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Biomedical subjects

E Arai

Publications and source records attributed to E Arai.

At least 37 records · Page 2Linked to original sources

Generalized eruptive histiocytoma: report of a pediatric case.

A one-year-old boy was seen with brownish, flat papules on his face, neck and upper arms. The lesions were symmetric, discrete, slightly raised, firm to the touch, and asymptomatic papular eruptions. Histological and immunohistochemical investigation revealed monomorphous infiltration of S-100 negative, lysozyme negative, and alpha 1-antitrypsin negative, but alpha 1-antichymotrypsin positive and vimentin positive histiocytic cells with small numbers of lymphocytic cells. The histiocytic cells did not show any foamy changes in the cytoplasm. No giant cells were found. The lesions increased in number during the first few years and then spontaneously regressed by the sixth year of age, leaving partial brownish pigmentation.

Child↗

Primary cutaneous T-cell-rich B-cell lymphoma.

A 61-year-old man presented with a skin tumour in the right axilla of 2 months' duration. An excision biopsy revealed a malignant lymphoma, of diffuse mixed small and large cell type, morphologically suggestive of T-cell lymphoma, but shown to be a T-cell-rich B-cell lymphoma by subsequent immunohistochemical staining. A review of the literature revealed 47 cases of T-cell-rich B-cell lymphoma with descriptions of primary sites, 35 nodal and 12 extranodal, of which only one was a cutaneous primary.

Diagnosis, Differential↗

Cutaneous histiocytic malignancy. Immunohistochemical re-examination of cases previously diagnosed as cutaneous "histiocytic lymphoma" and "malignant histiocytosis".

True histiocytic lymphoma (THL) and malignant histiocytosis (MH) have been defined by clinical and histologic findings and enzyme histochemistry. We reviewed cases previously diagnosed as cutaneous histiocytic lymphoma (HL) and MH with cutaneous lesions. These cases had been classified as "histiocytic" on the basis of previous enzyme histochemistry profiles of frozen tissue. Cutaneous tumor cells were reevaluated using a panel of immunohistochemical stains in formalin-fixed, paraffin-embedded tissue in correlation with histopathologic examination. The antibodies used in this study were directed against CD45 (leukocyte common antigen [LCA]), CD20 (L26) for B cells, CD3 and CD45RO (UCHL-1) for T cells, CD68 (KP-1) and lysozyme for histiocytes, as well as CD30 (BerH2) for Ki-1 positive cells. On re-evaluation, the seven cases originally classified as HL were reclassified as one case of THL with neoplastic cells positive for CD68 (KP-1) and lysozyme, two cases with immunohistochemical features of Ki-l lymphoma (including one of T-cell lineage), three cases of T-cell lymphoma, and one case of B-cell lymphoma, all associated with variable degrees of reactive histiocytosis. The four cases originally classified as MH were reclassified as two cases of MH and two cases of uncertain lineage. Although rare, histiocytic malignancies do exist. However, the diagnosis of histiocytic malignancy should be made only after careful correlation of atypical tumor cells in histopathologic sections and sections stained immunohistochemically. Erroneous classification of reactive histiocytes as neoplastic histiocytes using only enzyme histochemistry in frozen sections is a pitfall to be avoided.

Adult↗

Constitutional translocation t(4;22) (q12;q12.2) associated with neurofibromatosis type 2.

We report on a female patient with bilateral acoustic neurinomas and other tumors in the central nervous system (neurofibromatosis type 2: NF2) and the constitutional translocation, t(4;22) (q12;q12.2). The precise identification of the translocation breakpoint (q12.2) on chromosome 22 implies the refined localization of a gene responsible for NF2, and would provide a clue to its molecular characterization and to the isolation of the gene. Chromosomes of a paraspinal neurinoma from the patient were also analyzed, and the same karyotype as seen in cultured peripheral lymphocytes was found. The patient's father was also a carrier of the translocation, but he had no clinical symptoms of NF2, nor did other relatives. Several explanations are offered for the different expression of the translocation between the patient and her father.

Adult↗

[A case of Bezold's abscess associated with cholesteatoma].

