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M Tsuneyoshi

Publications and source records attributed to M Tsuneyoshi.

At least 55 records · Page 3Linked to original sources
PubMed1994

Xanthogranulomatous cholecystitis masquerading as gallbladder carcinoma.

We herein present a case of xanthogranulomatous cholecystitis which involved both the liver and transverse colon, clinically mimicking gallbladder carcinoma. Such cases may sometimes be judged inoperable due to extensive extra-gallbladder invasion, and thus it is necessary for physicians to take this lesion into consideration when making a diagnosis. An intraoperative biopsy is necessary, therefore, even when the features seem to clearly indicate inoperable carcinoma.

Aged↗
PubMed1994

Small-cell carcinoma combined with adenocarcinoma of the gallbladder. A case report with immunohistochemical and flow cytometric studies.

A small-cell carcinoma combined with adenocarcinoma of the gallbladder was detected in a 71-year-old Japanese woman. A nodular mass measuring 4.0 x 5.0 cm was located in the fundus of the gallbladder, in which a tiny depressed lesion measuring 2 mm in diameter was macroscopically and stereomicroscopically observed. Histologically, the depressed area revealed small-cell carcinoma that consisted of atypical cells with small, round to oval nuclei and scanty cytoplasm and was surrounded by ordinary well-differentiated adenocarcinoma. Immunohistochemically, the tumor cells in an adenocarcinomatous area were diffusely positive for carcinoembryonic antigen and showed an interspersed positivity to serotonin and gastrin, while the tumor cells in the small-cell carcinoma area were negative for both antigens. The nuclear DNA content of the tumor cells of both components was aneuploid; however, the first G0/G1 peak of the small-cell carcinoma was much smaller than that of the adenocarcinoma. These results indicated that the tumor revealed a divergence in functional differentiation, and this feature suggested an initial phase of composite small-cell carcinoma and adenocarcinoma in the gallbladder.

Adenocarcinoma↗
PubMed1993

Effects of preoperative transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma. The relationship between postoperative course and tumor necrosis.

BACKGROUND: The effects of preoperative transcatheter arterial chemoembolization (TAE) for hepatocellular carcinoma (HCC) remain a matter of controversy. METHODS: Seventy-two patients with HCC were entered in the study; the patients did not have the risk factors for disease recurrence of tumor larger than 5 cm in diameter, the presence of venous invasion, or intrahepatic metastasis. Only patients with 3 years of follow-up after curative resection were selected. Forty-six underwent TAE (Group I) and 26 did not undergo TAE (Group II). Group I was divided into three subgroups according to the degree of tumor necrosis: IA, complete necrosis; IB, partial necrosis; and IC, no necrosis. Group II was divided into two subgroups: IIB, partial necrosis; and IIC, no necrosis. RESULTS: Preoperative TAE did not improve the average disease-free survival rates of the group as a whole. For patients undergoing TAE, the survival rate of Group IB was significantly worse than that of Groups IA or IC. The survival rate of Group IB was worse than that of Group II, but the difference was not significant. In Group II, the survival of Group IIB was worse than that of Group IIC. Histologically, residual tumor cells lacking mutual contact were detected in some patients in Group IB. CONCLUSION: These results indicate that partial tumor necrosis caused by preoperative TAE or spontaneous tumor necrosis per se might facilitate postoperative disease recurrence. This may occur because in patients with partial necrosis, the remaining tumor cells are less firmly attached and more likely to be dislodged into the bloodstream during hepatic resection.

Adult↗
PubMed1993

Time trends of early gastric carcinoma. A clinicopathologic analysis of 2846 cases.

