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Biomedical subjects

M Tsuneyoshi

Publications and source records attributed to M Tsuneyoshi.

At least 181 records · Page 10Linked to original sources
PubMed1995

Intraductal papillary mucinous neoplasms of the pancreas associated with so-called "mucinous ductal ectasia". Histochemical and immunohistochemical analysis of 29 cases.

Twenty-nine patients (20 men, nine women; mean age, 65.9 years; range, 49-77 years) with intraductal papillary mucinous neoplasms associated with so-called "mucinous ductal ectasia" of the pancreas were studied both histochemically and immunohistochemically. These cases included six cases of hyperplasia, 13 adenomas, and 10 adenocarcinomas. The mean sizes of the hyperplasia, adenomas, and adenocarcinomas were 2.0 cm, 3.0 cm, and 4.8 cm in diameter, respectively. Tumor size correlated with the degree of cellular atypia. The proliferative rates were significantly higher in the carcinomatous epithelium with those in the hyperplastic and adenomatous epithelia. The polarity of distribution of carcinoembryonic antigen and carbohydrate antigen 19-9 were better preserved in the hyperplastic epithelia than in the carcinomatous epithelia. On the other hand, the papillary and nonpapillary hyperplastic epithelium contained mainly a neutral periodate-reactive glycoprotein with only trace amounts of sialomucins and sulphomucins. In addition, the adenomatous epithelium contained mostly sialomucins with a small amount of sulphomucins. The carcinomatous epithelium contained predominantly sulphomucin. The results of both the histological and immunohistochemical studies suggested the possibility of a sequential change from nonpapillary and papillary hyperplasia, via adenoma, to carcinoma in intraductal papillary-mucinous neoplasms associated with mucinous ductal ectasia. Moreover, these results, in combination with the histochemical findings, are considered helpful in making an appropriate preoperative diagnosis with endoscopic pancreatic ductal biopsy specimens, thus enabling the surgeon to select the most appropriate surgical procedure.

Adenocarcinoma, Mucinous↗
PubMed1995

An intestinal counterpart of pyogenic granuloma of the skin. A newly proposed entity.

Pyogenic granuloma is a common disease in the skin, but it is extremely rare in the gastrointestinal tract except for the oral cavity. We have seen three lesions (from three patients) of an intestinal counterpart of pyogenic granuloma and have reviewed their clinicopathologic features. Macroscopically, all three lesions revealed a polypoid growth with either a sessile or pedunculated configuration. All had an ulceration on the top. Microscopically, all these lesions were composed of a lobular proliferation of varying sizes of capillaries with an edematous stroma. Endothelial cells of the capillaries were swollen variously and in one case revealed a few mitotic figures. An inflammatory process was associated with the presence of ulcerations. Immunohistochemically, both Factor VIII-related antigen and QB-end/10(CD34) were positive only for the endothelial cells in all three cases. The characteristic macroscopic and histologic features thus allow for an early diagnosis of pyogenic granuloma in the gastrointestinal tract, which is similar to that observed in the skin.

Aged↗
PubMed1995

Small hepatocellular carcinomas undetected on two-phased incremental computed tomography. Angiographic and clinicopathologic findings.

RATIONALE AND OBJECTIVES: To elucidate the characteristic clinicopathologic features of hepatocellular carcinomas (HCCs) undetected on two-phased incremental computed tomography (CT). METHODS: Computed tomographic scans of 115 surgically resected small (< or = 3 cm) HCCs from 83 patients were performed 45 seconds and 6 minutes after the administration of contrast material. These scans were compared with corresponding angiographic and histopathologic findings. RESULTS: Eighty HCCs (70%) were depicted on the early images; 73 (63%) on the delayed images; and 89 (77%) using two-phased incremental CT. The small HCCs undetected on the early images but seen histologically had the following characteristics: (1) absence of a fibrous capsule, (2) well-differentiated tumor, (3) replacing growth patterns of the tumors, (4) lack of fatty metamorphosis and/or clear cell changes, (5) hypovascular on angiography. Those not seen on delayed images had the following characteristics: (1) absence of a fibrous capsule, (2) replacing growth patterns, and (3) presence of portal tracts in the tumors. CONCLUSIONS: The replacing growth pattern and the presence of portal tracts correlate with the undetectability on CT. For HCCs undetected on CT, treatment methods must be considered carefully, because the HCCs may be receiving transsinusoidal and portal blood supplies.

Adult↗
PubMed1995

Adenosquamous carcinoma of the gall-bladder with gastric foveolar-type epithelium.

