Biomedical subjects

A Iyoda

Publications and source records attributed to A Iyoda.

At least 19 recordsLinked to original sources

PubMed2001

Adjuvant chemotherapy for large cell carcinoma with neuroendocrine features.

BACKGROUND: In 1999, the World Health Organization categorized large cell neuroendocrine carcinoma, large cell carcinoma with neuroendocrine differentiation, and large cell carcinoma with neuroendocrine morphology as a variant of large cell carcinoma. Patients with large cell carcinoma with neuroendocrine features have poor prognoses, comparable to those for small cell lung carcinoma. Small cell lung carcinoma is sensitive to chemotherapy; however, it is still unclear whether large cell carcinoma with neuroendocrine features is responsive to adjuvant chemotherapy. METHODS: The authors analyzed 73 patients with large cell carcinoma with neuroendocrine features who underwent resection of the tumor and studied the effect of adjuvant chemotherapy for large cell carcinoma with neuroendocrine features. RESULTS: In patients with Stage I disease, the overall survival for patients with adjuvant chemotherapy based on cisplatin, carboplatin, or cyclophosphamide, which were used as standard chemotherapy for small cell lung carcinoma, were significantly higher than the overall survival for patients without adjuvant chemotherapy. In patients with Stage II, III, and IV disease, there was no significant difference between patients with adjuvant chemotherapy and without adjuvant chemotherapy. CONCLUSIONS: Adjuvant chemotherapy based on cisplatin, carboplatin, or cyclophosphamide prolongs survival of patients with large cell carcinoma with neuroendocrine features in early stage.

Adult↗

PubMed2001

Clinical characterization of pulmonary large cell neuroendocrine carcinoma and large cell carcinoma with neuroendocrine morphology.

BACKGROUND: Large cell carcinoma has been classified as four potential types based on its neuroendocrine morphology and evidence of neuroendocrine differentiation discernible by immunohistochemistry or electron microscopy. However, the clinical relation among these four categories has not been clearly defined. In 1999, the World Health Organization (WHO) categorized large cell neuroendocrine carcinoma as a variant of large cell carcinoma. MATERIAL AND METHODS The authors analyzed 119 cases of large cell carcinoma from a total of 2070 primary lung carcinoma cases resected surgically between 1969-1999. Using light microscopy, electron microscopy, and immunohistochemical staining, the authors reclassified these cases into large cell neuroendocrine carcinoma (LCNEC), large cell carcinoma with neuroendocrine differentiation (LCCND), large cell carcinoma with neuroendocrine morphology (LCCNM), and classic large cell carcinoma (CLCC). RESULTS: In multivariate analyses, the authors found that large cell carcinoma with neuroendocrine features, which combined LCNEC, LCCND, and LCCNM, impacted both the overall survival and disease-free survival of patients. The clinical behavior of LCCNM was similar to that of LCNEC. CONCLUSIONS: Large cell carcinomas with neuroendocrine features appear to be more clinically aggressive than CLCCs. The authors' findings suggest that the histologic identification of neuroendocrine features in tumor tissue from patients diagnosed with large cell carcinoma of the lung may have clinical relevance.

Adult↗

PubMed2001

Expression of vascular endothelial growth factor in thoracic sarcomas.

BACKGROUND: A body of data indicates that vascular endothelial growth factor (VEGF) expression by carcinomas is closely related to the prognosis of carcinomas. However, the relationship between VEGF expression and the prognosis of sarcomas is contradictory. METHODS: Tissue from 27 cases of thoracic sarcoma was analyzed immunohistochemically for VEGF expression while tumor vascularity was quantified using an antibody directed against endothelial CD34. The relationship between VEGF expression and the prognosis of patients with sarcomas was then evaluated semiquantitatively. RESULTS: The microvessel count in sarcomas with strong VEGF expression was significantly higher than that in sarcomas with absent or faint VEGF expression. The disease-free survival rates of sarcomas with strong VEGF expression were significantly lower than those of sarcomas with absent or faint VEGF expression. We found that strong VEGF expression impacted on the disease-free survival in multivariate analyses. CONCLUSIONS: VEGF expression of thoracic sarcomas is directly related to angiogenesis and tumor vascularity, and our findings suggest that strong VEGF expression is an independent prognostic factor in patients with thoracic sarcomas.