Since the advent of antibiotics, otogenic complications have decreased considerably. However, incomplete antibiotic therapy has altered the clinical course of middle ear disease so as to be more insidious. This paper reports a case of Bezold's abscess associated with cholesteatoma. A 48-year-old man visited our hospital presenting with a 4-day history of right otorrhea and a tender swelling in the right neck. Physical examination showed a febrile patient (38.8 degrees C) with right facial paresis and trismus. A hyperemic, hard and tender swelling was observed in his right neck from the lateral cervical to the mental region. The tympanic membrane was invisible because of granulation and swelling of the posterior wall of the external auditory canal. Intravenous clindamycin and ceftazidime therapy was started immediately. A CT-scan revealed a diffuse shadow with bony destruction in the right mastoid cortex. Extensive abscess formation was also found in the right sternocleidomastoid muscle, in the anterior neck and in the posterior neck. He was diagnosed as having Bezold's abscess associated with cholesteatoma. Radical mastoidectomy and drainage of the neck abscess was performed on the third day under general anesthesia. The mastoid cavity was found to be filled with pus and cholesteatoma debris. A small area of defective bone was found at the mastoid tip, through which there were communications between the mastoid cavity and the abscesses in the neck. Bony destruction was also found in the horizontal and vertical portion of the facial canal. Bacteroides and three kinds of gram-negative rods were cultured from the mastoid cavity.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗

Mycosis fungoides and Sézary syndrome in Japan. Clinicopathologic study of 107 autopsy cases.

We reviewed 111 clinical and pathological materials of patients who had been entered as mycosis fungoides (MF) or Sézary syndrome (SS) in the Annuals of the Pathological Autopsy Cases in Japan during the 29-year-period since the Annuals' inception in 1958. One hundred and seven patients were classified. Of these, 64 were in Group 1 (mycosis fungoides, MF), 23 in Group II (Sézary syndrome, SS), and 20 in Group III (non-Hodgkin's lymphoma, NHL). The clinicopathologic features of Groups I and II (MF, SS) were similar to those of cutaneous T cell lymphoma (CTCL) in Europe and the United States. Those of Group III (NHL) were indistinguishable from primary cutaneous non-Hodgkin's lymphoma. It was suggested that some patients with adult T cell leukemia/lymphoma (ATLL) with skin lesions used to be misdiagnosed as MF or SS in earlier years when ATLL was still unknown. It was concluded that CTCL in Japan has clinicopathologic features quite like those of CTCL in Europe and the United States and that they are probably the same disease.

Adolescent↗

[An autopsy case of Gerstmann-Sträusser-Scheinker's disease with spastic paraplegia as its principal feature].

A 38-year-old woman developed slowly progressive gait disturbance. At age 39 years she was admitted to our department because she could not walk without assistance. On neurological examination she was alert with normal mental functions. Horizontal nystagmus on both sides, minimal clumsiness in the left upper extremity on the finger-to-nose test and moderate degree of spasticity in bilateral lower extremities without evident motor weakness were present. The gait was spastic with small steps on a wide base. There was no sensory abnormalities. The deep tendon reflexes were hyperactive on both sides, on the lower extremities, with positive Babinski's sign. The sphincter functions were intact. During the following 5 years she gradually deteriorated and pseudobulbar palsy, emotional incontinence and the progressive dementia appeared in addition to severe spastic paraplegia. At age 45 years she was admitted to our nursing home and she died 3 months later, of pneumonia, on 6 years after the onset of her illness. Two elder sisters of her 7 siblings had the similar neurologic illness. The brain weighed 1,060 g. There was mild atrophy of cerebrum, cerebellum and brainstem. There were neuronal loss and gliosis in layers IV-VI of cerebral cortex with no evidence of the spongy state. Cerebellar cortex, cerebellar peduncles and spinocerebellar tracts were preserved. There was marked degeneration of corticospinal tract from cerebral peduncle to lateral funiculus of lumbar spinal cord. The most prominent feature was appearance of numerous multicentric amyloid plaques, which were marked in layers I-III of cerebral cortex and to a lesser extent in corpus striatum, hippocampus and the white matters of cerebrum and cerebellum.(ABSTRACT TRUNCATED AT 250 WORDS)

Amyloid↗

The abnormal occurrence and the differentiation-dependent distribution of N-acetyl and N-glycolyl species of the ganglioside GM2 in human germ cell tumors. A study with specific monoclonal antibodies.

