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K Hizawa

Publications and source records attributed to K Hizawa.

At least 37 records · Page 2Linked to original sources
PubMed1999

Depressed adenoma of the duodenum in patients with familial adenomatous polyposis: endoscopic and immunohistochemical features.

BACKGROUND: Depressed neoplastic lesions of the colorectum have been specified in patients with familial adenomatous polyposis (FAP). The aim of this study was to characterize endoscopic, histologic, and immunohistochemical features of depressed adenoma of the duodenum in patients with FAP. METHODS: Duodenoscopy was performed on 25 patients with FAP, and the neoplastic nonampullary lesions were classified as polypoid or depressed adenomas. The grade of dysplasia, the proliferative activity determined by Ki-67 labeling index (LI), and the grade of p53 expression were compared between polypoid and depressed neoplasia. RESULTS: Ten subjects had depressed nonampullary adenoma, whereas polypoid adenoma was found in the remaining 15 subjects. Moderate dysplasia was more frequent in depressed adenoma than in polypoid adenoma (70% vs. 27%, P = 0.04). Whereas p53 expression was not different between the two adenoma groups, the LI was significantly higher in depressed adenoma than in polypoid adenoma (59.7 +/- 9.5 vs. 47.5 +/- 10.7, P < 0.01). CONCLUSIONS: Depressed adenoma of the duodenum is a distinctive phenotype of duodenal neoplasm in patients with FAP. The high proliferative activity of depressed adenoma suggests that there may be a need to survey FAP patients with such lesions intensively.

Adenoma↗
PubMed1998

Dual-colour fluorescence in situ hybridization analysis of synovial sarcoma.

Mounting cytogenetic evidence indicates that synovial sarcomas, regardless of histological conformation, share the specific reciprocal chromosomal translocation t(X;18)(p11.2;q11.2). Application of dual-colour fluorescence in situ hybridization (FISH) on interphase nuclei isolated from archival paraffin-embedded material to identify the specific translocation is of diagnostic importance for pathological practice and retrospective study. Five cases of well-characterized biphasic synovial sarcomas, two monophasic fibrous synovial sarcomas, one embryonal rhabdomyosarcoma, one fibrosarcoma, and one malignant peripheral nerve sheath tumour were analysed. To visualize the translocated chromosomal fragments and their topographic relationships with centromeres of chromosomes X and 18, nuclei from each case were hybridized concurrently with chromosome X centromeric and chromosome 18 painting probes, and chromosome 18 centromeric and chromosome X painting probes, respectively. Six out of seven synovial sarcomas showed chromosomal alterations consistent with t(X;18). One biphasic synovial sarcoma had trisomy 18 and lacked the chromosomal translocation t(X;18). The other three spindle cell sarcomas and the normal control tissues showed the normal numerical and structural composition for chromosomes X and 18. It is indicated from the present study that when histological differential diagnosis is difficult, FISH would be a crucial aid in detecting a known specific chromosomal alteration and that dual-colour FISH is an efficient stable diagnostic tool for pathological research and daily diagnosis. The results also suggest that rare synovial sarcomas may lack the chromosomal translocation t(X;18). 1998 John Wiley & Sons, Ltd.

Adult↗
PubMed1998

Double-contrast radiographic assessment of lupus-associated enteropathy.

PURPOSE: To describe the double-contrast radiographic features of lupus-associated enteropathy. MATERIALS AND METHODS: Six patients with systemic lupus erythematosus involving the small bowel were assessed by double-contrast radiography of the duodenum and small intestine, with reference to clinical manifestations and jejunoscopic findings. RESULTS: Lupus-associated enteropathy could be categorized into two types: acute onset enteritis in four patients and protein-losing enteropathy with hyperlipidaemia in two patients. The former group presented with irregular thickening and spiculation in the folds of the multiple segments of the duodenum to the terminal ileum, and they were frequently accompanied by thumbprinting, suggestive of ischaemic change. The latter group was characterized by mildly thickened folds with multiple submucosal nodules in the upper portion of the jejunum. In one patient from this group, jejunal biopsy demonstrated lymphangiectasia. Both groups were successfully treated by high-dose prednisolone. Follow-up radiography in the former group showed a complete improvement within 2-7 weeks, whereas radiographic abnormalities in the latter remained even after 2 months. CONCLUSIONS: Lupus-associated enteropathy cases may be divisible into two types; an acute ischaemic enteritis type and a protein-losing enteropathy type, each presenting distinct radiographic features.

Acute Disease↗
PubMed1998

Comparative features of double-contrast barium studies in patients with isosporiasis and strongyloidiasis.

OBJECTIVE: To compare the gastrointestinal features of isosporiasis and strongyloidiasis. METHODS: Two patients with isosporiasis and three patients with strongyloidiasis were assessed by double-contrast radiography of the duodenum and small intestine, with reference to histology of the duodenal biopsy specimens. RESULTS: Both conditions affected the duodenum and the proximal jejunum, and showed similar radiographic changes as the diseases progressed. Thus, three patients with diarrhoea lasting 1 year or less showed only minimal or irregularly thickened mucosal folds, which seemed to result from mucosal inflammation. Two patients with long-standing disease periods (17 years and 30 years) presented a markedly granular mucosal appearance with effacement of the folds on radiography. These chronological differences in the radiographic features seemed to reflect the degree of villous atrophy. CONCLUSION: Isosporiasis has similar radiographic features of strongyloidiasis.

