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Biomedical subjects

T Hachisuga

Publications and source records attributed to T Hachisuga.

50 records · Page 3Linked to original sources

Carcinoma of the lower uterine segment. Clinicopathologic analysis of 12 cases.

Clinicopathologic features of 12 tumors of the lower uterine segment (isthmus) were studied and the findings compared with data on 196 tumors of the corpus endometrium proper. The mean age of these Japanese patients with tumors of the isthmus was 47 years and that of the patients with tumors of the corpus endometrium was 55 years. Seven of the isthmic tumors (58%) were graded as 3 (poorly differentiated) with histologic features of adenosquamous carcinoma, and all 12 tumors showed myometrial invasion. Endometrial hyperplasia or atypical endometrial glands were found in the endometrium adjacent to the tumor in 11 women. Normal mucosal structures of the lower uterine segment were uninvolved, in the area between the tumor and the endocervix, in only three patients. Four patients died of the disease within 36 months after surgery. In a comparison with the usual endometrial tumors of the corpus, tumors of the lower uterine segment tended to be high-grade adenosquamous carcinomas and myometrial invasion was more extensive. The short-term follow-up revealed that lower uterine segment tumors carried an unfavorable prognosis.

Adult↗

Malignant pericardial effusion in endometrial adenocarcinoma.

A case of endometrial adenocarcinoma in a 62-year-old woman with malignant pericardial effusion is presented. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic node dissection, and paraaortic node biopsy. Postoperatively, she was placed on a combination chemotherapy regimen of cisplatin, doxorubicin, and cyclophosphamide. The patient developed cardiac tamponade during the course of chemotherapy. Although we first suspected cardiotoxic effect of doxorubicin, cytologic examination revealed adenocarcinoma cells in the pericardial fluid. A review of the literature revealed no other cases of cardiac metastasis from endometrial carcinoma diagnosed during life.

Adenocarcinoma, Papillary↗

[Antiemetic efficacy of high-dose metoclopramide, diphenhydramine, methylprednisolone and diazepam on chemotherapy-induced emesis in gynecological malignancy].

The antiemetic efficacy of high-dose metoclopramide (MCP), diphenhydramine (DPH), methylprednisolone (MPL), and diazepam (DZP) was investigated in 40 gynecologic cancer patients for a total of 98 chemotherapy courses, treated with cisplatin (50 mg/m2). With MPL (500 mg i.v. x 2) plus DZP (5 mg i.m. x 2), no vomiting occurred in 0% and mild emesis (vomiting 1-2 times) occurred in 20% of 25 courses. With MCP (2 mg/kg i.v. x 5) plus DPH (40 mg i.v. x 3), no vomiting occurred in 35% and mild emesis occurred in 10% of 20 courses. With a combination of MCP plus DPH and MPL plus DZP, no vomiting occurred in 51% and mild emesis occurred in 25% of 53 courses. These results indicate that high-dose MCP plus DPH are effective in preventing cisplatin-induced vomiting. Furthermore, the antiemetic efficacy of MCP plus DPH (0-2 vomiting episodes: 45%) was significantly enhanced (p less than 0.05) by the combined use of MPL plus DZP (0-2 vomiting episodes: 76%).

Adult↗

Sebaceous gland tumor of the ovary.

A sebaceous gland tumor of the ovary was detected in a 60-year-old woman who underwent right salpingo-oophorectomy for a right ovarian cyst. The cyst was unilocular, weighed 820 g, and was filled with sebaceous material containing a few hair shafts. There was a protruded mass composed of lobules of mature or immature sebaceous cells over the inner surface of the cyst wall. She has been well for 4 years and 2 months after the surgery. This is the second well-documented case of this extremely rare type of tumor. This lesion is teratogenic with unilateral development of the sebaceous glands and malignant characteristics are nil.

Diagnosis, Differential↗

[A case of malignant peritoneal mesothelioma with a good response to treatment].

A rare case of malignant peritoneal mesothelioma in a 49-year-old Japanese woman is presented. The tumor was limited to the peritoneum, and was cytologically and histologically identified as being composed of two components, epithelial and non-epithelial forms. The transition in her CA-125 level suggested that this tumor had good prospects of developing into a malignant mesothelioma. The good prognosis of the patient is considered to be attributed to detecting this tumor in its early stage and to aggressive chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

Extremely well-differentiated adenocarcinoma ("adenoma malignum") of the cervix in a patient with Peutz-Jeghers syndrome.

