Biomedical subjects

N Shimizutani

Publications and source records attributed to N Shimizutani.

4 recordsLinked to original sources

PubMed1999

[Posterior mediastinal diffuse pleomorphic lymphoma].

A 26-year-old man presented with a 38 degrees C fever of undetermined origin in November 1977. His fever subsided in 1 month, but recurred concomitantly with dysphagia on December 10. For this reason, the patient visited our out patient clinic on December 15, and was hospitalized because a mass was found radiographically in the left lower lung field. A contrast-enhanced computed tomographic scan of the chest revealed an irregularly-shaped mass encircling the esophagus. Based on open-lung biopsy findings, the mass was diagnosed as non-Hodgkin's lymphoma, diffuse pleomorphic type. Neither swelling of the superficial lymph nodes nor hepatosplenomegaly was detected, and a bone-marrow aspiration specimen disclosed no atypical cells. Ga scintigraphy found accumulation only in this region, suggesting the posterior mediastinum as the origin of the lymphoma. Reports of non-Hodgkin's primary lymphoma in the posterior mediastinum are rare. Further, to our knowledge, there have been no reports at all on the diffuse pleomorphic type to date. This case was accordingly considered to be of highly informative value.

Adult↗

PubMed1999

[A case of Morgagni's foramen hernia difficult to differentiate from lipoma].

A 61-year-old woman was admitted for chest discomfort. She had been admitted before, in March 1995, because of a lesion detected on chest roentgenograms. At that time, she was given a diagnosis of mediastinal lipoma based on the findings of chest computed tomography (CT) and magnetic resonance imaging (MRI), but was discharged without active intervention due to lack of subjective symptoms. During follow-up, the patient again reported chest discomfort beginning in March 1998. Because chest radiography disclosed. The tumor had enlarged, the patient was admitted to the hospital by our department. Chest MRI disclosed a mass with a signal intensity equal to that of subcutaneous fat in the pericardial space on both T1-weighted and T2-weighted images. Although sagittal images demonstrated continuity of the mass into intraperitoneal fat, a conclusive diagnosis of diaphragmatic hernia could not be made at that time. On April 30, 1998, a thoracotomy was performed on the basis of a preoperative diagnosis of mediastinal lipoma. During surgery, a hernial ring was observed slightly to the right and behind the sternum. The hernia consisted only of greater omentum, and was diagnosed as Morgagni's foramen hernia.

Diagnosis, Differential↗

PubMed1999

[Sarcoidosis synchronously detected in identical twins].

We report on the synchronous detection of sarcoidosis in identical 22-year-old male twins. The patients visited a nearby physician because of fever and cough, were found to have abnormal chest shadows and thus admitted to our hospital. Both had swollen cervical and hilar nodes and lesions in both left and right lung fields, and also presented similar clinical symptoms. However, bilateral uveitis was observed only in the elder twin. Because epithelioid cell granulomas without caseous necrosis were histopathologically observed in tissue specimens from their cervical lymph nodes, the patients were given a diagnosis of sarcoidosis. Although they were positive for the HLA-D antigens DR 2 and DR 12, they were negative for DRw 52. an antigen that is considered to be quite common in Japanese sarcoidosis patients. Genetic factors were thought to be involved in the onset of sarcoidosis in these twins.

Adult↗

PubMed1999

[Three cases of semi-invasive pulmonary aspergillosis occurring in healthy or diabetic individuals].

We encountered three cases of suspected semi-invasive pulmonary aspergillosis, occurring in healthy or diabetic patients. Radiographic findings disclosed cavity formation in 2 of the patients, but only nodular lesions in 1. The beta-D glucan level was elevated in 1 patient, but was within the normal range in the other 2. Morphological findings indicated that all 3 patients had pulmonary aspergillosis. Following the oral administration of FLCZ to 1 patient and ITCZ to the other 2 for about 2 months, the radiographic lesions resolved and hematologic inflammatory reactions cleared up. Gefter et al and Sider et al have defined 2 types of aspergillosis that occur in mildly immuno-compromised or healthy individuals: the semi-invasive type, which destroys pulmonary tissue without vascular invasion and leads to cavity formation; and the locally invasive type, which is characterized by nodular or massive radiographic lesions without cavity formation. Semi-invasive aspergillosis was diagnosed in all 3 of the cases we reported.

Adult↗