Language：Japanese   Publisher：日本結核・非結核性抗酸菌症学会関東支部学会・日本呼吸器学会関東地方会  

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

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Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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Language：Japanese   Publisher：日本臨床外科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Abdominal ultrasonography in a 70-year-old woman showed a hypoechoic mass, 14 mm in diameter, in the pancreatic body. Computed tomography showed a mass with contrast effect in the pancreatic body. Test results for endocrine factors or tumor markers were normal. The initial consideration was nonfunctional pancreatic neuroendocrine tumor. Over 8 years of monitoring, the tumor diameter increased to 18 mm, until pancreatic tumor enucleation was performed. The postoperative diagnosis was pancreatic hamartoma, a rare type of benign pancreatic tumor. The preoperative diagnosis of pancreatic hamartoma is difficult, but consideration must be given to the possibility of hamartoma when encountering pancreatic tumors.

DOI： 10.2169/internalmedicine.5982-20

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Language：Japanese   Publisher：(一社)日本乳癌学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Breast cancer is the most common malignancy in women and has a risk of late recurrence. We report a case of metastasis to the stomach and colon 23 years after surgery, with characteristic findings. A 74-year-old woman underwent breast cancer resection at the age of 51. At the time, no additional therapy was performed despite the histological diagnosis of invasive lobular carcinoma with lymph node metastasis. Upper gastrointestinal endoscopy, which was performed as a follow-up for her chronic gastritis, revealed multiple erosions. Histology revealed diffuse proliferation of signet ring cell-like atypical cells, that were positive for cytokeratin CAM5.2 and estrogen receptor. These findings suggested metastasis from the invasive lobular breast carcinoma. Positron-emission tomography revealed sternal and vertebral metastases. Colonoscopy also performed to screen for intestinal metastasis revealed several lesions that resembled hyperplastic polyps. Although these lesions were not strongly suspected of metastasis, histology surprisingly revealed the same findings as the gastric metastasis. This case involved gastric and colorectal superficial metastases that were synchronously detected 23 years after primary treatment. We report that early-stage colorectal metastasis may resemble hyperplastic polyps, and biopsy should always be considered in patients with a history of breast cancer, regardless of years elapsed since treatment.

DOI： 10.1007/s12328-020-01285-3

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Language：Japanese   Publisher：Japan Pancreas Society  

<p>A-65-year-old man with a mass in the body of the pancreas seen on ultrasonography was referred for further evaluation. Abdominal contrast-enhanced computed tomography scan revealed a 10mm enhancing lesion in the body of the pancreas along with stenosis of the main pancreatic duct stenosis near the lesion and caudal dilation. Although a pancreatic neuroendocrine tumor was suspected, we performed endoscopic ultrasonography-guided fine-needle aspiration because pancreatic ductal carcinoma could not be ruled out. Histopathological analysis revealed a PNET G1. Distal pancreatectomy was performed, and immunostaining was positive for chromogranin A, synaptophysin and serotonin. Fibrosis caused by serotonin was thought to be involved in the pathogenesis of the main pancreatic duct stenosis in this patient.</p>

DOI： 10.2958/suizo.36.169

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Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is widely used as a first-line procedure for the definitive diagnosis of pancreatic solid tumor. Adverse events associated with the EUS-FNA procedure include acute pancreatitis, bleeding, infection, and duodenal perforation. Rarely, pancreatic tumors disseminate in the peritoneal cavity or seed in the gastric wall via the biopsy needle tract after EUS-FNA. Such seeding has been noted primarily in cases of adenocarcinomas and has not been associated with solid pseudopapillary neoplasm (SPN), a rare and potentially malignant tumor of the pancreas. This is the first report of a case of tumor seeding in the gastric wall after EUS-FNA of pancreatic SPN.

DOI： 10.2169/internalmedicine.3244-19

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The current study investigated the efficacy of podoplanin expression in tumor budding cells as a predictor of neck lymph node metastasis (NLM) in patients with tongue squamous cell carcinoma (SCC) of low tumor budding grade (TBG). A total of 99 patients with early T-stage tongue SCC of any clinical N status who received the initial curative treatment were enrolled. The association between podoplanin expression and NLM was immunohistochemically analyzed, with a focus on tongue SCC with low TBG. The disease-specific survival (DSS) rate was 77% at 5 years, and a significant difference was observed between the NLM-positive and NLM-negative groups, and between the low (n=77) and high (n=22) TBG groups. In the low TBG group, there was a significant difference in DSS between the NLM-positive and NLM-negative groups. The multivariate analysis showed that lymphatic vessel invasion (ly) [odds ratio (OR)=11.5, 95% confidence interval (CI): 1.50-87.6; P=0.02] and podoplanin expression (OR=7.07, 95% CI: 1.80-27.7; P=0.005) were significantly correlated with NLM. Furthermore, negative predictive values (NPV) of ly and podoplanin expression for NLM were 75% and 88%, respectively. Considering the balance of stratification case number adding to ratio, NLM-negative prediction by podoplanin was more significant than that by ly for the low TBG group. The results of the present study demonstrated that podoplanin expression in tumor budding is an independent and efficient predictor of NLM in the tongue SCC with low TBG. The low TBG and podoplanin-negative cases may be candidates for the wait and watch policy, therefore, reducing inappropriate elective neck lymph node dissections.

