A case of adenoid cystic carcinoma (ACC) of the breast in a 66-year-old woman is reported herein. ACC accounts for about 0.1% of all breast cancers. Our patient presented with a small, elastic and hard mass, measuring 2.0x2.0 cm, between both outer quadrants of the right breast. Although physical examination, ultrasonography and magnetic resonance (MR) mammography suggested a benign tumor, aspiration biopsy cytology (ABC) was performed twice, and the second ABC specimen was evaluated as suspicious for breast carcinoma. Breast conserving surgery with a level II lymph node dissection was subsequently performed. There was no lymph node metastases and estrogen receptor (ER) status was negative. Light microscopy revealed various growth patterns, with the cells showing biphasic cellularity. According to immunohistochemical analyses, CEA, actin and vimentin were positive, S-100 protein was negative, and the cytokeratin reaction was partially positive. Therefore, ACC of the breast was diagnosed. Although ACC of the breast is a rare neoplasm, it should be considered in the differential diagnosis even if various diagnostic imaging studies suggest a benign tumor of the breast. Awareness of this tumor will help prevent misdiagnosis.

Actins↗

PubMed2001

Penile schwannoma.

Schwannoma of the penis is extremely rare. A 65-year-old man presented with a subcutaneous tumor of penile shaft without any other symptoms. Histopathologic examination of the excised tumor revealed benign schwannoma. No recurrence has been observed over the 6 months since the surgery.

Aged↗

PubMed1998

[A case of cerebral venous angioma detected by slow velocity-encoding phase contrast MRA: appropriate determination of velocity encode].

We report a 86-year-old woman who has been diagnosed as cerebral venous angioma by slow velocity-encoding phase contrast magnetic resonance angiography (MRA). She had developed headache for one month. T1- and T2-weighted images showed a flow void sign in the right cerebellum with gadolinium enhancement. MRA using time-of-flight sequence revealed no abnormal vascular structures. Conventional phase contrast MRA (velocity encode, 40 or 60 cm/sec) did not disclose obvious vascular abnormalities. However, slow velocity-encoding (20 cm/sec) phase contrast MRA demonstrated a well-demarcated venous angioma in the right transverse sinus. Our results of MRAs suggest that velocity encode is a crucial factor for detection of venous angioma on phase contrast MRA. Slow velocity-encoding phase contrast MRA is a beneficial tool for evaluation of venous malformations, such as venous angioma.

Aged↗

PubMed1995

[Quantitative changes in cerebral blood flow of Shy-Drager syndrome induced by upright position: assessment by 99mTc-HMPAO].

We assessed orthostatic changes of cerebral blood flow (CBF) in 4 patients with Shy-Drager syndrome. Brain perfusion index (BPI) was measured by 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO). Cerebral angiography using aortic time-activity curve as an input function BPI values in supine and upright positions in Shy-Drager syndrome were compared with those in 2 cerebrovascular disease patients without orthostatic hypotension. BPI values in the upright position were significantly decreased in patients with Shy-Drager syndrome as compared with these in the supine position. No significant decrease in BPI was noted in the patients without orthostatic hypotension. These results suggest that the BPI measurement by 99mTc-HMPAO cerebral angiography is useful for the noninvasive evaluation of the orthostatic changes of the CBF.

Adult↗

PubMed1994

[A quantitative approach to the rCBF response to acetazolamide using 99mTc-HMPAO and graphical analysis].

A simple noninvasive method for a quantitative measurement of brain perfusion is presented using intravenous radionuclide angiography with 99mTc-hexamethylpropylene amine oxime (HMPAO). Graphical analysis was employed for the evaluation of the unidirectional influx constant (ku) of the tracer from the blood to the brain and the initial distribution volume (Vn) for the tracer, which is the volume of the exchangeable region plus the plasma space. The ku and Vn values were standardized to provide objective and comparable values, brain perfusion indices (BPI) and corrected Vn (Corr. Vn), between subjects by setting the size ratio of ROI(brain) to ROI(aorta) at 10 and 1, respectively. BPI and Corr. Vn of the whole brain were measured before and 20 min after injection of 1 g acetazolamide. After acetazolamide administration, BPI and Corr. Vn increased in all eight subjects with cerebrovascular diseases and one with a pituitary adenoma, by a mean of x 1.26 and 1.24, respectively. Increase of BPI showed a significant correlation with increase of Corr. Vn. This technique is easy to apply as an adjunct to SPECT and may be helpful in the measurement of brain perfusion changes in the acetazolamide test.

Acetazolamide↗

PubMed1993

Hepatocellular carcinoma: the diagnostic difficulties of ultrasonography and analysis of risk factors in MHTS.

Thirty-nine cases of hepatocellular carcinoma (HCC) out of 55,135 examinees were examined. The diagnostic problems of ultrasonography (US) in detecting HCC and the risk value of 10 factors in HCC were discussed. We also propose the surveillance programs for HCC in Multiphasic Health Testing and Services (MHTS). US will be performed at 3-, or 6 monthly intervals in conjunction with AFP monitoring for the examinees over 50 males and over seventy females with liver dysfunction (GOT > 38 IU/ml) is recommended.

Adult↗

PubMed1993

[Acetazolamide effect on vascular response in crossed cerebellar diaschisis as measured by 99mTc-HMPAO SPECT].

We studied the effect of acetazolamine (DIAMOXR) on vascular response in areas with crossed cerebellar diaschisis (CCD) using consecutive 99mTc-hexamethyl-propyleneamine oxime (HMPAO) SPECT studies before and after DIAMOX administration with a subtraction method. Regions of interest were drawn over the bilateral cerebellar cortices and interhemispheric asymmetry indices (IAI) were obtained. Eleven of 14 patients with CCD at baseline showed decrease of IAI after DIAMOX administration. Although there is a possibility of underestimation of increase in perfusion in unaffected cerebellar hemisphere, this result suggests a greater increase in perfusion in the affected cerebellar hemisphere as compared with in the contralateral unaffected one and suggests more dilatation of the arterioles in areas with CCD post-DIAMOX than in areas without CCD. However nonsignificant correlation between IAI at baseline and difference of IAI from baseline to post-DIAMOX did not support the hypothesis of more dilatation post-DIAMOX of more constricted arterioles.

Acetazolamide↗

PubMed1993

Demonstration of focal brain ischemia induced by hyperventilation using Tc-99m HMPAO SPECT.

A case with vasospasm of the right anterior cerebral artery induced by hyperventilation is presented. Consecutive Tc-99m HMPAO brain SPECT studies at rest and during hyperventilation greatly contributed to the quantitative evaluation of focal perfusion decrease in conjunction with contrast angiography. This technique seems to be useful for the detection of alterations in regional brain perfusion during short duration intervention.

Adult↗

PubMed1992

[A case of ureteral endometriosis; the usefulness of MRI for preoperative diagnosis].

A rare case of ureteral endometriosis is reported. A 46-year-old nulliparous woman was referred to our hospital because of right hydronephrosis which was detected by ultrasonography; Drip infusion pyelography showed right hydroureteronephrosis with the distal obstruction. MRI demonstrated right ovarian endometriosis and resultant ureteral stricture. Based on these findings, we made a preoperative diagnosis of right ureteral endometriosis. Right partial ureterectomy and ureteroureterostomy were performed. Pathological examination of the resected segment showed endometrial tissue around the ureteral lesion. She was administered LH-RH agonist (buserelin); her postoperative course was uneventful. IP showed no abnormalities 6 weeks after the operation. To our knowledge, this case is only the 55th case reported in the literature in Japan.

Endometriosis↗

PubMed1991