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M Tsuneyoshi

Publications and source records attributed to M Tsuneyoshi.

At least 199 records · Page 11Linked to original sources
PubMed1994

Adenosquamous carcinoma of the gallbladder: a clinicopathological, immunohistochemical and flow-cytometric study of twenty cases.

Twenty patients (7.4%) with adenosquamous carcinoma of the gallbladder were selected from 271 surgically resected gallbladder cancers. The 20 patients were composed of 8 men and 12 women with a mean age of 66.9 years. Histologically, all twenty tumors showed an abrupt transition between the adenocarcinoma (AC) and squamous cell carcinoma (SCC) areas, and well differentiated AC was also found in the peripheral area of the tumor. A histochemical and immunohistochemical study using alcian blue, periodic acid-Schiff, cytokeratins, involculin and tissue polypeptide antigen disclosed a different nature of the two components. DNA heterogeneity between the components was detected in 5 of 7 cases by flow cytometry. The positive rate of immunostaining for proliferating cell nuclear antigen in the SCC areas (mean 20.55%) was larger than that of the AC areas (mean 11.40%) (P = 0.0029), which indicated that the SCC areas had a greater proliferative capacity than AC areas. These results suggest that the SCC component of adenosquamous carcinoma of the gallbladder arose by a stepwise molecular progression of the pre-existing AC. Furthermore, the prognosis of adenosquamous carcinomas of the gallbladder (mean survival: 10 months) in the advanced stage (pTNM 2-4) was less favorable than those of papillary and well differentiated AC (mean survival: 99 months and 86 months) (P < 0.0001).

Adenocarcinoma↗
PubMed1994

Risk factors related to liver metastasis in colorectal carcinoma: a multivariate analysis of clinicopathologic and immunohistochemical variables.

Specimens from 48 consecutive patients undergoing surgery for colorectal carcinoma and having synchronous or metachronous liver metastases (Group 1) and those from 52 consecutive patients who had no evidence of hepatic metastases within at least 5 year after colorectal resection (Group 2) were selected and compared using a multiple logistic regression analysis. A multivariate analysis using a stepwise logistic regression revealed six independent risk factors significantly related to hepatic metastases. In addition, the following logistic regression model was obtained from this analysis. P = exp a/(1 + exp a): a = 3.524(SM-V) + 2.731(Ex-V) + 2.718(E/M) + 2.562(Lo) + 1.858(p53) + 1.941(HIR) - 4.397, where P is the probability of hepatic metastasis given six independent risk factors (E/M, Ex/M ratio; Lo, location; HIR, host inflammatory cell reaction). When the estimated probability "P" in the above logistic regression model is more than 0.55 after an examination of surgical specimens, we must consider adjuvant chemotherapy and closely monitor the patient to ensure early detection of hepatic metastases.

Adenocarcinoma↗
PubMed1994

Depressed adenoma of the colorectum: analysis of proliferative activity using immunohistochemical staining for proliferating cell nuclear antigen (PCNA).

Recently, depressed adenomas (DA) of the colorectum have been frequently detected in Japan. The natural history and carcinogenesis of these DA remain unclear. The histological features and cell kinetics of 13 DA were analyzed, using proliferating cell nuclear antigen (PCNA), and compared with 24 non-depressed adenomas (NDA), 12 non-neoplastic mucosa and 12 adenocarcinomas. The DA had a characteristic architecture when compared with the NDA, as demonstrated by a crowded collection of adenomatous tubules with small diameters. The adenomatous tubules tended to occupy the full thickness of the lamina propria at the center with superficial growth to the periphery. The PCNA-positive cells were mostly restricted to the lower half of the crypts in the non-neoplastic mucosa, and were distributed predominantly across the upper half area of the crypts in both the DA and NDA, whereas they were randomly distributed across any area in the adenocarcinomas. The mean labeling index of PCNA in the DA (43.2%) was significantly higher than that in the non-neoplastic mucosa (26.5%) and NDA (29.3%), but lower than that in the intramucosal component of the adenocarcinomas (70.0%). The DA should be seriously considered as a precancerous lesion because of its unusual histologic architecture and high proliferative activity.

Adenocarcinoma↗
PubMed1994

Three synchronous carcinomas of the papilla of Vater, common bile duct and pancreas.

