Inverted papilloma-like transitional cell carcinoma of the uterine cervix.
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Adult↗
Biomedical subjects
M Fukunaga
Publications and source records attributed to M Fukunaga.
Endovascular papillary angioendothelioma (Dabska tumor)
The histological diagnosis of endovascular papillary angioendothelioma (EPA) (Dabska tumor) is controversial although the tumor is included in the World Health Organization classification. Papillary endothelial proliferation with a central hyaline core is one of the most characteristic features of EPA; however, this type of proliferation has been observed in other vascular tumors, such as angiosarcoma, retiform hemangioendothelioma and glomeruloid hemangioma. Several vascular tumors have EPA-like foci and EPA is not well defined generally. Endovascular papillary angioendothelioma may not be a distinct entity and may well include a heterogeneous group of lesions.
Head and Neck Neoplasms↗
Microvenular hemangioma.
A case of microvenular hemangioma in a 23-year-old Japanese female is described. The patient presented with a slowly growing, solitary reddish plague on her back, which measured 15 x 17 mm. Histologically, the tumor was an infiltrative growth throughout the dermis. It consisted of thin-walled, small-sized, irregularly branched vascular vessels. The vascular lumina were narrow. The flattened endothelial cells had oval to spindle-shaped nuclei and scant cytoplasm that were immunohistochemically positive for endothelial markers. The tumor cells lacked cellular atypia, pleomorphism, and mitotic figures. The patient was well without disease 8 months after the excision. Pathologists and clinicians should be aware of the existence of this type of hemangioma with an infiltrative growth and avoid overdiagnosis and overtreatment.
Actins↗
Extrauterine low-grade endometrial stromal sarcoma: report of three cases.
Three cases of rare low-grade endometrial stromal sarcoma of the extrauterine tissue are presented. Each one occurred in the ovary, pelvic and abdominal cavities. Two were associated with endometriosis. Histologically, the tumors were characterized by an infiltrative and diffuse proliferation of uniform round or oval cells, abundant small vessels, low mitotic activity, the presence of foam cells and vascular invasion. Immunohistochemically, all tumors expressed vimentin, muscle markers (desmin, muscle-specific actin and alpha-smooth muscle actin) and progesterone receptors. Two tumors were diploid and one was aneuploid by flow cytometry. All patients were well with no evidence of disease 16-39 months after surgery. It is suggested that this neoplasm may arise with or without endometriosis under hormonal influence. This rare variant of Müllerian tumors should not be confused with adenosarcoma and soft tissue tumors, such as smooth muscle tumors and solitary fibrous tumor.
Abdominal Neoplasms↗
Neuroendocrine carcinoma of the liver: an autopsy case.
An autopsy case of hepatic neuroendocrine carcinoma is described. An 84-year-old man had a white solid tumor measuring 5 cm in greatest diameter and multiple small nodules in the non-cirrhotic liver. Microscopically, these lesions were characterized by solid nesting, trabecular, and insular arrangements of small- to medium-sized cells. The tumor cells were argyrophilic and electron microscopy showed dense core granules and formation of bile canaliculi. Immunohistochemically, the tumor cells were positive for cytokeratin CAM 5.2, chromogranin A, Leu-7, neuron-specific enolase, and alpha-fetoprotein. The tumor was diploid by flow cytometry. The patient had metastases in the vertebrae, lung, pancreas, and an hepatic hilar lymph node. The patient had an occult rectal tumor of intramucosal well-differentiated tubular adenocarcinoma without metastasis. No alternative primary source of the endocrine tumor was detected. The patient died 1 month after presentation.
Adenocarcinoma↗
Neuroendocrine carcinoma of the breast with Merkel cell carcinoma-like features.
A case of neuroendocrine carcinoma of the breast with Merkel cell carcinoma-like features occurring in a 38-year-old female is described. A 2.5 x 2.5 x 1.3 cm tumor in the upper-outer quadrant of the right breast was ill-defined, yellowish white and rubbery. Microscopically, the tumor was characterized by a diffuse proliferation of non-cohesive round cells. The tumor cells had round nuclei with finely dispersed chromatin and inconspicuous nucleoli. The cytoplasm was generally scant, pale to eosinophilic, and argyrophilic. There were scattered foci of small nests or intraductal proliferations. Immunohistochemically, many tumor cells showed positive reaction for CAM5.2, vimentin, chromogranin A, and synaptophysin. The tumor was also positive for neuron-specific enolase (NSE), Leu-7, calcitonin, S-100 protein, and glial fibrillary acidic protein. Flow cytometric analysis showed that the tumor was DNA diploid. An axillary lymph node was positive for metastasis. The patient was well, without disease, for 6 years after mastectomy. It is suggested that the tumor might originate from ductal cells and show Merkel cell carcinoma-like neuroendocrine differentiation.
