記述言語：英語   出版者・発行元：(一社)日本病理学会  

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記述言語：英語   出版者・発行元：(一社)日本病理学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Immune check point inhibitors (ICIs) have durable antitumor effects. However, autoimmune toxicities, termed immune-related adverse events, occur in some patients. We report a case of severe immune aplastic anemia (AA) in a patient with non-small cell lung cancer who was receiving atezolizumab with bevacizumab/carboplatin/paclitaxel. Although the cancer has not recurred, his bone marrow is depleted and he did not respond to immunosuppressive therapy. He has survived for 1.5 years with blood transfusions and infection control. Immune AA associated with ICIs is rare, and a treatment has not yet been established. This case report provides information on the management and treatment response of patients with AA caused by ICIs. Further studies should investigate the mechanism and pathogenesis of immune AA caused by ICIs.

DOI： 10.1272/jnms.JNMS.2024_91-302

PubMed

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記述言語：日本語   出版者・発行元：日本内科学会-関東地方会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND AIM: Some patients with functional gastrointestinal disorders exhibit pancreatic dysfunctions and pancreatic enzyme abnormalities. Thus, we aimed to clarify whether significant differences in clinical characteristics, prevalence of pancreatic enzyme abnormalities, duodenal inflammation, and protease-activated receptor 2 (PAR2) expression levels related to hypersensitivity exist between functional dyspepsia (FD) alone and FD-irritable bowel syndrome (IBS) overlap group. METHODS: Ninety-three patients based on the Rome IV criteria, FD alone (n = 44) and FD overlapped with IBS (n = 49) group were enrolled. The patients scored their own clinical symptoms after consuming high-fat meals. Serum trypsin, PLA2, lipase, p-amylase, and elastase-1 levels were measured. PAR2, eotaxin-3, and TRPV4 mRNA levels in duodenum were determined using real-time polymerase chain reaction methods. PRG2- and PAR2 in the duodenum were evaluated using immunostaining. RESULTS: FD score and global GSRS in patients with FD-IBS overlap were significantly higher than FD alone. Although the prevalence of pancreatic enzyme abnormalities in patients with FD alone was significantly (P < 0.01) higher than that in FD-IBS overlap, the ratio of aggravation of clinical symptoms following high-fat intake in patients with FD-IBS overlap was significantly higher (P = 0.007) than that in patients with FD alone. PAR2- and PRG2-double positive cells were localized in the degranulated eosinophils in the duodenum of patients with FD-IBS overlap. The number of PAR2- and PRG2-double positive cells in FD-IBS overlap was significantly (P < 0.01) higher than FD alone. CONCLUSIONS: Pancreatic enzyme abnormalities and PAR2 expression on degranulated eosinophils infiltrations in the duodenum may be associated with the pathophysiology of patients with FD-IBS overlap in Asian populations.

DOI： 10.1111/jgh.16250

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Perineural spread (PNS) from pelvic carcinoma has been regarded as a pathway to muscle and bone metastasis. However, few cases have been reported, especially in patients with bladder carcinoma. In the present report, we discuss a case of diffuse cancer involvement in the muscle 5 years after radical cystectomy for advanced bladder carcinoma. Careful observation of temporal changes on medical images confirmed PNS as the pathway to muscle metastasis (i.e., primary PNS). Our report presents early and post-treatment CT, MRI and FDG-PET/CT findings of PNS from the bladder carcinoma.

DOI： 10.1272/jnms.JNMS.2024_91-301

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本病院総合診療医学会  

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記述言語：日本語   出版者・発行元：(一社)日本病院総合診療医学会  

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記述言語：日本語   出版者・発行元：(株)篠原出版新社  