An 80 year old Japanese man had adenosquamous carcinoma of the gall-bladder characterized by an adenocarcinoma (AC) in the gall-bladder lumen and a squamous cell carcinoma (SCC) in the invaded region of the liver. In the AC, the tumor cells consisted of atypical columnar epithelium with pseudostratification, mimicking gastric foveolar epithelium, while atypical signet-ring cells were scattered within the SCC. There was an abrupt transition between the AC and SCC areas. The tumor cells in the AC area were intensely positive for galactose oxidase-Schiff staining, and paradoxical concanavalin A staining revealed these tumor cells to have Class II mucins. Immunohistochemically, the tumor cells in foveolar-type adenocarcinoma were diffusely positive for cathepsin D. Flow cytometrical analysis of DNA content showed the AC area to be diploid and the SCC area to be aneuploid. The S-phase fraction of the SCC area (46.9%) was larger than that of the AC area (19.5%). The positive rate of immunostaining for proliferating cell nuclear antigen in the SCC area (mean 50.627%) was larger than that of the AC area (mean 3.048%, P < 0.01). These results suggest that the AC area of this tumor, histochemically and immunohistochemically, showed gastric foveolar-type characteristics, the SCC component was squamous cell metaplasia of the pre-existing AC, and that the SCC area had a greater proliferating capacity than the AC area.

Aged↗
PubMed1995

Lymph-node metastases: efficacy for detection with helical CT in patients with gastric cancer.

PURPOSE: To determine the efficacy of helical computed tomography (CT) in the detection of lymphadenopathy in patients with gastric cancer. MATERIALS AND METHODS: Helical CT (5-mm section thickness, 5-mm/sec table incrementation) was performed in 58 patients (39 men, 19 women; mean age, 63.8 years) with gastric cancer; 1,082 lymph nodes (138 positive, 944 negative for metastasis) were resected at surgery. Findings at CT and resection were compared. Sensitivity for detecting lymph nodes was evaluated according to nodal size and presence of metastasis. RESULTS: Seven (1.1%) of 649 lymph nodes 1-4 mm, 160 (45.1%) of 355 nodes 5-9 mm, and 56 (72%) of 78 nodes larger than 9 mm were detected at CT. For nodes of at least 5 mm, sensitivity for detecting metastasis-positive nodes (79 [75.2%] of 105 nodes) was higher than that for detecting metastasis-negative nodes (137 [41.8%] of 328; P < .01). Differences between positive and negative nodes in CT attenuation (110 HU +/- 25 vs 66 HU +/- 32) and short-to-long axis ratios (0.81 +/- 0.15 vs 0.57 +/- 0.15; P < .001) were significant. CONCLUSION: Helical CT is effective for detection of metastatic lymphadenopathy from gastric cancer. CT attenuation and lymph-node configuration aid in diagnosis of malignant adenopathy.

Adult↗
PubMed1995

Silent cerebral infarction in a community-based autopsy series in Japan. The Hisayama Study.

BACKGROUND AND PURPOSE: The purpose of this study was to assess the prevalence and characteristics of silent cerebral infarction in a population-based consecutive autopsy series of residents of Hisayama, Kyushu, Japan. METHODS: Autopsy records, cerebral pathological findings, and clinical charts of 966 Hisayama residents recorded during the 26 years from 1961 to 1987 were examined (autopsy rate, 82.4%). The subjects were divided into three groups: those with both clinically apparent strokes and pathologically verified cerebral infarcts (stroke group), those having pathological evidence of cerebral infarction in the brain but without clinical stroke episodes (silent infarction group), and those with neither infarction nor stroke episode (noninfarction group). Risk factors and brain pathology in the three groups were compared. RESULTS: Silent cerebral infarction was found in 12.9% of the 966 subjects who had undergone autopsy, and its frequency increased with age. The subjects with silent infarcts were older, had higher systolic or diastolic blood pressure, and had atrial fibrillation more frequently than subjects in the noninfarction group. There were no significant differences in the locations of infarcts between the stroke and silent infarction groups, although infarcts tended to be located in the deeper area of the brain in the latter. The number and size of infarcts were smaller in the silent infarction group than in the stroke group. CONCLUSIONS: Diastolic blood pressure and atrial fibrillation appear to be strong predictors of silent cerebral infarction in the Japanese general population. Stroke becomes clinically apparent as infarct volume increases.

Adult↗
PubMed1995

[A case of hemophagocytic syndrome manifesting adult Still's disease and acute hepatitis].

