Masaru Oritsu

Publications (22)22.34 Total impact

• Article: Pathological differentiation of chronic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis/usual interstitial pneumonia.

  Tamiko Takemura, Takumi Akashi, Hiroyuki Kamiya, Soichiro Ikushima, Tsunehiro Ando, Masaru Oritsu, Michiru Sawahata, Takashi Ogura
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  ABSTRACT: Takemura T, Akashi T, Kamiya H, Ikushima S, Ando T, Oritsu M, Sawahata M & Ogura T (2012) Histopathology Pathological differentiation of chronic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis/usual interstitial pneumonia Aims:  To evaluate the histological characteristics differentiating chronic hypersensitivity pneumonitis (chronic HP) with a usual interstitial pneumonia (UIP)-like pattern from idiopathic pulmonary fibrosis (IPF)/UIP. Methods and results:  Surgical lung biopsy specimens from 22 patients with chronic HP diagnosed as having a UIP-like pattern upon histological examination and 13 patients with IPF/UIP were examined and the incidences of bronchiolitis, perilobular fibrosis, centrilobular fibrosis, bridging fibrosis, organizing pneumonia, fibroblastic foci, honeycombing, granulomas, giant cells, lymphocytic alveolitis and lymphoid follicles were compared. Bronchiolitis, centrilobular fibrosis, bridging fibrosis, organizing pneumonia, granulomas, giant cells and lymphocytic alveolitis were significantly more frequent among patients with chronic HP than among patients with IPF (all P < 0.01). Conclusions:  Centrilobular fibrosis, bridging fibrosis and organizing pneumonia, in addition to bronchiolitis, granulomas and giant cells, are characteristic features of chronic HP with a UIP-like pattern. These features are therefore important in differentiating chronic HP from IPF/UIP, as management strategies differ for the two disorders.
  Histopathology 05/2012; · 3.08 Impact Factor
• Article: [Three cases of allergic bronchopulmonary mycosis due to Schizophyllum commune].

  Aiko Masunaga, Kozo Morimoto, Tunehiro Ando, Soichiro Ikushima, Tamiko Takemura, Masaru Oritsu
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  ABSTRACT: We report 3 cases of allergic bronchopulmonary mycosis (ABPM) due to Schizophyllum commune. The first patient, an 82-year-old woman, presented with atelectasis of the left upper lobe with mucoid impaction due to Schizophyllum commune. The second patient, a 53-year-old woman, presented with atelectasis of the right middle lobe with mucoid impaction due to Schizophyllum commune. The last patient, a 49-year-old woman, underwent a left lingular lobectomy with a diagnosis of lung abscess, but the diagnosis was retrospectively changed to ABPM in a later review of the findings of the surgical specimens. The diagnosis and treatment of ABPM are not well defined, and this considerably delayed our diagnosis in these three cases. We hope to establish a more definitive diagnosis and treatment for ABPM through ongoing encounters with patients.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 12/2010; 48(12):912-7.
• Article: [Two cases of microscopic polyangitis with preceding interstitial pneumonia diagnosed by surgical lung biopsy].

  Hiroyuki Kamiya, Soichiro Ikushima, Rie Ishikawa, Atsuko Moriya, Aiko Arai, Tsunehiro Ando, Masaru Oritsu, Tamiko Takemura, Shigeru Kuramochi
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  ABSTRACT: We encountered 2 cases of microscopic polyangitis (MPA) with preceding interstitial pneumonia. The patients were elderly men, and radiological findings showed a UIP pattern in both cases. Furthermore, ANCA-associated vasculitis had been suspected since the first admission in case 1, because MPO-ANCA tests were positive, and the surgical lung biopsy revealed vasculitis in a honeycomb lesion. A diagnosis of idiopathic pulmonary fibrosis was made in case 2 because no findings of vasculitis were pathologically confirmed, and MPO-ANCA was not examined. Both patients were followed up without any treatment, but steroid therapy with immunosuppressants was initiated after a diagnosis of MPA was made from a renal failure complication. Remission continued in case 1, but patient 2 died due to a pulmonary hemorrhage complication, despite some temporary improvements. An autopsy revealed massive alveolar hemorrhage and neutrophil infiltration in the alveolar walls that suggested pulmonary capillaritis, in spite of the absence of pathological evidence, which was not detected in the honeycomb lesions. These 2 cases indicate that MPO-ANCA should be examined in the follow-up of chronic interstitial pneumonia. Furthermore, it should be assumed that the size of involved blood vessels, their distribution and the timing of occurrence may be different in individual case of ANCA-associated interstitial pneumonia.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2010; 48(4):274-81.
• Article: [Evaluation of KL-6 CLEIA reagent].

