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Biomedical subjects

M Tsuneyoshi

Publications and source records attributed to M Tsuneyoshi.

At least 217 records · Page 12Linked to original sources
PubMed1993

Intraductal papillary neoplasm of the pancreas.

BACKGROUND: In 1989, Morohoshi et al. reported an intraductal papillary neoplasm of the pancreas (IPNP), which was a morphologically distinct, but rare tumor. METHODS: Two cases with IPNP were analyzed by immunohistochemical and DNA flow cytometric methods. RESULTS: The patients included a 67-year-old man and a 71-year-old woman. Both tumors were characterized by a well-defined papillary growth in the cystically dilated main pancreatic ducts, associated with papillary and nonpapillary hyperplasia. Immunohistochemically, the tumor cells of both cases were positive for the epithelial markers (AE1/AE3 and CAM 5.2), and in one of the two cases, the tumor cells and hyperplastic cells surrounding the tumor conspicuously revealed multiple hormonal markers such as serotonin, somatostatin, glucagon, gastrin, and pancreatic polypeptide. The nuclear DNA content of the tumor cells of the first case, which showed moderate cellular atypia, was considered to be diploid, whereas that of the second case, which revealed severe atypia, was aneuploid. CONCLUSIONS: These results suggested that these tumors arose from multipotential stem cells capable of epithelial and neuroendocrine differentiation, and results of the flow cytometric study was related to the degree of cellular atypia of the tumors.

Adenocarcinoma, Mucinous↗
PubMed1993

The prognostic value of immunohistochemical staining for proliferating cell nuclear antigen in synovial sarcoma.

BACKGROUND: The biologic behavior of synovial sarcoma remains a matter of controversy. Some investigators considered proliferative activity to be an important prognostic factor in this tumor. METHODS: Fifty-six patients with synovial sarcoma were immunohistochemically studied with PC10, a monoclonal antibody to proliferating cell nuclear antigen (PCNA). The percentage of nuclear areas with positive staining for PCNA (PCNA score), quantified by using an image analyzer, was compared with nuclear atypia, tumor necrosis, mitoses, and survival. Fifty-one patients were available for survival analysis. DNA flow cytometry was performed on 30 patients and compared with PCNA score and survival. The prognostic variables were analyzed with a multivariate technique using the Cox hazard model. RESULTS: Nuclear atypia (mild, 14; moderate, 23; severe, 14), mitosis (low, 34; high, 17), and tumor necrosis (< 50%, 37; > 50%, 14) were found to highly affect survival in the log-rank test (P < 0.01). Sixteen patients with a high (> or = 12.5) PCNA score had a worse survival (P < 0.01) than did the 35 patients with a low (< 12.5) PCNA score. In patients in whom DNA flow cytometry was performed, the S+G2M-phase fraction showed no correlation with the clinical outcome. However, there was a significant relationship between the extent of PCNA staining and S+G2M fraction (correlation coefficient [CC] = 0.54; P = 0.002), although the CC between PCNA staining and the mitotic count was only 0.38. However, the ploidy pattern was not related to PCNA scores or prognosis. In a multivariate analysis, a high PCNA score (P = 0.017) and severe nuclear atypia (P = 0.0003) were strong prognostic factors. CONCLUSIONS: The results suggest that a high PCNA score is one of the poor prognostic factors in synovial sarcoma.

Adolescent↗
PubMed1993

Papillary cystic tumors of the pancreas. Assessment of their malignant potential.

BACKGROUND: Although the biologic characteristics of papillary cystic tumors (PCT) generally indicate a good prognosis, a malignant form has been reported. METHODS: Twenty-two examples of PCT were examined to assess their malignant potential by histologic, flow cytometric, and immunohistochemical studies. RESULTS: Three had hepatic, peritoneal, and/or lymph node metastases (metastasizing tumors [MT]); the other 19 PCT had no such metastatic features (nonmetastasizing tumors [NMT]). Venous invasion was detected in all three MT and two NMT. Compared with the 19 NMT, the MT had a higher nuclear grade and more prominent necrobiotic nests characterized by aggregates of cells with pyknotic nuclei and eosinophilic cytoplasm. In the flow cytometric analysis of cellular DNA content, one MT was aneuploid, and eight NMT were diploid. Immunohistochemically, there was no difference between the MT and NMT. CONCLUSIONS: These results support the assumption that venous invasion, nuclear grade, and prominent necrobiotic nests are useful as histologic parameters to detect the malignant potential of PCT.