Adolescent↗

PubMed2000

Castleman's disease in the posterior mediastinum: report of a case.

We report a case of Castleman's disease which developed in the posterior mediastinum, with a review of the Japanese literature. A 19-year-old female patient with asthma was pointed out to have an abnormal shadow in the right posterior mediastinum on chest X-ray. We had tried to perform thoracoscopic surgery for this tumor, but we had to convert the surgical approach from thoracoscopy to a thoracotomy because of both tight adhesion of the tumor and muscle and profuse bleeding from the tumor. The tumor was diagnosed to be the hyaline vascular type of Castleman's disease histopathologically. In the Japanese literature, Castleman's disease, which develops in the posterior mediastinum, has been reported to often accompany tight adhesion between the tumor and surrounding tissue, and profuse bleeding thus cannot be avoided at surgery. The large amount of bleeding observed during the surgery of a patient with Castleman's disease in the posterior mediastinum may be due to tight adhesion and hypervascularity of the tumor. Therefore, care should be exercised in choosing the surgical approach if Castleman's disease is suspected in cases of posterior mediastinal tumor.

Adult↗

PubMed2000

Undifferentiated spindle-cell sarcoma of the chest wall with vascular endothelial growth factor expression: report of a case.

The expressions of some growth factors have been immunohistochemically confirmed in several kinds of tumors, and in particular the expression of vascular endothelial growth factor (VEGF) has been reported to be closely related to tumor cell proliferation. We report herein a case of undifferentiated spindle-cell sarcoma arising in the chest wall with VEGF expression. A 67-year-old man, who presented with coughing, was found to have an abnormal shadow on his right chest wall. He was admitted to Chiba Rosai Hospital and preoperative diagnosis of the tumor was sarcoma. The tumor was thus resected along with the right chest wall and right lower lobe of the lung. Histopathologically, the tumor cells were spindle-shaped and showed severe atypism. The tumor cells were positive for vimentin and VEGF antibody with immunohistochemical staining, but they did not show differentiation to any special type of sarcoma. The tumor was diagnosed to be undifferentiated spindle-cell sarcoma. The microvessel density of the tumor was measured using CD34 and it was found to be higher than the average density of usual sarcomas. The prognosis of this case was poor. The patient died of tumor metastasis to the lung and bone 1 year later in spite of the fact that the tumor was resected.

Aged↗

PubMed2000

Clear cell adenocarcinoma with endobronchial polypoid growth.

Clear cell adenocarcinoma of the lung is extremely rare. On radiography, a 45-year-old female with fever was found to have an abnormal shadow in the left lower lung field. Bronchoscopy revealed a polypoid tumor in the left bronchus. On biopsy, the tumor was determined to be adenocarcinoma. Preoperative examination found no tumors outside of the lung. The patient underwent left lower lobectomy with bronchial wedge resection. The tumor had completely obstructed and dilated the left lower bronchus, but had not invaded the tissue outside the bronchial wall. Microscopically, the cytoplasm of the tumor cells contained abundant glycogen, and the tumor had solid and glandular structures. The tumor was diagnosed as clear cell adenocarcinoma of the lung.

Adenocarcinoma, Clear Cell↗

PubMed1999

Descending necrotizing mediastinitis: report of a case.

A 47-year-old man was admitted to our hospital for treatment of an odontogenic infection. He presented with a fever, signs of sepsis, and neck swelling, and was initially diagnosed as having a neck abscess. After cervical drainage, he showed no improvement, and mediastinitis was detected by chest X-ray and computed tomography. A thoracotomy and mediastinal drainage was subsequently performed for descending necrotizing mediastinitis, which resulted in marked improvement. To date, only 83 cases of descending necrotizing mediastinitis have been reported in Japan. We present herein an additional case, followed by a review of the Japanese literature.