  Kozo Morimoto, Rie Ishikawa, Atsuko Moriya, Aiko Masunaga, Hiroyuki Kamiya, Tsunehiro Ando, Souichiro Ikushima, Masaru Oritsu
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  ABSTRACT: KL-6 is a high-molecular-weight sialylated glycoprotein, classified as a cluster 9 pulmonary cell antigens, and is a sensitive marker for the clinical diagnosis of interstitial pneumonia and its activity, especially in the acute phase. Additionally, it is necessary to diagnosis that patient was not pneumothirax, pulmonary thromboembolism and heart failure. In this study, we evaluated a new assay system based on chemiluminescence EIA (CLEIA) on a fully automated analyzer. Both plasma and serum samples were used, and the master calibration method was applied, eliminating the need for a standard curve preparation. The assay time was shortened to less than 1 hour. Good correlations were observed between this assay and conventional assay kits, y = 1.094x-6.849, r = 0.986 using 326 samples, and between serum and plasma y = 0.997x-1.211, r = 0.997 using 225 paired samples. In addition, the alteration of KL-6 concentration in patients undergoing chemotherapy treatment resulted in similar results that with conventional kits, and elevated KL-6 concentrations were observed in samples from patients with interstitial pneumonia. These results underscore the usefulness of this new assay kit as a rapid test, particularly for the medical examination of outpatients and the treatment of emergency cases in the acute phase of interstitial pneumonia.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 12/2008; 46(11):859-63.
• Article: [Clinical comparison of male and female patients with pulmonary disease caused by Mycobacterium avium complex (P-MAC)].

  Kozo Morimoto, Rie Ishikawa, Atsuko Moriya, Aiko Masunaga, Hiroyuki Kamiya, Tsunehiro Ando, Souichiro Ikushima, Masaru Oritsu
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  ABSTRACT: The objective of this study was to clarify clinical feature of Pulmonary Mycobacterium avium complex disease (P-MAC). The present study was performed in 120 patients with P-MAC diagnosed during the period from January 2000 to March 2007. We divided P-MAC patients into four groups by the clinical disease type and gender, and retrospectively examined the clinical characteristics. The subjects were 15 male (NB-M) and 71 female (NB-F) patients with nodular bronchiectatic disease (NB), and 24 male (FC-M) and 10 female (FC-F) patients with fibrocavitary disease (FC). The average age was lowest in the NB-F group (58.0 yrs), and highest in the FC-M group (65.8 yrs). There were 17 patients in the FC-M group and only two patients in the FC-F group with a history of smoking. The average body mass index (BMI) was 16.9, with the lowest value in the FC-F group. In the FC-M group, most of the patients had underlying pulmonary disease, whereas in the FC-F group, only four patients had underlying old pulmonary tuberculosis. The average anterior-posterior dimension was 75.2 mm, being lowest in the FC-F group, and more than 90 mm in the other groups. The proportion of refractory cases was lowest in the NB-M group. We thought that we were able to clarify characteristics of patients with disease caused by MAC by analyzing the types of the disease separately in men and women.
  Kekkaku: [Tuberculosis] 12/2008; 83(11):711-5.
• Article: [Case of acute bird fancier's lung caused by a yellow-shouldered Amazon bird associated with lung cancer].