BACKGROUND: Despite recent improvements in the diagnostic accuracy and techniques for identifying early gastric carcinoma, gastric carcinoma remains a major cause of death in the world. METHODS: The clinicopathologic features of 2846 surgically resected early gastric carcinomas from 1962-1987 were reviewed, and the time trends of a variety of clinicopathologic factors were studied using both an univariate and a multivariate analysis. RESULTS: The differentiated type of carcinoma increased in frequency from 34-50%. The percentage of patients older than 60 years of age increased from 32-56%. The number of lesions measuring less than 3 cm increased from 28-56%. The frequency of shallow-type-IIc carcinomas measuring less than 3 cm, which had been previously difficult to detect and were mainly composed of differentiated carcinomas, increased from 46-69%. The relative proportion of the differentiated type of carcinoma was significantly higher in patients older than 60 years of age than in those younger than 60. The relative proportion of differentiated-type carcinomas measuring less than 3 cm, which had been easy to detect as opposed to undifferentiated-type carcinomas, significantly increased from 56-76%. CONCLUSIONS: The above time trends may indeed reflect genuine change. However, the recent increase in the rate of differentiated-type, small-sized carcinomas also suggests the possibility that such results may, in fact, be due mainly to improvements in both diagnostic accuracy and medical technology. Thus, a large number of undifferentiated-type, small-sized carcinomas might have merely failed to be found in routine gastric examination.

Age Factors↗
PubMed1993

Proliferating cell nuclear antigen in hepatocellular carcinoma and small cell liver dysplasia.

BACKGROUND: Recently, proliferating cell nuclear antigen (PCNA) has been measured by using a monoclonal antibody in a variety of malignant neoplasms. METHODS: The authors evaluated cell proliferative activity by immunostaining for PCNA in 92 hepatocellular carcinoma nodules and 14 lesions of small cell liver dysplasia. RESULTS: The average PCNA labeling indices (LI) in Grades I, II, III, and IV were 12.2%, 17.5%, 53.7%, and 83.9%, respectively. There were statistically significant differences in the PCNA LI between all the histologic grades, except for Grades I and II. The less differentiated the histologic grade, the higher the PCNA LI became. This finding was also recognized in a hepatocellular carcinoma showing a "nodule in a nodule" appearance, in which the less-differentiated inner nodule had a higher PCNA LI than did the well-differentiated outer lesion. For an analysis of the disease-free survival in 74 patients with clinical follow-up data, 2 groups of patients with a PCNA LI higher and lower than the average level (32.0%) were compared. The disease-free survival rate after surgery was significantly higher (P < 0.005), and the venous invasion was significantly less frequent (P = 0.0003) in the low PCNA LI group than in the high PCNA LI group. The average PCNA LI in small cell liver dysplasia was 13.9%, which was almost equal to that of Grades I and II hepatocellular carcinoma. CONCLUSIONS: The PCNA LI of hepatocellular carcinoma showed a close correlation with both the histologic findings and the biologic behavior. Small cell liver dysplasia was a small round focus having proliferative activity similar to that of Grades I and II hepatocellular carcinoma.

Aged↗
PubMed1993

Transitional cell carcinoma pattern in primary carcinoma of the fallopian tube.

BACKGROUND: A broad papillary proliferation resembling that in transitional cell carcinoma (TCC) of the urinary bladder was seen in 12 of 21 primary carcinomas of the Fallopian tube (PCFT). METHODS: According to their predominant histologic pattern (more than 50%), PCFT were classified into 9 TCC-predominant and 12 non-TCC-predominant tumors. The two groups were compared by clinicopathologic, histochemical, and immunohistochemical means. RESULTS: TCC-predominant tumors were grossly solid and microscopically demonstrated more frequent tumor necrosis and spindled tumor cells than non-TCC-predominant tumors. Mucin histochemistry revealed a correlation between TCC-predominant tumor and sulfomucin-predominant secretion and between non-TCC-predominant tumor and sialomucin-predominant secretion. Immunohistochemical studies for cytokeratins, vimentin, epithelial membrane antigen (EMA), Leu-M1, carcinoembryonic antigen (CEA), and CA 125 were not useful for discrimination between the two groups. Both groups showed similar features in patient age, clinical stage, cytology of ascites or peritoneal washing, and serum CA 125 level. Despite the similarity in treatment (surgery and postoperative chemotherapy) between the two groups, TCC-predominant tumors tended to relapse later (mean, 31.2 months after diagnosis) than non-TCC-predominant tumors (mean, 14.4 months after diagnosis), resulting in a significant difference in the 2-year disease-free survival rate. CONCLUSIONS: TCC pattern and non-TCC pattern are considered to be worthy of distinction in PCFT.

Adult↗
PubMed1993

Hepatoid adenocarcinoma of the stomach. A clinicopathologic and immunohistochemical analysis.