Human primary germ cell tumors were analyzed for the presence of the ganglioside GM2 using three specific monoclonal antibodies which can distinguish the molecular species of the sialic acid moiety: the antibody MK1-16 is specific for N-acetyl GM2, MK2-34 is specific for N-glycolyl GM2, and MK1-17 detects both N-acetyl and N-glycolyl GM2. When the occurrence of the GM2 antigen was tested in 107 cases of human germ cell tumors by the immunohistochemical technique using these antibodies, seminoma was characterized as having the highest frequency of N-acetyl GM2 (89.4%, 42 of 47 cases) among germ cell tumors, followed by embryonal carcinoma (40.0%), and teratocarcinoma (26.6%). Compared with this, yolk sac tumors and choriocarcinoma had a much lower positive incidence of the N-acetyl GM2 antigen. On the other hand, the N-glycolyl GM2 antigen was not found at all in 47 cases of seminoma (0%), and the positive incidence was very low in embryonal carcinoma (6.6%), although considerably higher incidences were obtained with choriocarcinoma (25.0%), yolk sac tumor (22.2%), and teratocarcinoma (13.3%). The presence and molecular species of the GM2 antigens in these human germ cell tumors were also ascertained chemically by the thin-layer chromatography (TLC) immunostaining of the ganglioside fractions prepared from primary germ cell tumors. These results indicate that seminoma specifically contains N-acetyl GM2 and no N-glycolyl GM2, suggesting that N-acetyl GM2 could be a good marker for seminoma. On the other hand, non-seminomatous germ cell tumors were characterized by the presence of N-glycolyl GM2, one of the Hanganutziu-Deicher antigens (H-D antigens). Moreover, the positive occurrence of N-glycolyl GM2 correlated very well with the degree of differentiation of non-seminomatous germ cell tumors, i.e., the differentiated tumors such as yolk sac tumors, choriocarcinoma, and teratocarcinoma had a higher positive incidence of N-glycolyl GM2 type H-D antigen but a lower positive incidence of N-acetyl GM2 when compared with embryonal carcinoma, the most undifferentiated tumors among non-seminomatous germ cell tumors.

Antibodies, Monoclonal↗

[Hematuria: an initial sign of cecal carcinoma].

A 79-year-old female was seen with hematuria, cystoscopy showed a non-papillary, broad-based tumor arising from the right anterolateral wall of the bladder. Transurethral biopsy revealed adenocarcinoma. Pelvic CT scanning revealed that the tumor extended from the bladder wall to the wall of the ileo-caecal intestine. Gastrointestinal series revealed no abnormal findings although the cecum could not be visualized clearly, and we could not distinguish whether the primary site was the bladder or intestine. Surgical exploration was performed. The main tumor seemed to arise from the cecum, extended downward and invaded the bladder wall. Right hemicolectomy and en bloc partial cystectomy were performed. The final diagnosis was adenocarcinoma of the cecum invading the bladder. We could find no reports on adenocarcinoma of the cecum in which hematuria was the initial symptom, as in this case, in Japan.

Adenocarcinoma↗

Specific skin lesions as the presenting symptom of hairy cell leukemia.

A 68-year-old Japanese man with a chief complaint of eczema-like dermatosis was diagnosed as having B-cell hairy cell leukemia (HCL) by demonstration of hairy cells in the skin lesions as well as in blood and bone marrow. He was treated with alpha-interferon, resulting in disappearance of skin lesions and reduction of his massive splenomegaly from 18 to 5 cm in about 14 months. Although specific skin lesions in HCL, shown by a review of the literature to occur in about 8% of cases, are not as uncommon as generally assumed, it is rare for HCL to present with specific skin lesions, the present case being only the second of its type mentioned in the literature.

