Suzuko Moritani

National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan

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Publications (87)170.47 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine which immunohistochemical markers are useful for the identification of neoplastic myoepithelial cells in adenomyoepithelioma of the breast, the expression of seven myoepithelial markers (α-smooth muscle actin (α-SMA), calponin, p63, CD10, cytokeratin 5/6, cytokeratin 14, and S-100) was examined in 19 lesions from 16 patients. The lesion consisted of seven spindle and 12 clear cell lesions. For normal myoepithelial cells, α-SMA, calponin, and p63 were significantly more sensitive than cytokeratin 5/6, cytokeratin 14, and S-100. There was no significant difference in the expression of α-SMA, calponin, p63, and CD10 in neoplastic myoepithelial cells of adenomyoepithelioma regardless of spindle or clear cell types. In spindle cell lesions, high-molecular weight cytokeratins (HMWCK; cytokeratin 5/6 and cytokeratin 14) tended to show higher staining scores and S-100 showed lower staining scores than other markers. In clear cell lesions, HMWCK showed significantly lower staining scores than the other five markers. There was no significant difference in staining scores among the other five markers. HMWCK showed a unique paradoxical staining pattern in clear cell lesions, with diffusely positive inner epithelial cells and completely negative outer myoepithelial cells. Although the sensitivity of HMWCK in clear cell lesions is low, with this unique paradoxical staining pattern and relatively high sensitivity in spindle cell lesions, HMWCK could be useful in diagnosing adenomyoepithelioma. In choosing immunohistochemical markers, any of the seven markers are useful, but combining HMWCK and any one of α-SMA, calponin, and p63 would be a good panel for the diagnosis of adenomyoepithelioma.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 12/2014; · 2.68 Impact Factor
  • Naoto Kuroda, Suzuko Moritani, Shu Ichihara
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    ABSTRACT: We report the first case of combined hepatoid and serous adenocarcinoma arising in the uterine corpus here. The patient is a 63-year-old Japanese woman. She presented with vaginal abnormal bleeding and subsequent imaging analysis disclosed a mass in the uterine corpus. This article is protected by copyright. All rights reserved.
    Histopathology 11/2014; · 2.86 Impact Factor
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    ABSTRACT: The apocrine type of encapsulated papillary carcinoma (ECP-A), of the breast is a rare neoplasm and there are only eight cases reported to date. Herein, we report the ninth case. A 68-year-old Japanese woman presented with a left breast mass. The cytoplasm of the tumour cells showed positive immunostaining for GCDFP-15. Myoepithelial cells were absent within the papillary structures and at the periphery of the lesion. The clinical course of the patient was uneventful 11 months after surgery. We postulate that EPC-A belongs to the molecular apocrine type of breast carcinoma.
    The Malaysian journal of pathology 08/2014; 36(2):139-143.
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    ABSTRACT: ABSTRACT Immunological status of patients with EBV-positive diffuse large B-cell lymphoma (EBV(+)DLBCL) without obvious immunodeficiency has not been elucidated. A multi-center prospective study was conducted to assess pretreatment T-cell responses to EBV, EBV-DNA load, and anti-EBV antibody in these patients. The proliferative and interferon (IFN)-γ-producing capacity of T-cells in response to autologous B-lymphoblastoid cell lines was determined using CFSE-based assay. Frequencies of EBV-specific CD4+ T-cells in EBV(+)DLBCL patients (n=13) were significantly higher than in healthy controls (HCs) (n=16) after both ex vivo and in vitro stimulation. Frequencies of EBV-specific CD8(+) T-cells in EBV(+)DLBCL patients tended to be higher than HCs after in vitro stimulation. EBV(+)DLBCL patients also showed increased IgG responses to lytic EBV-encoded antigens. Pretreatment plasma EBV-DNA level was significantly higher in EBV(+)DLBCL patients than EBV(-)DLBCL patients or HCs. In conclusion, EBV-specific T-cells showed increased reactivity, accompanied by higher levels of plasma virus DNA in patients with EBV(+)DLBCL.