DOI： 10.3892/ol.2020.11358

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Background and study aims  This study aimed to investigate the diagnostic accuracy and utility of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) performed using a Franseen needle on solid pancreatic lesions. Patients and methods  This study included 132 consecutive lesions sampled by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) using a 22-G conventional needle and 95 consecutive lesions evaluated by EUS-FNB using a 22-G Franseen needle to evaluate solid pancreatic lesions at our medical center between July 2013 and November 2018. We used propensity-matched analysis with adjustment for confounders. Patient data were analyzed retrospectively. Results  Diagnostic accuracy was higher in the Franseen needle group (Group F; 91.6 %, 87 /95) than in the conventional needle group (Group C; 86.3 %, 82 /95), showing no significant difference ( P  = 0.36). In Group F, diagnostic accuracies for pancreatic head lesions and lesions sampled by transduodenal puncture were 98.0 % (48/49) and 97.9 % (46/47), respectively. These values were significantly higher than values in Group C ( P  = 0.013, 0.01). Group F displayed a significantly lower number of punctures. In terms of differentiating benign from malignant lesions, Group C showed 85.1 % sensitivity (74/87), 100 % specificity (8/8), 100 % positive predictive value (74/74), and 38.1 % negative predictive value (8/21), compared to values of 90.1 % (73/81), 100 % (14/14), 100 % (73/73), and 63.6 % (14/22), respectively, in Group F. Sensitivity and negative predictive value were better in Group F. Conclusions  Franseen needles for EUS-FNB of solid pancreatic lesions offer similar puncture performance at different lesion sites while requiring fewer punctures than conventional needles.

DOI： 10.1055/a-0957-3005

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Language：Japanese   Publisher：(公社)日本臨床細胞学会  

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Publishing type：Research paper (scientific journal)   Publisher：BMC  

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Language：English   Publishing type：Research paper (scientific journal)  

Objectives While bile duct brush cytology during endoscopic retrograde cholangiopancreatography (ERCP) is a well-established procedure for detecting malignant biliary stricture, its sensitivity is reportedly low. We aimed to determine the pre-ERCP factors affecting brush cytology sensitivity. Methods We retrospectively analyzed 185 patients who underwent brush cytology during the first ERCP for undiagnosed biliary stricture at our institution between January 2014 and December 2016. We analyzed the relationship of age, sex, final diagnosis, stricture location, tumor size, stricture length, total bilirubin level, white blood cell count, and C-reactive protein level with brush cytology sensitivity. Results The following conditions were established as final diagnoses: benign disease, 19 cases (10.3%); intrahepatic cholangiocarcinoma, 10 cases (5.4%); hilar cholangiocarcinoma, 38 cases (20.5%); extrahepatic cholangiocarcinoma, 44 cases (23.8%); pancreatic cancer, 55 cases (29.7%); other malignant tumors, 19 cases (10.3%). The sensitivity and specificity of brush cytology were 60.8% and 94.7%, respectively. The stricture length, total bilirubin level, and white blood cell count in true-positive cases were significantly higher than those in false-negative cases. Furthermore, a stratified analysis of the bilirubin levels demonstrated that sensitivity was highest in patients with moderate jaundice (80% for a total bilirubin level of 10-20 mg/dL), but significantly lower in patients with severe jaundice (total bilirubin level ≥20 mg/dL). Conclusion While the sensitivity of brush cytology increases with bilirubin levels of up to 20 mg/dL, severe jaundice has a negative effect on sensitivity, warranting additional pathological examinations according to the pre-ERCP bilirubin level.

DOI： 10.2169/internalmedicine.1551-18

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The present case report describes a case of left renal clear cell carcinoma with brain, lung, para-aortic, and lymph node metastases (cT1bN1M1) in a 52-year-old Japanese male. The patient received sequential anticancer treatments with pazopanib, everolimus, and axitinib, but exhibited treatment-resistant tumor growth. Treatment with nivolumab resulted in a complete response in metastatic sites. However, the residual renal tumor, which was enhanced by contrast medium, required radical nephrectomy. Pathological analyses of the renal tumor revealed that it consisted of fibrotic and lymphocyte-infiltrated tissues in which morphological cancer cells were not detected. The majority of lymphocytes were cluster of differentiation (CD)8-positive, suggesting that cancer cells were attacked by these lymphocytes. Retrospective analyses of renal cell carcinoma tissues, which were biopsied before the anticancer treatment, revealed their infiltration by CD8-positive T cells. To the best of our knowledge, this is the first case report to examine renal tissue prior to and following treatment with nivolumab using immunohistochemical analysis.

DOI： 10.3892/mco.2018.1779

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The differential diagnosis of gastrointestinal subepithelial lesions (SELs) such as gastrointestinal stromal tumors from other benign tumors is important. In the present study, adequate sample rates of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with a 22G Franseen needle for SELs were evaluated. The present study included 57 consecutive lesions (61 sessions) of EUS-FNA using a 22G needle to evaluate SELs between July 2013 and October 2017. Adequate sample rates were compared retrospectively between a 22G conventional needle group (C group) and a 22G Franseen needle group (F group). The overall adequate sample rate was 80.3%. The adequate sample rates in the C and F groups were 75.0% (33/44) and 94.1% (16/17), respectively (P=0.15). For lesions ≥20 mm, the adequate sample rates were 82.8% (24/29) in the C group and 91.7% (11/12) in the F group, 8.9% higher in the F group. However, for lesions <20 mm, the adequate sample rates were 60% (9/15) in the C group and 100% (5/5) in the F group, 40% higher in the F group (P=0.65, 0.26). In conclusion, the results of the present study suggested that using a 22G Franseen needle for EUS-FNA evaluation of SELs may improve adequate sample rates in small lesions <20 mm in diameter.