Aged↗

[Xanthogranulomatous pyelonephritis: clinical experience of 8 cases].

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of granulomatous inflammation characterized by destruction of the renal parenchyma and replacement by solid sheets of lipid-laden macrophages. The first report was made by Schlagenhaufer in 1916. Due to diagnostic difficulties, relatively few cases have been reported. However, within the past 20 years, XGP has been recognized with increasing frequency. At present, over 400 cases have been reported. Recently, the computed tomographic (CT) findings of XGP have been described in a few sporadic case reports (1-4). Our clinical experience consists of 8 cases of XGP. The sonographic and computed tomographic findings in our cases are presented along with the correlation with the pathological specimens. We stress the importance of sonography and CT in preoperative planning. Moreover, in our cases we could obtain typical findings on sonography and CT, which enabled us to make a correct preoperative diagnosis. In this report we describe some specific features.

Adult↗

[Long-term effects of human seminal plasma from whole semen and from different fractions of split ejaculate on motility of human ejaculated spermatozoa].

A number of studies have implied that seminal plasma contains one or more factors that stimulate spermatozoal motility. On the other hand, many authors have shown that continuous, long term exposure to seminal plasma is detrimental to motility and survival of spermatozoa. In this study we examined the long term effects of human seminal plasma not only from whole semen but also from different fractions of split ejaculate on motility of human ejaculated spermatozoa. Washed spermatozoa were incubated in modified BWW medium containing human serum albumin with or without seminal plasma. A considerable percentage of spermatozoa maintained good progressive motility for up to 20 h. when free from seminal plasma. Addition of seminal plasma (20%, v/v) obviously depressed the motility, particularly progressive motility. The most depressive effect occurred in the first (prostatic) fraction of split ejaculate, and the effect of the last (vesicular) fraction was less harmful. These observations suggest that seminal plasma has (a) factor(s) that impair the maintenance of spermatozoal motility which originate possibly from the prostate or epididymis, since both fluids of these accessory organs appear to be secreted mainly into the first portion ejaculate.

Ejaculation↗

[Case report on testicular tumors in non-twin siblings].

A case report of testicular tumors in non-twin siblings is presented. A 42-year-old male was admitted to Kansai Electric Power Hospital with the complaint of swelling of the left scrotal contents. Left radical orchiectomy was performed with the diagnosis of a left testicular tumor. Histological examination revealed a seminoma of the left testis. Fifteen years later, his 43-year-old younger brother was admitted to Osaka University Hospital with the complaint of painless swelling of the left scrotal contents. Left radical orchiectomy was carried out with the diagnosis of a left testicular tumor. Histological examination showed a seminoma of the left testis. The former patient had a history of a scrotal trauma, but there was no history of orchitis or cryptorchism in these two siblings. To our knowledge, there have been reported 44 sets of testicular tumors in siblings. Eleven of these sets appeared in twins, while the other 33 sets were described in non-twin siblings. We discussed the 45 cases including our case of testicular tumors in siblings.

Adult↗

Treatment of malignant skin tumours with oral administration of BCG in enteric-coated capsules.

27 patients of stage Ib and 2 of malignant melanoma selected randomly were treated with the oral administration of BCG in enteric coated capsules in addition to the chemotherapy after the surgical treatment, while another 27 patients of the same stage of malignant melanoma with about the same background were treated with the same chemotherapy without BCG administration after the surgical treatment at the same period. The survival rate and the disease free time were observed in the patients of both groups with the results that the BCG group showed a significantly higher survival rate and a slightly higher disease free time than the control group. As an immunoparameter, the PPD reactions showed a higher conversion rate and increasing reaction size of the positive reactors in BCG group. Increasing the number of patients and observation period, the study will be continued in future.

Administration, Oral↗

[Metastatic ureteral tumor: a case report].

Among the secondary ureteral tumors, there have been a few true metastases to the ureters. We report a case of metastatic ureteral tumor from the pancreas, and review and discuss 60 cases collected from the Japanese literature.

Adenocarcinoma↗