若年性線維腺腫には異型乳管内病変が含まれることがある。しかし今回、広範囲に乳管内病変を認め非浸潤性乳管癌(DCIS)の診断となった症例を経験したので報告する。症例は18歳、女性。父方祖母が卵巣癌であった。17歳で乳房腫瘤を1個自覚し、約1年後には2個の腫瘤を認め、ともに増大傾向であった。若年性線維腺腫として乳房腫瘤摘出術を行ったところ、計3個の線維腺腫内にDCISを認めた。線維腺腫の間の乳腺組織にDCISがあることが推測され、再手術を行った。残存乳房内にDCISを認め、3個の線維腺腫とその周囲の乳腺組織にDCISが這うように進展したと考えられた。遺伝子検査は未施行だが、卵巣癌の家族歴があった。10代でも葉状腫瘍だけでなく乳癌の可能性があることを念頭に日常診療を行う必要があり、注意が必要である。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Esophageal gastrointestinal stromal tumors (E-GISTs) are often diagnosed early due to complaints such as dysphagia and are rarely found to be huge in size. Here, we report the treatment of a case of huge E-GIST successfully resected by minimally invasive surgery after neoadjuvant imatinib therapy. CASE PRESENTATION: An 86-year-old male patient with a 3-month history of dysphagia was referred to our hospital because of a suspected mediastinal tumor on chest X-ray. The chest computed tomography scan revealed a huge solid tumor, of about 100 mm in diameter, protruding into the left thoracic cavity. Histopathological examination results of fine-needle aspiration biopsy under endoscopic ultrasonography revealed a c-kit and CD34-positive esophageal gastrointestinal stromal tumor. The patient received neoadjuvant therapy with imatinib (400 mg/day) to reduce the size of the tumor and prevent rupture during resection. After 28 days of oral administration of imatinib, the tumor size decreased. However, the patient refused to continue treatment with imatinib and therefore underwent mediastino-laparoscopic transhiatal esophagectomy. We successfully resected the tumor completely with mediastino-laparoscopic surgical techniques. Esophageal reconstruction was performed using a gastric tube in the posterior sternal route. After an uneventful postoperative course, the patient was discharged postoperative day 14. Immunohistochemical findings of the resected specimen showed that the tumor cells were positive for c-kit, DOG-1 and CD34 and negative for smooth muscle actin and S100. CONCLUSIONS: Hybrid surgical procedure utilizing mediastino-laparoscopy might be useful for high-risk patient with esophageal tumors.

DOI： 10.1186/s40792-022-01464-z

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We have reported that refractory functional dyspepsia patients with pancreatic enzyme abnormalities (FD-P). We tried to analyze the prevalence of exocrine pancreatic insufficiency (EPI) in FD-P patients to clarify whether the pathophysiology of FD patients including clinical symptoms and quality of life were associated with EPI. We enrolled forty-nine patients presenting with typical symptoms of FD-P patients (n = 20) and asymptomatic patients with pancreatic enzyme abnormalities (AP-P) (n = 29). Five pancreatic enzymes (p-amylase, lipase, elastase-1, trypsin, and PLA2) were measured and STAI-state/-trait and SF-8 were evaluated. Pancreatic exocrine function was analyzed using N-benzoyl-l-tyrosyl-p-aminobenzoic acid (BT-PABA). There were no significant differences in patient background between FD-P and AP-P patients. BT-PABA test scores for FD-P patients (61.67 ± 5.55) were significantly (p = 0.01) lower than in AP-P patients (95.38 ± 2.36). Physical component scale (PCS) in FD-P patients was significantly (p = 0.002) lower than that in AP-P patients. STAI-state was relatively (p = 0.054) associated with BT-PABA test in FD-P and AP-P patients by multiple logistic regression analysis. The prevalence of EPI in FD-P patients was significantly higher than that in AP-P patients and was relatively associated with state of anxiety. Further studies will be needed to clarify how EPI or pancreatic enzyme abnormalities are associated with the pathophysiology of FD-P patients.

DOI： 10.3164/jcbn.21-67

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Desmoplastic malignant pleural mesothelioma (DMPM) is a sarcoma type mesothelioma, comprising about 5% of malignant pleural mesotheliomas. Although effusion cytology is commonly used as the primary diagnostic approach for mesothelioma, this may not be useful for DMPM due to its desmoplastic nature and bland cellular atypia. We hereby report a case of DMPM diagnosed through autopsy along with its cytological features that have not been described previously. CASE PRESENTATION: A male in his 60s with a history of occupational asbestos exposure was referred to our hospital with right chest pain. Chest computed tomography scan showed right pleural effusion. Thirteen months later, the patient died of respiratory failure. In autopsy, the scrape-imprint smear and the pleural effusions cytology were performed. The scrape-imprint smear samples exhibited spindle cells with mild nuclear atypia and grooves with fibrous stroma. In the pleural effusion cytology, spindle cells having mild nuclear atypia and grooves with loose epithelial connections were observed. Histological examination of the right pleura showed spindle cells proliferating with dense collagen fibers, as seen in cytological samples, thus rendering the diagnosis of DMPM. Diagnosis was confirmed by fluorescence in situ hybridization. CONCLUSION: Cytological procedures, such as pleural effusion cytology and scrape-imprinting method, may be useful as an ancillary tool in the diagnosis of rare tumors such as DMPM.

