of tumor recurrence at 6 months after surgery. Case 3: An 84-year-old man presented with macroscopic hematuria. The patient was diagnosed with small cell carcinoma of the urinary bladder at the stage ofcT3bN0M1 with multiple liver metastases. Complete remission was achieved by three courses of chemotherapy consisting of etoposide and carboplatin.
Hinyokika kiyo. Acta urologica Japonica 05/2008; 54(4):297-300.
-
[show abstract]
[hide abstract]
ABSTRACT: A unique case of ganglioneuroma mimicking a lipomatous tumor in a 73-year-old man is reported. The tumor was incidentally found on radiography performed for unrelated reasons. Because of the fat element, CT and magnetic resonance imaging suggested myelolipoma inside or outside the right adrenal gland. The laparotomy indicated that the tumor was located on the right adrenal gland. It was well circumscribed but not encapsulated, and was approximately 2 cm in diameter. Microscopically, ganglioneuromatous component was scattered in the background of a large amount of adipose tissue. Because the presence of such a large amount of adipose tissue seems to be rare in ganglioneuromas, its histogenesis is discussed.
Pathology International 04/2008; 58(3):183-6. · 1.62 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Liposarcomas are most commonly found in the extremities, in the retroperitoneum and, less often, in the head and neck area. The spermatic cord is a rare site of origin, accounting for about 3-7% of all liposarcomas. We report two cases of liposarcoma of spermatic cord. Case 1. A 69-year-old male presented with complaints of a painless left inguinal mass. MRI showed a huge fatty mass in the left inguinal region. The mass was removed with left testis and spermatic cord. Histopathological examination revealed a well-differentiated and dedifferentiated liposarcoma. The surgical margin was positive, so re-resection was performed. Complete excision was achieved after re-resection. Case 2. A 63-year-old male with the difficulty urinating had a left scrotal mass. Left radical orchiectomy was performed. Histopathological examination revealed a well-differentiated liposarcoma. These are the 84th and 85th cases of liposarcoma of the spermatic cord reported in Japan.
Hinyokika kiyo. Acta urologica Japonica 03/2008; 54(2):147-50.
-
[show abstract]
[hide abstract]
ABSTRACT: Reported herein is an unusual case of intrahepatic cholangiocarcinoma with lymphoepithelioma-like appearance in a 64-year-old man who was found to have an intrahepatic mass without cirrhosis. The tumor had two distinct histological patterns with dense lymphoplasmacytic infiltrate. The first was similar to nasopharyngeal undifferentiated carcinoma; the second pattern was a well-differentiated adenocarcinoma. Transition between the two components was observed in the same duct. Immunohistochemistry indicated that the tumor was immunoreactive with AE1/AE3 and cytokeratin (CK) 7, but negative for CEA and CK20. Stromal inflammatory infiltrate primarily consisted of plasma cells and lymphocytes. Immunohistochemical examination and in situ hybridization for EBV showed no integration of the virus in the tumor cells. Intrahepatic lymphoepithelioma-like carcinoma is rare, and most are associated with EBV. Only three cases were not associated with EBV. The authors would like to add one more example of the tumors not associated with EBV.
Pathology International 02/2008; 58(1):69-74. · 1.62 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Paragangliomas are rare neuroendocrine tumors that arise from hyperplastic paraganglionic cells and occur in or near the ganglia of the autonomic nervous system. Paragangliomas are classed as either functional or nonfunctional based on production of catecholamines. We report a case of retroperitoneal nonfunctional paraganglioma, which was successfully resected. A 26-year-old man presented with complaints of a mass palpable in his left lateral region. Blood and urine studies, including catecholamines, were within normal limits. Computed tomography and magnetic resonance imaging showed a solid cystic mass in the left retroperitoneal space without any distant metastasis. On exploration, there was an encapsulated, vascular mass 10 cm in diameter. There was no pedicle and no connection of the tumor to the abdominal or retroperitoneal organs. Complete excision of the tumor was performed smoothly. The postoperative period was uneventful. Histological findings were of paraganglioma, and there was no surgical margin. The patient did not receive any further treatment. Nine months after surgery, there were no signs of tumor recurrence.
Hinyokika kiyo. Acta urologica Japonica 12/2007; 53(11):801-4.
