PubMed Health⌕ Search

Biomedical subjects

M Setoyama

Publications and source records attributed to M Setoyama.

At least 37 records · Page 2Linked to original sources
PubMed1998

Prurigo as a clinical prodrome to adult T-cell leukaemia/lymphoma.

We report a case of adult T-cell leukaemia/lymphoma (ATLL) with prurigo as a prodromal skin manifestation. The patient was a 52-year-old woman with a 2-year history of a fluctuating skin condition consisting of pruritic papules and pigmentation on her lower legs and right buttock. Prurigo was diagnosed at her first visit in October 1995, and she was found to be seropositive for human T-cell lymphotropic virus type 1 (HTLV-1). Two years later, the skin lesions had spread over the patient's forearms and dorsa of the hands, and abnormal lymphoid cells had appeared in her peripheral blood. Southern blot analysis revealed monoclonal integration of HTLV-1 provirus in the peripheral blood, but not in a skin lesion. Based on these results, a diagnosis of overt ATLL of the smouldering type was made. The findings in this case indicate that in healthy HTLV-1 seropositive carriers, prurigo requires careful follow-up as a cutaneous prodrome of ATLL.

Blotting, Southern↗
PubMed1998

Membranocystic lesions in a patient with cytophagic histiocytic panniculitis associated with subcutaneous T-cell lymphoma.

A 51-year-old Japanese woman had erythematous, tender subcutaneous nodules on her lower legs and buttocks, as well as fever, pancytopenia, and liver dysfunction. Histopathologic examination of the nodules showed subcutaneous T-cell lymphoma with cytophagocytosis and membranocystic lesions. Our patient was unique in having the combination of cytophagic histiocytic panniculitis due to subcutaneous T-cell lymphoma and membranocystic lesions.

Cell Membrane↗
PubMed1998

Squamous cell carcinoma of the skin associated with sarcoid reactions in the regional lymph nodes.

Sarcoid reactions in lymph nodes with or without metastasis from a primary malignant neoplasm are well-known. However, it is extremely rare to find these reactions associated with cutaneous solid tumors; only one such case has appeared in the literature. Here we describe a case of an 83-year-old man with cutaneous squamous cell carcinoma accompanied by sarcoid reactions and metastatic foci in the regional lymph nodes. The possibilities of systemic sarcoidosis and tuberculosis were excluded after extensive examinations specific for these diseases. Some authors regard the sarcoid reaction to be a sign of a good prognosis on the basis of studies of a few patients with solid tumors. In our case, however, the patient died of pulmonary metastasis with pleuritis carcinomatosa shortly after surgery. Systematic analysis of a sufficient number of cases should be carried out to evaluate the clinical significance of this type of reaction.

Aged↗
PubMed1998

Linear lichen planus in the region of the mandibular nerve caused by an allergy to palladium in dental metals.

We observed a case of linear lichen planus extending from the right cheek to the jaw, which was accompanied by itching and an unusual sensation in the mouth. The eruption was located along the mandible and aligned with the mandibular nerve. The right molars of the patient contained metal compounds and these were considered to be the cause of his disease. Patch testing with various dental metals showed positive reactions to palladium and platinum. A biopsy specimen showed a lichenoid reaction in the lesional tissue, and dermal contact dermatitis was noted at the palladium patch test site. His dentist reported that palladium-silver-gold or nickel-chrome alloys without platinum had been used in the crown and bridge of his molars. After removal of the dental alloys, the skin eruption resolved with some residual hyperpigmentation. In addition, the peculiar mouth sensation disappeared dramatically within 2 months.

Allergens↗
PubMed1998

Elastofibroma dorsi.

Elastofibroma dorsi is a rare benign soft-tissue tumor which is solid, ill-defined and marked by slow growth. It is usually found in the subscapular region of older individuals. We report here the case of a 56-year-old Japanese man with elastofibroma dorsi which was located in the left subscapular region and measured 50 x 70 mm in size. The mass was very similar to tumors previously reported, both clinically and histologically. This entity has only rarely been described in the dermatological literature, but it should be considered in the differential diagnosis of subscapular complaints elderly patients.

Back↗
PubMed1998

Detection of HTLV-1 by polymerase chain reaction in situ hybridization in adult T-cell leukemia/lymphoma.