Adult↗
Uterine bizarre lipoleiomyoma.
A case of uterine bizarre lipoleiomyoma occurring in a 58-year-old woman is described. A subserosal 8.5 cm mass in the posterior wall of the body had a lipoma-like appearance with strands of fibrous tissue. Histologically, the tumor predominantly consisted of adipocytes which varied in size and shape. Some cells had the appearance of signet ring cells, some had hyperchromatic nuclei, and multivacuolated lipoblasts with hyperchromatic nuclei were observed throughout the lesion. The fibrous areas showed a proliferation of smooth muscle cells with and without atypical nuclei. There was no mitotic figure. Flow cytometric analysis indicated aneuploidy. The patient was well without disease 10 months after hysterectomy. Patients with this type of tumor need a close and long-term follow-up because of the paucity of clinical information.
Adipose Tissue↗
Small cell (oat cell) carcinoma of the breast.
A case of small cell (oat cell) carcinoma, which represents both the most distinctive and the least common type of breast carcinoma with neuroendocrine differentiation and usually shows the most aggressive behavior, is described. Radical mastectomy was performed on a 56-year-old female for a 10 cm tumor located in the outer part of the right breast with cutaneous ulceration Microscopically, the tumor predominantly consisted of a diffuse proliferation of small, round to ovoid cells with hyperchromatic nuclei and ill-defined, scant cytoplasm that was reminiscent of oat cell carcinoma of the lung. There were foci of invasive ductal carcinoma and ductal carcinoma in situ. Small cell carcinoma areas constituted approximately 90% of the neoplasm. The patient had axillary lymph node metastasis. The small tumor cells were argyrophilic and positive for CAM5.2, carcinoembryonic antigen, neuron-specific enolase, Leu-7, chromogranin A and synaptophysin. Flow cytometric analysis showed an aneuploid DNA content. The patient was alive and well without disease 4 years after surgery. Small cell carcinomas of the breast may exhibit a spectrum of malignancy that is comparable to similar tumors at better known primary sites.
Biomarkers↗
Neuroendocrine carcinoma of the breast: a case report of pure type.
A case of pure neuroendocrine carcinoma of the breast occurring in a 51-year-old female is described. The tumor located in the upper outer quadrant was a relatively well-circumscribed, uncapsulated, yellowish white, rubbery mass measuring 2.5 x 2.0 x 2.0 cm. Microscopically, the tumor was characterized by solid nest, lobular, trabecular, and insular arrangements of small to medium-sized cells with uniform round to oval hyperchromatic nuclei and pale to eosinophilic cytoplasm. It showed focal stromal invasion. The stroma was fibrous and rich in vascularity. The tumor cells were argyrophilic and positive for cytokeratin CAM5.2, Leu-7, neuron-specific enolase, and chromogranin A. Electron microscopy showed neurosecretory granules. The tumor was DNA diploid with a low S-phase fraction by flow cytometry. The axillary lymph nodes were negative for metastasis. The patient was well and without disease 16 months after mastectomy.
Breast Neoplasms↗
A placebo-controlled, single-blind study to determine the appropriate alendronate dosage in postmenopausal Japanese patients with osteoporosis. The Alendronate Research Group.