    Leukemia & lymphoma. 06/2014;
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    ABSTRACT: The introduction of combined antiretroviral therapy (ART) has reduced the mortality of patients with human immunodeficiency virus-1 infection worldwide. However, malignant lymphoma is a severe and frequent complication seen in patients with acquired immunodeficiency syndrome (AIDS). The diagnostic criteria for some categories of AIDS-related lymphoma were revised in the World Health Organization International Classification of Lymphoma, fourth edition. The purpose of this study was to assess the clinicopathological characteristics of Japanese patients with AIDS-related lymphoma according to the revised classification. In this retrospective study, 207 AIDS-related lymphoma cases diagnosed between 1987 and 2012 in Japan were subjected to histological subtyping and clinicopathological analyses. Diffuse large B-cell lymphoma (DLBCL) was the predominant histological subtype throughout the study period (n = 104, 50%). Among the DLBCL cases, 24% were of the germinal center (GC) type and 76% were of the non-GC type. Non-GC-type cases showed a significantly lower 1-year survival rate (43%) than the GC-type cases (82%). Cases of Burkitt lymphoma (n = 57, 28%), plasmablastic lymphoma (n = 16, 8%), primary effusion lymphoma (n = 9, 4%), Hodgkin lymphoma (n = 8, 4%), and large B-cell lymphoma arising in Kaposi sarcoma-associated herpesvirus-associated multicentric Castleman disease (n = 2, 1%) were also observed. Hodgkin lymphoma was more common in patients receiving ART (11.1%) than in ART-naïve patients (1.4%). Statistical analyses identified CD10 negativity, BCL-6 negativity, Epstein-Barr virus positivity, and Kaposi sarcoma-associated herpesvirus positivity as risk factors for poor prognosis. This information will help in the early diagnosis of lymphoma in patients with AIDS.
    Cancer Medicine 01/2014;
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    ABSTRACT: Birt-Hogg-Dubé syndrome (BHDS) is an autosomal dominant inherited disorder characterized by clinical features of skin lesions, pulmonary lesions and renal tumor. The gene responsible for this syndrome is located on chromosome 17p11.2 and designated as FLCN. In this article, we review renal tumors associated with BHDS with a focus on clinical and pathobiological aspects. Renal tumors often occur multifocally or bilaterally in the imaging analyses or gross examination. Histological examination of renal tumors includes a variety of subtypes such as hybrid oncocytic tumor, chromophobe renal cell carcinoma (RCC), oncocytoma, clear cell RCC and papillary RCC. The histologic discordance in multiple tumors seems to be characteristic of this syndrome. Oncocytosis is observed histologically in about half of the cases. Several investigations have elucidated that folliculin may be involved in the mammalian target of rapamycin (mTOR) pathway recently. Renal tumors composed of clear cells may behave in an aggressive fashion. However, renal tumors including hybrid oncocytic tumor, chromophobe RCC and oncocytoma behave mostly in an indolent fashion.
    Polish journal of pathology: official journal of the Polish Society of Pathologists 01/2014; 65(2):93-99. · 0.49 Impact Factor
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    ABSTRACT: In this paper, we searched for the common histologic features characteristic of renal tumors in patients with Birt-Hogg-Dubé syndrome (BHDS). We selected six patients with histologically confirmed renal tumor in BHDS. Germline FLCN gene mutation has been identified in five patients. Multifocality and bilaterality of the renal tumors were pathologically or radiologically confirmed in five and two cases, respectively. Histological subtypes of the dominant tumor included three previously described hybrid oncocytic tumors, one composite chromophobe /papillary/clear cell RCC and one unclassified RCC resembling hybrid chromophobe/clear cell RCC. In one case, chromophobe RCC and clear cell RCC were separately observed. Small papillary lesions located in the peripheral area of the tumor, which we designated as intratumoral peripheral small papillary tuft (ITPSPT), were identified in all patients. In conclusion, multifocality/bilaterality of renal tumors, discordance of histologic subtypes and the presence of ITPSPT may be important clues to identify BHDS -associated renal tumors.
