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Biomedical subjects

H Miyayama

Publications and source records attributed to H Miyayama.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Adult T cell leukemia with cytomegalovirus associated hemophagocytic syndrome].

A 59-year-old woman, diagnosed as adult T-cell leukemia (ATL), was admitted because of fever and disturbance of consciousness. Peripheral blood examination demonstrated leukopenia and anemia, and subsequently thrombocytopenia. Bone marrow aspiration showed the increase of mature histiocytes with hemophagocytosis and a diagnosis of hemophagocytic syndrome (HPS) was established. She died due to respiratory failure on the eighth hospital day. Autopsy histological examination revealed systemic cytomegalovirus (CMV) infection with CMV pneumonia, and also demonstrated the findings of HPS in bone marrow, lymph nodes, and spleen. This case was considered as virus associated hemophagocytic syndrome (VAHS) developed by CMV infection. CMV is one of the causative viruses of VAHS and the opportunistic infection. In the patient with ATL in the immunodeficiency state, VAHS accompanied with opportunistic infection might be one of the causes of pancytopenia.

Cytomegalovirus Infections↗
PubMed1994

[A case of paradoxical cerebral embolism through a patent foramen ovale diagnosed by necropsy].

A 62-year-old man was admitted to our hospital for disturbed consciousness and left-side motor sensory deficit. His blood pressure was 142/100 mmHg and an electrocardiogram was normal. CT of the brain revealed a low density area in the distribution of the right middle cerebral artery (MCA). Cerebral angiography demonstrated occlusion of the right internal carotid artery and an embolus. We diagnosed cerebral embolism, but we could not detect source of embolism. His condition deteriorated rapidly, and he died four days later. At necropsy, an elongated piece of thrombus 10 cm in length was lodged in a patent foramen ovale lying in each atrium. No other thrombus was seen in the heart, the myocardium and coronary arteries were normal. Both main pulmonary arteries contained thrombus. The lungs showed edema and congestion. There was no thrombus of both common iliac veins. The right internal carotid artery was occluded at its bifurcation by embolus, distal to which the cavernous segment was 7 cm filled with clot. We reported a rare paradoxical cerebral embolism through a patent foramen ovale diagnosed by necropsy. If no left-sided circulatory source can be demonstrated, the possibility of a paradoxical embolism should be considered.

Heart Septal Defects, Atrial↗
PubMed1994

[Neurocutaneous melanosis--a case report].

Neurocutaneous melanosis is a rare congenital phacomatosis characterized by the presence of large or multiple congenital melanocytic nevi and benign or malignant pigmented cell tumors of the leptomeninges. A 14-month-old boy was admitted with a recent history of vomiting and drowsiness. He was found to have multiple congenital melanocytic nevi. Gd-enhanced MRI showed ventriculomegaly and leptomeningeal enhancement in the ambient cistern. CSF cytology revealed abnormal cells with pigmented granules. A diagnosis of hydrocephalus with malignant neurocutaneous melanosis was made. The patient was treated with combination chemotherapy (DAV therapy, ACNU intrathecal perfusion therapy, interferon beta therapy) while controlling intracranial pressure by CSF drainage, but in spite of treatment he died due to rapid progression of leptomeningeal infiltration. Postmortem examination revealed meningeal malignant melanomas predominantly at the base of the brain and benign meningeal melanosis over the cerebral cortex. Newborn infants or infants with large or multiple congenital melanocytic nevi should be carefully followed, especially for the first two years. When hydrocephalus or convulsions occur in patients with skin lesions, Cd-enhanced-MRI and careful CSF cytology studies should be performed to detect meningeal abnormalities.

Humans↗
PubMed1993

Aggressive osteoblastoma of the calcaneus.