Aged↗
PubMed1998

Primary liposarcoma of the stomach: a case report and a review of the literature.

Primary liposarcoma of the stomach is rare and only seven cases have been described in the English literature. Here we report the eighth case, which occurred in a 68-year-old woman who presented with repeated tarry stools and hematemesis. Endoscopic examination revealed a large ulcerated submucosal mass at the gastric angle. The patient was treated by total gastrectomy. On microscopic examination, the tumor showed the features of a well differentiated sclerosing liposarcoma. Immunohistochemically, many spindle to stellate tumor cells were diffusely positive for vimentin and CD34. Positivity for S-100 protein was found in the adipocytic component, including lipoblasts, in addition to some spindle-shaped tumor cells. On ultrastructural examination, the spindle to stellate cells had features characteristic of fibroblasts. No recurrence or metastasis was seen during 13 months. Liposarcoma of the stomach has to be considered in the differential diagnosis with other submucosal lesions, such as gastric lipoma and gastrointestinal stromal tumor.

Aged↗
PubMed1998

Collagenous fibroma (desmoplastic fibroblastoma): report of four cases and review of the literature.

BACKGROUND: Collagenous fibroma (desmoplastic fibroblastoma) is poorly recognized and may be mistaken for other benign or even malignant spindle-cell tumors of soft tissue because of the small number of reported cases. DESIGN: Collagenous fibromas resected from four adult women were studied histologically and immunohistochemically. RESULTS: The tumors were well-circumscribed firm masses, measuring from 1.0 to 13.8 cm (mean, 5.5 cm) across the greatest diameter, located in the subcutaneous or deep soft tissue of the shoulder, thigh, back, and neck. Each of the tumors was characterized by a paucicellular lesion with spindle- and stellate-shaped fibroblastic cells embedded in a hypovascular, densely fibrous stroma. Mitotic figures and necrosis were not identified. One tumor contained dystrophic calcification and metaplastic bone, and another included small foci of floretlike multinucleated giant cells. Although appearing well demarcated on gross examination, one tumor focally infiltrated the surrounding skeletal muscle and adipose tissue. On immunohistochemical examination, all of the tumors were diffusely positive for vimentin. One tumor showed focal staining for alpha-smooth muscle actin, and another was partially positive for desmin, a staining profile that is typical of myofibroblasts. No tumor recurred during the follow-up periods of 67 to 108 months (mean, 93 months). CONCLUSION: Collagenous fibroma may be a distinctive fibrous soft-tissue tumor with benign biological behavior.

Adult↗
PubMed1997

Thyroid neoplasia and familial adenomatous polyposis/Gardner's syndrome.

This study was conducted to clarify the actual morbidity and clinicopathologic features of thyroid neoplasia in patients with familial adenomatous polyposis. We analyzed the clinical records of 49 Japanese patients with familial adenomatous polyposis diagnosed at our institute. Six of these patients had thyroid neoplasias (3 carcinomas, 2 adenomas, and 1 of unknown histology). Among 17 patients (11 men and 6 women) who had been examined by thyroid ultrasonography or in whom postmortem examination was performed; we categorized 6 patients with thyroid tumor as the TT group, and the remaining 11 without thyroid tumor as the NTT group. The clinical features of the two groups were compared. Thyroid neoplasia was detected by physical examination in 2.3% of 43 patients so examined and was detected in 25% of 8 patients examined by thyroid ultrasonography, and in 44% of the 9 patients subjected to postmortem examination. There were no significant differences between the TT and NTT groups in gender; age at first admission, colectomy, and last follow-up visit; number of colonic polyps; or in presence of colorectal cancers, gastroduodenal adenomas, gastric fundic gland polyposis, retinal pigmented lesions, or extraintestinal tumors. The thyroid gland is frequently affected in patients with familial adenomatous polyposis, but there may be no association between thyroid neoplasia and other clinical manifestations.

Adenomatous Polyposis Coli↗
PubMed1997

Endoscopic hydrostatic balloon dilation of ulcer-induced pyloric stenosis in rheumatoid arthritis and secondary amyloidosis.

We describe a 50-year-old Japanese woman with rheumatoid arthritis who presented with near-complete gastric outlet obstruction. The patient also suffered from secondary gastrointestinal and cardiac amyloidosis. Gastroscopy revealed multiple huge gastric antral ulcers in which amyloid deposits were identified on histologic examination. The ulcers became scars after treatment with omeprazole, which cause in severe pyloric stenosis. Endoscopic hydrostatic balloon dilation under fluoroscopic guidance was performed twice for 10 min. The pyloric outlet remained sufficiently patent 22 months later.

Amyloidosis↗
PubMed1997

Carcinoid tumors of the duodenum: report of three cases treated by endoscopic resection.

Three patients with small (less than 1 cm) duodenal carcinoid tumors are described, two of whom underwent endoscopic resection using simple snare polypectomy. In the third patient, a small tumor (5 mm) could no longer be found after initial biopsies on subsequent repeated endoscopic-bioptic follow-up. All three patients are free of local recurrence or systemic symptoms 2-14 years after the procedure.

Adult↗