BACKGROUND: The clinicopathologic and immunohistochemical features of the primary gastric hepatoid adenocarcinomas still remain unclear. METHODS: The authors evaluated 28 hepatoid adenocarcinomas (HC) of the stomach on the basis of characteristic histologic features resembling hepatocellular carcinoma, which were selected from the 7200 cases of primary gastric carcinoma in their files. Additionally, 22 alpha-fetoprotein (AFP)-positive adenocarcinomas without hepatoid features (APC) were also selected. RESULTS: The HC cases fell into the following two groups: HC with AFP-positive tumor cells (Group 1; 15 cases) and HC without AFP-positive cells (Group 2; 13 cases). Histologically, the glycogen granules and hyaline globules were common features in HC. The incidence of a venous invasion of HC (Groups 1 and 2) was higher than that of APC (Group 3). There were no significant differences among the three groups regarding clinical features, macroscopic features, and the incidence of lymphatic permeation. An immunohistochemical study showed that HC had differentiation into various directions. As for the advanced carcinomas, the 5-year survival rates of patients with HC (Groups 1 and 2) and those with APC (Group 3) were 11.9% (21.4%, 8.3%) and 38.2%, respectively. The prognosis of Group 1 was similar to that of Group 2, but was poorer than that of Group 3. CONCLUSIONS: The findings suggested that HC, as shown by its characteristic histologic features, had a poor prognosis whether producing AFP or not, and that HC should therefore be distinguished from AFP-positive carcinoma without hepatoid features.

Adenocarcinoma↗
PubMed1993

Prognostic factors of malignant fibrous histiocytoma of bone. A clinical and histopathologic analysis of 34 cases.

BACKGROUND: Malignant fibrous histiocytoma (MFH) of bone is a rare bone tumor, and its prognosis has been controversial. METHODS: Thirty-four patients with MFH of bone were examined clinicopathologically for prognostic factors. RESULTS: The most common skeletal site of the tumor was the femur (15 cases), followed by the pelvic bones (6 cases), tibia (5 cases), and fibula (5 cases). Of 29 patients available for follow-up, the 5-year survival rate of 17 who underwent adequate surgical treatment was 63%. The 5-year survival rate of the remaining 12 patients, including 5 with MFH of the pelvic bone who received inadequate or palliative surgery, was 17%. All six patients who received intensive chemotherapy combined with adequate surgical treatment were alive and well 5 years after the initial treatment. Histologically, the presence of desmoplasia and chronic inflammatory infiltration in the tumor tended to be prognostic indicators, although not to a statistically significant extent. Patients whose tumors contained wide areas of desmoplasia had a worse prognosis (5-year survival rate, 20%). In contrast, those with a prominent chronic inflammatory infiltrate had a 5-year survival rate of 78%. CONCLUSIONS: These histologic variables would be helpful for predicting the prognosis of MFH of bone. Adjuvant intensive chemotherapy combined with adequate initial surgery may effect a clinical cure.

Adolescent↗
PubMed1993

Intraductal papillary neoplasm of the pancreas.

BACKGROUND: In 1989, Morohoshi et al. reported an intraductal papillary neoplasm of the pancreas (IPNP), which was a morphologically distinct, but rare tumor. METHODS: Two cases with IPNP were analyzed by immunohistochemical and DNA flow cytometric methods. RESULTS: The patients included a 67-year-old man and a 71-year-old woman. Both tumors were characterized by a well-defined papillary growth in the cystically dilated main pancreatic ducts, associated with papillary and nonpapillary hyperplasia. Immunohistochemically, the tumor cells of both cases were positive for the epithelial markers (AE1/AE3 and CAM 5.2), and in one of the two cases, the tumor cells and hyperplastic cells surrounding the tumor conspicuously revealed multiple hormonal markers such as serotonin, somatostatin, glucagon, gastrin, and pancreatic polypeptide. The nuclear DNA content of the tumor cells of the first case, which showed moderate cellular atypia, was considered to be diploid, whereas that of the second case, which revealed severe atypia, was aneuploid. CONCLUSIONS: These results suggested that these tumors arose from multipotential stem cells capable of epithelial and neuroendocrine differentiation, and results of the flow cytometric study was related to the degree of cellular atypia of the tumors.

Adenocarcinoma, Mucinous↗
PubMed1993

The prognostic value of immunohistochemical staining for proliferating cell nuclear antigen in synovial sarcoma.

