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Biomedical subjects

Takashi Marui

Publications and source records attributed to Takashi Marui.

At least 37 records · Page 2Linked to original sources
PubMed2002

Aspiration biopsy of nodular sarcoidosis of the muscle.

The nodular form of muscular sarcoidosis is rare and the condition is often confused with a soft tissue neoplasm. We present a case of nodular muscular sarcoidosis of the right calf in a 52-yr-old woman which was diagnosed by thin-needle aspiration biopsy (TNAB). In this patient, a calf mass was the initial manifestation of sarcoidosis. Contrast-enhanced computed tomographic scans of the calf showed a mass with peripheral ring-like enhancement. T2-weighted magnetic resonance images demonstrated a mass with central hypointensity and marked peripheral hyperintensity. TNAB revealed noncaseating epithelioid cell granulomas in association with multinucleated giant cells. Combined with the radiologic findings, TNAB is considered a useful modality for the diagnosis of nodular muscular sarcoidosis.

Biopsy, Needle↗
PubMed2002

Scrape and fine-needle aspiration cytology of extraskeletal osteosarcoma.

Extraskeletal osteosarcoma is a rare malignant soft tissue tumor whose cytologic findings are infrequently reported. We describe scrape and fine-needle aspiration biopsy (FNAB) cytology findings of an extraskeletal osteosarcoma in the right shoulder of a 24-yr-old man. Initial computed tomography revealed multiple ossification foci within the lesion. After excision of the primary tumor, the tumor recurred 13 months later. Scrape smears of both the primary tumor and FNAB smears of the recurrent tumor revealed moderate cellularity, cell clusters, and individual cells, closely associated with dense, homogeneous, acellular matrix material. The cells had elongated, oval, or partially bizarre-shaped nuclei with a coarse chromatin pattern and prominent nucleoli. The scrape smears contained large fragments of matrix material consistent with osteoid.

Adult↗
PubMed2002

Reliability of fine-needle aspiration biopsy in the initial diagnosis of soft-tissue lesions.

We retrospectively reviewed fine-needle aspiration biopsy (FNAB) specimens of 301 soft tissue lesions of the extremities and trunk. Final diagnoses were 137 benign and 86 malignant neoplasms and 78 nonneoplastic lesions. Of the 301 FNAB samples, 279 (93%) were adequate for cytologic diagnosis. The adequate FNAB specimens were initially grouped into three broad categories: benign (197 cases), malignant (57 cases), and suspicious for malignancy (25 cases). Sensitivity and specificity for diagnosis of a malignant lesion were 92% and 97%, respectively. The specimens were cytomorphologically classified into nine categories: small round (14 cases), spindle cell (77 cases), epithelioid/polygonal (16 cases), pleomorphic (29 cases), myxoid (19 cases), lipomatous (37 cases), epithelial (23 cases), inflammatory lesions (28 cases), and others (36 cases). Specific FNAB diagnoses were correct in 151 of 279 cases (54%) in combination with clinical and radiologic findings. FNAB is a valuable technique for the primary diagnosis of soft-tissue lesions.

Adolescent↗
PubMed2002

Mechanical stretching force promotes collagen synthesis by cultured cells from human ligamentum flavum via transforming growth factor-beta1.

Although mechanical stress as a result of spinal instability is known to cause hypertrophy of the ligamentum flavum resulting in degenerative spinal canal stenosis, the mechanism of the ligament hypertrophy is not well understood. In the present study, we investigated the effect of mechanical stretching force on collagen synthesis and transforming growth factor-beta1 (TGF-beta1) production using ligament cells isolated from human ligamentum flavum in vitro. Ligamentum flavum cells (LFCs) were isolated from human ligamentum flavum obtained from patients who underwent lumbar spine surgery. The LFCs were subjected to a mechanical stretching force using a commercially available stretching device that physically deformed the cells. Collagen synthesis and TGF-beta1 production levels in the LFCs were then examined. Notable increases were observed in the gene expressions of collagen types I, III, and V in LFCs subjected to mechanical stretching force. The increase in collagen gene expression of LFCs was inhibited in the presence of anti-TGF-beta1 antibodies. Production of TGF-beta1 by the LFCs also increased significantly by the mechanical stretching force. Exogenous application of TGF-beta1 was confirmed to increase collagen synthesis of the LFCs. This data indicated that mechanical stretching force can promote TGF-beta1 production by LFCs, resulting in hypertrophy of the ligament.

Adult↗
PubMed2002

Osteosarcoma of the distal radius treated by intraoperative extracorporeal irradiation.

Osteoblastic osteosarcoma in the distal radius of a 50-year-old woman was treated by en bloc resection, intraoperative extracorporeal irradiation, and reimplantation. Twenty-three months after surgery finger function was good. No tumor recurrence or distant metastasis was found at the final follow-up examination. Intraoperative extracorporeal irradiation and reimplantation is an easy and convenient reconstructive surgical procedure after en bloc excision of a tumor in the distal radius. A biologic reconstruction with a precise anatomic fit is possible, and long-term endoprosthetic problems and maintenance of bone-banking facilities for allografts are avoided.

Bone Neoplasms↗
PubMed2002

Intracortical lipoma of the femur.

The authors report on a rare case of intracortical lipoma of the right femur in a 74-year-old woman. Magnetic resonance imaging and computed tomography of the femur demonstrated an intracortical lesion in the lateral diaphysis. No medullary involvement by the lesion was noted. Both imaging methods revealed the presence of fat in the lesion. Histologically, the tumor consisted of a large area of mature adipose tissues, admixed with foci of fat necrosis, calcification, and myxoid degeneration. Total excision of the tumor was curative. This is the second reported case of intracortical lipoma.