    Annals of diagnostic pathology 01/2014;
  • Journal of clinical pathology 11/2013; · 2.43 Impact Factor
  • Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 06/2013; · 2.68 Impact Factor
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    ABSTRACT: To clarify the diagnostic clues of ductal carcinomas in situ (DCIS) associated with papilloma and optimal clinical management of papilloma diagnosed on core needle biopsy (CNB). A total of 50 surgically resected cases were examined histopathologically and topographically. Thirty-nine cases (78%) spread in segmental fashion. Papilloma and DCIS were intermingled closely in 44 cases (88%), occupying the same areas in varying proportions from DCIS-predominant to papilloma-predominant. The two components occupied discrete areas and collided focally in six cases (12%). Most were non-high-grade. Cribriform and solid architectures with fibrovascular stroma were frequent. The cribriform pattern was unique, consisting of fused tubules separated by fibrovascular stroma. Intraductal myoepithelial cells were present to varying degrees in 40 cases (80%). In 38 cases (76%), points were identified where papilloma and DCIS coexisted or collided within a single lumen (CC point). Forty-eight cases (96%) had either intraductal myoepithelial cells or CC points, implying that DCIS and papilloma existed in the same duct system. Radiology showed segmental abnormalities in 83% of the available cases. Intraductal myoepithelial cells do not always guarantee benignity. Surgical resection is recommended for papilloma in CNB when radiology shows segmental abnormalities.
    Histopathology 05/2013; · 2.86 Impact Factor
  • Toshinobu Kubota, Suzuko Moritani, Shu Ichihara
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    ABSTRACT: BACKGROUND: A primary ductal adenocarcinoma of the lacrimal gland is a rare epithelial malignant tumor, and its clinicopathological and immunohistochemical features have not been well determined. The purpose of this study was to determine the clinicopathological characteristics of lacrimal duct carcinomas and to determine their long-term prognosis. METHODS: We performed immunohistochemical studies of biological and proliferative markers of primary ductal adenocarcinomas of the lacrimal gland in five patients, and followed their long term prognosis. We also reviewed nine published cases of primary ductal adenocarcinomas of the lacrimal gland. RESULTS: All specimens were positive for the androgen receptor, and three of five specimens overexpressed the HER-2/neu protein. Nuclear immunostaining for p53 ranged from 10 % to 95 % and that of Ki-67 from 20 % to 70 % in the tumor cells. Four of five patients had distant metastases and three patients died from the disease during the 5-year follow-up. CONCLUSIONS: Our findings indicate that primary ductal adenocarcinomas of the lacrimal gland express androgen receptors and a wide range of proliferative markers. Their long-term prognosis is poor.
    Albrecht von Graæes Archiv für Ophthalmologie 04/2013; · 1.93 Impact Factor
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    ABSTRACT: Background Massive lymphadenopathy and direct mediastinal invasion are well-recognized phenomena in patients with small cell lung cancer (SCLC). The aim of this study was to assess the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of SCLC. Methods We retrospectively reviewed the records of 780 patients who underwent EBUS-TBNA at our institution from March 2004 to June 2012. Of these, 101 had a final diagnosis of SCLC. Excluding 3 patients with known SCLC who underwent EBUS-TBNA for staging purposes and including 2 patients who underwent EBUS-TBNA twice for the diagnosis of recurrence after achieving complete response by chemoradiation therapy during the study period, a total of 100 EBUS-TBNA procedures in 98 patients were analyzed. Results Other diagnostic tests prior to the initial EBUS-TBNA had failed to yield a diagnosis in 41 patients. The overall diagnostic yield of EBUS-TBNA for SCLC was 97% (97 of 100). Rapid on-site cytologic evaluation (ROSE) was performed at the operator's discretion in 77 procedures. ROSE did not have any impact on diagnostic yield (99% with ROSE vs. 90% without ROSE, p=0.1), but the use of ROSE was associated with fewer lesions (mean 1.1 with ROSE vs. 1.6 without ROSE, p<0.01) or aspirates (mean 2.3 with ROSE vs. 4.0 without ROSE, p<0.01). Conclusions EBUS-TBNA provided a high diagnostic yield in SCLC with or without ROSE. EBUS-TBNA can be recommended for patients suspected to have SCLC, even if other diagnostic tests have failed.