Aggressive osteoblastoma of the left calcaneus in 29-year-old Japanese woman is reported. Her initial symptom was heel pain while walking. This was a primary calcaneal tumor, initially diagnosed as a benign osteoblastoma. After a 5-year follow-up (from the initial curettage), there was local recurrence. The histologic findings of aggressive osteoblastoma were confirmed after right lower leg amputation. The recurrent tumor was mildly aggressive to the talocalcanean joint and the retrocalcaneal area, without distant metastasis. The characteristics of the primary and recurrent tumors were examined by the radiologic, histologic, and electron microscopic procedures. Although there are questions about aggressive osteoblastoma, the authors believe that there are osteoblastic tumors of borderline malignancy between benign osteoblastoma and low-grade osteosarcoma. The current case was an example compatible with an aggressive osteoblastoma with the proposed name of Dorfman classification Group 4.

Adult↗
PubMed1992

[Brain metastases from Wilms' tumor without systemic involvement--a case report and review].

A 3-year-old boy presented with multiple brain metastases 21 months after the resection of stage II Wilms' tumor. Metastasis to other organs was not found. He was treated by total removal of a large metastatic tumor in the left temporal lobe and post-operative radiotherapy and chemotherapy. He has been in complete remission for 20 months after surgery. Cerebral metastasis from Wilms' tumor without systemic metastases is very rare. It is speculated that brain metastases occurred in this patient because most of the anticancer agents used in the primary treatment for Wilms' tumor were not able to cross the blood brain barrier.

Antineoplastic Agents↗
PubMed1991

[Expression of ras oncogene p21 in relation to prognostic factors of human breast cancer].

For the purpose of demonstrating the relationship between the expression of ras oncogene p21 protein and clinico-pathological characteristics which reflected the prognosis, 253 women with breast cancer who underwent mastectomy were analyzed. Ras p21 was detected in 133 (52.6%). In histological types, scirrhous carcinomas were more often ras p21-positive, and papillo-tubular carcinoma were usually negative. And histological grade was significantly correlated with ras p21. The degrees of invasion to fat tissues and infiltration into lymphatic vessels were also significantly correlated with ras p21. Tumors with lymph node metastases expressed higher levels of ras p21 than nonmetastasizing tumors in smaller tumors, especially in papillo-tubular carcinomas. And patients with elevated ras expression tended to have a poor prognosis. These results suggested that an elevated ras expression may play an important role in the development of aggressive tumors.

Adenocarcinoma↗
PubMed1991

[A case of leiomyoma of the trachea].

An asymptomatic 59-year-old male in whom an abnormal shadow was detected on indirect chest X-ray film, was referred to our hospital for further examination. Further examinations revealed no problem at the previously checked site. However, bronchoscopy revealed a protruding hemispheric lesion on the membranous portion of the trachea 2 cm above the carina. The biopsy specimens revealed that the lesion was leiomyoma of the trachea. Transbronchoscopic biopsy was performed three times and the lesion disappeared. A few small fibrous nodules remained. The incidence of this primary tracheal tumor is rare, and benign lesions are much less common than malignant lesions. Furthermore, leiomyoma of the trachea is extremely rare. Only 20 cases have been reported in Japanese and English literature. The average age of the reported cases, including our case, was 49.3 years old. Among the male patients, most cases were around 50 years old but among female patients, there was no standard age for this disease. Clinical symptoms included coughing, dyspnea, wheezing and bloody sputum. There were several patients with severe dyspnea, two of which died. Ten patients (50%) had been misdiagnosed as having bronchial asthma. If a case is suspected to be bronchial asthma in which and where bronchodilators have little effect, we must always consider the possibility of this type of lesion, and perform further examinations and treatment.

Bronchoscopy↗
PubMed1989

Involution of lymph node histiocytes in AIDS.

Lymph nodes of human immunodeficiency virus (HIV)-infected patients were studied histologically and immunohistochemically to elucidate the pattern of involution of various histiocytes in AIDS. Specimens consisted of one node with hyperplasia, five with atrophy, and three with severe atrophy. Antibodies such as L25, ID1, My4, 12, anti-Leu 3a, KiM4, OKT6 and anti-S100 protein were used for identification of the histocytes. Another antibody, VAK5, was used to demonstrate HIV antigen. T-zone histiocytes were mildly decreased in the hyperplastic node, but considerably decreased in the atrophic nodes. My4+ sinus histiocytes were unchanged in number and enlarged in the hyperplastic node, but not decreased in the atrophic nodes. Follicular dendritic cells (FDCs), defined by KiM4, were mostly depleted in the atrophic nodes. The T4 antigen was detected in some of the sinus histiocytes of the atrophic nodes. T6-positive cells were not found in any of the nodes. HIV antigen was detected only in FDCs. It is therefore suggested that various histiocytes respond differently to HIV, and that T-zone histiocytes and sinus histiocytes persist up to the late stage of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Two cases of inflammatory pseudotumor of the lung].