DOI： 10.3892/mco.2018.1709

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Spandidos Publications  

Histone deacetylase (HDAC) inhibitor is known to have a cytotoxic effect on ovarian cancer cell lines. The present study analyzed the association between immunohistochemical HDAC expression and clinicopathological findings, in particular, the association with histological type and effect of chemotherapy. The histology of the 201 ovarian cancers addressed was as follows: Serous carcinoma (SEC), 100 cases
clear cell carcinoma (CCC), 56 cases
endometrioid carcinoma (EMC), 36 cases
and mucinous carcinoma (MUC), 9 cases. Immunohistochemical analyses of HDACs 1, 2, 3, 4, 5, 6 and 7 expression levels were performed using tissue microarrays, composed of 201 primary tumors and 38 tumors following chemotherapy. Overexpression of HDAC1 was detected in the nucleus of all cases with MUC, followed by CCC (80%), SEC (73%), and EMC (53%). CCC specifically demonstrated HDAC7 expression in both the nucleus (27%) and the cytoplasm (54%), and HDAC6 expression in the nucleus (34%). The comparison between prior to and following chemotherapy revealed a nuclear expression increase in HDAC1 (76% vs. 92%
P=0.03) and HDAC7 (0.0 vs. 16%
P=0.01), and cytoplasmic expression increase in HDAC6 (40 vs. 74%
P=&lt
0.01) and HDAC7 (16 vs. 66%
P=&lt
0.01). HDAC1 nuclear expression adversely affected overall survival in SEC (P=0.02) and EMC (P=0.03), and HDAC7 cytoplasmic expression in CCC was associated with a poor prognosis (P=0.06). In multivariate analysis, HDAC6 nuclear expression was determined as a poor prognostic factor (hazard ratio=3.51
95% confidence interval, 1.49 to 8.27, P=&lt
0.01). In the subgroup analysis, HDAC6 nuclear expression was associated with a poor prognosis in CCC (P=0.07), International Federation of Obstetrics and Gynecology stage III/IV (P=0.07), and suboptimal surgery (P=&lt
0.01). In conclusion, HDACs may be associated with the prognosis of ovarian cancers, depending on the histological subtypes, and upregulated following chemotherapy. HDAC1, 6 and 7 may therefor act as promising therapeutic targets in the future.

DOI： 10.3892/ol.2018.7726

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DOI： 10.1016/j.vgie.2017.11.010

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DOI： 10.1016/j.gie.2017.04.033

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Granular cell tumors are uncommon neoplasms and a small number of these neoplasms have been reported as showing malignant behavior. Here, we report a rare case of a solitary granular cell tumor that exhibited atypical histology, including an extensive desmoplastic stroma, in a 69-year-old woman. The surgical specimen revealed localized areas of spindling cells, areas of cellular pleomorphism, and p53 overexpression. Based on previously published criteria, we classified this lesion as an atypical granular cell tumor. To date, only very few case reports have documented this desmoplastic variant of granular cell tumor. However, the classifications of benign, atypical, and malignant granular cell tumors are still controversial, owing to an overlap of morphological and immunohistochemical profiles and lack of consistent histological criteria. Additionally, it is unknown whether the histology of the desmoplastic variant in the present case is significant for the classification of granular cell tumors and prediction of patient prognosis. Regardless of these issues, awareness, and close follow-up are required because of potential recurrences of this rare variant of granular cell tumor.

DOI： 10.1097/DAD.0000000000000760

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Gastroenterological Endoscopy Society  

<p>The association between esophageal squamous cell carcinoma and esophageal achalasia has been well known. However, almost all cases of esophageal carcinoma are in the advanced stage when they are detected. We herein report a case of coexisting superficial esophageal carcinoma with esophageal achalasia and successful treatment with minimally invasive surgical modalities. A 74-year-old woman was referred for the treatment of superficial carcinoma of the esophagus associated with esophageal achalasia. She has been suffering from achalasia for the past 20 years. Periodic endoscopic examination detected slightly depressed irregular mucosa in the upper thoracic esophagus, and histopathological examination of biopsy specimens revealed squamous cell carcinoma. Magnified narrow band imaging during endoscopic examination showed irregular intra-epithelial capillary loops in the lesion and we diagnosed the depth of tumor invasion as T1a-LPM. Esophageal achalasia was diagnosed as the sigmoid type and the maximum diameter of the esophagus was 4.5 cm as observed on barium swallow. We first performed endoscopic submucosal dissection (ESD) of the superficial esophageal carcinoma. Histopathological findings of the resected specimen revealed squamous cell carcinoma and the tumor invaded the lamina propria mucosa (LPM) without any vascular invasion. Four months later, we performed laparoscopic surgery for esophageal achalasia. She is well and alive without tumor recurrence and without any symptoms related to esophageal achalasia.</p>

DOI： 10.11280/gee.59.1403

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Publishing type：Research paper (scientific journal)   Publisher：学研メディカル秀潤社  

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Publishing type：Research paper (scientific journal)   Publisher：学研メディカル秀潤社  

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Publishing type：Research paper (scientific journal)   Publisher：学研メディカル秀潤社  

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Publishing type：Research paper (scientific journal)   Publisher：学研メディカル秀潤社  

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Publishing type：Research paper (scientific journal)   Publisher：学研メディカル秀潤社  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

The aim of this study was to investigate the prevalence of Lynch syndrome among Japanese patients with surgically resected colorectal cancer at a single institution.
Of 616 colorectal cancer patients who underwent surgical operation in our institution from January 2005 to August 2010, immunohistochemistry analyses for mismatch repair proteins (MLH1, MSH2, MSH6, and PMS2) and microsatellite instability (MSI) testing for surgically resected, formalin-fixed paraffin-embedded colorectal cancer specimens from 138 colorectal cancer patients under 60 years of age were undertaken. Hypermethylation of the MLH1 promoter and BRAF mutation were analyzed where necessary.
Seven patients were identified as candidates for genetic testing by mismatch repair protein loss (n = 7) or MSI-H (n = 6). Methylation of MLH1 was detected in one case. Three patients were diagnosed with Lynch syndrome, comprising 2.2 % of the total colorectal cancer patients younger than 60 years of age.
The prevalence of Lynch syndrome among hospital-based diagnosed cancer patients may therefore be lower than expected in Japan compared with Western populations.