Adenocarcinoma↗
PubMed1993

Case report 793. Periosteal osteosarcoma of the clavicle.

A case of periosteal osteosarcoma in an 18-year-old boy has been reported. This is the first reported case of periosteal osteosarcoma arising in the clavicle. The radiological features in this case were entirely similar to those in long bones such as the femur and tibia. In addition to the radiological features and pathologic findings, various clinical aspects and prognosis were also discussed.

Adolescent↗
PubMed1993

Benign schwannoma in the hepatoduodenal ligament: report of a case.

A 62-year-old woman with a large mass in the hepatic hilus underwent surgery. Histologically the tumor was predominantly composed of spindle-shaped cells with nuclear palisading and cells that stained positively for S-100 protein. The diagnosis was benign schwannoma (neurilemoma). The presence of lymphoid cuffing with lymphoid follicles in the capsule and xanthomatous change differed from conventional soft parts schwannoma and closely resembled benign schwannoma in the gastrointestinal tract.

Bile Duct Neoplasms↗
PubMed1993

Primary rhabdomyosarcoma of the iliac bone in an adult: a case mimicking fibrosarcoma.

Primary rhabdomyosarcoma of bone is exceedingly rare. We present a case of rhabdomyosarcoma of the iliac bone in a 32-year-old male. Histologically, the tumour consisted mainly of a uniform proliferation of elongated spindle cells arranged in a herring bone pattern, simulating fibrosarcoma. Focally there was a conventional embryonal pattern with scattered rhabdomyoblasts possessing an eosinophilic cytoplasm. Immunohistochemical studies disclosed expression of muscle markers such as desmin and muscle-specific actin, in both the embryonal and spindle-cell areas and myoglobin only in the embryonal areas. Such histological features are unusual for classical embryonal rhabdomyosarcoma. The anatomical site and age of the patient are also atypical.

Adult↗
PubMed1993

Papillary cystic tumours of the pancreas: an analysis by nuclear morphometry.

Papillary cystic tumour (PCT) is a rare, low-grade malignant pancreatic neoplasm, in which the histological criteria for malignancy are still uncertain. We performed a histological examination of 3 metastasizing PCTs, while comparing them with 18 non-metastasizing PCTs, using a computed image analyser. The mean maximum nuclear diameter, the mean standard deviation (SD) of the nuclear diameter, the mean nuclear area and the nuclear-nonnuclear (N/NN) ratio obtained by the image analyser of the metastasizing PCTs (7.23 microns, 2.21 microns, 30.45 microns2, 36.41%) were all significantly larger than those of the non-metastasizing PCT (6.34 microns, 1.59 microns, 23.66 microns2, 23.74%; P < 0.005, P < 0.005, P < 0.005, P < 0.001 respectively). However, there were no statistical differences in either the nuclear ellipsoidity or nuclear regularity. These results suggested that nuclear morphometry might be a useful parameter to define metastatic potential, in addition to histological variables such as venous invasion, nuclear grade and mitotic rate.

Adolescent↗
PubMed1993

Significance of pericryptal fibroblasts in colorectal epithelial tumors: a special reference to the histologic features and growth patterns.