  Rie Ishikawa, Kozo Morimoto, Atsuko Moriya, Aiko Arai, Hiroyuki Kamiya, Tsunehiro Ando, Souichiro Ikushima, Masaru Oritsu, Hideya Kitamura, Tamiko Takemura
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  ABSTRACT: A 69-year-old man was admitted to our hospital complaining of generalized weakness and cough for one month. Chest computed tomography (CT) demonstrated bilateral ground-glass opacities and a nodule in right S6 about 11mm in diameter with multiple mediastinal lymph node swellings. After admission the patient's symptoms improved without therapy and examination of the bronchoalveolar lavage fluid (BALF) and transbronchial lung biopsy (TBLB) revealed findings compatible with acute hypersensitivity pneumonitis. We did not consider that the acute hypersensitivity was caused by the patient's Amazon bird, because he had been breeding them for 40 years. However after obtaining a careful history, it became clear that close and frequent contact with the bird had occurred for the first time in the previous year. On the basis of the anti-bird excreta antibody found in the patient's serum and BALF, we diagnosed this case as a case of acute bird fancier's lung caused by the yellow-shouldered Amazon bird. We diagnosed the nodule in right S6 as lung adenocarcinoma by a thoracoscopic lung biopsy, and performed lower lobe lobectomy. We considered that the mediastinal lymph node swellings were caused by hypersensitivity pneumonitis.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 03/2008; 46(2):141-5.
• Article: [A study on clinical features of Mycobacterium kansasii pulmonary disease in women].

  Hiroyuki Kamiya, Soichiro Ikushima, Tetsu Sakamoto, Kozo Morimoto, Tsunehiro Ando, Masaru Oritsu
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  ABSTRACT: To clarify clinical features of M. kansasii pulmonary disease in women. We performed a retrospective analysis of M. kansasii pulmonary disease in women compairing with that in men. We focused on 8 female cases of M. kansasii pulmonary disease during the past 7 years from June 1998 to August 2005. The cases of M. kansasii pulmonary disease in women have increased in the latter few years. The mean age of female cases was higher than that of male cases, 65.6 and 53.1 years old, respectively. The number of female cases with smoking history was lower than that of male cases, 37.5% and 90.0%, respectively. Two female cases had underlying pulmonary diseases, as compared with 10 male cases, 25.0% and 33.3%, respectively. The radiological findings in female cases included 2 cavitary opacities, 1 infiltrative opacity and 5 nodular, bronchiectatic opacities, as compared with 27 cavitary opacities, 1 infiltrative opacity, 1 solitary nodular opacity and 1 nodular, bronchiectatic opacity in male cases. MAC was also detected in 2 female cases, who presented with nodular, bronchiectatic opacities. On the other hand, there were 6 female cases, in which no other NTM was detected. 3 cases showed cavitary or infiltrative opacities, which improved with the following 3 tuberculous drugs INH, RFP, and EB (HRE), while others showed nodular, bronchiectatic opacities, in which 2 cases showed radiological exacerbations without any treatment and another one revealed an improvement with HRE. M. kansasii pulmonary disease in women tends to be identified in elderly who smoke less and have no underlying pulmonary diseases, and most of radiological findings in female cases revealed nodular, bronchiectatic opacities. Summing up all these findings, clinical features of M. kansasii pulmonary disease in women was considered to resemble that of MAC infection, and it was speculated that the increase of M. kansasii pulmonary disease in women has some relationship with that of MAC infection in middle or lingular lobe. However, it was confirmed that some cases of M. kansasii pulmonary disease in women might primarily present with nodular, bronchiectatic lesions, regardless of MAC infection.
  Kekkaku: [Tuberculosis] 03/2008; 83(2):73-9.
• Article: Disseminated cryptococcosis complicated with bilateral pleural effusion and ascites during corticosteroid therapy for organizing pneumonia with myelodysplastic syndrome.

  Hiroyuki Kamiya, Rie Ishikawa, Atsuko Moriya, Aiko Arai, Kozo Morimoto, Tsunehiro Ando, Soichiro Ikushima, Masaru Oritsu, Tamiko Takemura
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  ABSTRACT: An 83-year-old man with myelodysplastic syndrome was admitted to our hospital due to dyspnea and abnormal shadows on chest X-ray films during corticosteroid therapy for organizing pneumonia. He was diagnosed as having disseminated cryptococcosis with pulmonary lesions after detecting Cryptococcus neoformans. Both bilateral pleural effusion with or without ipsilateral pulmonary lesions and ascites ensued, and it was assumed that both direct involvement and serositis were associated with the fluid accumulation. Cryptococcal yeast was only detected in the right pleural effusion, and the titer of cryptococcal antigen was quite different between body cavities, even though it was positive in all sites.
  Internal Medicine 02/2008; 47(22):1981-6. · 0.94 Impact Factor
• Article: Inhalation of inorganic particles as a risk factor for idiopathic pulmonary fibrosis--elemental microanalysis of pulmonary lymph nodes obtained at autopsy cases.