DOI： 10.1007/s00595-015-1232-1

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Other Link： http://search.jamas.or.jp/link/ui/2016076057

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Publishing type：Research paper (scientific journal)   Publisher：医学書院  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Surgical Association  

The patient in our case was a 90-year-old man with a medical history of resection of the lower anterior rectum for the treatment of a rectal carcinoid tumor 24 years previously. The possibility of the presence of right pleural fluid was considered ; however, this possibility was ruled out by his chest radiography results. Computed tomography (CT) showed the presence of a tumor lesion in the S5 region of the liver. However, his chest CT findings were normal. At first, we intended to resect the intrahepatic bile duct tumor, but considering the patient's old age, we performed a partial S5 liver resection. The results of a histological examination led to the diagnosis of a neuroendocrine tumor (NET) ; the disease was later identified as liver metastasis of the rectal carcinoid tumor that was resected 24 years previously. At present, 7 months after the surgery, the patient is still alive without recurrence. In general, rectal carcinoid tumor is thought to be a low-grade tumor. Thus, tumor progression is slow. Therefore, the possibility of recurrence after a long period of time should be considered during treatment of patients with a medical history of a rectal carcinoid tumor.

DOI： 10.3919/jjsa.76.2263

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Other Link： http://search.jamas.or.jp/link/ui/2015405509

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Surgical Association  

The sigmoid colon, and rectum are major sites of endometriosis development, but in contrast, small intestinal endometriosis is rare. We encountered a case of endometriosis of the ileum with endosalpingiosis in the regional lymph node treated surgically because of recurrent bowel obstructive symptoms. A 50-year-old woman presented with recurrent bouts of bowel obstruction, the cause of which could not be determined through multiple evaluations. She was re-hospitalized because of recurrent abdominal distension. Although an abdominal computed tomography revealed a suspected tumorous lesion in the terminal ileum and dilated small bowel, we could not determine the final diagnosis. Exploratory laparotomy was performed for recurrent bowel obstruction. Serosa of the terminal ileum exhibited scarring with induration, resulting in bowel obstruction, and ileocecal resection was performed. Histological examination revealed glandular structures of various sizes comprising cubical and columnar epithelium surrounded by spindle cells from the subserosal to submucosal layers of the ileum. As we observed glandular structures comprising cubical epithelium in the regional lymph node, we diagnosed the case as bowel obstruction caused by endometriosis of the ileum with metastatic involvement of endosalpingiosis in the regional lymph node.

DOI： 10.3919/jjsa.76.2220

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Other Link： http://search.jamas.or.jp/link/ui/2015405501

Publishing type：Research paper (scientific journal)   Publisher：日本臨床  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Other Link： http://search.jamas.or.jp/link/ui/2015046823

Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Lymphoreticular Tissue Research  

A 35-year-old man was referred to our hospital because of left supraclavicular and cervical lymphadenopathies. Histopathological examination of the lymph nodes revealed reactive lymphadenopathy. He visited our hospital three years after the initial diagnosis because of enlarged left cervical lymph nodes. Histopathologically, both Hodgkin/Reed-Sternberg (H/RS) and lymphocyte-predominant (LP) cells were found in the lymph node. We first suspected nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), because these cells were CD15^- and CD30^-. However, the diagnosis of lymphocyte-rich classical Hodgkin lymphoma (LRCHL) was finally confirmed, because these cells were found to be CD20^-, Bob.1⁺, Oct.2^-, and BCL6^- by additional immunostaining. The patient was treated with six cycles of ABVD chemotherapy, and a complete response was achieved. However, he underwent autologous stem-cell transplantation after high-dose chemotherapy owing to a relapse 10 months after primary treatment. Distingushing LRCHL from NLPHL was difficult in this patient, because histopathological examination showed both H/RS and LP cells, and immunostaining revealed these cells to be triple negative (CD15^-, CD30^- and CD20^-). Accumulation of such cases are necessary to establish better criteria for the differential diagnosis and assessment of clinical behavior.

DOI： 10.3960/jslrt.55.23

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Other Link： http://search.jamas.or.jp/link/ui/2016174984

Publishing type：Research paper (scientific journal)   Publisher：医学書院  

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Publishing type：Research paper (scientific journal)   Publisher：医学書院  

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：京都府立医科大学  

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Other Link： http://search.jamas.or.jp/link/ui/2014307872

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Publishing type：Research paper (scientific journal)   Publisher：文光堂  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Other Link： http://search.jamas.or.jp/link/ui/2013338152

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Gastroenterological Endoscopy Society  

Background and Aim : Presently, the differential diagnosis of gastric adenoma and well-differentiated adenocarcinoma by endoscopy is very difficult. We carried out magnifying endoscopy with narrow band imaging (NBI) in lesions that required discrimination between gastric adenoma and well-differentiated adenocarcinoma, and prospectively evaluated whether the tumor typing that we propose is useful for their differential diagnosis.<BR>Methods : The materials were 93 lesions that required differential diagnosis between gastric adenoma and welldifferentiated adenocarcinoma among the gastric epithelial tumors for which endoscopic treatment was planned at three facilities during the 14 months between November 2008 and December 2009. According to the typing method proposed by our facility based on images of the mucosal ultrastructure and microvessels obtained by magnified endoscopy combined with NBI, type I-II and type III-V lesions were diagnosed as gastric adenoma and well-differentiated adenocarcinoma, respectively, before endoscopic treatment, and the accuracy of the diagnoses were prospectively examined by comparing them with the postoperative pathological findings.<BR>Results : Of the 93 lesions, 87 could be typed into the five types of our typing method, but six lesions could not be classified. The 87 lesions consisted of 16 type I, 12 type II, 29 type III, 27 type IV, and three type V lesions. The percentages of accurate preoperative diagnoses of types I-II as adenoma and types III-V as well-differentiated adenocarcinoma were 79% and 93%, respectively.<BR>Conclusions : The tumor typing based on NBI was useful for the endoscopic differentiation of gastric adenoma and well-differentiated adenocarcinoma.