DOI： 10.1272/jnms.JNMS.2022_89-605

PubMed

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We present a case of solitary chondrosarcoma arising from the proximal phalanx of the ring finger in an elderly man. The chondrosarcoma developed over a period of 14 years, during which the phalanx became progressively more deformed. Several radiographic investigations were carried out, but the patient declined further suggested diagnostic examinations (computed tomography, magnetic resonance imaging, biopsy). Eventually, the lesion became significantly enlarged, and radiographs showed osteolytic lesions in the phalangeal bone. Ray amputation of the finger was required to establish a wide resection of the chondrosarcoma. Most osteochondral tumors arising from the phalanges are benign tumors such as enchondromas, but primary chondrogenic malignant bone tumors (chondrosarcomas) occasionally occur. Chondrosarcoma of the phalanx is difficult to distinguish from enchondroma of the phalanx, because histological investigations of the two neoplasms often produce similar findings. Even with a combination of clinical, biopsy, and imaging findings, differentiating these neoplasms is still challenging, because the characteristic clinical and radiological features of chondrosarcoma do not appear until it becomes aggressive and starts to cause destructive changes. Once that happens, radical expanded resection of the tumor is essential. Therefore, longstanding enchondroma-like lesions should be actively treated in elderly patients, even if a definite diagnosis of chondrosarcoma cannot be made.

DOI： 10.1272/jnms.JNMS.2022_89-602

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

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記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

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記述言語：日本語   出版者・発行元：神奈川整形災害外科研究会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japan Endocrine Society  

The incidence of papillary thyroid carcinoma (PTC) is increasing worldwide. The biomarkers to identify aggressive types of PTC are limited, illustrating the need to establish reliable novel biomarkers. Protein disulfide isomerase A3 (PDIA3) is a chaperone protein that modulates the folding of newly synthesized glycoproteins and stress-responsive proteins in the endoplasmic reticulum. Although the role of PDIA3 in various cancers such as breast, uterine cervix, head and neck, and gastrointestinal tract has been examined, its expression in thyroid cancer has not been reported. We retrospectively reviewed accumulated data with long-term follow-up of 1,139 PTC patients, and investigated the correlation between immunohistochemical expression of PDIA3 in PTC patients and clinicopathological features and prognosis. PDIA3 expression was significantly lower in PTCs compared to normal thyroid tissues (NTT; n = 80, p = 0.002). In PTCs, correlation between low PDIA3 expression and lymph node metastasis (p = 0.018) and the number of positive nodes (p = 0.004) was observed. Patients with low PDIA3 expression exhibited worse cause-specific survival compared to those with high PDIA3 expression (p = 0.013). Our findings indicate that low PDIA3 expression is related to poor clinical outcome in PTC patients, and that PDIA3 may potentially be a novel ancillary biomarker. Further clarification of the biological role of PDIA3 in PTC is warranted for the future clinical application.

DOI： 10.1507/endocrj.ej21-0394

PubMed

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記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

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記述言語：日本語   出版者・発行元：日本膵・胆管合流異常研究会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Ganglion cysts are common benign lesions in the hand and wrist. However, intratendinous ganglion cysts are fairly rare lesions. We present the case of a 73-year-old woman with an intratendinous ganglion cyst occurring in the extensor pollicis longus (EPL) tendon of her right hand. The subcutaneous mass moved according to the movement of the EPL tendon of her right thumb. Magnetic resonance imaging showed a space-occupying lesion in the EPL tendon. Biochemical and hematoimmunological examinations ruled out diabetes mellitus, rheumatoid arthritis and other connective tissue diseases. She complained of a motion pain during thumb extension, and she had desired surgery. Intraoperatively, an intratendinous cyst was identified within the tendon substance of the EPL, in which a part of the cyst was herniated into a slit in the tendon substance, just distal to the extensor retinaculum without remarkable proliferative synovial tissue. The EPL tendon was opened longitudinally, and a cystic lesion was enucleated. The pathological findings showed that the cyst wall consisted of fibrous tissue with degeneration, lacking epithelial lining. Postoperative recovery was uneventful. Six months after surgery, the patient had no residual pain and cyst recurrence. The rarity of intratendinous ganglion cysts makes diagnosis and treatment challenging. Since intratendinous ganglion cysts and associated synovitis frequently weaken the structure of the affected tendons, prompt diagnosis and surgical excision are necessary.