Two cases of inflammatory pseudotumor of the lung were reported. Case 1. A 68 year-old man was referred to our hospital because of an abnormal shadow on chest X-ray. He had a history of pneumonia in the right upper lobe five months before. The chest X-ray film revealed a coin lesion in the right upper lung field (S1), the same segment as the previous pneumonia. Although RPF and INH were administered for three months, the shadow did not change, and cough and sputum continued. In order to confirm the diagnosis, open thoracotomy was performed and microscopic findings of the resected tumor showed inflammatory pseudotumor; proliferation of fibrous tissue with infiltration by inflammatory cells (plasma cells, lymphocytes and a few neutrophils). Case 2. A 35 year-old man was admitted to our hospital because of an abnormal shadow on chest X-ray, i.e. a coin lesion with vascular indentation in the left lower lung field (S8). A wedge resection including the mass was performed, and histopathologic examination revealed inflammatory pseudotumor, or plasma cell granuloma; proliferation of fibrous connective tissue with infiltration by predominantly mature plasma cells. Both patients have been doing well after the operation. We also reviewed 46 cases reported in the Japanese literature and discussed various aspects of this disease. Of 10 patients who had a history of previous respiratory tract infection, 8 had histopathologic features with various inflammatory cells, including many lymphocytes, as in our Case 1. Although the common etiology of inflammatory pseudotumor is obscure, we suppose that in some cases the lesion may be a result of post-inflammatory repair process.

Adult↗
PubMed1988

Histo- and immunopathological features of terminal AIDS. An autopsy case of a Japanese man with neurological signs as initial symptoms.

An autopsy case of a 37-year-old Japanese man, confirmed as an AIDS patient infected by an undetermined route of transmission, is presented. The initial symptoms of full-blown AIDS in this case were neurological, and the patient died of severe pneumonia 9 months after onset. The main histo- and immunopathological features were a marked depletion of helper-inducer T cells and dendritic reticulum cells in the lymphoid tissues, opportunistic infections, and some neuropathologic changes. Very few cells, possibly macrophages, immunoreactive with a monoclonal antibody (VAK-5) against HIV-gag protein P24 were found in the mediastinal lymph nodes. Numerous pathogens had induced opportunistic infections in many organs: severe and generalized cytomegalovirus infection, Pneumocystis carinii pneumonia, bronchopneumonia (possibly due to Pseudomonas aeruginosa), candidiasis in the tongue and oral cavity, and atypical mycobacteriosis in the pulmonic hilar lymph nodes. Vascular proliferation was found in the perinodal regions of some lymph nodes, but this was not neoplastic vascular proliferation compatible with that of localized Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Massive IgE-hyperimmunoglobulinemia and storage histiocytosis in Sézary syndrome. A postmortem study.

Substantial evidence has accumulated that the Sézary syndrome is grouped together as "cutaneous T-cell lymphoma" and forms a subset of T-cells programmed for helper interactions with B-cells in their production of immunoglobulins; IgA, IgG, and IgM. The authors describe an autopsy case of a 64-year-old Japanese man, with cutaneous T-cell lymphoma in association with IgE-type lambda hyperimmunoglobulinemia. The serologic and immunocytochemical studies suggest that Sézary cells from our patient are T-cell proliferations in association with IgE-specific helper activity. In addition, histiocytosis was interestingly noted, for the first time, in the generalized lymph nodes, spleen, and bone marrow by the autopsy. The cytoplasm of swelled histiocytes contained IgE-type lambda immunoglobulin by the PAP method that probably represented altered immunoglobulin.

Cell Division↗
PubMed1984

Hepatic granuloma. Report of a case successfully treated by hepatectomy and antituberculous therapy.

