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Biomedical subjects

M Tsuneyoshi

Publications and source records attributed to M Tsuneyoshi.

At least 253 records · Page 14Linked to original sources
PubMed1992

Long survivors after pancreatoduodenectomy for pancreas head carcinoma.

Twelve Japanese patients with pancreas head carcinoma who survived 3 years or more after a pancreatoduodenectomy and 50 who survived less than 12 months were reviewed clinicopathologically. The 12 patients who survived for greater than or equal to 3 years exhibited more favourable prognostic factors: a higher incidence of jaundice; a smaller mass; a higher prevalence of an earlier stage tumour and adenocarcinoma of differentiated type; and a lower incidence of venous invasion, lymph node metastasis, and cancer cells at the surgical margins. However the difference was not significant. Univariate log-rank analysis regarding 13 prognostic variables showed that histologic type was a significant factor but multivariate Cox regression analysis failed to reveal an independent significant parameter. Nine of the 12 long-term survivors showed lymph node metastasis and six of the 12 revealed cancer cells at the surgical margins. Six of the 12 long-term survivors died from local recurrence and/or distant metastasis 37-78 months after operation. Only two patients survived more than 5 years after the operation. At the time of writing, one of them was still alive and another was dead 78 months after the operation. Pancreatoduodenectomy for pancreas head carcinoma infrequently offers a permanent cure for the patients with pancreas head carcinoma but sometimes produces a worthwhile long-term survival, even if the resected margins were affected by malignant cells or the lymph node metastasis was evident.

Adenocarcinoma↗
PubMed1992

Microcarcinoma of the endometrium: a mapping study with special reference to cytologic atypia in the endometrium.

In order to elucidate the basis for the development of an endometrial carcinoma, we looked for microcarcinomas measuring < 5 mm in greatest diameter, and studied their histologic characteristics and those of the neighboring endometrium. Using serial step section methods, two microcarcinomas were detected. A microcarcinoma was found in one of 14 uteri resected for atypical hyperplasia and the other was found in one of 114 uteri resected for endometrial carcinoma. The neighboring endometrium of the former was adenomatous and had atypical hyperplasia and that of the latter was atrophic and contained atypical glands characterized by cytologic atypia and not by architectural changes. The findings may suggest endometrial carcinomas to have two pathogenetic forms: a carcinoma associated with hyperplasia and occurring in premenopausal women, a second carcinoma associated with atrophic endometrium and occurring in postmenopausal women. Atypical glands in atrophic endometria may indicate that endometrial specimens from postmenopausal women should be carefully screened for cytologic atypia.

Adenocarcinoma↗
PubMed1992

Carcinoid tumor arising in the wall of a congenital bile duct cyst.

We report an extremely rare case of carcinoid tumor arising in a congenital choledochal cyst. The dilated choledochal cyst in a 66-year-old Japanese woman was surgically resected, after which the ovoid elevated tumor, measuring 1.5 x 1.5 cm, was detected in the proximal portion of the cyst. A carcinoid tumor was histologically confirmed. To the best of our knowledge, this is the first published case of carcinoid tumor in a choledochal cyst.

Aged↗
PubMed1992

Coincident occurrence of granular cell tumor of the stomach with an early gastric carcinoma.

In a 41-yr-old Japanese woman, a rare coincident lesion composed of granular cell tumor and early gastric adenocarcinoma was detected in the stomach. Beneath the poorly differentiated adenocarcinoma almost limiting to the mucosa, the granular cell tumor measuring 1.2 x 0.8 cm was spreading mainly in the submucosa without forming polypoid nodule. To the best of our knowledge, this is the first published report on this type of coincidence. Immunohistochemically, the cells of the granular cell tumor were strongly positive for S-100 protein, but negative for muscle markers (HHF 35, desmin), some of which connected with perineural Schwann cells surrounding small vessels in the submucosa. These features suggested that granular cell tumor in our case arose from Schwann cells surrounding small vessels in the submucosa of the stomach.

Adenocarcinoma↗
PubMed1991

Pancreatoduodenal carcinoma: a clinicopathologic study of 304 patients and immunohistochemical observation for CEA and CA19-9.