DOI： 10.1272/jnms.JNMS.2021_88-416

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

背景:肺粘表皮癌はまれな腫瘍であり、粘膜下腫瘍様の形態をとることから気管支擦過細胞診での組織型推定がしばしば困難となる。気管支擦過および洗浄検体にて術前細胞診断に苦慮した肺低悪性度粘表皮癌の1例を経験したので報告する。症例:40歳代、女性。検診にて胸部異常陰影を指摘され当院を受診し、胸部CTにて左下葉気管支内に境界明瞭な結節を認めた。気管支擦過・洗浄細胞診では、核がほぼ中心性で異型の弱い多陵形細胞と、ごくわずかではあるが核偏在性で細胞質に多量の粘液を含んだ泡沫状の細胞を認めた。しかしいずれも異型に乏しく、細胞量も少なかったため、組織型推定は困難であった。最終的に生検および手術検体で肺低悪性度粘表皮癌と診断された。結論:下気道発生の粘表皮癌の細胞診断においては気管支擦過細胞診に比べ、穿刺吸引細胞診での検体採取が有用とされているが、異型の弱さや採取されてきた細胞の各成分の割合、細胞量によっては診断が困難となることがある。細胞の採取方法にとらわれず、特徴的な細胞像を理解し、臨床像、画像所見や腫瘍の発生部位から粘表皮癌の可能性を念頭に置くことが肝要である。(著者抄録)

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

背景:肺粘表皮癌はまれな腫瘍であり、粘膜下腫瘍様の形態をとることから気管支擦過細胞診での組織型推定がしばしば困難となる。気管支擦過および洗浄検体にて術前細胞診断に苦慮した肺低悪性度粘表皮癌の1例を経験したので報告する。症例:40歳代、女性。検診にて胸部異常陰影を指摘され当院を受診し、胸部CTにて左下葉気管支内に境界明瞭な結節を認めた。気管支擦過・洗浄細胞診では、核がほぼ中心性で異型の弱い多陵形細胞と、ごくわずかではあるが核偏在性で細胞質に多量の粘液を含んだ泡沫状の細胞を認めた。しかしいずれも異型に乏しく、細胞量も少なかったため、組織型推定は困難であった。最終的に生検および手術検体で肺低悪性度粘表皮癌と診断された。結論:下気道発生の粘表皮癌の細胞診断においては気管支擦過細胞診に比べ、穿刺吸引細胞診での検体採取が有用とされているが、異型の弱さや採取されてきた細胞の各成分の割合、細胞量によっては診断が困難となることがある。細胞の採取方法にとらわれず、特徴的な細胞像を理解し、臨床像、画像所見や腫瘍の発生部位から粘表皮癌の可能性を念頭に置くことが肝要である。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BackgroundPancreatic body and tail cancer easily invades the retroperitoneal tissue, including the transverse mesocolon. It is difficult to ensure a dissected peripancreatic margin using standard distal pancreatectomy for advanced pancreatic body and tail cancer.Thus, we developed a novel surgical procedure to ensure dissection of the peripancreatic margin. This involved performing dissection deeper than the fusion fascia of Toldt and further extensive en bloc resection of the root of the transverse mesocolon. We performed distal pancreatectomy with transverse mesocolon resection (DP-TCR) using the mesenteric approach and achieved good outcomes.MethodsThere are two main considerations regarding the surgical procedure using the mesenteric approach: 1) dissection deeper than the fusion fascia of Toldt (securing the vertical margin) and 2) modular resection of the pancreatic body and tail, with the root of the transverse mesocolon and adjacent organs in a horizontal direction (ensuring the caudal margin).ResultsFrom 2017 to 2019, we performed DP-TCR using the mesenteric approach for six patients with advanced pancreatic body and tail cancer. Histopathological radical surgery was possible in all patients who underwent DP-TCR. No perioperative complications of grade IIIa or above in the Clavien-Dindo classification were observed in any patients.ConclusionsWe believe that DP-TCR is useful as a radical surgery for advanced pancreatic body and tail cancer with extrapancreatic invasions.