Drainage↗

PubMed1999

Human pulmonary dirofilariasis: report of six cases.

We report six cases of pulmonary dirofilariasis diagnosed at our laboratory with clinical and pathological features. The nodules of dirofilariasis were round in three cases as previously reported, however dumbbell-shaped in two cases. The nodule did not attach to the pleura in four cases. Microscopically, the nodules were granulomas composed of central coagulation necrosis and peripheral fibrosis with round cell infiltration, histiocytes, and multinucleated giant cells. Necrotic pulmonary artery with single or multiple sections of degenerated nematode was observed in the center of the nodule. Dilated bronchioles with inflammation were observed in the nodule in four cases. Collapse of the alveoli, organizing pneumonia, hemosiderin-laden macrophages were observed around the nodule. We suppose that the nodule is not an infarction but a granuloma caused by antigen released from the nematode. Because the pulmonary dirofilariasis is difficult to be differentiated from primary or metastatic lung carcinoma, and the inflammation exists around the nodule, the nodule should be removed surgically.

Aged↗

PubMed1998

[Detection of emphysematous bullae in spontaneous pneumothorax by three-dimensional computed topography].

The patient was a 20-year-old woman with spontaneous pneumothorax, who had had pneumothorax twice on each side. Three-dimensional computed topographic (CT) images were made as follows. The range 12.5 cm caudad from the pulmonary apex was scanned by rapid helical CT, and three-dimensional images were obtained with the surface-rendering technique at a voxel extraction threshold ranging-850 HU to 1,600 HU. The three-dimensional CT images provided a stereotactic rendering of the lung surface. Irregular findings were observed at both pulmonary apices; they indicated the presence of one emphysematous bulla in the right lung and many emphysematous bullae of various sizes in the left lung. These findings were highly consistent with the sites and structures of the emphysematous bullae, as observed during thoracoscopy, which suggests that three-dimensional CT is a useful method for diagnosing and evaluating emphysematous bullae in patients with spontaneous pneumothorax.

Adult↗

PubMed1997

[A resected case of diffuse malignant pleural mesothelioma diagnosed by thoracoscopic biopsy].

A 53-year-old male was admitted with cough and chest pain. A chest X-ray film showed left pleural effusion and a chest CT revealed irregular thickening of the pleura. Pleural fluid cytology and percutaneous needle biopsy were negative for malignancy. Thoracoscopic findings revealed fibrin network with pleural effusions and yellow-white pleural thickening, but neither nodules nor masses were found. The thoracoscopic biopsy specimen from the pleural thickening resulted in the diagnosis of malignant pleural mesothelioma. Left pleuropneumonectomy with mediastinal lymph node dissection was performed. Since detailed inspection of the pleural cavity and taking large biopsy samples under thoracoscopic examination are possible, we consider thoracoscopic biopsy to be a useful method for obtaining diagnosis of malignant pleural mesothelioma. Pleuropneumonectomy and systematic lymph node dissection of the pulmonary hilum and mediastinum were believed to be necessary for the surgical treatments.

Biopsy↗

PubMed1996

[Supraannular implantation of bioprosthetic valve for severe tricuspid valve regurgitation associated with atrial septal defect in an adult patient].

With an adult atrial septal defect, there was often regurgitation of the mitral and tricuspid valve due to volume overload in a long term period. Especially concerning tricuspid regurgitation, what can be done surgically has not yet been decided. For severe tricuspid regurgitation, some cases where tricuspid valve annuloplasty were performed have had exacerbation of tricuspid regurgitation. We experienced a case where tricuspid valve supraanular implantation without excision of native tricuspid valve (TVSI) was performed for severe tricuspid regurgitation associated with atrial septal defect, and improved. A 53-year-old female complained of dyspnea on exertion. An atrial septal defect was revealed being 4 cm in size, complicated with severe tricuspid regurgitation (IV), and 62 mmHg difference of pressure from the right atrium to right ventricle shown by a ultrasonography. Pulmonary artery pressure was 66/16 mmHg by cardiac catheter. Patch closure for ASD and TVSI for TR was performed on her, and amelioration of cardiac function was recognized.