-
[show abstract]
[hide abstract]
ABSTRACT: A 77-year-old man was admitted to our hospital for a scheduled examination after transurethral resection of transitional cell carcinoma of urinary bladder. Tumor reccurence was found in the bladder by cystoscopic examination. Total cystectomy and unilateral cutaneous ureterostomy were performed. Histologically the tumor was composed of epithelial and sarcomatous elements. Therefore, we diagnosed this tumor as sarcomatoid carcinoma. The patient died of lung metastasis three months after operation. Autopsy findings showed lung metastasis and local reccurence which were composed of carcinomatous and sarcomatous elements. About 64 cases of sarcomatoid carcinoma of the urinary bladder have been reported in the Japanese literature and are reviewed briefly here.
Hinyokika kiyo. Acta urologica Japonica 11/2007; 53(10):713-6.
-
[show abstract]
[hide abstract]
ABSTRACT: We report a case of primary adenocarcinoma of the prostate producing carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). A 64-year-old man referred to our hospital with dysbasia. Two years ago, he was diagnosed with prostate cancer at another hospital and received radiotherapy and endocrine therapy. Serum CEA and CA 19-9 levels were increased to 3,990 ng/ml and 11,700 U/ml at the time of our hospitalization. However, his serum PSA level remained low. After hospitalization, the disease rapidly progressed and he died a month later. In the histology of autopsy specimen, the prostate showed no sign of malignancy, but bone showed metastasis of prostate cancer. Immunohistochemical staining for CEA and PSA demonstrated the existence of each protein in bone metastasis.
Hinyokika kiyo. Acta urologica Japonica 08/2007; 53(7):485-7.
-
[show abstract]
[hide abstract]
ABSTRACT: A total of 978 of transrectal prostate biopsies performed between January 1998 and December 2005 at Ikeda Municipal Hospital were reviewed to determine the usefulness of the systematic 12 core biopsy including the apex and transition zone (TZ). Prostate cancer was detected in 531 of the 978 cases (54.3%). The systematic 6 core biopsy was performed between 1998 and 2000. In this group the cancer detection rate was 40.8% (87 out of 213 cases). In the systematic 12 core biopsy group since 2001 the cancer detection rate was 58.0% (444 out of 765 cases). The cancer detection ratio in the systematic 12 core biopsy group was significantly higher than that in the 6 core group (p<0.0001). In the subgroup whose prostate-specific antigen (PSA) value was in the gray zone (4. 1-10.0 ng/ml), the cancer detection rate was 22.9% (25 of 109 cases) in the systematic 6 core biopsy group and 45.7% (186 of 407 cases) in the systematic 12 core biopsy group. Of the 444 cases diagnosed as having prostate cancer by the systematic 12 core biopsy, 64 cases (14.4%) had positive cores only in additional cores from the apex and TZ. Our study revealed that the systematic 12 core prostate biopsy including the apex and TZ was useful for improving the cancer detection ratio of the prostate.
Hinyokika kiyo. Acta urologica Japonica 07/2007; 53(6):365-8.
-
[show abstract]
[hide abstract]
ABSTRACT: Lobular carcinoma of the breast is known to metastasize to unusual sites such as the gastrointestinal tract, peritoneum, and gynecologic organs. We report a patient with intraperitoneal metastases from lobular carcinoma who was originally treated for an unknown primary cancer. Ten years later, a tumor was found in her left breast and the diagnosis was changed to peritoneal metastases from invasive lobular carcinoma. Immunohistochemistry revealed that the metastases were high molecular weight cytokeratin (CK34betaE12) and estrogen receptor-positive, but were E-cadherin-negative. These results assisted in diagnosis. Surgeons should be aware of the characteristics of metastasis lobular carcinoma.
Breast Cancer 02/2007; 14(3):333-6. · 1.36 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Among patients with negative initial biopsies of the prostate, 51 patients underwent total 59 repeat biopsies at the Department of Urology of Ikeda Municipal Hospital between January 1998 and April 2004. Overall 26 patients (44.1%) were confirmed to have cancer, 22 patients by second repeat biopsy (22/51), four patients by third biopsy (4/7) and none by fourth biopsy (0/1). Clinical parameters (age, PSA, PSA density, PSA velocity) were analyzed for the possibility to predict the pathological outcome. Significant differences between the positive biopsy group and the negative biopsy group were obtained in age, PSA level and prostatic volume. Of the diagnostic evaluations including palpation and imaging studies (DRE, TRUS, MRI), the most powerful predictor for prostate cancer seemed to be the MRI findings, especially in the cases of short-interval repeat biopsy. Biopsies directed at the positive lesion on MRI in addition to systematic prostate biopsies should be useful.
Hinyokika kiyo. Acta urologica Japonica 07/2005; 51(6):373-6.