Alendronate (4-amino-1-hydroxybutylidene-1,1-bisphosphonate) is a potent inhibitor of bone resorption. The efficacy and safety of 36 weeks of treatment with alendronate were evaluated in Japanese women with osteoporosis, osteoporotic osteopenia or artificial menopause. The bone mineral density (BMD) of the lumbar vertebrae, markers of bone and calcium metabolism and clinical symptoms were monitored. A total of 113 randomly selected patients with osteoporosis or osteopenia were enrolled in the study, of whom 12 were excluded from the analyses because of lack of data. As a result, 101 patients were evaluated for the safety of the drug. Since eight patients were excluded from the efficacy analysis, 93 were evaluated. The incidence of adverse effects in the placebo (P), alendronate 2.5 mg/day (L) and alendronate 10 mg/day (H) groups increased with increasing dose of alendronate, being 6.1, 14.3 and 18.2%, respectively. The most common adverse effects were gastrointestinal symptoms, none of which was serious. Lumbar BMD increased after 36 weeks of drug administration to 5.21%, 5.64% and -0.90% in the L, H and P groups, respectively (P < 0.001, L vs. P and H vs. P). Serum alkaline phosphatase activity, serum osteocalcin and urinary deoxypyridinoline excretion were significantly decreased in a dose-related manner. Serum calcium and phosphorus were also significantly decreased after alendronate administration. Serum intact PTH was transiently increased. The present results indicate that alendronate effectively decreases bone turnover in a dose-related manner and increases lumbar BMD at a dosage of 2.5 mg/day, the lowest dose used in this study, in Japanese patients with osteoporosis.
Adult↗
[X-ray absorptiometry].
Bone mass measurements are essential in the diagnosis of osteoporosis, the monitoring of its progression, and the evaluation of therapeutical responses. Among various methods of bone mass measurements, single- and dual-X-ray absorptiometry, SXA and DXA, have shown excellent fundamental performance. In this paper, the principles of SXA and DXA; i.e., factors of fundamental performance, such as precision, data-acquisition, and radiation dose, the practice of DXA, recent advances in DXA, such as the lateral spine scan, the measurement of body composition, application to BMD measurement of the bones of small animals and at sites of metal implants, morphometry of the spine, and geometrical measurement in the proxial femur, and clinical applications to osteoporosis were particularly reviewed.
Absorptiometry, Photon↗
[Intra-arterial chemotherapy to improve quality of life in cases of unresectable advanced or recurrent breast cancer].
We performed repetitive intra-arterial infusion chemotherapy (I.A.) with epirubicin in order to improve the quality of life (QOL) in 3 cases with locally advanced or recurrent breast cancer which were diagnosed as surgically unresectable and seemed uncontrollable by outpatient systemic chemotherapy. The patients were admitted to our hospital for chest wall invasion, lymph node metastasis, bleeding, pain, or edema in upper extremity. Therapeutic effects included 1 case of CR and 2 cases of PR in the primary site, and similar effects were obtained in metastasized lymph nodes. We could perform mastectomy in both of the 2 cases with locally advanced cancer after I.A., Although leukocytopenia, which was the dose limiting factor in this regimen, was observed in all 3 cases, it was Grade 2 or 3 and recovered by G-CSF. With regard to their QOL, symptoms which had driven them to inpatient treatment remarkably improved in all of the cases. Thus, after 2 series of I.A. they could receive maintenance systemic chemotherapy as outpatients. Our findings showed that the I.A. as a local control treatment in patients with unresectable advanced or recurrent breast cancer is useful for the improvement of their QOL.
Antibiotics, Antineoplastic↗
[Long-term survival in a case of multiple liver metastasis from postoperative gastric cancer effectively treated by hepatic intraarterial infusion chemotherapy using MMC and pirarubicin].
We experienced a case of multiple liver metastasis from postoperative gastric cancer who showed long-term survival with hepatic arterial infusion chemotherapy (HAI) of MMC and pirarubicin. A catheter was inserted into the hepatic artery, and 4 mg of MMC and 20 mg of pirarubicin were administered through an implantable port catheter every two to four weeks. The total dose of MMC and pirarubicin by the time of this report was 164 mg and 820 mg, respectively. The follow-up CT scan 2 months after the beginning of HAI showed a decrement of the liver tumors. The decrease rate at 12 and 17 months was 50% and 70%, respectively, which was diagnosed as partial response (PR). The therapeutic effect at 49 months is still PR without any sign of tumor enlargement of extra hepatic lesion.
Antineoplastic Combined Chemotherapy Protocols↗
Epithelial metaplastic changes in ovarian endometriosis.