DOI： 10.1272/jnms.JNMS.2021_88-408

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Pathological nipple discharge (PND) is a relatively common symptom of breast cancer affecting the nipple. Mammary ductscopy (MD) allows direct visualization of the ductal lumen and collection of a cytological specimen using duct-washing cytology (DWC). Herein, we clarified the diagnostic efficacy of DWC for the detection of breast cancers with PND, compared with fine-needle aspiration cytology (FNAC). METHODS: We retrospectively examined 48 patients with PND who underwent DWC by MD (ductosccopy group; histologically determined by intraductal biopsy [IDB] or surgical specimen). The results of sensitivity and specificity of DWC were compared with that of FNAC (conventional group; histologically determined by core needle biopsy). Clinicopathological factors were compared between the ductoscopy and the conventional groups. RESULTS: Of eight histologically malignant cases in the ductoscopy group, one case was cytologically judged as malignant and three as indeterminate. Sensitivity and specificity of DWC were 50.0% and 82.5%, respectively. Malignant cases were mostly solid papillary carcinomas (SPCs), and benign cases were intraductal papillomas (IDPs). In the conventional group, sensitivity and specificity of FNAC were 88.0% and 38.2%, respectively, and malignant cases were mainly invasive carcinomas of no special type. Tumors in the ductocsopy group had more favorable prognostic features than those in the conventional group. CONCLUSION: DWC has limited diagnostic value due to the high incidence of SPC, whose cytological features are indistinguishable from IDP. As DWC alone may be unreliable, comprehensive examination with IDB and MD findings is recommended.

DOI： 10.1002/dc.24572

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Intravenous immunoglobulin (IVIG) therapy has been used to treat sepsis, but its mechanisms of action remain unclear. Sepsis causes multiple organ failure, such as acute lung injury (ALI), which involves apoptosis of alveolar epithelial cells. In this study, we hypothesized that IVIG suppresses apoptosis in alveolar epithelial cells and evaluated mortality, cytokine levels, histological changes in the lung, and alveolar epithelial cell apoptosis after IVIG administration, in mice with experimentally induced sepsis. METHODS: Mice received an injection of vehicle (saline) or immunoglobulin (100 mg/kg or 400 mg/kg) into the tail vein, after which they underwent cecal ligation and puncture. A sham-operated group was used as the normal control. Survival was assessed in all groups after 72 hours. Plasma levels of TNF-α and IL-6, histopathological changes and wet-to-dry ratio in lung, and alveolar epithelial cell apoptosis were evaluated in all groups at 4 hours after surgery. RESULTS: In the vehicle group, histopathological injury of the lung was severe, and apoptosis of alveolar epithelial cells was significant. Survival and plasma cytokine levels were better in the IVIG treatment groups than in the vehicle group. IVIG 400 mg/kg suppressed apoptosis of alveolar epithelial cells and reduced ALI. CONCLUSION: IVIG suppressed inflammatory cytokine levels and improved survival. Lung histopathology and alveolar epithelial cell apoptosis were improved by IVIG treatment, in a dose-dependent manner. Suppressing apoptosis in alveolar epithelial cells appears to be a mechanism by which IVIG improves survival.

DOI： 10.1272/jnms.JNMS.2020_87-303

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記述言語：日本語   出版者・発行元：(株)篠原出版新社  

Solid Papillary Carcinoma(SPC)の特徴を手術症例と乳管内視鏡施行例を用いて臨床病理学的に検討した。2015年7月〜2019年6月の乳癌手術例389例中、SPCは18例(4.6%)であった。SPCの平均年齢は57.1歳で、分布は若年と高齢の2つのピークを持っていた。診断契機は乳頭分泌10、腫瘤8で、術式は部分切除10、乳房切除8であった。平均浸潤径はSPCが0.24cm、浸潤性乳管癌が1.89cmで、平均進展径はSPCが3.98cm、非浸潤性乳管癌が3.38cmであった。同時期の乳管内視鏡施行例112例中、乳癌は18例で、うちSPCは11例(61.1%)であった。SPCの内視鏡所見は乳管内乳頭腫との鑑別が困難であった。SPCは乳頭分泌で診断されることが多く、乳管内進展傾向が強いが、限局する症例もあるので部分切除も可能である。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)篠原出版新社  

乳房部分切除の断端陰性率に影響を及ぼす因子について検討した。2017年4月〜2019年2月に乳房部分切除を施行した原発性乳癌92例を対象とした。病変などの位置情報をもとに水系エマルジョン樹脂塗料で切除範囲の模型を作製し、点墨で使用した。標本上、全切片で断端から5mm以上の距離が確保された場合を陰性と判定した。模型上の病変の数といった情報や臨床病理学的因子と断端陰性率との関連を検討した。断端陰性率は53.3%であった。模型上の病変数の増加とともに、断端陰性率は有意に低下した。組織型や核グレードも断端陰性率に関連した。単一病変の症例比の増加と切除技術向上に伴う単一病変の断端陰性率の向上により、経時的に断端陰性率は上昇した。(著者抄録)

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

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DOI： 10.1272/jnms.JNMS.2018_86-404