We report a 20 year-old woman with hemophagocytic syndrome. In February 1993, she developed high fever, arthralgia, salmon-like pink eruption, leukocytosis and splenomegaly. She was diagnosed as adult Still's disease and successfully treated with intravenous immunoglobulin and oral prednisolone. In September 1993, she was re-admitted to our hospital complaining of general fatigue and low grade fever and treated with oral prednisolone at a daily dose of 15 mg. On October 2, 1993, she suddenly developed high fever and salmon-like pink eruption on her leg followed by the marked increase of serum transaminase and LDH levels (GOT 3,270 IU/l, GPT 1,880 IU/l, LDH 5,480 IU/l) on October 7. Since hepatic failure progressed, we started methylprednisolone pulse therapy and plasmapheresis. However, because of the progression of pancytopenia caused by hemophagocytosis, the treatment with VP-16 was initiated. However, she died of DIC on November 2, 1993. Autopsy revealed submassive necrosis of the hepatocytes with moderate infiltration of histiocytes. She was retrospectively diagnosed as hemophagocytic syndrome whose manifestations are very similar to those in adult Still's disease and acute viral hepatitis.

Acute Disease↗
PubMed1995

A comparative study of nuclear morphometry and proliferating activity in neuroectodermal tumors of bone and Ewing's sarcoma of bone.

A neuroectodermal tumor of bone (NTB) is a small round cell tumor with Homer Wright rosettes. The differences in the nuclear profiles, proliferating activities, and biologic behavior between NTB and Ewing's sarcoma of bone (ESB) are still controversial. In this study, 11 cases of NTB and 12 cases of ESB were compared by a nuclear morphometrical approach using an image analyzer. In addition, the proliferative activity was also evaluated between the two groups by an immunohistochemical study using proliferating cell nuclear antigen (PCNA). The nuclei of NTB were found to be significantly more elliptical (Form Ell: NTB = 0.725, ESB = 0.743, P = 0.017) and irregular (Form Ar: NTB = 0.908, ESB = 0.933, P = 0.046) than those of ESB. The maximum diameter of the nuclei in NTB was larger than those of ESB (NTB = 6.92 micron, ESB = 6.33 micron, P = 0.017), however, there were no significant differences in the nuclear area between the two groups. Immunohistochemically, the mean PCNA score of the NTB (10 cases) were significantly higher than those of ESB (7 cases) (NTB = 25.9, ESB = 11.6, P = 0.005). The mitotic activities of NTB (17/10HPF) were also higher than ESB (6/10HPF) (P = 0.0008). There were no significant differences between the two groups in survival (log-rank test: P = 0.324) according to our small series. Our results suggest that these two tumors should be separated because their proliferating activity is different and they can be separated by some nuclear profiles.

Adolescent↗
PubMed1995

Leiomyosarcoma versus bizarre and cellular leiomyomas of the uterus: a comparative study based on the MIB-1 and proliferating cell nuclear antigen indices, p53 expression, DNA flow cytometry, and muscle specific actins.

There is still controversy over the criteria for malignancy of smooth muscle tumors (SMTs) of the uterus. We examined 51 cellular SMTs using immunohistochemistry for MIB-1, proliferating cell nuclear antigen (PCNA), p53, HHF35, alpha-smooth muscle actin (SMA), and flow cytometry. Morphologically, the 51 cases were classified into 24 leiomyosarcomas (LMS), two uncertain malignant potential, four bizarre leiomyomas, and 21 cellular leiomyomas. The mean values of the MIB-1 and PCNA indices showed significant differences between LMS and benign SMTs. p53 cells were positive in eight of 24 leiomyosarcomas, and 12 of 22 were aneuploid. HHF35 and alpha-SMA showed a diffuse positivity in almost all the benign SMTs. In contrast, 10 of the 24 LMS were either focally positive or negative for SMA. Using a logistic regression model, at cut-off points of 3.6 on the MIB-1 index and 15.6 on the PCNA index, the LMS and the benign SMTs were classified with an overall accuracy of 92% and 82%, respectively. Moreover, by combining the MIB-1 index and alpha-SMA positivity, the cut-off point could be established at 0.492 on the probability scale with the highest overall accuracy of 96%. Regarding the prognosis of LMS, p53 positivity was correlated with survival (p = 0.0357). A combination of the MIB-1 index and alpha-SMA was helpful in distinguishing between LMS and benign SMT. Moreover, p53 positivity was considered to be a good marker for predicting the prognosis of LMS.