BACKGROUND: The biologic behavior of synovial sarcoma remains a matter of controversy. Some investigators considered proliferative activity to be an important prognostic factor in this tumor. METHODS: Fifty-six patients with synovial sarcoma were immunohistochemically studied with PC10, a monoclonal antibody to proliferating cell nuclear antigen (PCNA). The percentage of nuclear areas with positive staining for PCNA (PCNA score), quantified by using an image analyzer, was compared with nuclear atypia, tumor necrosis, mitoses, and survival. Fifty-one patients were available for survival analysis. DNA flow cytometry was performed on 30 patients and compared with PCNA score and survival. The prognostic variables were analyzed with a multivariate technique using the Cox hazard model. RESULTS: Nuclear atypia (mild, 14; moderate, 23; severe, 14), mitosis (low, 34; high, 17), and tumor necrosis (< 50%, 37; > 50%, 14) were found to highly affect survival in the log-rank test (P < 0.01). Sixteen patients with a high (> or = 12.5) PCNA score had a worse survival (P < 0.01) than did the 35 patients with a low (< 12.5) PCNA score. In patients in whom DNA flow cytometry was performed, the S+G2M-phase fraction showed no correlation with the clinical outcome. However, there was a significant relationship between the extent of PCNA staining and S+G2M fraction (correlation coefficient [CC] = 0.54; P = 0.002), although the CC between PCNA staining and the mitotic count was only 0.38. However, the ploidy pattern was not related to PCNA scores or prognosis. In a multivariate analysis, a high PCNA score (P = 0.017) and severe nuclear atypia (P = 0.0003) were strong prognostic factors. CONCLUSIONS: The results suggest that a high PCNA score is one of the poor prognostic factors in synovial sarcoma.

Adolescent↗
PubMed1993

Papillary cystic tumors of the pancreas. Assessment of their malignant potential.

BACKGROUND: Although the biologic characteristics of papillary cystic tumors (PCT) generally indicate a good prognosis, a malignant form has been reported. METHODS: Twenty-two examples of PCT were examined to assess their malignant potential by histologic, flow cytometric, and immunohistochemical studies. RESULTS: Three had hepatic, peritoneal, and/or lymph node metastases (metastasizing tumors [MT]); the other 19 PCT had no such metastatic features (nonmetastasizing tumors [NMT]). Venous invasion was detected in all three MT and two NMT. Compared with the 19 NMT, the MT had a higher nuclear grade and more prominent necrobiotic nests characterized by aggregates of cells with pyknotic nuclei and eosinophilic cytoplasm. In the flow cytometric analysis of cellular DNA content, one MT was aneuploid, and eight NMT were diploid. Immunohistochemically, there was no difference between the MT and NMT. CONCLUSIONS: These results support the assumption that venous invasion, nuclear grade, and prominent necrobiotic nests are useful as histologic parameters to detect the malignant potential of PCT.

Adenocarcinoma↗
PubMed1993

Case report 793. Periosteal osteosarcoma of the clavicle.

A case of periosteal osteosarcoma in an 18-year-old boy has been reported. This is the first reported case of periosteal osteosarcoma arising in the clavicle. The radiological features in this case were entirely similar to those in long bones such as the femur and tibia. In addition to the radiological features and pathologic findings, various clinical aspects and prognosis were also discussed.

Adolescent↗
PubMed1993

Benign schwannoma in the hepatoduodenal ligament: report of a case.

A 62-year-old woman with a large mass in the hepatic hilus underwent surgery. Histologically the tumor was predominantly composed of spindle-shaped cells with nuclear palisading and cells that stained positively for S-100 protein. The diagnosis was benign schwannoma (neurilemoma). The presence of lymphoid cuffing with lymphoid follicles in the capsule and xanthomatous change differed from conventional soft parts schwannoma and closely resembled benign schwannoma in the gastrointestinal tract.

Bile Duct Neoplasms↗
PubMed1993

Primary rhabdomyosarcoma of the iliac bone in an adult: a case mimicking fibrosarcoma.