A total of 304 patients with pancreatoduodenal carcinoma were studied clinicopathologically and immunohistochemically in order to clarify features of carcinoma of four different sites of origin; carcinoma of the ampulla of Vater (Am), the distal common bile duct (DCBD), the head of the pancreas (PH), and the extra-ampullary duodenum (Du). The mean greatest diameter of 87 PH was 3.5 cm compared with 2.7 cm of 149 Am and 2.7 cm of DCBD. Histopathologically, 40% of Am were papillary adenocarcinoma, while about half of DCBD, PH and Du were tubular adenocarcinoma. PH invaded lymphatic (85%), vascular (62%), and perineural (95%) spaces and metastasized lymph nodes (72%) more frequently than Am (77%, 35%, 24%, 50%), DCBD (47%, 61%, 65%, 45%), and Du (76%, 29%, 35%, 65%), respectively. More than 50% of PH invaded the resected margins, whereas in only 2% of Am, the surgical margins were affected by malignant cells. Immunohistochemically, PH was more frequently positive for both carcinoembryonic antigen (CEA) (98%) and carbohydrate antigen (CA) 19-9 (91%) than Am (83%, 62%), DCBD (94%, 58%), and Du (56%, 11%), respectively. The stromal staining type of CEA and CA 19-9 was more frequently seen in PH (27%, 44%) than in Am (9%, 31%), DCBD (11%, 8%) and Du (0%, 0%), showing a more dedifferentiated nature of PH. The cumulative 3-year survival rate of 87 patients with PH (15%) was worse than that of 149 with Am (42%, P less than 0.001), of 51 with DCBD (25%) and of 17 with Du (58%, P less than 0.001). The survival curve of 87 with PH was worse than that of 51 with DCBD, of 149 with Am (P less than 0.001) and of 17 with Du (P less than 0.001). Cox regression analysis, using eleven profound prognostic variables, revealed that venous invasion, perineural infiltration, surgical margin, and histopathologic type were profound prognostic factors. Pancreatic carcinoma has a more dedifferentiated histopathologic nature, showing a more aggressive growth and fares worse than Am, DCBD, and Du.

Ampulla of Vater↗
PubMed1991

Carcinoma of the cystic duct.

Carcinoma of the cystic duct is a rare neoplasm, and we herein report four cases of carcinoma of the cystic duct. The patients consisted of a 69 year old and 71 year old woman and a 61 year old and 93 year old man. They complained of either abdominal pain or abdominal mass. All the tumors were microscopically well-differentiated adenocarcinoma, mostly limited to the wall, that showed no lymph node or distant metastasis. Three patients who had undergone resection were doing well 20 days, 67 months, and 125 months after the operation, respectively. These findings may suggest that not only the early development of symptoms caused by obstruction of the narrow lumen of the cystic duct, but also slow growth and late metastasis produce a favorable clinical course in patients with carcinoma of the cystic duct.

Aged↗
PubMed1991

Sclerosing adenosis of the prostate. Histopathologic and immunohistochemical analysis.

A prostatic lesion, histologically identical to sclerosing adenosis of the breast, was found in five (1.9%) of 263 patients who underwent transurethral resection, open prostatic adenectomy, radical prostatectomy, or total cystoprostatectomy. This uncommon lesion was a localized proliferation of crowded small glands, small solid nests, and individual cells embedded in a cellular stroma, mimicking a small acinar prostatic adenocarcinoma. The proliferating glands were lined by a single layer of secretory cells surrounded by an eosinophilic membranous structure. Basal cells were disclosed in individual glands or as small nests and even individual cells with immunostainability for basal cell-specific cytokeratin (EAB903), S-100 protein, and muscle-specific actin (HHF35). These findings indicate the benign nature of the lesion with myoepithelial differentiation of the basal cells. In contrast, all 25 small acinar adenocarcinomas examined as controls lacked positive stains for the above three antibodies, verifying the usefulness of these antibodies to distinguish between this benign lesion from adenocarcinoma.

Acid Phosphatase↗
PubMed1991

Colorectal carcinomas incidentally detected in autopsied cases and inpatients.