Actins↗
PubMed1994

Long-term follow-up study of patients with gastric adenomas with malignant transformation. An immunohistochemical and histochemical analysis.

BACKGROUND: Little is known about the changes in the immunohistochemical and histochemical characteristics that take place during the malignant transformation of gastric adenoma (GA). METHODS: Nine patients with GA who developed carcinoma (Group A) and 33 who did not (Group B) during an equivalent follow-up period (mean, 76.4 months; range, 38-166 months) were studied. Tissue sections from these patients were stained for p53, c-erbB-2, bcl-2, carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and proliferating cell nuclear antigen (PCNA), and by high iron diamine-alcian blue staining. The gastric or intestinal phenotypes of the GA cells were evaluated histochemically by paradoxical concanavalin A and galactose oxidase-Schiff reactions. RESULTS: In Group A, the following were more frequent; severe dysplasia (77.8% vs. 0%, P < 0.001), villous structures (66.7% vs. 9.1%, P < 0.05), sulfomucin secretion (88.9% vs. 39.4%, P < 0.05) and mixed gastric-intestinal phenotype (77.8% vs. 9.1%, P < 0.001). The development of carcinoma in Group A positively correlated with an increase in p53 expression and PCNA-labeling index. None of the adenomas was positive for c-erbB-2, but four of nine carcinomas showed positive reactions. CONCLUSIONS: Mucin histochemistry of GA may be of some value in assessing the potential for subsequent carcinoma. Immunoexpression of c-erbB-2, bcl-2, CA 19-9, and CEA have only limited value. In contrast to p53, the immunoexpression of c-erbB-2 is a late event in the malignant transformation of GA.

Adenoma↗
PubMed1994

Epstein-Barr virus in gastric carcinoma with lymphoid stroma. Special reference to its detection by the polymerase chain reaction and in situ hybridization in 99 tumors, including a morphologic analysis.

BACKGROUND: Gastric carcinoma with lymphoid stroma (GCLS) has been reported to have a more favorable prognosis than ordinary gastric carcinoma, however, the precise mechanism of the pathogenesis for GCLS remains unclear. METHODS: The authors analyzed 99 GCLS in 94 patients for Epstein-Barr virus (EBV) sequences using polymerase chain reaction (PCR) and in situ hybridization (ISH); these were compared with 42 ordinary gastric carcinomas. RESULTS: Two series of PCR showed 81 (82%) and 46 (47%) of the 99 GCLS to have EBV sequences, which were significantly higher compared with ordinary gastric carcinoma (50% and 9.5%, respectively). With ISH using thymine-thymine dimerized oligonucleotide probes corresponding to EBV-encoded small RNA 1 (EBER1), 82 (83%) of 99 GCLS showed clear, intense hybridization signals localized over the nuclei of the tumor cells, in contrast to only 4 (9.5%) of 42 ordinary carcinomas (P < 0.001). A comparative morphologic analysis of EBER1-positive and negative GCLS revealed that typical features of GCLS, such as mild cellular pleomorphism, rare mitoses, a marked degree of lymphoid stroma, and mild fibrosis, together with a lymphoid infiltration within the cancer cell nests were significantly more frequent in EBER1-positive GCLS. CONCLUSIONS: More than 80% of GCLS were associated with EBV. The presence of EBV association in GCLS was characterized by the above morphologic features.

Adenocarcinoma↗
PubMed1994

Expression of proliferating cell nuclear antigen in Wilms' tumors and other pediatric renal tumors: the correlation between histologic classification and proliferative activity.

In order to estimate the proliferative activities in each prognosis predicting histologic type immunohistochemical studies for proliferating cell nuclear antigen (PCNA) have been performed on 27 pediatric renal tumors using formalin-fixed paraffin-embedded specimens. Image analyses determined the percentage of positive areas for PCNA, which were then represented in the PCNA score. The PCNA scores of nephroblastomas without anaplasia roughly correlated with the S phase fractions obtained by flow cytometry. The PCNA scores for each tumor were as follows; the renal specimens for the control study (n = 10, a mean +/- SD of 8.04 +/- 3.59%); the nephroblastomas without anaplasia (n = 15, 27.70 +/- 7.59%); the nephroblastomas with anaplasia (n = 3, 36.89 +/- 1.17%); the sarcomatous renal tumors (n = 5, 27.75 +/- 5.02); the renal cell carcinomas (n = 2, 28.31 +/- 0.86%), a congenital mesoblastic nephroma and a juxtaglomerular cell tumor (10.05 and 10.80%, respectively). The PCNA scores of the pediatric renal tumors correlated with neither the outcome of the patients nor the histologic groups in predicting the prognosis for such pediatric renal tumors.