Multiple carcinomas of the pancreatico-biliary tree are rare. A 53 year old Japanese man was diagnosed as having an adenocarcinoma in the papilla of Vater. During the operation, he was also found to have a polypoid mass in the common bile duct. While cutting the operative specimen into stepwise sections, a small tumor was also detected incidentally in the main pancreatic duct of the pancreatic head. Histologically, all three tumors proved to be papillary adenocarcinomas and were restricted to the mucosa. Immunohistochemically, all three tumors were positive for carcinoembryonic antigen, carbohydrate antigen 19-9, chromogranin A and serotonin, while they were negative for somatostatin. Immunoreactivity to the tumor suppressor gene p53 protein (PAb 1801) was found in all three tumors. A flow cytometric analysis of the cellular DNA content revealed all three tumors to be aneuploid. The above results suggested that these three tumors from different sites all had the same histological, immunohistochemical and flow cytometrical characteristics.

Adenocarcinoma, Papillary↗
PubMed1994

Colorectal counterpart of gastric depressed adenoma. A comparison with flat and polypoid adenomas with special reference to the development of pericryptal fibroblasts.

The histological features of 28 depressed adenomas (DAs) were compared with those of 40 flat adenomas (FAs) without a central depression and those of 29 polypoid adenomas (PAs), with special reference to the development of pericryptal fibroblasts (PCFs), using immunohistochemical staining for muscle-specific actin (HHF-35). The DAs were composed of a crowded collection of adenomatous tubules with smaller diameters than those of the PAs. With regard to PCF development, the DAs had poorly developed PCFs; PCF (-), (+), and (++) numbered 12 (43%), 16 (57%), and 0 (0%), respectively. On the other hand, the nondepressed adenomas (PAs and FAs) had well-developed PCF; PCF (-), (+), and (++) numbered 5 (7%), 35 (51%), and 29 (42%), respectively. In addition, the number of PCFs seemed to decrease in the sequence of PAs, followed by FAs and DAs. According to our results, the DAs had a characteristic histological architecture together with poorly developed PCFs features, which distinguished them from the PAs. In conclusion, the depressed adenomas were considered a subtype of the flat adenomas. The depletion of PCFs seems to correlate with the depressed growth of the adenoma.

Actins↗
PubMed1994

Fibrosarcoma versus fibromatoses and cellular nodular fasciitis. A comparative study of their proliferative activity using proliferating cell nuclear antigen, DNA flow cytometry, and p53.

We analyzed the proliferative activities, immunoreactivity of the p53 protein, and aneuploidy in patients with benign and malignant fibrous lesions, including 19 with nodular fasciitis (cellular type) (6-88 years old, mean 42.9), 11 with abdominal fibromatoses (22-74 years old, mean 37.9), 13 with extraabdominal fibromatoses (2-38 years old, mean 19.5), and 23 with fibrosarcomas (adult type: 16-71 years old, mean 47.3; infantile type: 3 months to 9 years, mean 2.9) using immunohistochemistry to determine proliferating cell nuclear antigen (PC10) and p53 protein (CM1) as well as performing DNA flow cytometry. The proliferating cell nuclear antigen (PCNA) score was measured as the ratio of PCNA-positive nuclear size/total nuclear size determined by an image analysis computer system. The distribution pattern of the PCNA-positive cells was uneven in each instance of nodular fasciitis, in contrast to the distribution in abdominal fibromatosis, extraabdominal fibromatosis, and fibrosarcoma. Both fibrosarcoma (28.4 +/- 20.0) and nodular fasciitis (33.6 +/- 20.9) exhibited a larger value and a greater variation in the PCNA score than did either abdominal (13.5 +/- 14.5) or extraabdominal fibromatosis (19.9 +/- 21.5). Abdominal fibromatosis exhibited a smaller value and less variation in the score. In short, the PCNA score did not correlate with the malignant potential. The proliferative index (S + G2 + M fraction) in fibrosarcoma was significantly higher than in either nodular fasciitis or abdominal fibromatosis. Aneuploidy was detected in five cases (26%) of fibrosarcoma, while six (26%) fibrosarcomas showed p53 positivity. Furthermore, p53-positive patients had a worse survival (0.01 < p < 0.05), and p53 positivity correlated with the proliferative index (p < 0.01). In conclusion, the PCNA score simply indicates the proliferative activity independent of malignant potential. On the other hand, p53 positivity, proliferative index, and aneuploidy are all indicators of malignant potential in fibroblastic lesions, and p53 positivity may reflect a poor prognosis.