  Hideya Kitamura, Shizuko Ichinose, Takumi Hosoya, Tsunehiro Ando, Soichiro Ikushima, Masaru Oritsu, Tamiko Takemura
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  ABSTRACT: Exposure to inorganic particles may induce fibrosis in the lung. However, the association between exposure to inorganic particles and the pathogenesis of idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP) is obscure. We examined inorganic particles in the pulmonary hilar lymph nodes affected by IPF/UIP to investigate whether inhaled elements are involved in the etiology, and whether there is an increasing risk of developing IPF/UIP. Twenty-three IPF/UIP cases and 23 controls without IPF/UIP were investigated. Pulmonary hilar lymph nodes constituted the study material. The elemental analysis was performed using scanning electron microscopy with an energy dispersive X-ray spectroscope, and we analyzed particles quantitatively and qualitatively. The results showed that the cases contained silicon and aluminum as compared with the control in lymph nodes, and these deposits were statistically significantly associated with an increased risk of IPF/UIP (adjusted odds were 2.99, 95% CI: 1.29-6.85 and 57.84, 95% CI: 1.45-2306.19, respectively). In addition, higher nickel levels in lymph nodes were associated with lung cancer. This study shows that inorganic particles, such as Si and Al, have higher concentrations in the hilar lymph nodes in IPF/UIP, and may play a role in one of the risk factors in the pathogenesis of IPF/UIP.
  Pathology - Research and Practice 02/2007; 203(8):575-85. · 1.21 Impact Factor
• Article: [A case of eosinophilic bronchiolitis complicated with eosinophilic sinusitis].

  Kozo Morimoto, Keisuke Oota, Tetsu Sakamoto, Hiroyuki Kamiya, Tsunehiro Ando, Souichiro Ikushima, Masaru Oritsu, Tamiko Takemura
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  ABSTRACT: A 42-year-old man was admitted to our hospital, complaining of dyspnea and cough for six months. Chest CT demonstrated thickening of the bronchial walls and some centrilobular nodules. From the laboratory data and the clinical course, he was first suspected to have bronchial asthma. However, it was necessary to rule out bronchiolitis due to other causes, because he had no previous asthma history and also because of the CT findings. We performed surgical lung biopsy to make a definite diagnosis. The pathological findings revealed eosinophilic bronchiolitis. While dyspnea and the eosinophilic nasal polyp improved by treatment with oral steroid therapy, the eosionophilic sinusitis and bronchiolitis relapsed after steroid tapering. Improvement and relapse of nasal and lower airway symptoms were synchronously observed. Eosinophilic bronchiolitis and eosionophilic sinusitis in this case may be considered to be a category of airway eosinophilic inflammation.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 01/2007; 44(12):980-4.
• Article: [Autopsy study of chronic necrotic aspergillosis of the lung associated with organizing pneumonia].

  Taisuke Morimoto, Tetsu Sakamoto, Keisuke Ota, Tsunehiro Ando, Soichiro Ikushima, Masaru Oritsu, Tamiko Takemura
  The Japanese journal of antibiotics 11/2006; 59(5):391-6.
• Article: Sarcoidosis and NOD1 variation with impaired recognition of intracellular Propionibacterium acnes.