Bioprosthesis↗

PubMed1995

[A case of diffuse malignant mesothelioma diagnosed by thoracoscopic biopsy].

We report a case of diffuse malignant mesothelioma discovered by thoracoscopic examination undertaken while formulating a preoperative diagnosis. A 61-year-old male complained of coughing and sputum production, and was admitted because his chest roentgenogram indicated an abnormal shadow. Chest CT scanning demonstrated right pleural effusion and multiple nodules sited on the diaphragm. Because aspiration biopsy of such nodules was difficult, we performed a thoracoscopic examination. The thoracoscopic findings demonstrated bloody pleural effusion in the right thoracic cavity and multiple nodules on the diaphragm, parietal and pulmonary pleura. They were white and 0.5 to 2 cm in size. By excisional biopsy, these were diagnosed as epithelial-type diffuse malignant mesothelioma. We therefore performed panpleuropneumonectomy. Even though we completely resected the canal of thoracoscope and drainage tube, microscopic findings showed invasion of mesothelioma cells into this thoracoscopic canal. Although we suggest that, in preoperative diagnosis of pleural tumor, thoracoscopy is efficient to perform a pathological examination and confirm the extension of tumor, in the actual operation, we believe that the thoracoscopic canal should be resected.

Biopsy↗

PubMed1995

[Multiple systemic embolization from floating thrombus in left atrium].

A 66-year-old woman was referred to our hospital because of cerebral infarction, myocardial infarction and renal infarction. Further examination indicated that she was suffering from mitral valve stenosis with a floating thrombus in the left atrium. She underwent emergency mitral valve replacement and thrombectomy. The thrombus was attached to the left atrium by only four thin and weak strings and removed easily. We think that the thrombus was the precursor of a free-floating ball thrombus without stalk.

Aged↗

PubMedDate not supplied

Ultrastructural study of intranuclear inclusion bodies of pulmonary adenocarcinoma.

Intranuclear inclusion bodies are sometimes observed in pulmonary adenocarcinoma by light microscopy. Electron microscopic characteristics of lung cancer cells with intranuclear inclusion bodies were studied. In addition, polymerase chain reaction (PCR) was performed using primers coding for human papillomavirus (HPV) types 16, 18, and 33. Eosinophilic intranuclear inclusion bodies were observed in 22 out of 285 cases by light microscopy. Immunohistochemically, cancer cell nuclei stained with PE-10. Three types of intranuclear inclusion bodies were classified electron microscopically. Type A showed aggregation of electron dense particles (30-40 nm) with an electron-dense core and was most frequently observed. Type B consisted of a mass of branching and whirling tubular structures. Type B intranuclear inclusions had a relationship with inner nuclear membrane. In type C, several spherical inclusions were observed in one nucleus. HPV DNA was detected using PCR and type-specific probes in a case with type A inclusion bodies. This study suggests that intranuclear inclusion bodies in pulmonary adenocarcinoma are formed by several different mechanisms.

Adenocarcinoma, Papillary↗

PubMedDate not supplied

Microsatellite alterations in patients with thoracic sarcoma.

Few studies on sarcomas have examined the relationships between microsatellite alterations in particular loci, tumor prognosis and tumorigenesis, because sarcomas are uncommon and those prognoses can be confounded by coexisting factors, such as tumor site. We studied the relationship between microsatellite alterations and prognosis in 31 patients with thoracic sarcoma. The frequency of loss of heterozygosity (LOH) at 17p13 in stage IV sarcomas was significantly higher than that in stage I and III sarcomas (p<0.05). The 5-year survival for patients with LOH at 17p13 was significantly lower than that for patients without LOH (p<0.05). Six of 31 cases (19.4%) revealed replication error. These results suggest that p53 abnormality occurs during advanced stages of sarcoma and are related to patient prognosis, and it is possible that aberrations in mismatch repair activity are related to sarcoma tumorigenesis.

Adolescent↗

PubMedDate not supplied

Cytomorphologic features characteristic of tumor stages of thymomas.