DOI： 10.11280/gee.55.2050

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：International College of Surgeons  

This retrospective study investigated the clinicopathologic characteristics and clinical outcomes of esophageal basaloid squamous carcinoma (BSC). Among 190 patients with esophageal carcinoma treated surgically between 1998 and 2011, we identified 9 (4.7%) with BSC. All of the patients were male, with a median age of 65 years. The frequencies of venous invasion, lymphatic invasion, and lymph node metastasis were 56%, 89%, and 67%, respectively. A total of 2 patients were pathologic stage 1, 5 were stage 2, and 2 were stage 3. Tumor recurrence was observed in 56% of the patients. The 5-year survival rate for patients with esophageal BSC was 40%, which was compatible with the figure of 53.8% for control patients (n=18) with typical squamous cell carcinoma matched for sex, age, tumor location, and pathologic stage (P = 0.45). Although esophageal BSC shows aggressive lymph-vascular invasion and has a high likelihood of recurrence, its prognosis seems identical to that of typical squamous cell carcinoma.

DOI： 10.9738/CC195

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Recently, we reported a case of gastric mucosa-associated lymphoid tissue (MALT) lymphoma presenting with unique vascular features. In the report, we defined the tree-like appearance (TLA) on the images of abnormal blood vessels which resembled branches from the trunk of a tree in the shiny mucosa, in which the glandular structure was lost. The 67-year-old female was diagnosed with gastric MALT lymphoma. The patient received eradication therapy for H. pylori. Conventional endoscopy revealed multiple ill-delineated brownish depressions in the stomach and cobblestone-like mucosa was observed at the greater curvature to the posterior wall of the upper gastric body 7 mo after successful eradication. Unsuccessful treatment of gastric MALT lymphoma was suspected on conventional endoscopy. Conventional endoscopic observations found focal depressions and cobblestone-like appearance, and these lesions were subsequently observed using magnified endoscopy combined with narrow band imaging to identify abnormal vessels presenting with a TLA within the lesions. Ten biopsies were taken from the area where abnormal vessels were present within these lesions. Ten biopsies were also taken from the lesions without abnormal vessels as a control. A total of 20 biopsy samples were evaluated to determine whether the diagnosis of MALT lymphoma could be obtained histologically from each sample. A positive diagnosis was obtained in 8/10 TLA (+) sites and in 2/10 TLA(-) sites. Target biopsies of the site with abnormal blood vessels can potentially improve diagnostic accuracy of gastric MALT lymphoma.

DOI： 10.4253/wjge.v4.i4.151

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

The interpretation of colonic biopsies related to inflammatory conditions can be challenging because the colorectal mucosa has a limited repertoire of morphologic responses to various injurious agents. Only few processes have specific diagnostic features, and many of the various histological patterns reflect severity and duration of the disease. Importantly the correlation with endoscopic and clinical information is often cardinal to arrive at a specific diagnosis in many cases.

DOI： 10.1007/s00535-012-0539-6

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Gastroenterological Endoscopy Society  

Objective : The purpose of this study was : (1) to observe, via narrow band imaging (NBI) magnifying endoscopy, discolored depressed lesions, in which the differential diagnosis included gastric adenoma and well-differentiated adenocarcinoma, and which were classified as Group III by biopsy ; (2) to characterize them by their endoscopic appearance ; and (3) to evaluate the usefulness of our previously reported system (which is useful for the diagnosis of IIa-like gastric lesions) for the classification of these lesions by type.<BR>Methods : Nine discolored depressed lesions, classified as Group III by biopsy, were studied in patients who had undergone conventional endoscopy and NBI magnifying endoscopy in our department during the 16 months between November 2008 and February 2010. These lesions were observed with NBI magnifying endoscopy, classified according to our proposed system of type classification, and compared with the results of the pathological examination of the resected specimens and with 59 discolored, flat-elevated lesions (classified as Group III by biopsy) that had been observed during the same period.<BR>Results : Pathological examination of all nine resected specimens led to a diagnosis of well-differentiated adenocarcinoma. Based on NBI magnification findings, 0, 0, 2, 3, and 4 lesions were classified as Type I, II, III, IIIs, and IV, respectively. The discolored depressed lesions resembled elevated lesions with a depression, such as type IIa+IIc, with respect to NBI findings, pathological features, and the site of the lesion.<BR>Conclusion : These results suggest that our proposed system of type classification is also useful for the differential diagnosis of benign vs. malignant, discolored, depressed lesions.

DOI： 10.11280/gee.54.11

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：COLLEGE AMER PATHOLOGISTS  

DOI： 10.5858/arpa.2011-0376-LE

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

We present a 69-year-old woman with a chief complaint of postmenopausal bleeding. She was diagnosed as having an endometrioid adenocarcinoma by biopsy, and underwent a total abdominal hysterectomy. At the time of surgery, granulation tissue-like nodules were found on the peritoneal serosa of the uterus. In the intraoperative cytology of peritoneal washing, atypical cells were noted. The intraoperative frozen section of the peritoneal nodule revealed granulation tissue with proliferating mesothelial cells. Microscopic examination of the permanent section showed keratin granulomas without viable adenocarcinoma cells on the serosal surface of the ovaries, fallopian tubes and broad ligaments. Postoperative chemotherapy was administered. She has been alive with no evidence of recurrence for 6 months postoperatively. It should be noted that the prognosis of cases in peritoneal keratin granuloma without viable cancer cells is favorable, and that the histological examination is essential for its diagnosis.

DOI： 10.1186/1746-1596-6-104

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Background and Aim:
Presently, the differential diagnosis of gastric adenoma and well-differentiated adenocarcinoma by endoscopy is very difficult. We carried out magnifying endoscopy with narrow band imaging (NBI) in lesions that required discrimination between gastric adenoma and well-differentiated adenocarcinoma, and prospectively evaluated whether the tumor typing that we propose is useful for their differential diagnosis.
Methods:
The materials were 93 lesions that required differential diagnosis between gastric adenoma and well-differentiated adenocarcinoma among the gastric epithelial tumors for which endoscopic treatment was planned at three facilities during the 14 months between November 2008 and December 2009. According to the typing method proposed by our facility based on images of the mucosal ultrastructure and microvessels obtained by magnified endoscopy combined with NBI, type I-II and type III-V lesions were diagnosed as gastric adenoma and well-differentiated adenocarcinoma, respectively, before endoscopic treatment, and the accuracy of the diagnoses were prospectively examined by comparing them with the postoperative pathological findings.
Results:
Of the 93 lesions, 87 could be typed into the five types of our typing method, but six lesions could not be classified. The 87 lesions consisted of 16 type I, 12 type II, 29 type III, 27 type IV, and three type V lesions. The percentages of accurate preoperative diagnoses of types I-II as adenoma and types III-V as well-differentiated adenocarcinoma were 79% and 93%, respectively.
Conclusions:
The tumor typing based on NBI was useful for the endoscopic differentiation of gastric adenoma and well-differentiated adenocarcinoma.