Adolescent↗
PubMed1994

Possible multicentric occurrence of hepatocellular carcinoma: a clinicopathological study.

To assess the features of multicentric occurrence in hepatocellular carcinoma, we analyzed 10 of 72 patients (14%) who had undergone hepatic resection for hepatocellular carcinoma from May 1989 to October 1992 both clinically and pathologically. The multicentric occurrence of hepatocellular carcinoma was defined among the simultaneously detected small tumors as (a) at least one tumor consisting of extremely well-differentiated (grade I) hepatocellular carcinoma growing in a replacing pattern or (b) one of a group of hepatocellular carcinomas growing in an area of adenomatous hyperplasia. Of the 10 patients, the tumors in 9 were diagnosed as synchronous multicentric hepatocellular carcinomas, whereas the tumor in 1 was considered metachronous. All patients had cirrhosis; one of them had hepatitis B virus infection and nine patients had HCV infection. The inflammatory findings in the parenchyma were determined on the basis of serum enzyme values (AST, 89 +/- 27 IU/L; ALT, 96 +/- 43 IU/L). One or two tumors in 9 of 10 patients had thin trabecular or trabecular patterns showing replacing growth. In addition, one of the two tumors in two of nine patients was observed growing in areas of adenomatous hyperplasia. Recurrences were found in 4 of 10 patients. The 3-yr disease-free survival rate was 23%. Multiple recurrences were recognized in the two patients, and in the patients who underwent repeat surgery, grade I tumors were also found. Even though these tumors were small and well-differentiated, the recurrence rate was high. Therefore to detect the recurrence of metachronous multicentric hepatocellular carcinoma at an earlier stage, careful follow-up after surgery should be carried out.

Carcinoma, Hepatocellular↗
PubMed1994

Xanthogranulomatous cholecystitis masquerading as gallbladder carcinoma.

We herein present a case of xanthogranulomatous cholecystitis which involved both the liver and transverse colon, clinically mimicking gallbladder carcinoma. Such cases may sometimes be judged inoperable due to extensive extra-gallbladder invasion, and thus it is necessary for physicians to take this lesion into consideration when making a diagnosis. An intraoperative biopsy is necessary, therefore, even when the features seem to clearly indicate inoperable carcinoma.

Aged↗
PubMed1994

Small-cell carcinoma combined with adenocarcinoma of the gallbladder. A case report with immunohistochemical and flow cytometric studies.

A small-cell carcinoma combined with adenocarcinoma of the gallbladder was detected in a 71-year-old Japanese woman. A nodular mass measuring 4.0 x 5.0 cm was located in the fundus of the gallbladder, in which a tiny depressed lesion measuring 2 mm in diameter was macroscopically and stereomicroscopically observed. Histologically, the depressed area revealed small-cell carcinoma that consisted of atypical cells with small, round to oval nuclei and scanty cytoplasm and was surrounded by ordinary well-differentiated adenocarcinoma. Immunohistochemically, the tumor cells in an adenocarcinomatous area were diffusely positive for carcinoembryonic antigen and showed an interspersed positivity to serotonin and gastrin, while the tumor cells in the small-cell carcinoma area were negative for both antigens. The nuclear DNA content of the tumor cells of both components was aneuploid; however, the first G0/G1 peak of the small-cell carcinoma was much smaller than that of the adenocarcinoma. These results indicated that the tumor revealed a divergence in functional differentiation, and this feature suggested an initial phase of composite small-cell carcinoma and adenocarcinoma in the gallbladder.

Adenocarcinoma↗
PubMed1993

Effects of preoperative transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma. The relationship between postoperative course and tumor necrosis.