A 62 year-old male presented with high fever, weight loss and painful hepatomegaly. The clinical presentation, results of laboratory studies, angiography and laparotomy suggested hepatic abscess or cholangiocarcinoma. He underwent left lobe hepatectomy, and pathological examinations revealed granuloma. Acid-fast bacilli, fungi and parasites were not identified by special stainings. Hepatic tuberculosis was considered most likely because, after operation, an intermediate-strength purified protein derivative (PPD) skin test gave strongly positive results and his subsequent response to antituberculous treatment was excellent. His complex clinical features and the diagnostic difficulties were outlined.

Antitubercular Agents↗
PubMed1982

Pathogenesis of 1,2-dimethylhydrazine-induced carcinomas in rat intestine. I. The induction of mucin producing carcinomas in rat intestine.

Seventy four white male Wistar rats were divided into two groups and given weekly subcutaneous injections of 30 mg 1,2-dimethylhydrazine (DMH) 2HC1/kg body weight for 10 or 15 weeks, respectively, and the histological properties and distribution of DMH-induced rat carcinomas were investigated. The carcinomas induced by DMH were classified mainly into mucin producing carcinomas and non-mucin producing ones. In the large intestine, the group treated for 15 weeks induced significant incidences of mucin producing carcinomas composed mainly of cells containing intracellular mucin. Mucin producing carcinomas consisted of poorly differentiated adenocarcinoma, signet ring cell carcinoma and mucinous carcinoma, and these often coexisted within the same tumor mass. Mucin producing carcinomas tended to develop in the proximal colon and caecum, while non-mucin producing carcinomas were frequent in the distal colon. This method was thought to be a useful model to study glycoproteins of cancer cells.

1,2-Dimethylhydrazine↗
PubMed1982

Pathogenesis of 1,2-dimethylhydrazine-induced carcinomas in rat intestine. II. Histochemical and ultrastructural characteristics of glycoproteins of 1,2-dimethylhydrazine-induced carcinoma cells.

Two hundred twenty seven lesions of DMH-induced intestinal carcinomas of 68 male Wistar rats were investigated by means of histochemical and electron microscopic properties to study their histogenesis and mucinogenesis. Among the epithelial glycoproteins, surface glycoprotein on the microvilli with glycocalyces was distinguishable from mucin in the cytoplasm based on histochemical staining and ultrastructural findings. From the phenotypic characteristics of glycoproteins, it was suggested that DMH-induced carcinomas could be classified into mucin producing carcinomas composed mainly of cells containing intracellular mucins and non-mucin producing ones. The mucin producing carcinomas consisted of poorly differentiated adenocarcinoma, signet ring cell carcinoma, and mucinous carcinoma presumably resulting from various degrees of differentiation into goblet cells. Their staining attitude varied and cells with neutral mucin, sialomucin and sulphated mucin were observed in the signet ring cell carcinoma. In addition, abnormal synthesis of glycoproteins was observed with ConA-paradox staining and PATS/PB/KOH/PAS. These histochemical properties suggested irregulatory synthesis of glycoproteins in carcinomas. In non-mucin producing carcinomas, glycoproteins were found mainly on the apical surface and contained sialomucin. A deviated differentiation into an absorptive cell could form an intracytoplasmic cyst filled with an aggregation of glycocalyces, so becoming another type of signet ring cell.

1,2-Dimethylhydrazine↗
PubMed1981

A postmortem study of malignant glucagonoma with heart muscle hypertrophy, including chemical, histochemical, immunohistological and ultrastructural observations.

The autopsy findings in a 58 year old female with the typical glucagonoma syndrome with heart muscle hypertrophy are described. Despite remission of a skin rash and hyperglucagonemia following removal of metastatic liver tumors, the patient died of massive cerebral hemorrhage caused by uncontrolled hypertension and septic cerebral angiitis. On the basis of surgical and autopsy materials, the tumors in the pancreas and liver were defined as malignant glucagonoma by histological, histochemical, immunohistochemical, and ultrastructural studies. The pathohistological changes in several organs that might be related to the hypersecretion of pancreatic glucagon are discussed.

Adenoma, Islet Cell↗