We analyzed the appearance of pericryptal fibroblasts (PCFs) identical to myofibroblasts in human colorectal epithelial tumors (adenomas, carcinomas) by an immunohistochemical method, with special reference to the histologic features and tumor growth patterns. The majority (61.5%) of adenomas contained well-developed PCFs. In contrast, carcinomas contained more poorly developed PCFs than adenomas. Approximately one third (35.4%) of the intramucosal and most (89.6%) of the submucosal carcinoma components had poorly developed PCFs. Pericryptal fibroblast development in pure carcinomas also was evaluated in association with two types of tumor growth patterns: polypoid growth carcinoma (PG-Ca) and nonpolypoid growth carcinoma (NPG-Ca). Polypoid growth carcinoma tended to contain well-developed PCFs, whereas NPG-Ca tended to lack PCFs. From the above findings, it is suggested that PCFs gradually decrease in the sequence of adenoma, intramucosal carcinoma, and submucosal invasive carcinoma. In addition, the two growth types (PG-Ca and NPG-Ca) are histologically different in PCF development, and the lack of a PCF network in NPG-Ca seems to be the reason why NPG-Ca can invade the submucosa more easily than PG-Ca, which has a consistent PCF network.

Adenoma↗
PubMed1993

Stereomicroscopic examination of surface morphology in colorectal epithelial tumors.

The mucosal surface structure of epithelial neoplasms in the large intestine was examined by a stereomicroscope, and the correlation between histologic and macroscopic features was studied. The surface structure of the colonic mucosa could be readily and clearly observed using the stereomicroscope after superficial staining, and neoplastic lesions were identified as well-defined foci of the unique structures that were conspicuously different from those in the normal mucosa. Five hundred two adenomas and 159 carcinomas were examined and divided into five types according to stereomicroscopic appearance: long ellipsoid (359 lesions), cerebriform (141 lesions), leaf-like (16 lesions), dense tiny pits (89 lesions), and devastated (56 lesions). In the first three types benign adenomas predominated in the majority of cases (94.7%, 72.3%, and 68.8%, respectively) and the variation in the surface features correlated well with the histologic types. In the latter two types the frequency of malignancy was strikingly high (49.4% and 92.9%, respectively), with the devastated mucosal appearance being highly indicative of invasive carcinoma. Macroscopically, exophytic polypoid configurations were frequently found in the first three types, whereas flat nonpolypoid configurations predominated in the cases with dense tiny pits. Our results indicate that there is a close relationship between the surface structure of epithelial neoplasms in the large intestine and their histologic features and growth patterns.

Adenoma↗
PubMed1993

Undifferentiated spindle cell carcinoma of the gallbladder: a clinicopathologic, immunohistochemical, and flow cytometric study of 11 cases.

Eleven primary spindle cell carcinomas (SpCCs) of the gallbladder are reported. They occurred in eight women and three men ranging in age from 59 to 80 years (mean age, 66.5 years). Histologically, the tumors showed interlacing bundles of atypical spindle cells with eosinophilic cytoplasm, oval to elongated nuclei, and conspicuous nucleoli. Eight SpCCs contained tiny foci of neoplastic glands similar to those seen in adenocarcinoma, and two of these cases also had small foci of neoplastic squamous epithelium. A gradual transition between the squamous cell carcinoma and the spindle cell component was observed in one tumor. Immunohistochemically, all SpCCs were positive for at least one of the epithelial markers (epithelial membrane antigen, nine cases; AE1/AE3, nine cases; carcinoembryonic antigen, three cases; and EAB 903, one case), and the tumor cells also were immunoreactive to mesenchymal marker (vimentin, eight cases), muscle markers (alpha-smooth muscle actin, one case; desmin, one case), and histiocytic marker (HAM 56, one case). Abnormalities in tumor suppressor gene p53 expression also were found in two of the 11 SpCC cases using monoclonal antibody PAb 1801. In six cases for which data were available flow cytometry revealed aneuploidy in three SpCCs (50%). The survival curve of the SpCC cases (mean survival, 9 months) was less favorable than that of 224 cases of adenocarcinoma of the gallbladder (mean survival, 81 months) (P = .0011). These results indicate that SpCC of the gallbladder is an epithelial tumor with sarcomatoid components and its prognosis is unfavorable.

Adenocarcinoma↗
PubMed1993

An adequate sampling of the prostate to identify prostatic involvement by urothelial carcinoma in bladder cancer patients.