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1177/1066896918791031

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

背景:脊索腫は、仙骨や頭蓋底など軸骨格を中心に発症する比較的まれな腫瘍であり、組織学的に確定診断にいたるには担空胞細胞の同定が重要な手掛かりとなる。われわれは、術前細胞診で担空胞細胞を認めず、診断に苦慮した脊索腫の1例を報告する。症例:69歳、女性。転倒後の仙骨部領域の持続的な疼痛を訴え、当院を受診。骨盤部レントゲン、MRIで、仙骨領域に分葉化する腫瘤を認めた。穿刺吸引細胞診では、多量の粘液物質内に多形性や核異型を有する紡錘形細胞の増生を認めたが、特徴的な担空胞細胞は同定できず、軟骨肉腫を第一に考えた。その後、生検、手術検体で、好酸性の胞体をもつ上皮様異型細胞の増生を認め、脊索腫と確定診断された。結論:脊索腫の細胞診では、担空胞細胞が同定できない場合、診断が困難となる。臨床、画像的に脊索腫が示唆される場合、典型的な細胞像を欠いても、脊索腫の可能性があることを念頭におく必要がある。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01209&link_issn=&doc_id=20190510310005&doc_link_id=%2Few5saibo%2F2019%2F005801%2F006%2F0029-0034%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Few5saibo%2F2019%2F005801%2F006%2F0029-0034%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

RATIONALE: Preiser disease or avascular necrosis (AVN) of the scaphoid causes intolerable wrist pain and malalignment of the carpal bones. In previously reported cases, patients have had a history of steroid use for systemic illness such as autoimmune hemolytic anemia, systemic lupus erythematosus, or renal transplantation, or have had other risk factors, such as smoking, alcoholism, or infection. In particular, systemic glucocorticoid therapy has been most commonly associated with the disease. Although there are reports of AVN of the scaphoid induced by systemic glucocorticoids, no prior report has associated AVN of the carpal bones with repeated local injections of glucocorticoids. PATIENT CONCERNS: We present a case in which it was strongly suspected that AVN of the scaphoid was induced by repeated local glucocorticoid injections. The patient had no history of excessive alcohol use, smoking, or trauma, except for local repeated steroid injections. DIAGNOSES: Initially, she had diagnosed with de Quervain's disease and was treated by repeated local glucocorticoid injections followed by surgery for de Quervain's disease. Five years after surgery for de Quervain's disease, the patient presented at our hospital with sudden onset of intolerable pain in her right wrist without a history of trauma. In spite of nonsurgical treatment with rest, immobilization, analgesia, and surgery, her wrist pain was not improved. After further repeated local steroid injections in her wrist, radiographs, and magnetic resonance imaging of her wrist showed the AVN of the scaphoid. INTERVENTIONS: Surgery was performed and the fragmented proximal scaphoid and the entire lunate were resected. OUTCOMES: The diagnosis was confirmed according to the histopathological examination of the proximal scaphoid bone, which showed the characteristic of AVN of the scaphoid. At follow-up evaluation, radiographs of the right wrist showed no progression of osteoarthritis. The patient had no tenderness or residual pain at the wrist and had no desire to pursue additional surgery. LESSONS: We have presented a case with AVN of the scaphoid, which was strongly suspected to be associated with the repeated local steroid injections. Further studies are required to more fully elucidate the association between AVN of the scaphoid and repeated local steroid injections.

DOI： 10.1097/MD.0000000000012413

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Background: Characteristics of a cancer-positive margin around a resected uncinate process of the pancreas (MUP) due to a pancreticoduodenectomy are difficult to understand by standardized evaluation because of its complex anatomy. The purposes of this study were to subclassify the MUP with tissue marking dyes of different colors and to identify the characteristics of sites that showed positivity for cancer cells in patients with pancreatic head carcinoma who underwent circumferential superior mesenteric arterial nerve plexus preserving pancreaticoduodenectomy. Results of this evaluation were used to review operation procedures and perioperative methods.
Method: We divided the MUP into 4 sections and stained each section with a different color. These sections were the pancreatic head nerve plexus margin (Area A), portal vein groove margin (Area B), superior mesenteric artery margin (Area C), and left of the superior mesenteric artery margin (Area D). The subjects evaluated were 45 patients who had carcinoma of the pancreatic head and were treated with circumferential superior mesenteric arterial nerve plexus-preserving pancreaticoduodenectomy.
Results: Of the 45 patients, nine cases (90%) of incomplete resection showed cancer-positivity in the MUP. Among the 4 sections of the MUP, the most cases of positive results [MUP(+)] were found in Area B, with Area A(+), 0 case; Area B(+), 6 cases; Area C(+), 2 cases; and Area D(+), 3 cases (total, 11 sites in 9 patients). Relapse occurred in 7 of the 9 patients with MUP(+). Local recurrence was observed as initial relapse in all 3 patients with Area D(+). In contrast, the most common site of recurrence other than that in patients with Area D(+) was the liver.
Conclusion: By subclassifying the MUP with tissue marking dyes of different colors, we could confirm regional characteristics of MUP(+). As a result, circumferential superior mesenteric arterial nerve plexus preserving pancreticoduodenectomy was able to be performed in R0 operations in selected patients while a better postoperative quality of life was maintained. Furthermore, Area D(+) represents an extension beyond the limit of the local disease and may indicate the need for early aggressive adjuvant chemotherapy.