BACKGROUND: The effects of preoperative transcatheter arterial chemoembolization (TAE) for hepatocellular carcinoma (HCC) remain a matter of controversy. METHODS: Seventy-two patients with HCC were entered in the study; the patients did not have the risk factors for disease recurrence of tumor larger than 5 cm in diameter, the presence of venous invasion, or intrahepatic metastasis. Only patients with 3 years of follow-up after curative resection were selected. Forty-six underwent TAE (Group I) and 26 did not undergo TAE (Group II). Group I was divided into three subgroups according to the degree of tumor necrosis: IA, complete necrosis; IB, partial necrosis; and IC, no necrosis. Group II was divided into two subgroups: IIB, partial necrosis; and IIC, no necrosis. RESULTS: Preoperative TAE did not improve the average disease-free survival rates of the group as a whole. For patients undergoing TAE, the survival rate of Group IB was significantly worse than that of Groups IA or IC. The survival rate of Group IB was worse than that of Group II, but the difference was not significant. In Group II, the survival of Group IIB was worse than that of Group IIC. Histologically, residual tumor cells lacking mutual contact were detected in some patients in Group IB. CONCLUSION: These results indicate that partial tumor necrosis caused by preoperative TAE or spontaneous tumor necrosis per se might facilitate postoperative disease recurrence. This may occur because in patients with partial necrosis, the remaining tumor cells are less firmly attached and more likely to be dislodged into the bloodstream during hepatic resection.

Adult↗
PubMed1993

Time trends of early gastric carcinoma. A clinicopathologic analysis of 2846 cases.

BACKGROUND: Despite recent improvements in the diagnostic accuracy and techniques for identifying early gastric carcinoma, gastric carcinoma remains a major cause of death in the world. METHODS: The clinicopathologic features of 2846 surgically resected early gastric carcinomas from 1962-1987 were reviewed, and the time trends of a variety of clinicopathologic factors were studied using both an univariate and a multivariate analysis. RESULTS: The differentiated type of carcinoma increased in frequency from 34-50%. The percentage of patients older than 60 years of age increased from 32-56%. The number of lesions measuring less than 3 cm increased from 28-56%. The frequency of shallow-type-IIc carcinomas measuring less than 3 cm, which had been previously difficult to detect and were mainly composed of differentiated carcinomas, increased from 46-69%. The relative proportion of the differentiated type of carcinoma was significantly higher in patients older than 60 years of age than in those younger than 60. The relative proportion of differentiated-type carcinomas measuring less than 3 cm, which had been easy to detect as opposed to undifferentiated-type carcinomas, significantly increased from 56-76%. CONCLUSIONS: The above time trends may indeed reflect genuine change. However, the recent increase in the rate of differentiated-type, small-sized carcinomas also suggests the possibility that such results may, in fact, be due mainly to improvements in both diagnostic accuracy and medical technology. Thus, a large number of undifferentiated-type, small-sized carcinomas might have merely failed to be found in routine gastric examination.

Age Factors↗
PubMed1993

Proliferating cell nuclear antigen in hepatocellular carcinoma and small cell liver dysplasia.

BACKGROUND: Recently, proliferating cell nuclear antigen (PCNA) has been measured by using a monoclonal antibody in a variety of malignant neoplasms. METHODS: The authors evaluated cell proliferative activity by immunostaining for PCNA in 92 hepatocellular carcinoma nodules and 14 lesions of small cell liver dysplasia. RESULTS: The average PCNA labeling indices (LI) in Grades I, II, III, and IV were 12.2%, 17.5%, 53.7%, and 83.9%, respectively. There were statistically significant differences in the PCNA LI between all the histologic grades, except for Grades I and II. The less differentiated the histologic grade, the higher the PCNA LI became. This finding was also recognized in a hepatocellular carcinoma showing a "nodule in a nodule" appearance, in which the less-differentiated inner nodule had a higher PCNA LI than did the well-differentiated outer lesion. For an analysis of the disease-free survival in 74 patients with clinical follow-up data, 2 groups of patients with a PCNA LI higher and lower than the average level (32.0%) were compared. The disease-free survival rate after surgery was significantly higher (P < 0.005), and the venous invasion was significantly less frequent (P = 0.0003) in the low PCNA LI group than in the high PCNA LI group. The average PCNA LI in small cell liver dysplasia was 13.9%, which was almost equal to that of Grades I and II hepatocellular carcinoma. CONCLUSIONS: The PCNA LI of hepatocellular carcinoma showed a close correlation with both the histologic findings and the biologic behavior. Small cell liver dysplasia was a small round focus having proliferative activity similar to that of Grades I and II hepatocellular carcinoma.

Aged↗
PubMed1993

Transitional cell carcinoma pattern in primary carcinoma of the fallopian tube.