Primary rhabdomyosarcoma of bone is exceedingly rare. We present a case of rhabdomyosarcoma of the iliac bone in a 32-year-old male. Histologically, the tumour consisted mainly of a uniform proliferation of elongated spindle cells arranged in a herring bone pattern, simulating fibrosarcoma. Focally there was a conventional embryonal pattern with scattered rhabdomyoblasts possessing an eosinophilic cytoplasm. Immunohistochemical studies disclosed expression of muscle markers such as desmin and muscle-specific actin, in both the embryonal and spindle-cell areas and myoglobin only in the embryonal areas. Such histological features are unusual for classical embryonal rhabdomyosarcoma. The anatomical site and age of the patient are also atypical.

Adult↗
PubMed1993

Papillary cystic tumours of the pancreas: an analysis by nuclear morphometry.

Papillary cystic tumour (PCT) is a rare, low-grade malignant pancreatic neoplasm, in which the histological criteria for malignancy are still uncertain. We performed a histological examination of 3 metastasizing PCTs, while comparing them with 18 non-metastasizing PCTs, using a computed image analyser. The mean maximum nuclear diameter, the mean standard deviation (SD) of the nuclear diameter, the mean nuclear area and the nuclear-nonnuclear (N/NN) ratio obtained by the image analyser of the metastasizing PCTs (7.23 microns, 2.21 microns, 30.45 microns2, 36.41%) were all significantly larger than those of the non-metastasizing PCT (6.34 microns, 1.59 microns, 23.66 microns2, 23.74%; P < 0.005, P < 0.005, P < 0.005, P < 0.001 respectively). However, there were no statistical differences in either the nuclear ellipsoidity or nuclear regularity. These results suggested that nuclear morphometry might be a useful parameter to define metastatic potential, in addition to histological variables such as venous invasion, nuclear grade and mitotic rate.

Adolescent↗
PubMed1993

Significance of pericryptal fibroblasts in colorectal epithelial tumors: a special reference to the histologic features and growth patterns.

We analyzed the appearance of pericryptal fibroblasts (PCFs) identical to myofibroblasts in human colorectal epithelial tumors (adenomas, carcinomas) by an immunohistochemical method, with special reference to the histologic features and tumor growth patterns. The majority (61.5%) of adenomas contained well-developed PCFs. In contrast, carcinomas contained more poorly developed PCFs than adenomas. Approximately one third (35.4%) of the intramucosal and most (89.6%) of the submucosal carcinoma components had poorly developed PCFs. Pericryptal fibroblast development in pure carcinomas also was evaluated in association with two types of tumor growth patterns: polypoid growth carcinoma (PG-Ca) and nonpolypoid growth carcinoma (NPG-Ca). Polypoid growth carcinoma tended to contain well-developed PCFs, whereas NPG-Ca tended to lack PCFs. From the above findings, it is suggested that PCFs gradually decrease in the sequence of adenoma, intramucosal carcinoma, and submucosal invasive carcinoma. In addition, the two growth types (PG-Ca and NPG-Ca) are histologically different in PCF development, and the lack of a PCF network in NPG-Ca seems to be the reason why NPG-Ca can invade the submucosa more easily than PG-Ca, which has a consistent PCF network.

Adenoma↗
PubMed1993

Stereomicroscopic examination of surface morphology in colorectal epithelial tumors.

The mucosal surface structure of epithelial neoplasms in the large intestine was examined by a stereomicroscope, and the correlation between histologic and macroscopic features was studied. The surface structure of the colonic mucosa could be readily and clearly observed using the stereomicroscope after superficial staining, and neoplastic lesions were identified as well-defined foci of the unique structures that were conspicuously different from those in the normal mucosa. Five hundred two adenomas and 159 carcinomas were examined and divided into five types according to stereomicroscopic appearance: long ellipsoid (359 lesions), cerebriform (141 lesions), leaf-like (16 lesions), dense tiny pits (89 lesions), and devastated (56 lesions). In the first three types benign adenomas predominated in the majority of cases (94.7%, 72.3%, and 68.8%, respectively) and the variation in the surface features correlated well with the histologic types. In the latter two types the frequency of malignancy was strikingly high (49.4% and 92.9%, respectively), with the devastated mucosal appearance being highly indicative of invasive carcinoma. Macroscopically, exophytic polypoid configurations were frequently found in the first three types, whereas flat nonpolypoid configurations predominated in the cases with dense tiny pits. Our results indicate that there is a close relationship between the surface structure of epithelial neoplasms in the large intestine and their histologic features and growth patterns.

Adenoma↗