    Respiratory Investigation. 01/2013;
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    ABSTRACT: Background: Several studies have reported that specimens from mediastinal lesions located adjacent to the esophagus can be sampled using an ultrasound bronchoscope instead of an ultrasound endoscope. Objectives: The aim of this study was to evaluate the diagnostic utility of transesophageal bronchoscopic ultrasound-guided fine needle aspiration using an ultrasound bronchoscope in patients with stage I/II sarcoidosis. Methods: Thirty-three patients suspected of having stage I/II sarcoidosis were included in this prospective study. Needle aspiration through the esophagus using an ultrasound bronchoscope was performed for hilar and/or mediastinal lymph nodes. The final diagnosis of sarcoidosis was based on clinicoradiological compatibility and pathological findings. Results: A total of 62 lymph nodes with a mean shortest diameter of 13.6 mm were examined. Of the 33 patients enrolled, 29 were given a final diagnosis of sarcoidosis. Four of the residual patients had other diseases (1 lung cancer, 1 tuberculosis, 2 non-specific lymphadenitis). Transesophageal bronchoscopic ultrasound-guided fine needle aspiration showed noncaseating epithelioid cell granulomas in 25 of 29 patients (86%; 95% confidence interval 73-100) with the final diagnosis of sarcoidosis. No complications were observed. Conclusions: Transesophageal bronchoscopic ultrasound-guided fine needle aspiration is feasible, safe and accurate for the diagnosis of stage I/II sarcoidosis.
    Respiration 12/2012; · 2.92 Impact Factor
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    ABSTRACT: PURPOSE: To determine whether serologic factors correlate with early relapse in cases of IgG4-related orbital inflammation, a lymphoproliferative disorder. DESIGN: Retrospective cohort study. METHODS: We examined the orbital images and serum data of 30 patients with (n=24) or without (n=6) corticosteroid treatment before and after corticosteroid treatment and 6 months after discontinuation of corticosteroid treatment. RESULTS: Seven patients (23%) (all with corticosteroid treatment) had elevated serum levels of rheumatoid factor. Of the 24 patients with corticosteroid treatment, 24 (100%) showed regression of the lesion, but 8 of the 24 (33%) showed relapse. The serum IgG4 levels before and after corticosteroid treatment were not significantly different between the relapsed and nonrelapsed groups (P=.5 and P=.2, respectively). However, the incidence of patients who were rheumatoid factor-positive was significantly higher in the relapsed group (P=.02). The 6 patients without corticosteroid treatment showed minor proliferation or regression of the lesion at the 6-month follow-up. CONCLUSIONS: The serum rheumatoid factor level may correlate with proliferative activity in IgG4-related orbital inflammation.
    American Journal of Ophthalmology 10/2012; · 4.02 Impact Factor
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    ABSTRACT: Backgrounds: Nipple discharges from patients with ductal carcinoma in situ (DCIS) can contain high levels (>1,000 ng/ml) of human epidermal growth factor receptor 2 (HER2) protein (Inaji et al. 1993). This leads to a hypothesis that tumor markers are frequently concentrated intraductally in early breast cancers. Methods: To test the hypothesis, HER2-ECD and CA15-3 of the needle washout fluid from 29 benign lesions, 26 DCIS, and 95 invasive carcinomas of the breast were measured. The needle was rinsed out with 2 ml of saline, diluting the biomarkers by 3.5%. The measuring limit for HER2-ECD (0.5 ng/ml) and that for CA 15-3 (4 U/ml) were used as the cutoff values, respectively. Results: The proportion of patients with positive HER2-ECD values was 6.9% in cases of benign lesions, 26.9% in DCIS, and 10.5% in invasive carcinomas. The proportion of patients with positive CA 15-3 values was 6.9% in cases of benign lesions, 42.3% in DCIS, and 10.5% in invasive carcinomas. The proportion of patients with any biomarker elevation was 6.9% in cases of benign lesions, 46.2% in DCIS, and 15.8% in invasive carcinomas. Thus, biomarker elevation was most frequent in DCIS, followed by invasive carcinomas (P<0.01). HER2-ECD values over 6 ng/ml (undiluted value:171.3 ng/ml) or CA 15-3 values over 25 U/ml (undiluted value:1485.7 U/ml) were seen exclusively in DCIS or invasive ductal carcinomas with an extensive intraductal component, supporting the hypothesis. Immunohistochemical studies of cases with elevation of CA15-3 and/or HER2-ECD indicated that intraductal secretions are positive for the markers. Conclusions: Some tumor antigens are concentrated intraductally even if they were not detectable in the serum. Chemiluminescence measurement of these biomarkers could strengthen cytological diagnosis. Furthermore, our approach may be useful to identify a subset of breast cancer patients who are suitable for intraductal molecular targeted therapy.