The distribution of any involved prostatic urethra, ducts and acini by urothelial carcinoma was studied to determine an adequate sampling method for detecting prostatic involvement using the maps of 38 cystoprostatectomy specimens. A total of 31 patients had prostatic duct and acini involvement, while 7 had prostatic urethral involvement alone. However, the distribution of the involved prostatic urethra, ducts and acini varied. In 29 of the 31 patients (93.5%) with prostatic duct and acini involvement, urethral carcinoma in situ and/or superficial gland involvement (an involvement of the afferent ducts within a few millimeters of the urethral mucosa) at the 5 and/or 7 o'clock position of the verumontanum portion was identified. In 7 patients with prostatic urethral involvement alone 2 had carcinoma foci at the 5 and/or 7 o'clock position of the verumontanum portion. Furthermore, the frequency of deeper gland involvement (an involvement of true prostatic acini except for superficial glands) was higher in patients with superficial gland involvement at the 5 and/or 7 o'clock position of the verumontanum portion (57.7%) than in patients without such involvement (20.0%). Therefore, this study emphasizes that a transurethral resection biopsy containing prostatic tissue at the 5 and/or 7 o'clock position of the verumontanum portion substantially improves the detection of prostatic duct and acini involvement in bladder cancer patients. Moreover, if the prostatic superficial glands are involved at the 5 and/or 7 o'clock position of the verumontanum portion, the potential involvement of the deeper glands should also be suspected.

Carcinoma in Situ↗
PubMed1993

Primary collision neoplasm of malignant melanoma and adenocarcinoma in the lung. A case report.

We report an extremely rare case of a primary collision neoplasm in the lung consisting of malignant melanoma and adenocarcinoma. A malignant melanoma was histologically diagnosed by a transbronchial lung biopsy of the lung nodule in a 61-year-old woman, in whom there was no demonstrable primary malignant melanoma found elsewhere. However, at autopsy the above two components of the pulmonary tumor were both histologically and immunohistochemically confirmed. There was little intermingling of the two tumors. The malignant melanoma was positive for monoclonal antibody specific for melanotic tumor (HMB45) and S-100 protein but was negative for epithelial membrane antigen (EMA), while it was the opposite in the adenocarcinoma. This case is, to our knowledge, the first reported collision tumor of the above two components.

Adenocarcinoma↗
PubMed1993

Papillary cystic tumor of the pancreas. Is it a hormone-dependent neoplasm?

In order to attempt to examine the question of whether papillary cystic tumors (PCT) of the pancreas represent a hormone-dependent neoplasm or not, three cases of PCT were biochemically and immunohistochemically investigated. The patients included a 27-year-old man, a 14-year-old girl and a 21-year-old female. Two of the three patients showed measurable biochemical levels of progesterone receptor in the tumors by the dextran-coated charcoal (DCC) method, and an immunohistochemical study revealed that the nuclei of the tumor cells in all the three cases were diffusely positive for progesterone receptor. In the literature, there have been more than 300 female patients of PCT with a significant minority of only twenty male patients, and the mean age of the cases with PCT in men (31.4 years old) is higher than that in women (25.5 years old) (P < 0.05). These results therefore suggest that PCT is a sex hormone-dependent neoplasm.

Adolescent↗
PubMed1993

Malignant oncocytoma of the parotid gland: a case report with an immunohistochemical and ultrastructural study.

A rare case of a 71-year-old man with malignant oncocytoma is presented. The tumour was found in the left parotid region with enlarged lymph nodes in the neck. The resected parotid mass consisted of three discrete nodules, each histologically characterized by a uniform proliferation of oncocytic tumour cells. The patient underwent repeated operations for recurrences and metastases, and eventually died of acute pneumonia 18 months after the first admission. Metastases to the lymph nodes, ribs, spine and liver had been clinically pointed out. Immunohistochemically, the tumour cells were positive for alpha-1-antitrypsin, alpha-1-antichymotrypsin, lactoferrin, secretory component and carcinoembryonic antigen (CEA), while they were negative for S-100 protein and HHF35 (muscle specific actin). Ultrastructural pictures disclosed numerous mitochondria in the cytoplasm of the tumour cells, revealing neither myofibrils nor secretory granules. These findings therefore support the concept that this tumour is of a glandular epithelial origin.