BACKGROUND: A broad papillary proliferation resembling that in transitional cell carcinoma (TCC) of the urinary bladder was seen in 12 of 21 primary carcinomas of the Fallopian tube (PCFT). METHODS: According to their predominant histologic pattern (more than 50%), PCFT were classified into 9 TCC-predominant and 12 non-TCC-predominant tumors. The two groups were compared by clinicopathologic, histochemical, and immunohistochemical means. RESULTS: TCC-predominant tumors were grossly solid and microscopically demonstrated more frequent tumor necrosis and spindled tumor cells than non-TCC-predominant tumors. Mucin histochemistry revealed a correlation between TCC-predominant tumor and sulfomucin-predominant secretion and between non-TCC-predominant tumor and sialomucin-predominant secretion. Immunohistochemical studies for cytokeratins, vimentin, epithelial membrane antigen (EMA), Leu-M1, carcinoembryonic antigen (CEA), and CA 125 were not useful for discrimination between the two groups. Both groups showed similar features in patient age, clinical stage, cytology of ascites or peritoneal washing, and serum CA 125 level. Despite the similarity in treatment (surgery and postoperative chemotherapy) between the two groups, TCC-predominant tumors tended to relapse later (mean, 31.2 months after diagnosis) than non-TCC-predominant tumors (mean, 14.4 months after diagnosis), resulting in a significant difference in the 2-year disease-free survival rate. CONCLUSIONS: TCC pattern and non-TCC pattern are considered to be worthy of distinction in PCFT.

Adult↗
PubMed1993

Hepatoid adenocarcinoma of the stomach. A clinicopathologic and immunohistochemical analysis.

BACKGROUND: The clinicopathologic and immunohistochemical features of the primary gastric hepatoid adenocarcinomas still remain unclear. METHODS: The authors evaluated 28 hepatoid adenocarcinomas (HC) of the stomach on the basis of characteristic histologic features resembling hepatocellular carcinoma, which were selected from the 7200 cases of primary gastric carcinoma in their files. Additionally, 22 alpha-fetoprotein (AFP)-positive adenocarcinomas without hepatoid features (APC) were also selected. RESULTS: The HC cases fell into the following two groups: HC with AFP-positive tumor cells (Group 1; 15 cases) and HC without AFP-positive cells (Group 2; 13 cases). Histologically, the glycogen granules and hyaline globules were common features in HC. The incidence of a venous invasion of HC (Groups 1 and 2) was higher than that of APC (Group 3). There were no significant differences among the three groups regarding clinical features, macroscopic features, and the incidence of lymphatic permeation. An immunohistochemical study showed that HC had differentiation into various directions. As for the advanced carcinomas, the 5-year survival rates of patients with HC (Groups 1 and 2) and those with APC (Group 3) were 11.9% (21.4%, 8.3%) and 38.2%, respectively. The prognosis of Group 1 was similar to that of Group 2, but was poorer than that of Group 3. CONCLUSIONS: The findings suggested that HC, as shown by its characteristic histologic features, had a poor prognosis whether producing AFP or not, and that HC should therefore be distinguished from AFP-positive carcinoma without hepatoid features.

Adenocarcinoma↗
PubMed1993

Prognostic factors of malignant fibrous histiocytoma of bone. A clinical and histopathologic analysis of 34 cases.

BACKGROUND: Malignant fibrous histiocytoma (MFH) of bone is a rare bone tumor, and its prognosis has been controversial. METHODS: Thirty-four patients with MFH of bone were examined clinicopathologically for prognostic factors. RESULTS: The most common skeletal site of the tumor was the femur (15 cases), followed by the pelvic bones (6 cases), tibia (5 cases), and fibula (5 cases). Of 29 patients available for follow-up, the 5-year survival rate of 17 who underwent adequate surgical treatment was 63%. The 5-year survival rate of the remaining 12 patients, including 5 with MFH of the pelvic bone who received inadequate or palliative surgery, was 17%. All six patients who received intensive chemotherapy combined with adequate surgical treatment were alive and well 5 years after the initial treatment. Histologically, the presence of desmoplasia and chronic inflammatory infiltration in the tumor tended to be prognostic indicators, although not to a statistically significant extent. Patients whose tumors contained wide areas of desmoplasia had a worse prognosis (5-year survival rate, 20%). In contrast, those with a prominent chronic inflammatory infiltrate had a 5-year survival rate of 78%. CONCLUSIONS: These histologic variables would be helpful for predicting the prognosis of MFH of bone. Adjuvant intensive chemotherapy combined with adequate initial surgery may effect a clinical cure.

Adolescent↗