    24th European Congress of Pathology, Prague, Czech Republic; 09/2012
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    ABSTRACT: Endometrial polyps are very common benign endometrial lesions, but their pathogenesis is poorly understood, except for a few studies indicating the possibility of benign stromal neoplasm. Although the histopathological diagnosis of endometrial polyp on a surgical specimen is straightforward, it is often difficult to differentiate endometrial polyp from endometrial hyperplasia on a biopsy or curettage specimen. Presently, there is no immunohistochemical marker helpful in this differential diagnosis. In this study, we examined p16 expression in 35 endometrial polyps and 33 cases of endometrial hyperplasia that included 16 simple hyperplasias, 14 complex atypical hyperplasias, and 3 complex hyperplasias without atypia. Stromal p16 expression differed significantly between the two groups; it was seen in 31 (89 %) endometrial polyps, but in only 1 (3 %) endometrial hyperplasia. The percentage of p16-positive stromal cells ranged from 10 to 90 % (mean, 47 %) and the positive cells tended to be distributed around glands. Six cases of endometrial hyperplasia within an endometrial polyp were also examined and all cases showed stromal p16 expression. There was no difference in glandular p16 expression between endometrial polyps 33 (94 %) and hyperplasia 27 (82 %). The p16-immunoreactivity was mostly confined to metaplastic epithelial cells in both groups. Stromal p16 expression might be a peculiar characteristic of endometrial polyp and constitute a useful marker for the diagnosis, especially in fragmented specimens from biopsy or curettage. Stromal p16 expression might be a reflection of p16-induced cellular senescence, which has been documented in several benign mesenchymal neoplasms.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 07/2012; 461(2):141-8. · 2.68 Impact Factor
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    ABSTRACT: Birt-Hogg-Dubé (BHD) syndrome is an autosomal dominant disorder characterized by fibrofolliculomas, renal tumors, and pulmonary cysts with recurrent pneumothorax. Multiple pulmonary cysts and pneumothorax are the key signs for diagnosing BHD syndrome. The pathologic features of BHD pulmonary cysts, however, are poorly understood. This disorder is caused by mutations in the gene that encodes folliculin (FLCN). FLCN is regarded as a tumor suppressor; it mediates cellular activities by interacting with the mammalian target of rapamycin (mTOR). In this study, we investigated the lungs of 11 patients from 9 BHD families. The majority of patients consulting doctors were women between 30 and 60 years of age who had pulmonary cysts and repeated pneumothoraces. Genomic DNA testing revealed 5 different mutation patterns. Histopathologic examination found that the inner surface of cysts was lined by epithelial cells, sometimes with a predominance of type II pneumocyte-like cuboidal cells. The cysts occasionally contained internal septa consisting of alveolar walls or showed an "alveoli within an alveolus" pattern. The cells constituting the cysts stained positive for phospho-S6 ribosomal protein expression, suggesting activation of the mTOR pathway. Although BHD pulmonary cysts are frequently misdiagnosed as nonspecific cystic diseases, they are distinctly different in histopathology from other bullous changes. Mechanical stress such as rupture and postrupture remodeling allows mesothelial invagination and fibrosis. Such modified BHD pulmonary cysts are virtually indistinguishable from nonspecific blebs and bullae. We propose a new insight, namely, that the BHD syndrome-associated pulmonary cyst may be considered a hamartoma-like cystic alveolar formation associated with deranged mTOR signaling.