In a 29-year-old woman with the Peutz-Jeghers syndrome (PJS), an extremely well differentiated adenocarcinoma (adenoma malignum) of the uterine cervix was detected. The cervical lesion consisted of a polypoid mass, measuring 3.5 cm in greatest diameter, composed of extremely well differentiated tubules resembling those of the endocervical glands, yet containing a few Paneth cells. Immunohistochemical stains displayed cytoplasmic carcinoembryonic antigen in this tumor. The ovaries had no apparent abnormality. The diagnosis of the PJS was based on the presence of numerous hamartomatous polyps of the rectum and cutaneous pigmentation around the lips, fingers, and toes. The patient underwent a simple total hysterectomy and was subsequently treated with chemotherapy. In an 11 year follow-up, there has been no recurrence of the cervical tumor and she is currently well. The clinicohistopathologic differences of this cervical tumor in patients with and without PJS are briefly discussed.

Adenocarcinoma↗

Angioleiomyoma. A clinicopathologic reappraisal of 562 cases.

Five hundred sixty-two cases of angioleiomyoma in our files on soft tissues were reappraised clinicopathologically. There was a preponderance in females with a ratio of 1.7:1. The angioleiomyoma could be separated into three histologic subtypes: capillary or solid (374 cases), cavernous (61 cases), and venous (127 cases) types. Five hundred (89%) occurrences were in the extremities, 48 in the head, and only 14 in the trunk. The tumors caused pain and/or tenderness in 327 cases, in which 262 were of the solid type. In 16 cases, small groups of mature fat cells were demonstrated within the tumor, suggesting the hamartomatous nature of these smooth muscle tumors.

Adolescent↗

Subsequent endometrial carcinoma with adjuvant tamoxifen treatment in Japanese breast cancer patients.

This study aimed to detail the clinicopathologic features of endometrial carcinomas that developed in Japanese patients receiving adjuvant tamoxifen treatment for breast cancer patients. Ten endometrial carcinomas in tamoxifen-treated breast cancer patients were collected from two medical centers. The endometrial carcinomas included two stage Ia, four stage Ib, two stage Ic and two stage IIIc. Three tumors were Grade 1, six were Grade 2, and one was Grade 3. The tumor was limited to the endometrium in two cases. Myometrial invasion was limited to the inner half of the myometrium in five cases and involved the outer half in three. A mild degree of lymphovascular space invasion was identified in five cases. Deep cervical invasion was recognized in one case. The cell types comprised nine endometrioid adenocarcinomas and one serous carcinoma. Five of eight postmenopausal endometrial carcinomas were associated with polypoid endometrial lesions composed of cystically dilated atrophic and proliferative glands widely separated by fibrotic stroma. Two patients with retroperitoneal lymph node metastases died of endometrial cancer. One patient developed a contralateral breast cancer during tamoxifen treatment. No patient died of breast cancer. We did not demonstrate a higher frequency of either high-grade tumors or unfavorable histologic subtypes in tamoxifen-treated Japanese breast cancer patients.

Adenocarcinoma↗

Papillary carcinoma of the thyroid occurring during pregnancy. Report of a case diagnosed by fine needle aspiration cytology.

A case of papillary carcinoma of the thyroid gland occurring during pregnancy in a 29-year-old woman is described. The enlarged thyroid nodule was first detected at 10 weeks of gestation; fine needle aspiration (FNA) of the nodule showed no cytologic evidence of malignancy. Repeat FNA at 30 weeks of gestation produced inadequate material for diagnosis. A final FNA at 38 weeks of gestation showed classic cytologic features of papillary carcinoma, including papillary structures, grooved nuclei and intranuclear cytoplasmic inclusions. After delivery, the patient was treated with total thyroidectomy and cervical lymph node dissection. The enlargement of the nodule in this case during the course of the pregnancy suggests a relationship between pregnancy and the malignant development of thyroid nodules; this is discussed along with the utility of FNA cytology for diagnosing thyroid cancers during pregnancy.

Adult↗

Cytologic findings in endometrial hyperplasia.

The cytologic findings in 15 endometrial hyperplasias were compared with those of normal endometrium and well-differentiated endometrial adenocarcinoma. Differences in tumor diathesis, hypercellularity, uneven internuclear distance, severe piling up of nuclei, anisokaryosis, nuclear size and macronucleoli were the main cytologic findings that were noted among the three conditions. These features varied in the different types of endometrial hyperplasia. It is not clear that these cytologic findings can be used to cytologically diagnose endometrial hyperplasia because some of the findings involve subjective judgments by different cytologists. Further studies on larger series of cases will be necessary to establish the cytologic criteria for the correct interpretation of endometrial abnormalities.

Adenocarcinoma↗