Cardiac myxomas are benign tumors which sometimes secrete interleukin-6 (IL-6), however, the pathogenesis and the IL-6 secreting cells are not clear. There are vascular myosin heavy chain isoforms; SM2 expression is specific to mature smooth muscle cells, while SMemb is a nonmuscle-type isoform which is expressed in immature mesenchyme cells. We hypothesized that immature mesenchyme cells play pivotal roles in the secretion of IL-6; we studied these expression in resected samples of myxoma. SMemb expression was increased but SM2 expression was not in the channels of myxoma. Increased IL-6 transcription was observed in the SMemb expressing cells in the channel. Therefore, mesenchyme cells with immature phenotype in the channel play pivotal roles of inflammation and pathogenesis of cardiac myxoma.

Adult↗

PubMedDate not supplied

Idiopathic saccular aneurysm of the azygos vein.

Idiopathic saccular aneurysm of the azygos vein is a rare condition. We report the case of a 52-year-old man with saccular aneurysm of the azygos vein who underwent surgical resection. Preoperative dynamic computed tomography revealed strong and rapid enhancement of the chest mass. Magnetic resonance imaging showed a thoracic tumor with low signal intensity on the T1-weighted image and coexistence of low and high signal intensity on the T2-weighted image. Intraoperative findings showed cystic dilatation of the azygos vein. Although an accurate preoperative diagnosis of saccular azygos vein aneurysm is difficult, especially differential diagnosis between this anomaly and mediastinal tumors, a markedly enhanced mass shown by dynamic computed tomography was useful for the preoperative diagnosis of this anomaly.

Azygos Vein↗

PubMedDate not supplied

A case of Zollinger-Ellison syndrome produced by gastrinoma in the duodenum accompanied with multiple endocrine neoplasia type 1.

A case of Zollinger-Ellison syndrome produced by gastrinoma in the duodenum accompanied by multiple endocrine neoplasia type-1 (MEN-1) is reported. A 46 year-old female underwent distal gastrectomy due to gastric ulcer 5 years ago. As ulceration of the residual stomach recurred, further examination was performed. Hyperprolactinemia, hypergastrinemia, primary hyperparathyroidism, pancreatic tumor, and duodenal carcinoid were evident, and the diagnoses of Zollinger-Ellison syndrome and MEN-1 were established. The origin of the gastrin secretion was suspected to be from the pancreatic tumor, so sampling of the portal blood was performed. As lesion on the gastrinoma in the pancreas could not be identified, total parathyroidectomy was performed for primary hyperparathyroidism. The level of the gastrin secretion, however, remained high. Partial resection of the duodenum for the duodenal carcinoid and a distal pancreatectomy were carried out concurrently. Immunohistochemical study of the anti-gastrin antibody revealed duodenal tumor cells. Initially, the gastrinoma was thought to be in the pancreas, however, the lesion accompanied with MEN-1 and the Zollinger-Ellison syndrome had occurred in the duodenum.

Duodenal Neoplasms↗

PubMedDate not supplied

Basaloid squamous carcinoma of the esophagus with analysis by in situ nick end labeling and PCNA immunostaining.

BACKGROUND/AIMS: Basaloid squamous carcinoma (BSC) of the esophagus has been associated with poor outcome after surgery. In this study, apoptosis and cell proliferation of BSC were studied to evaluate the malignant potential of this cancer. METHODOLOGY: In tissue samples from 4 out of 5 BSC patients (1 patient with pre-operative radiotherapy was excluded) and from 30 patients with squamous cell carcinomas (SCCs) of the esophagus, apoptosis was studied by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL), and cell proliferation was evaluated by the immunostaining of proliferating cell nuclear antigen (PCNA). Two of the 5 patients with BSC died of recurrence and the remaining 2 patients are alive without recurrence. RESULTS: TUNEL-positive cells and PCNA-positive cells were observed to exist randomly and independently in the BSC samples. In the well- and moderately differentiated SCCs, TUNEL-positive cells and PCNA-positive cells were locally observed. The apoptotic index was significantly lower in the BSC than in the SCC tissues, and the PCNA labeling index was significantly higher in BSC than in SCC. CONCLUSIONS: These results suggest that BSC of the esophagus has great proliferative activity and weak apoptosis. These characteristics may reflect the aggressive behavior and poor prognosis of esophageal BSC. Early detection of this tumor, as in the present 2 cases, will contribute to a better prognosis.

Aged↗