  Tsuyoshi Tanabe, Ikuo Ishige, Yoshimi Suzuki, Yukie Aita, Asuka Furukawa, Yuki Ishige, Keisuke Uchida, Takashige Suzuki, Tamiko Takemura, Soichiro Ikushima, Masaru Oritsu, Tetsuji Yokoyama, Yukari Fujimoto, Koichi Fukase, Naohiro Inohara, Gabriel Nunez, Yoshinobu Eishi
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  ABSTRACT: Sarcoidosis is a systemic granulomatous disease of unknown etiology. NOD2 mutations have been shown to predispose to granulomatous diseases, including Crohn's disease, Blau syndrome, and early-onset sarcoidosis, but not to adult sarcoidosis. We found that intracellular Propionibacterium acnes, a possible causative agent of sarcoidosis, activated NF-kappaB in both NOD1- and NOD2-dependent manners. Systematic search for NOD1 gene polymorphisms in Japanese sarcoidosis patients identified two alleles, 796G-haplotype (156C, 483C, 796G, 1722G) and 796A-haplotype (156G, 483T, 796A, 1722A). Allelic discrimination of 73 sarcoidosis patients and 215 healthy individuals showed that the frequency of 796A-type allele was significantly higher in sarcoidosis patients and the ORs were significantly elevated in NOD1-796G/A and 796A/A genotypes (OR [95% CI]=2.250 [1.084, 4.670] and 3.243 [1.402, 7.502], respectively) as compared to G/G genotype, showing an increasing trend across the 3 genotypes (P=0.006 for trend). A similar association was found when 52 interstitial pneumonia patients were used as disease controls. Functional studies showed that the NOD1 796A-allele was associated with reduced expression leading to diminished NF-kappaB activation in response to intracellular P. acnes. The results indicate that impaired recognition of intracellular P. acnes through NOD1 affects the susceptibility to sarcoidosis in the Japanese population.
  Biochimica et Biophysica Acta 10/2006; 1762(9):794-801. · 4.66 Impact Factor
• Article: [Diagnostic criteria of neurosarcoidosis].

  Manabu Sakuta, Toshihide Kumamoto, Takahiro Iizuka, Kazutoshi Nishiyama, Masaru Oritsu
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  ABSTRACT: We have collaborated with Japanese Sarcoidosis Society and Japanese Society of Respiratory Disease to provide a new diagnostic criteria of neurosarcoidosis. At least two of six examinations are important. These include bilateral hilar lymphadenopathy, abnormal uptake of 67Ga scintigraphy, broncho alveolar lavage fluid examination, elevated serum ACE, negative tuberculin reaction, and elevated serum or urinary calcium level. (definite) Having positive clinical findings which suggest a neurosarcoidosis. Pathology proven case. (probable) Having positive clinical findings which suggest a neurosarcoidosis. Pathology proven in other organ. At least two of six examinations are positive. (possible) Having positive clinical findings which suggest a neurosarcoidosis. At least two of six examinations are positive. CNS sarcoidosis, sarcoid neuroopathy and sarcoid myopathy are separately diagnosed. Kveim reaction which is time consuming, not so specific, and difficult to obtain its antigen is no more necessary.
  Nō to shinkei = Brain and nerve 07/2006; 58(6):471-6.
• Article: [A case of volcanic ash lung: report of a case].

  Junko Shojima, Soichiro Ikushima, Tsunehiro Ando, Akihiko Mochida, Takashi Yanagawa, Tamiko Takemura, Masaru Oritsu
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  ABSTRACT: A 57-year-old woman inhaled much volcanic ash without using a mask every day during the eruption of the Miyake Volcano in August 2000. An abnormal shadow was pointed out on her chest radiography by chance, after she sought refuge in Higashimurayama city in September. She had no respiratory symptoms and her chest radiography in an annual health check in July 2000 had showed no abnormality. She was admitted to our hospital and thoracoscopic lung biopsy was performed. We diagnosed it as lung inflammation caused by volcanic ash. The reasons for diagnosis were because the abnormal shadow appeared after the inhalation of volcanic ash, chest computed tomography showed diffuse irregular shadows with air bronchogram, thoracoscopic lung biopsy showed cellular-bronchiolitis around crystals, and the results of mineralogical analysis of the particles in alveolar macrophages detected in the biopsy specimen by scanning electron microscopy (SEM) were very similar to those of volcanic ash. The shadow on her chest radiography disappeared gradually without any treatment, but she avoided further exposure to volcanic ash. It is necessary to consider volcanic ash capable of causing lung inflammation.
  Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 04/2006; 44(3):192-6.
• Article: Sarcoidosis with acute recurrent polyarthritis and hypercalcemia.