    The American journal of surgical pathology 04/2012; 36(4):589-600. · 4.06 Impact Factor
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    ABSTRACT: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been reported to be an accurate and safe method to confirm a pathologic diagnosis of sarcoidosis. However, only a few retrospective or small prospective studies have been published on EBUS-TBNA versus transbronchial lung biopsy (TBLB), which has been the standard method for making a pathologic diagnosis of sarcoidosis so far. The aim of this study was to compare the diagnostic yield of EBUS-TBNA and TBLB through a flexible bronchoscope in patients with stage I and II sarcoidosis. A total of 62 patients with suspected stage I and II sarcoidosis were included in this prospective study. EBUS-TBNA was performed (2 lymph nodes, 2 needle passes for each lymph node), followed by TBLB (5 biopsy specimens from multiple lung segments) in the same setting. The final diagnosis of sarcoidosis was based on clinicoradiologic compatibility and pathologic findings. Of the 62 patients enrolled, 54 were given a final diagnosis of sarcoidosis. The diagnostic yield of EBUS-TBNA and TBLB for sarcoidois by showing noncaseating epithelioid cell granuloma was 94% (stage I, 97%; stage II, 88%) and 37% (stage I, 31%; stage II, 50%), respectively. The difference was statistically significant (P < .001). One case of pneumothorax and 3 cases of moderate bleeding (7%) resulted from TBLB, and 1 case of severe cough (2%) from EBUS-TBNA. The diagnostic yield of EBUS-TBNA for stage I and II sarcoidosis is higher than for TBLB.
    The Journal of thoracic and cardiovascular surgery 02/2012; 143(6):1324-9. · 3.41 Impact Factor
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    Toshinobu Kubota, Suzuko Moritani
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    ABSTRACT: Orbital IgG4-related disease, which can occur in adults of any age, is characterized by IgG4-positive lymphoplasmacytic infiltrations in ocular adnexal tissues. The signs and symptoms include chronic noninflammatory lid swelling and proptosis. Patients often have a history of allergic disease and elevated serum levels of IgG4 and IgE as well as hypergammaglobulinemia. Orbital IgG4-related disease must be differentiated from idiopathic orbital inflammation and ocular adnexal marginal zone B-cell lymphoma to ensure appropriate and effective treatment. Systemic steroid therapy decreases the size of the lesions, but relapse often occurs when systemic steroid therapy is discontinued.
    ISRN rheumatology. 01/2012; 2012:412896.
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    Kazuo Yamamura, Ken Kondo, Suzuko Moritani
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    ABSTRACT: We report a case of primary malignant melanoma (MM) of the stomach. The patient, a 73-year-old man, was referred to our hospital for investigation of an elevated lesion in the stomach, detected by gastroscopy. On admission, physical examinations and laboratory data were unremarkable. Gastroscopy revealed a pigmented, elevated tumor, approximately 2 cm in diameter, in the posterior wall of the stomach. A biopsy was taken, which resulted in a diagnosis of MM, based on the presence of melanin in tumor cells. F-18 fluorodeoxyglucose positron emission tomography showed no accumulation of tracer except for the tumor in the stomach, indicating that it was a primary MM of the stomach. The patient underwent distal gastrectomy, but died of recurrence 1 year later. Very few cases of primary MM of the stomach have been reported. Thus, we report this case, followed by a review of the literature.
    Surgery Today 12/2011; 42(2):195-9. · 0.96 Impact Factor

Publication Stats

528 Citations
170.47 Total Impact Points

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Institutions

  • 2004–2014
    • National Hospital Organization Nagoya Medical Center
      • • Division of Pathology
      • • Department of Respiratory Medicine
      Nagoya, Aichi, Japan
  • 2007–2013
    • National Hospital Organization Sagamihara Hospital
      Sagamihara, Kanagawa, Japan
    • Hyogo College of Medicine
      Nishinomiya, Hyōgo, Japan
  • 2011
    • Nagoya University
      • Division of Surgery
      Nagoya-shi, Aichi-ken, Japan
  • 2003
    • University of Maryland, Baltimore
      • Department of Pathology
      Baltimore, MD, United States
  • 2001
    • Shiga University of Medical Science
      • Department of Pathology
      Ōtu, Shiga, Japan