The cytologic findings of the tumor cells characteristic of the stages of thymomas were investigated to assess the invasiveness of the tumors. Forty-six patients with thymoma who underwent extensive thymectomy without pre-operative corticosteroid therapy were included in this study. The histologic subtypes included 18 round/oval, 20 mixed, and 8 spindle type. The stages of thymoma classified according to Masaoka's clinicopathological classification included 16 stage I, 20 stage II, 6 stage III, 2 stage IVa, and 2 stage IVb, and myasthenia gravis was recognized in 5 patients. Cytologic findings were retrospectively analyzed in the Papanicolaou-stained stamp smears obtained from the cut surfaces of thymoma specimens. Morphometry of the epithelial tumor cells using Cosmozone-1A was performed to evaluate the validity of our cytologic categories. Compared with the cytologic findings of stage I or II thymomas, those of epithelial tumor cells in stage III or IV more frequently showed necrotic background (50.0%-stage III or IV vs 11.1%-stage I or II, p=0.006), large clusters of epithelial tumor cells (70.0% vs 36.1%, p=0.055), marked nuclear enlargement (90.0% vs 52.7%, p=0.033), marked anisokaryosis (100% vs 52.7%, p=0.006), marked nuclear polymorphism (40.0% vs 5.5%, p=0.004), hyperchromasia (50.0% vs 11.4%, p=0.007) and prominent nucleoli (50.0% vs 16.6%, p=0.028) whereas no significant correlation was observed between cytologic findings and tumor volume. Morphometric studies of thymoma tumor cells revealed that the nuclear size (mean values, 78.8 microm(3)-stage III or IV vs 58.2 microm(3)-stage I or II), the coefficient of variation of the nuclear size (0.326 vs 0.282), and the nuclear rotundity (0.849 vs 0.858) differed significantly between the two categories (p<0.05). Our findings demonstrated that there were significant differences between the cytologic findings of epithelial tumor cells of stage I or II thymomas and those of stage III or IV thymomas, and that the cytologic findings of thymoma tumor cells appear to be useful for distinguishing between non-invasive and invasive thymomas.

Adolescent↗

PubMedDate not supplied

Surgical resection combined with intrathoracic hyperthermic perfusion for thymic carcinoma with an intrathoracic disseminated lesion: a case report.

Thymic undifferentiated carcinoma has a poor prognosis. We encountered a patient with thymic carcinoma associated with an intrathoracic disseminated lesion, who underwent surgery combined with intrathoracic hyperthermic perfusion after systemic chemotherapy and showed good results. The 45-year-old man was diagnosed as having a thymoma with an intrathoracic disseminated lesion. After he underwent three courses of systemic chemotherapy, he was admitted to our hospital. An anterior mediastinal tumor and an intrathoracic disseminated lesion remained, and were treated by surgical resection combined with intrathoracic hyperthermic perfusion. The tumors were histopathologically diagnosed as thymic undifferentiated carcinomas with pleural dissemination. At present, approximately 16 months after surgery, the patient is alive without recurrence.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Genetics and lung carcinoma in Okinawa Prefecture, Japan.

BACKGROUND: Although the incidence of all cancers in Okinawa is the lowest in Japan, that of lung cancer is high. This study was performed to clarify the underlying mechanism of this tendency. MATERIALS AND METHODS: Family histories of the lung cancer patients in Okinawa, p53 mutation, microsatellite alterations, and titers of serum anti-p53 antibodies were examined. RESULTS: The number of patients who had relatives with some malignancies in relatives was low in Okinawa, but lung cancer was frequently observed in their relatives. Overexpression of p53 protein was frequently observed in squamous cell carcinoma (SCC) than in adenocarcinoma (AD), and in smokers than in non-smokers. Anti-p53 antibodies were detected in 17.4%. The incidence of loss of heterozygosity at D3S643 and at IFNA were higher in SCC than in AD. CONCLUSIONS: Lung cancer was frequently observed in relatives of lung cancer patients. Pulmonary SCC had different genetic alterations compared with pulmonary AD in Okinawa.

Adult↗