Adolescent↗
PubMed1994

Exophytic variant of fibrous dysplasia (fibrous dysplasia protuberans).

Two cases of an exophytic variant of fibrous dysplasia (fibrous dysplasia protuberans) are reported in which the lesions protruded far beyond the normal bone contour mimicking surface lesions of bone. The first case was an 18-year-old man who had a pedunculated calcified mass of the sixth rib in association with radiologically diagnosed fibrous dysplasia of the skull. The second case was a 33-year-old man who had an exophytic lesion of the proximal tibia. Both of these patients were shown to have benign fibro-osseous lesions consistent with fibrous dysplasia. The intramedullary portions of the host bone adjacent to the exophytic masses also were involved by the fibro-osseous lesions and this fact suggests that the lesions may arise eccentrically in the medullary spaces and mainly grow outwards. It is important to be aware that fibrous dysplasia occasionally presents as an excrescence on the surface of bone. Careful radiographic and histological correlation is required to make a correct diagnosis of this rare variant of fibrous dysplasia.

Adolescent↗
PubMed1994

Neuroblastoma with a distinct organoid pattern: a clinicopathologic, immunohistochemical, and ultrastructural study.

We studied the organoid pattern in neuroblastoma, defined here as a characteristic histologic feature of the thin fibrovascular meshwork regularly surrounding the individual nests of neuroblastic cells. Among 75 neuroblastomas in our files, 11 cases were qualified as having the recognizable organoid pattern by hematoxylin-eosin stain morphology. The patients comprised five girls and six boys with ages at diagnosis ranging from 1 to 60 months (mean age, 14 months). Nine of the tumors were adrenal and two were retroperitoneal primary. The stages were I (four cases), III (two cases), IV (two cases), and IVS (two cases). All eight patients younger than 1 year are alive and well, whereas two of three patients older than 1 year died of disease. Immunohistochemical staining of those tumors having an organoid pattern showed a considerable number of S-100 protein-positive spindle cells present, mainly in the meshwork areas. Putative Schwann cells were identified ultrastructurally in five of the six tumors examined. In conclusion, organoid pattern in neuroblastoma is easily recognizable, is an indicator of good prognosis in younger children, and may well represent a close relationship between neuroblasts and putative Schwann cells.

Adrenal Gland Neoplasms↗
PubMed1994

Genetic origin of malignant trophoblastic neoplasms.

The genetic origin of three trophoblastic neoplasms (two choriocarcinomas and a placental site trophoblast tumor (PSTT)] was determined by analysis of the restriction fragment length polymorphism (RFLP) pattern. One choriocarcinoma, which was believed not illogically to have developed from an antecedent complete mole, contained both paternal and material RFLP alleles and thus was probably the product of a normal fertilization. The other choriocarcinoma was not of gestational origin but had RFLPs homozygous at some loci and heterozygous at others, compatible with the parthenogenic origin of this tumor from a germ cell after meiosis I. The PSTT required amplification of DNA sequences by polymerase chain reaction (PCR) because of the small amount of tumor material available. This tumor contained RFLP alleles from both parents and appeared to have resulted from a previous unrecognized (and abnormal) pregnancy.

Adult↗
PubMed1994

Benign glandular peripheral nerve sheath tumor. A case report.

The glandular peripheral nerve sheath tumor is a rare variant of nerve sheath neoplasms in which the focally occurring glands are lined by cells showing divergent differentiation. The vast majority of the reported nerve sheath tumors harboring these glands have been malignant. We herein present a case of benign glandular peripheral nerve sheath tumor in a 43-year-old woman who had no evidence of von Recklinghausen's disease. Histologically, the tumor is composed of spindle cell component and collections of glandular component. The glandular component occupied the central two-thirds of the lesion and was lined by a single layer of nonciliated cuboidal or columnar cells. No mitotic figures were recognized in the spindle cell area. This spindle cell area had neurofibroma-like features rather than schwannoma. Many of the spindle cells had positive reaction products for S-100 protein. The glandular lining epithelium were positive for cytokeratins (CAM 5.2, AE1/AE3, PKK1) and EMA. Some epithelial cells were immunoreactive for CEA, chromogranin, somatostatin and Leu-7. These immunohistochemical findings support the neuroendocrine differentiation of the epithelial element from the schwannian component.

Adult↗