DOI： 10.1111/j.1443-1661.2010.01070.x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

The development of modern endoscopic techniques, easier and greater access to healthcare, and interest in Helicobacter pylori infection and its implications have all led to a significant increase in upper endoscopies. In turn, gastroenterologists and pathologists have been recognizing an ever-increasing number of patterns of mucosal injury. Consequently, there is now an interest in a wider aspect of non-neoplastic gastric pathology, namely, non-HP (H. pylori) gastritis. In this review, we present major clinico-pathological entities, based on either the salient morphological features or the underlying etiologies.

DOI： 10.1007/s00535-009-0146-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

Recently, dermoscopic visualization has been improved, allowing for the identification of malignant melanoma (MM) of the sole in situ. When the parallel ridge pattern is evident on dermoscopy, the proliferation of solitarily arranged melanocytes in the crista profunda intermedia should be examined histologically, since this may be a clue to the early diagnosis of MM in situ. We reviewed 145 Japanese cases of melanocytic nevus on the sole, and investigated several useful histological features for the diagnosis of MM in situ using a recent proposal as well as several standard histological criteria of MM in situ. Five cases were considered to be an early-stage MM in situ out of 145 cases previously diagnosed as melanocytic nevi of the sole. These cases showed several specific features, including solitarily arranged melanocytes or melanocyte nests comprising fewer than four cells. Our findings indicate that early-stage MM of the sole in situ can be diagnosed by using new dermoscopy-related histological findings. They are (i) irregular distribution of solitary melanocytes at the crista profunda intermedia with or without small nests (up to three melanocytes) on the slope of rete ridges; and (ii) larger melanocytes with a halo around the nucleus.

DOI： 10.1111/j.1440-1827.2009.02483.x

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Gastroenterological Endoscopy Society Kanto Chapter  

A 73-year-old male patient underwent esophagectomy and reconstruction using a colon via antethoracic route for esophageal cancer in 1994. He had been followed up with an upper gastrointestinal endoscopy for five years after surgery. He presented to his family physician with fever and coughing. His doctor introduced him to the department of the pulmonary disease at our hospital because of the elevation of CEA and CYFRA. He received CT and PET. PET showed SUV uptake in colonic interposition. He received an upper gastrointestinal endoscopy and laterally spreading tumors were identified. These lesions were considered a good candidate for endoscopic resection. The lesions were safely and completely removed by ESD and EMR. Histological examination diagnosed the specimen as high grade tubular adenoma. The patient was hospitalized for 4 days after endoscopic treatment to confirm the absence of complications such as delayed perforation and bleeding, and was then discharged.<br> Upper endoscopic screening is recommended after five years follow up of colonic interposition and lesions may be detected early and removed safely by endoscopy.

DOI： 10.11641/pde.77.2_60

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Gastroenterological Endoscopy Society Kanto Chapter  

A 73-year-old male patient underwent esophagectomy and reconstruction using a colon via antethoracic route for esophageal cancer in 1994. He had been followed up with an upper gastrointestinal endoscopy for five years after surgery. He presented to his family physician with fever and coughing. His doctor introduced him to the department of the pulmonary disease at our hospital because of the elevation of CEA and CYFRA. He received CT and PET. PET showed SUV uptake in colonic interposition. He received an upper gastrointestinal endoscopy and laterally spreading tumors were identified. These lesions were considered a good candidate for endoscopic resection. The lesions were safely and completely removed by ESD and EMR. Histological examination diagnosed the specimen as high grade tubular adenoma. The patient was hospitalized for 4 days after endoscopic treatment to confirm the absence of complications such as delayed perforation and bleeding, and was then discharged.<br> Upper endoscopic screening is recommended after five years follow up of colonic interposition and lesions may be detected early and removed safely by endoscopy.

DOI： 10.11641/pde.77.2_60

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

We investigated the presence of lymphatic invasion detected by D2-40 immunostaining compared to conventional hematoxylin-eosin (HE) staining in primary pancreatic cancer. We also compared the alkaline phosphatase-fast red detection method with the 3,3&apos;-diaminobenzidine (DAB) detection method. We reviewed 25 cases of pancreatic cancer with lymph node (LN) metastases and 15 cases without LN metastases and evaluated the detection rate of lymphatic invasion by HE stain slide alone and D2-40 immunostains. Regarding the cases with positive LN metastasis, 4 (16%) of the 25 cases showed lymphatic invasion by HE slide alone, whereas 7 cases (28%) demonstrated positive lymphatic invasion by D2-40 immunostain. On the other hand, even in cases with negative LN metastasis, 3 of the 15 cases revealed lymphatic invasion by D2-40 immunostaining. Lymphatic invasion was easily detected by alkaline phosphatase-fast red technique, especially at the lower magnification. Regarding the location of lymphatic invasion, it was recognized not only at the peripheral portion but also in the central part of the tumors by D2-40 immunostains; this was difficult to identify by HE stain slide alone. Our study indicates that lymphatic invasion may be overlooked when only HE stain slides are used. In addition, the alkaline phosphatase-fast red detection method (vivid red color) is a distinctive advantage compared with the DAB detection method (brown color), especially in detecting lymphatic invasion at the lower magnification. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.anndiagpath.2009.03.002