  Takeo Sato, Tsunehisa Tsuru, Kiyofumi Hagiwara, Kazuhisa Miyashita, Hiroaki Matsuno, Atsuo Goto, Masaru Oritsu, Teruhiko Hamanaka, Osamu Akiyama
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  ABSTRACT: A 45-year-old woman had bleary eyes and recurrent episodes of fever and arthritis in the knees and ankles. The patient had anterior uveitis, negative findings of the tuberculin test, and an increased serum lysozyme level, but bilateral hilar lymphadenopathy (BHL) was absent. During the course of her disease, the serum calcium and angiotensin-converting enzyme levels gradually increased to above the normal level, and the patient was clinically diagnosed as having sarcoidosis. The clinical features of arthritis were typical of those of Löfgrens syndrome although BHL and erythema nodosum were absent. The patient was successfully treated with 15 mg/day of prednisolone.
  Internal Medicine 02/2006; 45(6):363-8. · 0.94 Impact Factor
• Article: Trimethoprim-sulfamethoxazole-induced hypersensitivity syndrome associated with reactivation of human herpesvirus-6.

  Taisuke Morimoto, Takeo Sato, Akihiro Matsuoka, Tetsu Sakamoto, Keisuke Ohta, Tsunehiro Ando, Soichiro Ikushima, Kiyofumi Hagiwara, Hiroaki Matsuno, Osamu Akiyama, Masaru Oritsu
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  ABSTRACT: A 27-year-old man who had a history of bronchial asthma, eosinophilic enteritis, and eosinophilic pneumonia presented with fever, skin eruptions, cervical lymphadenopathy, hepatosplenomegaly, atypical lymphocytosis, and eosinophilia two weeks after receiving trimethoprim (TMP)-sulfamethoxazole (SMX) treatment. After the withdrawal of TMP-SMX and the administration of high-dose steroid, these systemic symptoms gradually resolved. During the disease course, the patient showed a transient increase in anti-human herpesvirus (HHV)-6 antibody titers and HHV-6 DNA in the peripheral blood, indicating the reactivation of a latent HHV-6 infection. This is the first case of TMP-SMX-induced hypersensitivity syndrome associated with the reactivation of a latent viral infection.
  Internal Medicine 02/2006; 45(2):101-5. · 0.94 Impact Factor
• Article: Evaluation of microsatellite markers in association studies: a search for an immune-related susceptibility gene in sarcoidosis.

  Goh Tanaka, Ikumi Matsushita, Jun Ohashi, Naoyuki Tsuchiya, Soichiro Ikushima, Masaru Oritsu, Minako Hijikata, Taiji Nagata, Kazuhiko Yamamoto, Katsushi Tokunaga, Naoto Keicho
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  ABSTRACT: Association studies using linkage disequilibrium (LD) between candidate loci and nearby markers have been proposed to identify susceptibility genes for complex diseases. We analyzed polymorphisms of microsatellites (MSs) and LD patterns of the regions in which candidate genes related to the Th1 immune response have been annotated and attempted to identify a susceptibility gene for sarcoidosis in a marker-based association study. Nineteen MSs were identified in six Th1-related genes (IFNGR1, IFNGR2, IL12RB1, IL12RB2, STAT1 and STAT4) and then eight were further characterized as useful polymorphic markers. Most of these MSs showed LD with single nucleotide polymorphisms (SNPs) on both 5' and 3' ends of these candidate genes, in which r(2) values between at least one of the MS marker alleles and the SNPs were higher than 0.1. A significant association with one MS allele near STAT4 was shown and a cluster of SNPs in LD with the MS marker was associated with sarcoidosis. These results suggest that association studies using not only SNPs but also multi-allelic MS within or near candidate loci would be useful markers to search for a disease susceptibility gene, especially in populations with unknown LD structure.
  Immunogenetics 04/2005; 56(12):861-70. · 2.93 Impact Factor
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  Article: Phenotype of regenerative epithelium in idiopathic interstitial pneumonias.