Adenoma↗
PubMed1993

Vimentin-positive gastric carcinomas with rhabdoid features. A clinicopathologic and immunohistochemical study.

We studied 71 patients with solid-type gastric adenocarcinoma selected from 5,437 surgically resected specimens during the period from 1975 to 1988; six had vimentin-positive adenocarcinomas, and five of these were advanced. One was at an early stage. All six tumors showed the same histologic features and had either a diffuse or alveolar arrangement, with tumor cells having either poor or no cohesiveness. Many tumor cells were round to polygonal, with eosinophilic or clear cytoplasm and large, eccentric vesicular nuclei, as seen in malignant rhabdoid tumors of the kidney. In all cases, the cytoplasm showed coexpression of vimentin and cytokeratin as revealed by double immunostaining. Four of the five cases with advanced carcinoma died of the disease 1 to 6 months after surgery. The cases with vimentin-positive tumors had significantly poorer prognoses than those with vimentin-negative tumors. We also studied adenocarcinomas of various histologic types randomly selected from our file (160 intestinal type and 69 diffuse type of Lauren) but failed to detect any vimentin positive ones. These results indicate that vimentin is expressed in some of the solid-type adenocarcinomas, which have a poor prognosis, and indicating that rhabdoid-like cells may be found in a variety of adenocarcinomas of the stomach.

Adenocarcinoma↗
PubMed1993

Inflammatory fibroid polyp of the stomach. A special reference to an immunohistochemical profile of 42 cases.

Forty two cases (46 lesions) of inflammatory fibroid polyp (IFP) of the stomach were reviewed histologically and studied immunohistochemically. The paraffin sections were stained with a panel of antibodies against alpha-smooth-muscle actin, HHF-35, desmin, vimentin, lysozyme, alpha-1-antitrypsin, alpha-1-antichymotrypsin, KP1, Mac 387, S-100 protein, neuron-specific enolase, factor VIII RAg, and with Ulex europaeus agglutinin I. The lesions ranged in size from 0.3 to 3.5 cm with a mean of 1.2 cm. Forty (87.0%) IFPs occurred in the antrum, five in the gastric body, and one in the cardia. In all but two lesions, the mucosal layer was involved, and 20 (43.5%) lesions were entirely restricted to the mucosa. All 46 IFPs tested diffusely positive with vimentin. Positive reactions for alpha-smooth-muscle actin and HHF-35 were observed in 12 (26.1%) and 10 (21.7%) IFPs, respectively. Two lesions with alpha-smooth-muscle actin and one lesion with HHF-35 showed a diffuse staining. Seventeen (37.0%) lesions were focally positive for KP1, and seven (15.2%) IFPs were focally positive for Mac 387. All other antibodies and agglutinin were negative with the proliferating cells. The results of this study confirmed (a) the presence of myofibroblastic and histiocytic lines of differentiation in addition to the main fibroblastic features for the main cellular component in IFP, and (b) the heterogeneity of the immunoprofile of IFP.

Adult↗
PubMed1993

Benign gastric ulcer grossly resembling malignancy. A clinicopathologic study of 20 resected cases.

Twenty cases of benign gastric ulcers preoperatively interpreted to be malignant were reviewed clinicopathologically to clarify why these ulcers grossly appeared malignant. Macroscopically, the lesions often had an irregular margin (75%) and elevated surrounding mucosa (45%), and were often located on the greater curvature (40%) and near the pylorus (40%). Microscopically, most ulcers were large (21 mm) and shallow, reaching the submucosa (70%), and many were characterized by marked fibrosis (35%) and inflammatory cell infiltration (25%), sometimes accompanied by lymphoid hyperplasia. For such ulcers, which look malignant, careful examination by radiography, endoscopy, and biopsy should diminish the indications for surgery.

Adult↗