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Focal nodular hyperplasia (FNH) of the liver is considered to develop as a hyperplastic response to a preexisting vascular abnormality. From the pathogenic point of view, we studied histological alterations in the extranodular background liver tissue of FNH (FNH-bg-liver). We compared ten FNH-bg-livers with ten non-FNH cases (non-FNH-liver) and found small uniform nodule formations with ring-like siderosis in the FNH-bg-livers (4/7, 57%) but not in the non-FNH-livers. Abnormal small arteries not accompanied by portal tracts were observed in six of six FNH-bg-livers for which immunohistochemical study was available, while this was observed in only three of the ten non-FNH-livers. CD34-positive sinusoids around the portal tracts were observed in only the FNH-bg-livers (3/6, 50%). Further, two of ten FNH-bg-livers had ectopic pancreatic tissue. Ring-like siderosis, abnormal small arteries, CD34-positive sinusoids, and ectopic pancreatic tissue were characteristic in the extranodular background liver tissue in cases of FNH.

DOI： 10.1007/s00428-009-0743-9

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Language：English   Publisher：SPRINGER TOKYO  

With regard to the esophagus, the term "squamous dysplasia" has been used in European countries, the United States, and China, while its use is controversial in Japan. Recently, "low-grade intraepithelial neoplasia" and "high-grade intraepithelial neoplasia" have been used as inclusive terms for dysplasia and carcinoma in situ in the World Health Organization classification. Endoscopically, it is often difficult to identify squamous intraepithelial neoplasia by conventional endoscopy, but application of iodine is useful for the diagnosis of such a lesion. In addition, new types of endoscopic techniques, including magnifying endoscopy, narrow-band imaging (NBI), and endocytoscopy are helpful to detect squamous intraepithelial neoplasia. NBI is very useful for identifying the intrapapillary capillary loop pattern. Regarding the pathological criteria of squamous dysplasia and squamous cell carcinoma, the views of Japanese and Western pathologists have differed significantly. Before the term "intraepithelial neoplasia" was introduced, severe dysplasia as diagnosed by Western pathologists was in fact the same as squamous cell carcinoma in situ or noninvasive carcinoma as diagnosed by Japanese pathologists. This problem has been solved by the introduction of the Vienna classification; however, there are still some issues that need to be resolved. One of them is the presence of basal layer type squamous cell carcinoma in situ, which is often underdiagnosed as lowgrade intraepithelial neoplasia by Western pathologists. Endoscopic treatments such as endoscopic mucosal resection and endoscopic submucosal dissection have recently become possible choices for squamous intraepithelial neoplasia; however, these techniques are not in widespread use in the West. We believe that a consensus meeting between Japanese and Western pathologists as well as endoscopists should be held promptly to reach a common ground for the nomenclature.

DOI： 10.1007/s00535-008-2298-y

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

In this review article, we demonstrate the mucin expression profile in normal tissue, invasive ductal carcinoma (IDC), two subtypes of intraductal papillary-mucinous neoplasm (IPMN dark cell type and IPMN clear cell type), pancreatic intraepithelial neoplasia (PanIN), and mucinous cystic neoplasm (MCN) of the pancreas. In MUC1, there are various glycoforms, such as poorly glycosylated MUC1, sialylated MUC1, and fully glycosylated MUC1. IDCs showed high expression of all the glycoforms of MUC1. IPMNs dark cell type showed no expression or low expression of all the glycoforms of MUC1. IPMNs clear cell type showed low expression of poorly glycosylated MUC1, but expression of sialylated MUC1 and fully glycosylated MUC1. Expression of MUC2 was negative in IDCs, high in IPMNs dark cell type and low in IPMNs clear cell type. MUC5AC was highly expressed in IDCs, IPMNs dark cell type, and IPMNs clear cell type. MUC6 expression was higher in IPMNs clear cell type than in IDCs and IPMNs dark cell type. Our recent study demonstrated that high expression of MUC4 in IDCs is correlated with a poor outcome for patients. In PanINs, expression of both MUC5AC and MUC6 are an early event, whereas up-regulation of MUC1 is a late event. MCNs do not look as if they will show a specific mucin expression profile according to the literature review.

DOI： 10.1007/s00534-006-1169-2

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japan Society of Coloproctology  

Anorectal malignant melanoma is a rare disease, and patients with this disease have a poor prognosis. Herein, we report a rare case of anorectal malignant melanoma with long survival by surgical resection and immunosurveillance therapy.<br>A 69-year-old female visited our hospital complaining of melena. Anorectal malignant melanoma was suspected by colonoscopy. After local resection in January 1998, the patient was diagnosed as anorectal malignant melanoma by pathologic analysis, and abdominoperineal excision of the rectum and lymphadenectomy were performed. After the first operation, each recurrence of the disease occurred in the small intestine, paracardiact fat, left mammary gland and axillary lymph nodes or gluteal fat between January 2000 through January 2003. Each recurrent lesion was removed by surgery. In addition, immunosurveillance therapy against the disease has been performed since April 2000, and no signs of recurrence in the patient have been observed to date.<br>In conclusion, surgical resection could be useful in the therapy for anorectal malignant melanoma.

DOI： 10.3862/jcoloproctology.60.146

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Other Link： http://search.jamas.or.jp/link/ui/2007150693

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：TAYLOR & FRANCIS INC  

A 7-month-old infant was noted to have vaginal bleeding that was accompanied by a discharged tumor fragment. The histological diagnosis was endodermal sinus tumor. Her serum alpha-fetoprotein (AFP) was increased to 358.7 ng/mL, and magnetic resonance imaging showed a 1.8 x 1.0 cm tumor in the vagina. She received combination chemotherapy with cyclophosphamide, pirarubicin, carboplatin, and etoposide. The tumor in the images disappeared and the serum level of AFP returned to the normal range after 2 cycles. Treatment was complete without surgical or radiological therapy. More than 45 months after the completion of chemotherapy, she is alive without signs of recurrence.