A method for nonradioactive polymerase chain reaction in situ hybridization was developed and used to determine the distribution of human T-lymphotropic virus type I (HTLV-I) proviral DNA in paraffin-embedded surgical specimens of adult T-cell leukemia/lymphoma (ATLL). As controls, we used biopsy samples of five cases of mycosis fungoides, cells of an HTLV-I-infected cell line (MT2), as well as HTLV-1-negative cells (YAS). We successfully detected the amplicon of the HTLV-1 tax sequence in the nuclei of the cutaneous infiltrating lymphoid cells in 90% (9/10) of ATLL cases. Studies also revealed the existence of HTLV-1 provirus DNA in nuclei of sweat gland epithelial cells and vascular endothelial cells as well as lymphoid cells in ATLL patients. Mycosis fungoides and YAS cells were negative for the HTLV-I tax sequence, but MT2 cells were strongly positive. The results indicated that this technique was more sensitive in detecting intracellular amplicons than was the previous in situ hybridization method. Through its use, we were able to easily determine the distribution of HTLV-I-positive cells among the various cells and tissues of paraffin-embedded archival materials.

Adult↗
PubMed1997

Autologous bone marrow transplantation for patients with advanced chronic myelogenous leukemia.

We report on seven chronic myelogenous leukemia (CML) patients who received autologous bone marrow transplantation (ABMT) using bone marrow (BM) cells while at the chronic phase (CP) under the various treatments. Of the seven patients, four progressed to accelerated phase (AP) in 83-248 weeks after onset and three patients entered blastic crisis (BC) in 84-171 weeks after onset. All patients received high-dose chemoradiotherapy followed by infusion with 11.3 +/- 12.1 x 10(7) (average +/- S.D.) of bone marrow mononuclear cells (BM-MNCs)/kg IFN-alpha was resumed shortly after platelet recovery. Of the four patients in AP, one developed a recurrence of blastoma in 7 weeks, one progressed to second AP in 138 weeks after ABMT and two patients have survived the second CP for 159 and 330 weeks since ABMT, respectively. One of them achieved the complete disappearance of Ph1-positive metaphases for 33 weeks after ABMT. Of patients who received AMBT in BC, three relapsed within 8 weeks and died in 9, 17 and 58 weeks after ABMT, respectively. Hematological recovery was delayed in four patients. Therefore, we retrospectively re-evaluated the number of BM-MNCs collected through 50 procedures from 40 patients with CML-CP. The total MNCs obtained from 30 collections under IFN-alpha treatment was 27.4 +/- 30.9 x 10(8) cells (average +/- S.D.), being significantly lower than that obtained from 20 collections in pre-treatment state or with single chemotherapy other than IFN-alpha treatment (81.8 +/- 68.2 x 10(8) cells) (P < 0.005). The total number of MNCs correlated to white blood cell (WBC) count at BM collection (P < 0.01), which was also lower in the IFN-alpha(+) group than in the IFN-alpha(-) group (7.2 +/- 5.7 and 25.6 +/- 32.3 x 10(9)/l; P < 0.005). Our findings suggested that ABMT with the use of a sufficient number of progenitor cells might be helpful to CML patients in early AP and reach in extended periods of second CP. In addition, we suggest that BM collection is required before the start of IFN-alpha therapy because the total number of BM-MNCs correlated to the WBC count, which might be lower in IFN-alpha treatment.

Adolescent↗
PubMed1997

Steatocystoma multiplex: a case with unusual clinical and histological manifestation.

A 35-year-old man at our clinic was found to have steatocystoma multiplex manifested by dome-shaped nodules confined to the scalp and forehead. One of four cyst biopsy specimens revealed large lining cells with granular cytoplasm adjacent to typical steatocystoma epithelial lining cells. Neither fibrosis nor inflammatory changes were noted in the surrounding connective tissue. The large granular lining cells had immunohistochemical characteristics of the macrophage/monocyte lineage. This case appears to be an unusual clinical and histological manifestation of steatocystoma multiplex.

Adult↗
PubMed1997

Case of dermatofibroma with monster cells: a review and an immunohistochemical study.

We report a dermatofibroma with monster cells. The patient was a 79-year-old woman who had a dark-brown nodule of her left leg for approximately 3 years. The lesion was composed of spindle-shaped fibroblastic cells, histiocytic cells, and multinucleated giant cells. Most of the histiocytic cells had foamy cytoplasm with numerous hemosiderin deposits. In addition to these cells, bizarre multinucleated cells with markedly hyperchromatic nuclei and xanthomatous cells with very large nuclei (monster cells) were also noted. No mitotic figures of the cellular components were present. This lesion has been shown to be completely benign despite the presence of pleomorphic or bizarre cells. From a clinical standpoint, recognition of a benign lesion of this type is very important since an incorrect histologic interpretation could result in inappropriate treatment.

Aged↗
PubMed1997

Adult T-cell leukemia/lymphoma associated with noninfectious epithelioid granuloma in the skin: a clinicopathologic study.

Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) are infrequently associated with noninfectious granulomas in involved or noninvolved organs. Adult T-cell leukemia/lymphoma (ATLL) is an aggressive lymphoproliferative neoplasm associated with T-lymphotropic virus type 1 (HTLV-1). We describe a case of cutaneous type ATLL, affecting mainly the skin as a maculopapular eruption, in which some skin biopsies contained epithelioid cell granulomas in the lymphoma cutis (ATLL) lesion. These Lennert's-like epithelioid clusters were also present in lymph nodes, which showed some degree of invasion by the ATLL lymphocytes. Although prognosis of ATLL is generally poor, our patient has had a less aggressive course, with a survival time to date of 13 years. Our findings suggest that the presence of epithelioid granulomata in an ATLL patient may be a manifestation of a host response which confers some protection against the disease progression. To our knowledge, this is the first report of a case of ATLL with a noninfectious granuloma similar to a Lennert's lesion.

Connective Tissue Diseases↗
PubMed1997

A case of adult T-cell leukemia/lymphoma (ATLL) with angiocentric and angiodestructive features.

This report describes a case of adult T-cell leukemia/lymphoma (ATLL) with angiocentric and angiodestructive features. The patient was a 66-year-old Japanese woman who began developing widespread skin lesions ten months prior to admission. The diagnosis of ATLL was made on the basis of her having an antibody to human T-cell lymphotropic virus type-1 (HTLV-1) and typical flower cells (ATLL cells) in peripheral blood smears. Once hospitalized, the course of her disease was very acute and severe, as is seen with angiocentric lymphoma. Based on histological features, this case was judged not to be angiocentric lymphoma; however, it may lie within the spectrum of angiocentric immunoproliferative lesions (AIL). The findings in this case strongly suggest that HTLV-1 can be a pathogenic factor in the expression of angiocentric and angiodestructive features in ATLL, as is Epstein-Barr virus (EBV) (1-4). To our knowledge the present case is the sixth reported in the literature of lymphoma in which these features are associated with HTLV-1 infection (5-7).

Aged↗
PubMed1997

Adult T-cell leukemia/lymphoma presenting with digital gangrene.

There have been only a few reports in the literature of lymphoma patients suffering from digital gangrene. The present case, a 40-year old man with adult T-cell leukemia/lymphoma (ATLL) showed marked edematous and dyshidrosis-like changes of the digital fingers. As a result of these changes, most of the fingertips of this patient were affected by gangrene. Histologically, lesions showed organized thrombi occluding veins in the middle dermis. In patients suffering from malignant lymphoma, digital swelling and pain associated with cyanosis should receive careful attention because of the possibility of digital gangrene. To our knowledge, this report is on the first ATLL case in the literature presenting with digital gangrene associated with occlusive thrombi.

Adult↗
PubMed1997

SLE with death from acute massive pulmonary hemorrhage caused by disseminated strongyloidiasis.

We describe a case of disseminated strongyloidiasis involving a female patient with active systemic erythematosus (SLE). The cause of death was massive pulmonary hemorrhage induced by a filariform larvae infection. This was initially diagnosed during examination of the bronchoalveolar lavage fluid just 2 days before her death. The case indicated that immunosuppressed individuals would be paid attention to possible parasitic infection prior to starting therapy even in non-endemic areas as well as other microorganisms.

Acute Disease↗
PubMed1996

Cutaneous metastasis of an osteosarcoma. A case report.

Sarcomas seldom metastasize to the skin. This report describes a rare instance of this phenomenon. A 24-year-old patient with a history of osteosarcoma (osteoblastic type) of the right humerus was seen with a cutaneous nodule on the left temple. Histologic examination of the skin showed the lesion to be a metastatic osteosarcoma. On histologic examination, a proliferation of bizarre mononucleated or multinucleated osteoblastic cells was noted in the dermis and subcutis. Although osteoid formation and calcification were not recognized, as they had been in contrast to the primary lesion, basic structures and components of the skin lesion were identical to those of the primary tumor tissue. Cutaneous metastasis from on osteosarcoma of bone is an extraordinarily rare event and, as far as we can determine, has only been reported three times.

Adult↗
PubMed1996

Human T lymphotropic virus-1 infection.

Human T lymphotropic virus-1 (HTLV-1) is a retrovirus which infects T lymphocytes (CD4+) to cause adult T cell leukaemia/lymphoma (ATL), tropical spastic para-paresis and several other HTLV-1 associated disorders. ATL has been reported worldwide but areas of high incidence include Japan (particularly the south-west), Central and South America, northern Iran, West and Central Africa and Melanesia. In the general Japanese population, HTLV-1 carriage is 0.1% but this can be as high as 50% in endemic areas. Six per 10000 carriers are estimated to progress to ATL each year. The three major routes of infection are mother to baby through breast-feeding, sexual intercourse and blood transfusion. There is a lengthy latency period of up to 40 years before the development of ATL. Up to 50% of ATL patients present with a cutaneous eruption. Diagnosis is established by the detection in lymphocytes of monoclonal integration of HTLV-1 proviral DNA. Even with aggressive treatment, ATL patients generally have a poor prognosis.

Biopsy, Needle↗