During the past 20 yr, 17 colorectal carcinomas (0.47%) were incidentally detected among 3,638 autopsied patients without clinically evident colorectal carcinoma, including 2,232 males and 1,406 females, more than 40 yr old. Among the 15 male and two female index subjects, six (0.33%) were detected in the first and 11 (0.60%) in the second decade. During their survival periods, fecal occult blood studies were performed in 14 cases and positive in 12 (86%); however, two of them had gastric ulcers which were responsible for the occult blood. During the recent 11 yr, six cases (0.48%) of colorectal carcinoma (four of them males; two, females) also were detected among 1,249 inpatients who were examined by barium enema and/or colonoscopy, including 816 males and 433 females, 40 yr old, or more, in the Department of Radiology. Fecal occult blood was detected in four cases (67%) before colonic investigation. Compared with 708 surgically resected carcinomas, the incidental lesions from both sources were smaller, consisted of higher percentages of Dukes' A type, and arose predominantly from the sigmoid colon and, rarely, from the rectum. These results indicate that the prevalence of colorectal carcinoma and its predominance in the sigmoid colon have not only apparently but actually increased in Japan, apart from improved diagnostic capabilities, and that false-negative rates with occult blood tests were surprisingly low in these autopsied cases and inpatients.

Aged↗
PubMed1990

Soft tissue sarcoma with additional anaplastic components. A clinicopathologic and immunohistochemical study of 27 cases.

This clinicopathologic study concerns 27 cases of "dedifferentiated" soft tissue sarcoma (DSTS), including 14 liposarcomas, six leiomyosarcomas, five chondrosarcomas, and two rhabdomyosarcomas. In addition, the authors conducted an immunohistochemical survey of 23 cases and an electron microscopic examination of three. The findings were compared with observations of 32 cases of de novo malignant fibrous histiocytoma (MFH). All tumors contained additional distinct anaplastic portions indistinguishable from MFH under conventional light microscopy, ultrastructurally, and in cases of immunoreactivity for alpha-1-antichymotrypsin and alpha-1-antitrypsin and on lectin histochemical findings for ricinus communis agglutinin and concanavalin agglutinin. The desmin reactivity present in anaplastic portions of 14 DSTS and in eight de novo MFH is taken to mean that myofibroblasts are present in these tumors. The anaplastic components of DSTS are presumed to represent the proliferation of another clone of undifferentiated mesenchymal cells that fail to differentiate along any specific lineage other than fibroblast-like cells, histiocyte-like cells, and myofibroblasts. Nineteen patients died of tumor and four are alive and well 1.6, 1.7, 2.1, and 5.2 years after the initial treatment, respectively.

Adolescent↗
PubMed1990

Osteosarcoma arising in a benign dermoid cyst of the ovary.

We present a rare case of an osteosarcoma arising in a benign dermoid ovarian cyst. The cyst, removed intact from the right ovary of a 52-year-old Japanese woman, was unilocular, measured 10 x 9 x 8 cm, weighed 176 g, and contained yellow-brownish greasy material. From the inner surface of the cyst there protruded a subsessile solid mass, measuring 3.1 x 2.5 x 2.0 cm, with a variegated cut surface. Histologically, the cyst was an ordinary dermoid cyst, and the solid mass consisted of osteosarcoma with focal chondroblastic differentiation. Postoperative combination chemotherapy was prescribed and the patient remains alive and well 16 months postoperatively. This case is the third documented in the world literature.

Dermoid Cyst↗
PubMed1990

Bednar tumor (pigmented dermatofibrosarcoma protuberans). An analysis of six cases.

Six cases of Bednar tumor were analyzed clinicopathologically along with a review of 39 published cases. The findings were then compared with data on 44 cases of ordinary dermatofibrosarcoma protuberans (DFSP) obtained from our files. The clinical manifestations of the patients and the anatomic locations of the tumors were similar between the two categories, but the rate of recurrence was lower in cases of Bednar tumor. The histologic pattern of Bednar tumor was indistinguishable from ordinary DFSP except for scattered melanosome-containing cells. Ultrastructural and immunohistochemical examinations showed no evidence of neuroectodermal differentiation of dominant spindle-shaped cells in Bednar tumor, supporting a fibroblastic line of differentiation. The origin and pathogenesis of the melanosome-containing cells were considered. These cells failed to react with HMB-45, a melanoma-specific antibody, and the large majority of melanosomes present were mature or at Stage IV, plus a few immature ones at Stage II. These pigmented cells do not appear to be neoplastic, and cannot be used as proof to indicate that Bednar tumor is a neuroectodermal neoplasm.

Adolescent↗
PubMed1990

Congenital primitive neuroectodermal tumor with epithelial and glial differentiation. An ultrastructural and immunohistochemical study.