DOI： 10.1272/jnms.84.32

Web of Science

PubMed

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記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

The form and timing of the local recurrence of lung cancer can be unpredictable and unexpected. Pseudomesotheliomatous adenocarcinoma is a rare tumor that mimics malignant pleural mesothelioma both clinically and pathologically. Distinguishing pseudomesotheliomatous adenocarcinoma from malignant pleural mesothelioma on the basis of clinical findings can be difficult; therefore, a biopsy is usually required for diagnosis. Here we report on a 73-year-old Japanese man who presented with extensive dissemination along the pleural surfaces and clinical findings similar to those of pseudomesotheliomatous lung cancer 10 years after undergoing left upper lobectomy for lung adenocarcinoma. This report provides information that will help physicians establish an accurate diagnosis in similar cases.

DOI： 10.1272/jnms.81.173

Web of Science

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPANDIDOS PUBL LTD  

The overexpression of fibroblast growth factor receptor (FGFR) 4 has been reported in various human cancers, but it has not been studied in pancreatic ductal adenocarcinoma (PDAC) or its precursor lesion, pancreatic intraepithelial neoplasia (PanIN). Moreover, there is controversy as to whether FGFR4 has a mitogenic role in carcinogenesis or other functions. Therefore, the expression and roles of FGFR4 in pancreatic cancer were investigated. Immunohistochemical staining was performed using an anti-FGFR4 antibody in PDAC and PanIN cases. The expression levels of FGFR4 mRNA and protein were investigated in PDAC cell lines by qRT-PCR and Western blot, respectively. Changes were analyzed in cell morphology, proliferation, migration, invasion and attachment in PDAC cell lines with or without the stimulation of FGFR4 by FGF19, as a known specific ligand. The changes in mRNA levels associated with transformation and tumorigenesis as a result of FGF19 administration were also evaluated. FGFR4 was expressed in 39 of 53 PDAC cases (73.6%) and its expression tended to be related to longer overall survival (P=0.068). Moreover, it was frequently expressed in high-grade PanIN lesions [10 of 11 lesions (90.9%)], whereas it was hardly expressed in low-grade PanIN lesions [1 of 10 lesions (10.0%)] (P=0.0003). FGFR4 stimulation of PDAC cells resulted in significantly increased cell adhesion to laminin and fibronectin (P&lt;0.05) and decreased cell migration (P&lt;0.05). The results of PCR array analysis indicated that this was a result of up-regulation of the integrin alpha 4 family. In contrast, cell morphology or proliferation in PDAC cells was not affected. We showed that FGFR4 expression is markedly increased in high-grade PanIN and PDAC compared with that in normal and low-grade PanIN, and that FGFR4 stimulation by FGF19 of PDAC cells contributes to tumor suppression by increasing cell adhesion to extracellular matrix.

DOI： 10.3892/ijo_00000832

Web of Science

PubMed

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記述言語：日本語   出版者・発行元：(株)医学書院  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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記述言語：日本語   出版者・発行元：(公社)神奈川県医師会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

背景:脊索腫は、仙骨や頭蓋底など軸骨格を中心に発症する比較的まれな腫瘍であり、組織学的に確定診断にいたるには担空胞細胞の同定が重要な手掛かりとなる。われわれは、術前細胞診で担空胞細胞を認めず、診断に苦慮した脊索腫の1例を報告する。症例:69歳、女性。転倒後の仙骨部領域の持続的な疼痛を訴え、当院を受診。骨盤部レントゲン、MRIで、仙骨領域に分葉化する腫瘤を認めた。穿刺吸引細胞診では、多量の粘液物質内に多形性や核異型を有する紡錘形細胞の増生を認めたが、特徴的な担空胞細胞は同定できず、軟骨肉腫を第一に考えた。その後、生検、手術検体で、好酸性の胞体をもつ上皮様異型細胞の増生を認め、脊索腫と確定診断された。結論:脊索腫の細胞診では、担空胞細胞が同定できない場合、診断が困難となる。臨床、画像的に脊索腫が示唆される場合、典型的な細胞像を欠いても、脊索腫の可能性があることを念頭におく必要がある。(著者抄録)