  Nae Hinata, Tamiko Takemura, Soichiro Ikushima, Takashi Yanagawa, Tsunehiro Ando, Junko Okada, Masaru Oritsu, Morio Koike
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  ABSTRACT: The epithelial alteration in interstitial pneumonias is one of the repair processes at the sites of disease activity. Regenerative epithelial cells may participate in remodeling of the lung. To determine the phenotype of regenerative epithelial cells in usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP), the expression of Clara cell 10KD protein (CC10), cytokeratin (CK) 14 and 17, surfactant apoprotein (SP)-A, KL-6/MUC1, transforming growth factor (TGF) beta2 were examined in 25 patients with UIP, 9 patients with NSIP and normal lung tissues from 10 patients with lung cancer. In honeycomb lesions of UIP, non-ciliated columnar cells mainly expressed CC10, cuboidal cells expressed CC10, CK17, CK14 and SP-A in descending order. Fibroblastic foci are covered by CK17, CK14, CC10, and a few SP-A positive flattened or cuboidal cells. Regenerative epithelium in NSIP mainly comprised cuboidal cells expressing SP-A, CC10 and CK17. KL-6 was more remarkably expressed in cuboidal and non-ciliated columnar cells both in UIP and NSIP. Expression of TGFbeta2 was observed in cuboidal and flattened epithelium. In severe fibrotic areas, CC10 expressing cells were more prominent, while SP-A positive cells were more prominent in less fibrotic areas. Regenerative epithelial cells in remodeling area in UIP may be derived from bronchiolar basal cells and Clara cells, while most of those in NSIP may be derived from type II pneumocytes. The different origin of regenerative epithelium may reflect the severity and extent of the injury and the degree of consequent fibrosis in UIP and NSIP.
  Journal of medical and dental sciences 10/2003; 50(3):213-24.
• Article: [Roentgenographic type and CT findings in pulmonary sarcoidosis].

  Masaru Oritsu
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  ABSTRACT: There are five roentgenographic type of intratracic changes, Type 0 means no visible intratracic findings. Type I is bilateral hilar lymphadenopathy, Type II is bilateral hilar adenopathy accompanied by parenchymal infiltration. Type III is only parenchymal infiltration and type IV is advanced fibrosis. CT findings are peribroncho-vascular markings, diffuse small nodules, and large irregular nodules. Usually diffuse small nodules had tendency to improve, although peribronchial markings, atelectacis, pleural thickening, and bullae are irreversible and progressive. CT plays an important role in the diagnosis and prognostic value in pulmonary sarcoidosis.
  Nippon rinsho. Japanese journal of clinical medicine 10/2002; 60(9):1747-51.
• Article: Hyperplastic epithelial foci in honeycomb lesions in idiopathic pulmonary fibrosis.

  Lei Qunn, Tamiko Takemura, Soichiro Ikushima, Tsunehiro Ando, Takashi Yanagawa, Osamu Akiyama, Masaru Oritsu, Noboru Tanaka, Toshio Kuroki
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  ABSTRACT: Seventy-two cases of idiopathic pulmonary fibrosis (IPF) were examined from 2856 consecutive autopsy cases at the Japanese Red Cross Medical Center in Tokyo from 1973-1996. Primary lung cancer had arisen in 31 of 72 cases of IPF (43%), significantly higher than the incidence in cases without IPF (8.1%) and in the cases with non-IPF chronic lung diseases (11.9%). Hyperplastic epithelial foci in the honeycomb lesions of IPF cases were significantly more prominent in the lower than in the upper lobe, in cases with or without lung cancer, and they were more prominent in the lower lobe of IPF with than in those without cancer. The length of hyperplastic epithelial foci in the lower lobe of IPF cases was longer than that in interstitial pneumonia-associated with collagen vascular diseases. There was a higher PCNA labeling index of hyperplastic epithelial foci in IPF cases than in cases of interstitial pneumonia-associated with collagen vascular diseases. The PCNA labeling index was almost the same between smokers and nonsmokers with IPF. Overexpression of p53 was observed in hyperplastic epithelial foci in honeycomb lesion of IPF. DNA ploidy analysis of hyperplastic epithelial foci in the paraffin sections of 12 IPF cases revealed aneuploidy patterns in eight cases. These results strongly suggest that accelerated cell proliferation occurs in the honeycomb lesion of IPF, and that regenerative epithelia becomes susceptible to carcinogenic agents in addition to the smoking effect.
  Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 10/2002; 441(3):271-8. · 2.49 Impact Factor