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Biomedical subjects

K Kiyomatsu

Publications and source records attributed to K Kiyomatsu.

10 recordsLinked to original sources

Radiographic observation of a case of gastrointestinal stromal tumor in stomach.

A case of gastrointestinal stromal tumor (GIST) in stomach was presented. Serial barium meal x-ray examinations revealed an enlarging elevated lesion on the fornix of the stomach. Tumor volume doubling time was found to be 299 days. Microscopic and immunohistochemical studies of the resected tumor disclosed GIST, uncommitted type, low grade malignant/potentially malignant. A radiographic feature of this rare type of gastric submucosal tumor was demonstrated in this report.

Female↗

Liposarcoma developing in the paratesticular region: report of a case.

A 74-tear-old man presented to our hospital with a 2-year history of a painless and slow-growing fixed mass in the left paratesticular region. There were no specific abnormalities in the laboratory data, and the tumor markers were within normal limits. Computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US) revealed findings suggestive of either inguinal hernia or lipoma. However, intraoperatively, the tumor was observed to roll up the isolateral spermatic cord and testicular vessels, which led to the differential diagnosis of liposarcoma. The tumor was then widely resected along with the left testis, spermatic cord, and testicular vessels. Histopathologic study confirmed the diagnosis of well-differentiated liposarcoma, but no malignant cells were found in any of the surgical margins. A periodical follow-up has been performed by US every 3 months, and no evidence of recurrence or metastasis has been seen in the 6 months since his operation, without any postoperative adjuvant therapy.

Aged↗

Mastopathy of the accessory breast in the bilateral axillary regions occurring concurrently with advanced breast cancer.

We herein report a 41-year-old Japanese woman who demonstrated advanced cancer in the left breast occurring concurrently with mastopathy of the accessory breast tissue in the bilateral axillary regions, which appeared to be metastatic lymphadenopathy. A preoperative examination, including a mammogram, US, and CT, did not provide us with a definite diagnosis of the axillary masses: it was essential to diagnose the masses preoperatively since a bilateral mastectomy with nodal dissection is called for if the right axillary masses are metastatic from a cancer in the right breast. An intraoperative cytological examination from the bilateral axillary masses revealed adenosis with fibrocystic changes in the accessory breast tissue. We therefore performed a modified radical mastectomy only on the left side. The patient was thus saved from an unnecessary mastectomy of the right breast. Based on our experience, we wish to emphasize that the accessory breast tissue should be considered for a differential diagnosis when evaluating the axillary masses in order to avoid over-surgery, especially when a patient has been diagnosed to have massive breast cancer. An intraoperative cytological examination is strongly recommended to reach a final diagnosis in such confusing cases.

Adult↗

A case of liver cirrhosis with a hyperplastic nodular lesion.

A hyperplastic nodular lesion resembling focal nodular hyperplasia (FNH) was found in the cirrhotic liver of a 50-year-old male patient. A nodule was detected by ultrasonography and hepatic angiography conducted as part of a routine follow-up study for chronic liver disease, and was excised under a diagnosis of suspected hepatocellular carcinoma. Grossly, central stellate scar-like septa subdividing the nodule ware noted. These fibrous septa contained many small arteries and veins, as well as bile ducts. The parenchyma of the nodule also contained many small arteries. Although these findings were similar to those seen in typical FNH, the present lesion was different in that it was encapsulated, occurred against a background of liver cirrhosis, lacked hepatocyte hyperplasia and showed hemosiderin deposition.

Hemosiderin↗

[Pathomorphologic study on early hepatocellular carcinoma (HCC)--a study of cell density in well-differentiated HCC of the early stage].

In order to clarify the histologic characteristics of well-differentiated hepatocellular carcinoma (HCC), a comparative morphometric study on cell density was performed in 15 HCCs smaller than 2 cm in diameter, 6 HCCs with marked fatty and/or clear cell change, 7 hyperplastic nodules, 5 hyperplastic nodules containing foci of HCC, and non-cancerous areas of the livers bearing small HCC. In well-differentiated HCC, marked increase of cell density accompanying by decrease of cell size and increase of nuclear cytoplasm ratio were prominent, and the cell density was approximately two times larger than that of the non-cancerous area in most cases. In HCCs with marked fatty and/or clear cell change, as an increase of cell density was not evident because of swelling of the cytoplasm due to fat and/or glycogen accumulation, it should be careful to differentiate them from non-cancerous nodular lesions including hyperplastic nodule with marked fatty change. Hyperplastic nodules could be divided into two groups; those with marked increase of cell density, and those without increase of cell density. In the former group, 5 of the 7 nodules contained cancerous foci.

Carcinoma, Hepatocellular↗

Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy.

Among 579 autopsy cases of hepatocellular carcinoma (HCC), 55 cases (9.4%) exhibited a sarcomatous appearance. The incidence of HCC with a sarcomatous appearance has been increasing over the past 17 years. A sarcomatous appearance was found in 20 out of 335 autopsy cases of HCC (5.9%) during the 12 years from 1969 to 1980, and in 35 out of 244 autopsy cases of HCC (14.3%) during the last 6 years, when effective anticancer therapies, such as the one-shot injection of anticancer agents into the hepatic artery (one-shot therapy) and transcatheter arterial embolization (TAE), have become popular. A sarcomatous appearance was found in 20.9% of the cases undergoing anticancer therapy and in 4.2% of the cases not undergoing anticancer therapy. Among the various anticancer therapies, the sarcomatous appearance was most frequent (27.6%) in cases with repeated TAE. Thus, a close relationship between the sarcomatous appearance in HCC and anticancer therapies was suggested. Regarding the development of the sarcomatous appearance, we presume that it may be caused by the phenotypic change of HCC cells caused by anticancer therapy, or that a number of factors, including anticancer therapy, may accelerate the proliferation of the sarcomatous cells existing in the original tumor as one of the histological components. In order to clarify the true nature of sarcomatous lesions in HCC, further histological and biological studies are required.

Carcinoma, Hepatocellular↗