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記述言語：日本語   出版者・発行元：日本内科学会-関東地方会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語   出版者・発行元：(公社)日本臨床細胞学会  

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

この研究の目的は術直前に造影超音波で乳癌の広がり診断を行い,その結果に従って切除し組織学的に評価して,造影超音波とMRIの広がり診断を比較することである.2015年9月〜2016年6月に文書によるインフォームドコンセントを取得し,乳腺部分切除を施行した乳癌21例を対象とした.症例ごとにMRI,造影超音波と組織学的広がり長径を測定し,MRIまたは造影超音波の組織学的広がり長径との一致率を比較した.造影超音波は全麻下で術直前に行い,低エコー域での造影の有無で評価した.造影超音波による広がり診断に従って部分切除を行い,標本は全割し階段状切片で評価した.組織学的広がり長径との一致率はMRI 57.1%,造影超音波52.4%で,MRIと同様に組織学的広がり長径と造影超音波はよく相関した(r=0.755,p&lt;0.0001).造影超音波は手術と同じ体位でできるので,乳房部分切除の切除範囲の設定に有用である.(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(公社)日本婦人科腫瘍学会  

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記述言語：日本語   出版者・発行元：特定非営利活動法人 日本呼吸器内視鏡学会  

DOI： 10.18907/jjsre.37.1_120_4

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

Background: Spontaneous pneumothorax is a relatively rare complication of lung cancer. Herein, we report two cases of lung cancer &lt;i&gt;in situ&lt;/i&gt; with spontaneous pneumothorax as the initial symptom. Cases: Case 1: A 63-year-old male presented to our outpatient clinic with chest discomfort. He had a collapsed lung, and we inserted a chest drainage tube through the thoracic cavity to re-expand the lung. Computed tomography of the chest showed a large emphysematous bulla at the lung apex. Video-assisted thoracoscopic surgery was used to resect the bulla, and the final pathological diagnosis was an emphysematous bulla with adenocarcinoma &lt;i&gt;in situ&lt;/i&gt;. Case 2: A 45-year-old man presented to our outpatient clinic with pain in the left chest and dyspnea. To treat an almost completely collapsed lung, we inserted a chest drainage tube into the thoracic cavity. Air leakage continued for a few days, so we resected the bulla. The final pathological diagnosis was an emphysematous bulla with a squamous cell carcinoma &lt;i&gt;in situ&lt;/i&gt;. Conclusion: It is important to consider the possibility of lung cancer in patients with pneumothorax and emphysematous changes, especially in middle-aged or elderly patients.

DOI： 10.1272/manms.11.161

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本呼吸器学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：日本語   掲載種別：会議報告等   出版者・発行元：(株)メディカルレビュー社  

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記述言語：日本語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：英語   出版者・発行元：特定非営利活動法人日本臨床細胞学会  

CiNii Books

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記述言語：英語   出版者・発行元：特定非営利活動法人日本臨床細胞学会  

CiNii Books

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

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記述言語：日本語   出版者・発行元：(一社)日本病理学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

There have been few studies of kidney volume. Therefore, we performed a study of mean kidney volume and its correlations with sex, lateral asymmetry, kidney length, width, thickness and weight in 103 kidneys excised from 54 cadavers used for practical training in the department of anatomy of this university. Mean kidney volume was 131.0&amp;plusmn;97.4 m&lt;i&gt;l&lt;/i&gt; (103 kidneys) and was greater in males than in females (p&lt;0.05) but showed no lateral asymmetry. A strong correlation was only observed for mean kidney volume with weight (r=0.919), but no other correlations were observed. Next, the correlation between kidney-volume and cross-sectional area was investigated by measuring cross-sectional area after 59 kidneys having a macroscopically favorable appearance from 30 cadavers were sectioned frontally along the major axis. A strong correlation (r=0.769) was observed between cross-sectional area (mean: 45.82&amp;plusmn;9.84 cm&lt;sup&gt;2&lt;/sup&gt;) and mean kidney volume (133.47&amp;plusmn;52.33 m&lt;i&gt;l&lt;/i&gt;). These findings suggest that approximate values for kidney volume and weight can be obtained from kidney measurements using X-rays imaging and can, in turn, be applied clinically.&lt;br&gt;

DOI： 10.1272/manms.2.27

CiNii Books

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