-
[show abstract]
[hide abstract]
ABSTRACT: A unique case of repeatedly intussuscepted colonic lipoma mimicking an epithelial tumor in a 50-year-old man is reported. The tumor was located in the ascending colon and was approximately 5 cm in diameter. Colonoscopic and barium-enema examinations suggested a huge epithelial tumor because of its nodule-aggregating appearance. In contrast, computed tomography examination showed a fatty element in the core of the lesion. The biopsy specimens suggested a primary angiomatous lesion because of its pronounced vascular proliferation. Because the presumed diagnoses based on the examinations were different, the preoperative diagnosis was not confirmed. The tumor was composed of intramural lipoma with a multiple polypoid mucosa overlay. This lesion was unique in that the lipoma appeared to be within the muscularis propria and the multiple polypoid appearance of its covering mucosa. The mucosal changes including florid vascular proliferation, fibromuscular obliteration and epithelial regeneration suggested a reparative process, with ischemic damage due to the effects of intussusception being the most likely event. It should be kept in mind that even a simple lipoma can have a unique appearance reminiscent of epithelial tumor when it repeatedly experiences intussusception.
Pathology International 04/2005; 55(3):160-4. · 1.62 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We report a case of endometrioid adenocarcinoma of the prostate. A 60-year-old man visited our hospital with high serum prostate specific antigen (PSA) level (6.4 ng/ml). Digital rectal examination revealed prostatic enlargement but no induration was palpable. Magnetic resonance imaging (MRI) of the prostate demonstrated the low intensity mass lesion around the prostatic urethra on T2-weighted images. Because a prostate cancer revealed by transrectal and transperineal needle biopsy of the prostate, retropubic radical prostatectomy was performed and histological finding showed endometrioid adenocarcinoma of the prostate. We review 41 cases reported in the Japanese literature and discuss them briefly.
Hinyokika kiyo. Acta urologica Japonica 10/2004; 50(9):649-52.
-
Shiro Adachi,
Masato Hanada,
Yoshiyuki Kobayashi,
Kohichi Tsutahara,
Shin-ichiro Fukuhara,
Naoki Mori,
Tsuneo Hara,
Hideyo Mukai,
Emi Shimasaku,
Masaru Kawai,
Naoto Kishikawa,
Seiji Yamaguchi
[show abstract]
[hide abstract]
ABSTRACT: A black-colored and well-circumscribed renal tumor in a 71-year-old woman is reported. The tumor was unique in that it was rich in vasculature and exclusively composed of perivascular epithelioid clear cells. Morphological features were reminiscent of conventional renal cell carcinoma (RCC). However, immunohistochemical examinations showed that the tumor cells did not express any epithelial markers, but diffusely and intensely expressed a melanocytic marker, gp-100/HMB-45. Another striking feature of the tumor was a large amount of cytoplasmic pigment that made the tumor wholly black. The pigment was not stained with Berlin-blue, completely bleached with potassium permanganate, and stained with Fontana-Masson staining, which suggests that the pigment was melanin. Morphological features and immunohistochemical findings indicated that the present tumor was an extreme example of a perivascular epithelioid clear cell tumor with a large amount of melanin, which has not been previously reported. One should be aware of the pure form of perivascular epithelioid clear cell tumor of the kidney because it is sometimes very difficult to differentiate this tumor from conventional RCC. Immunohistochemical examinations and the presence of cytoplasmic melanin can help the differentiation.
Pathology International 05/2004; 54(4):261-5. · 1.62 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Lobular carcinoma of the breast presents with various clinical manifestations. Lobular carcinoma comprises about one fifth of cases of ductal carcinoma. Intestinal metastasis is dominant in cases of lobular carcinoma. Without a prior diagnosis of lobular carcinoma of the breast, the diagnosis of intestinal metastasis from breast cancer is difficult. A 52-year-old women underwent duodenogastrectomy for duodenal cancer. About 18 months later, she underwent mastectomy for lobular carcinoma of the breast. The duodenal cancer consisted mainly of malignant cells invading the submucosa that were identical to those in the breast. Immunohistochemical assays for estrogen receptor also confirmed breast cancer metastasis. Duodenal obstruction was the first sign of isolated metastatic lobular carcinoma of the breast in this case. The characteristic metastatic pattern of lobular carcinoma, which differs from that of ductal carcinoma, should be kept in mind to ensue proper diagnosis. Preceding breast surgery for lobular carcinoma should prompt investigation based on the typical metastatic pattern.
Breast Cancer 02/2004; 11(3):306-8. · 1.36 Impact Factor