A congenital primitive neuroectodermal tumor associated with epithelial and glial elements is described. This soft-tissue tumor present on the right temple of a newborn boy consisted mainly of small round cells of the primitive neuroepithelial type, occasionally forming rosettes. The other components were focal glandular structures producing mucin, and aggregates of epithelioid cells bearing clear cytoplasm, both being distributed throughout the entire tumor. Additional glandular and clear cell components were strongly positive for various epithelial markers, such as carcinoembryonic antigen, epithelial membrane antigen, and cytokeratin. Epithelioid cells were also positive for neuron-specific enolase and S100 protein. Glial differentiation was evidenced in some of the epithelioid cells by localization of cytoplasmic glial fibrillary acidic protein. These findings suggest that this tumor derives from a remnant of a neural crest, and the possibility of a special type of peripheral primitive neuroectodermal tumor is considered.

Epithelium↗
PubMed1989

Squamous cell carcinoma arising in mature cystic teratoma of the ovary. Clinicopathologic and topographic analysis.

Clinical and pathologic features of 28 patients with squamous cell carcinoma (SCC) arising in mature cystic teratoma (MCT) of the ovary were analyzed. The overall 5-year survival rate of these patients was 52%. Clinical staging (Stage I versus Stages II or more), histologic differentiation (well versus moderately or poorly differentiated SCC), and the presence of vascular invasion were factors affecting the prognosis of these patients. In 11 tumors, including 2 of the 4 examined in stepwise serial sections, the SCC was considered to have originated from a columnar epithelium (ciliated or nonciliated) or from a metaplastic squamous epithelium. On the other hand, no SCC was a direct transition from the ordinary epidermis of the teratomatous skin tissue. These results strongly support the proposal that SCC arising in MCT derives from the columnar epithelium.

Adult↗
PubMed1989

Clear cell chondrosarcoma. A case report with topographic analysis.

A case of clear cell chondrosarcoma located in the right proximal end of the femur is presented. Radiologically, the tumor appeared as a large osteolytic lesion with mottled calcification resembling chondroblastoma. Histologically, the greater portion was made up of tumor cells with abundant clear cytoplasm and usually distinct boundaries, associated with areas of conventional chondrosarcoma. The proportion of the clear cell areas was about 60%, and they were mainly distributed along the tumor periphery. Moreover, myxoid chondrosarcoma-like areas, a feature not previously mentioned in clear cell chondrosarcoma, were observed, occupying about 10% of the tumor area.

Adult↗
PubMed1989

Endotracheal neurilemoma with a lymphoid cuff. An ultrastructural and immunohistochemical study.

A neurilemoma occurred in the trachea of a 63-year-old woman complaining of dyspnea. Microscopically, the excised tumor was composed predominantly of cellular areas of Antoni type A tissue and had a peripheral lymphoid cuff. The schwannian origin was confirmed both immunohistochemically and ultrastructurally. This tumor without nuclear palisading and Verocay bodies differed somewhat from a conventional soft tissue neurilemoma and closely resembled a particular form of neurilemoma of the stomach, previously reported as a unique entity. Thus, this type of neurilemoma does occur in sites other than the gastrointestinal tract.

Female↗
PubMed1989

Comparative study of neuroectodermal tumor and Ewing's sarcoma of the bone. Histopathologic, immunohistochemical and ultrastructural features.

We carried out a histologic, immunohistochemical and ultrastructural study of 19 tumors, previously classified as Ewing's sarcoma of the bone (ESB). The tumors were categorized histologically into four groups according to the presence or absence and the distribution of Homer-Wright rosettes, together with the immunohistochemical and ultrastructural features: 1) neuroectodermal tumor of bone (NTB) with diffusely dispersed rosettes (4 cases), 2) conventional ESB totally lacking the rosettes (9 cases), 3) intermediate-type tumor with characteristics of both NTB and ESB (4 cases), and 4) spindle cell-type tumor with focal rosettes (2 cases). Ultrastructurally, NTB contained neurotubules and neurosecretory granules, whereas ESB consisted of only undifferentiated cells. Immunoreactivity with antineural antibodies, such as Leu-7, and those against synaptophysin, NSE, neurofilament, and chromogranin, was detected in the majority of NTB, in intermediate- and spindle cell-type tumors and in two of the nine cases of ESB. In view of these findings, we propose that use of the term "neuroectodermal tumor of the bone" should be restricted to tumors with an extensive distribution of rosettes, and that those without unequivocal rosettes should be classified as ESB, although ESB may be the most undifferentiated form of NTB and some overlap may occur between the two tumor types.

Adolescent↗