DOI： 10.1080/08880010600856972

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Gastroenterological Surgery  

We report a case of adenosquamous carcinoma of the rectum with synchronous multiple liver and bone metastases. A 73-year-old woman was admitted to our hospital complaining of narrow stools and lumbago. A biopsy specimen histologically revealed a poorly differentiated adenocarcinoma. She was diagnosed as having advanced rectal cancer with multiple liver metastases and bone metastasis based on imaging findings. She underwent a Hartmann operation for the relief of symptoms like bleeding and stenosis. Macroscopically, the type 3 tumor had a cross section of 3.0×3.0cm and was located in the rectum. Histological findings showed an adenosquamous carcinoma invading the subserosa with marked lymphatic and venous invasion. After the operation, she received combination chemotherapy with intrahepatic arterial infusion of 5-FU and intravenous infusion of CPT-11 and 1-LV, according to the chemotherapy protocol for colon cancer. The characteristics of a large number of patients with adenosquamous cell carcinoma of the colorectum should be collected and analyzed. Furthermore, to improve the clinical outcome of patients with multiple hematogeneous metastases, new adjuvant therapy using molecular and genetic approaches should be pursued.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING ASIA  

Our previous immunohistochemical studies in the pancreas, intrahepatic bile duct, and ampulla of Vater demonstrated that an invasive carcinoma with a poor outcome showed a pattern of MUC1 (membrane-bound mucin) positive and MUC2 (intestinal-type secretory mucin) negative, whereas many of the non-invasive tumors with favorable outcome showed a pattern of MUC1 negative and MUC2 positive. The aim of this study is to compare the expression profiles of MUC1 and MUC2 mucins in extrahepatic bile duct carcinomas to gain insight into the relationship between the biological nature of the carcinomas and the role of mucins. We examined the expression profiles of MUC1 of different glycoforms and MUC2 in 60 extrahepatic bile duct carcinomas using immunohistochemistry. The expression of MUC1/CORE (core peptide of MUC1), MUC1/DF3 (core peptide of MUC1 with sialyl oligosaccharides) and MUC1/MY.1E12 (sialylated MUC1) showed a significant relationship with tumor progression factors such as poor differentiation, deep invasion, lymph node metastasis, lymphatic invasion or perineural invasion. In contrast, the expression of MUC1/HMFG-1 (fully glycosylated MUC1) did not show a significant relationship with the tumor progression factors. In the different glycoforms of MUC1 examined, the expression of MUC1/DF3 and MUC1/MY.1E12 was related with the poor outcome of the patients. In contrast, the expression of MUC2 was inversely related with the tumor progression factors and poor outcome. In the 52 patients with advanced tumors, only MUC1/DF3 high expression correlated with poor prognosis. In conclusion, MUC1/DF3 was the most useful prognosis indicator among the various glycoforms of MUC1 mucins.

DOI： 10.1046/j.1440-1827.2002.01414.x

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Language：Japanese   Publisher：Japanese Society for Molecular Tumor Marker Research  

DOI： 10.11241/jsmtmr.18.61

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Responsible for pages：230-238   Book type：Scholarly book

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Language：Japanese   Publisher：(公社)日本臨床細胞学会  

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Language：Japanese   Publisher：(公社)日本臨床細胞学会  

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Language：Japanese   Publisher：日本医科大学医学会  

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Language：Japanese   Publisher：日本医科大学医学会  

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Language：English   Publisher：(一社)日本病理学会  

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Language：Japanese   Publisher：(一社)日本病理学会  

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J-GLOBAL

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Language：Japanese   Publisher：腎癌研究会  

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J-GLOBAL

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Language：Japanese   Publisher：(一社)日本リンパ網内系学会  

J-GLOBAL

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Language：Japanese   Publisher：(公社)日本臨床細胞学会  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本病理学会  

J-GLOBAL

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J-GLOBAL

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Other Link： http://search.jamas.or.jp/link/ui/2016074511

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Other Link： http://search.jamas.or.jp/link/ui/2015342122

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J-GLOBAL

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J-GLOBAL

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：MOSBY-ELSEVIER  

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Language：Japanese   Publisher：日本臨床外科学会  

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J-GLOBAL

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Language：Japanese   Publisher：(一社)日本消化器内視鏡学会  

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Language：Japanese   Publisher：(一社)日本大腸肛門病学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：MOSBY-ELSEVIER  

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Language：Japanese   Publisher：一般社団法人日本外科学会  

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Publisher：文光堂  

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Language：Japanese   Publisher：一般社団法人日本消化器外科学会  

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Language：Japanese   Publisher：(一社)日本大腸肛門病学会  

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：MOSBY-ELSEVIER  

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Language：Japanese   Publisher：一般社団法人日本外科学会  

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Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：English   Publisher：(一社)日本病理学会  

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Language：Japanese   Publisher：(一社)日本病理学会  

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Language：Japanese  

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Other Link： http://hdl.handle.net/10232/6571

Language：Japanese   Publisher：日本組織細胞化学会  

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Other Link： http://search.jamas.or.jp/link/ui/2006048320

Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：Japanese   Publisher：特定非営利活動法人日本臨床細胞学会  

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Language：Japanese   Publisher：一般社団法人日本消化器外科学会  

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Venue：東京  

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Venue：東京都新宿区  

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Venue：東京都新宿区  

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Venue：兵庫県神戸市  

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Venue：Washington, DC  

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Venue：東京都新宿区  

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Venue：東京都新宿区  

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Venue：福岡県久留米市  

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Venue：福岡県久留米市  

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Venue：兵庫県神戸市  

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Venue：大阪  

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Venue：Colorado, USA  

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Venue：金沢  

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Venue：京都  

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Venue：大阪  

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Venue：Vancouver, BC, Canada  

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Venue：青森  

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Venue：神奈川県横浜  

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Venue：兵庫県神戸市  

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Venue：兵庫県神戸市  

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Venue：San Antonio, USA  

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Venue：大阪，大阪国際会議場  

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