Little is known concerning epithelial metaplastic changes (metaplasia) in ovarian endometriosis. Three hundred fifteen consecutive cases of ovarian endometriosis between 1987 and 1995 were retrieved from hospital files and clinicopathologically analyzed. Two hundred fifty-seven cases were not associated with malignant ovarian epithelial tumor or atypia Four cases were atypical endometriosis. The remaining 54 cases were associated with malignant ovarian epithelial tumor, including borderline tumor. Metaplasias in ovarian endometriosis were observed in 162 (63%) cases not associated with malignant epithelial tumor or atypia. Ciliated cell and eosinophilic metaplasias were the most common (44%, respectively), followed by hobnail (13%) and mucinous (4%) types. Metaplasias in endometriosis were observed in all of the four atypical endometriosis cases and all of the 54 cases with malignant ovarian epithelial tumor. Among these cases, ciliated cell and eosinophilic metaplasia were also the most common. There was no correlation between types of carcinoma and types of metaplasia in endometriosis, but in all of the four Müllerian mucinous borderline tumors, ovarian endometriosis with mucinous metaplasia and hyperplasia was contiguous or intimately associated with the tumor. Metaplasia was often observed in ovarian endometriosis and most frequently was associated with malignant ovarian epithelial tumor or atypia. Metaplastic changes in ovarian endometriosis should not be interpreted as neoplastic features. Mucinous metaplasia and hyperplasia in ovarian endometriosis might be closely associated with the development of Müllerian mucinous borderline tumors.
Adult↗
[A case of locally advanced breast cancer successfully treated with intra-arterial infusion chemotherapy of high-dose epirubicin].
A case of locally advanced breast cancer was treated with intra-arterial infusion chemotherapy using high-dose epirubicin. The 1st and 2nd cycle consisted of 210 mg (day 1, 4, 7) and 150 mg (day 1, 4, 7), respectively. After completion of 2 cycles of the regimen, remarkable loco-regional control and improved QOL were obtained. Leucopenia (nadir; 1,000/mm3) was the dose limiting factor, but well-tolerated with supportive therapy. The patient underwent salvage surgery and maintenance intra-venous chemotherapy (epirubicin; 30 mg/3 weeks). At this writing, the patient is enjoying favorable QOL. These findings suggested that this modality was effective for cases with exctensive loco-regional involvement.
Antibiotics, Antineoplastic↗
Lymphoepithelioma-like carcinoma of the renal pelvis: a case report with immunohistochemical analysis and in situ hybridization for the Epstein-Barr viral genome.
Lymphoepithelial carcinoma is a relatively common malignancy in the nasopharynx, but it rarely occurs at other sites. Described herein is the first case of a renal pelvic neoplasm that closely resembled lymphoepithelial carcinoma, with analyses of histology, immunophenotype, in situ hybridization for the Epstein-Barr viral genome, and flow cytometric DNA ploidy. The tumor was detected in an 70-year-old Japanese man who presented with hematuria Histologic examination showed an undifferentiated round or spindle cell carcinoma (cytokeratin 7+, cytokeratin 20+, epithelial membrane antigen+, vimentin-) with abundant lymphocytes (predominantly UCHL-1+ T cells), plasma cells, and macrophages in and around the tumor cell nests. The tumor was limited to the pelvis, with a minute focus of carcinoma in situ. No Epstein-Barr viral genomic sequences were detected by in situ hybridization. The tumor had an aneuploid DNA content. The patient remains well without disease 6 years after surgery and radiotherapy. Recognition of this type of renal pelvis carcinoma is important to avoid misdiagnosis.
Aged↗
3-(13-Hydroxytridecyl)-1-[13-(3-pyridyl)tridecyl]pyridinium chloride (YM-53792), a novel inhibitor of NF-AT activation.
A compound, YM-53792, was identified as an inhibitor of interleukin-2 (IL-2) gene promoter activity, using a Jurkat cell-based reporter system in which the luciferase gene is regulated by the IL-2 gene promoter. Production of IL-2, interleukin-4 (IL-4) and interleukin-5 (IL-5) from human peripheral blood mononuclear cells was suppressed by YM-53792 in a dose-dependent fashion. Since expression of these cytokine genes is known to be regulated by NF-AT, we examined whether the promoter activity created by multimerization of NF-AT elements was inhibited with YM-53792. YM-53792 inhibited this promoter activity, but not AP-1- and NF-kappaB-driven promoter activities nor SV40 enhancer/promoter activity. In addition, electrophoretic mobility shift assays did not detect NF-AT/DNA complexes when nuclear extract prepared from YM-53792-treated, PMA/A23187-stimulated Jurkat cells was used, whereas AP-1/DNA complexes were observed. These results suggest that YM-53792 specifically inhibits the activation of NF-AT.
Cyclosporine↗
[Progress on therapy of intractable edema].
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Albumins↗