Aged↗
PubMed2002

Anterior spinal artery syndrome after total spondylectomy of T10, T11, and T12.

Although radical resection is the best treatment for local aggressive benign tumors or malignant tumors of the spine, total spondylectomy for lower thoracic vertebrae may cause anterior spinal artery syndrome. There are few reports in the literature in which this syndrome has been documented in association with thoracic spondylectomy, although this syndrome is the most common neurologic complication after abdominal aortic surgery. A 50-year-old woman with a giant cell tumor of the thoracic vertebrae was treated by posterior and anterior surgery. Thoracic segmental arteries from T10 to T12 had to be resected bilaterally to dissect the aorta free from the tumor. After resection of all feeding arteries to the tumor, the tumor and entire parts of T10, T11, and T12 were removed. Postoperative neurologic examination disclosed flaccid paralysis of the lower extremities and sphincter incontinence. Although pain and temperature sensation were absent, vibration and position sense were intact, showing anterior spinal artery syndrome. Intraoperative somatosensory-evoked potential monitoring only showed that transient deterioration failed to adequately reflect this neurologic injury. Major reconstructive surgery involving lower thoracic regions may cause anterior spinal artery syndrome. Somatosensory-evoked potential monitoring might not reliably predict overall neurologic outcome involving the blood supply of the lower thoracic regions.

Evoked Potentials, Somatosensory↗
PubMedDate not supplied

Fibroma of tendon sheath originating from the knee joint capsule.

We present a rare case of fibroma of the tendon sheath originating from the posterior joint capsule of the knee in a 50-year-old man. Magnetic resonance (MR) imaging revealed a lesion posterior to the medial femoral condyle. The lesion showed hypointensity on all T1-weighted, T2-weighted, short tau inversion recovery (STIR), and contrast-enhanced T1-weighted images. Plain computed tomographic (CT) scans showed a lesion with isodensity to muscle. The lesion showed no enhancement on postcontrast CT scans.

Fibroma↗
PubMedDate not supplied

Subacute osteomyelitis of long bones: diagnostic usefulness of the "penumbra sign" on MRI.

Although subacute osteomyelitis of long bones is not uncommon, it is usually confined to metaphysis. Two unusual cases of subacute osteomyelitis that traversed a growth plate are described. There may be some radiological difficulties in distinguishing it from other malignant or benign lesions. On magnetic resonance (MR) imaging, both of the present cases showed characteristic four-layered appearance and the penumbra sign. These characteristic findings on MR imaging are considered to facilitate establishing the radiologic diagnosis.

Adolescent↗
PubMedDate not supplied

A true intra-articular lipoma of the knee in a girl.

A 16-year-old girl presented with a soft-tissue mass in the anterolateral aspect of her right knee. Magnetic resonance imaging revealed an intra-articular tumor arising from the anterior fat pad of the knee. The tumor showed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. It was resected under arthroscopic guidance. Grossly, the tumor was composed of soft, yellowish adipose tissue. Pathologic examination revealed a collection of mature adipocytes with marked myxoid changes in the matrix. A diagnosis of lipoma was made. True intra-articular lipomas should be distinguished from lipoma arborescens, which is considered to be a reactive process. In the English language literature, we found only 7 cases of true intra-articular lipoma reported previously. The present case is the youngest patient with such a tumor, and all the previous reports are of the tumor in adult patients. Intra-articular lipoma should be considered in the differential diagnosis of intra-articular masses in adolescents.

Adolescent↗
PubMedDate not supplied

Allograft replacement of common iliac artery mycotic aneurysm caused by Bacteroides fragilis vertebral spondylitis--a case report.

Mycotic aneurysm secondary to vertebral spondylitis is a rare but life-threatening pathology with high mortality and morbidity. The authors describe a successfully treated case of mycotic aneurysm of the common iliac artery complicated with vertebral spondylitis in a 74-year-old man. Under midline laparotomy, complete debridement of the infected tissues, in-situ replacement of the common iliac artery with cryopreserved aortic allograft, and iliac bone autotransplantation and omentopexy to fill the debrided cavity were performed. The postoperative course was uneventful, and he remains well 3 years after his operation without persistent infection or allograft rejection.

Aged↗
PubMedDate not supplied

Scrape and fine-needle aspiration cytology of elastofibroma.

BACKGROUND: Cytological findings of elastofibroma have rarely been reported and, to the best of our knowledge, have been illustrated in only 4 patients in the English language literature. MATERIALS AND METHODS: We retrospectively reviewed fine-needle aspiration biopsy (FNAB) and scrape smears in 5 cases of elastofibroma. RESULTS: All the lesions were typically located between the rib cage and the scapula. The cytological smears consisted of mature adipocytes, fibroblasts, collagen fibers, globular bodies and characteristic "braid-like" or "fern-like" structures, revealing degenerative elastic fibers. All the smears were specifically diagnosed as elastofibroma in combination with clinical and radiological findings. CONCLUSION: FNAB smears of elastofibromas may be hypocellular due to their densely fibrous nature and therefore diagnostic material may often be overlooked. Careful evaluation of the background of the smears coupled with full knowledge of the clinical and radiological findings, including magnetic resonance imaging, is required to establish the correct diagnosis.

Adipocytes↗
PubMedDate not supplied

Reimplantation of autoclaved or irradiated cortical bones invaded by soft tissue sarcomas.

BACKGROUND: Bone defects after excision of malignant bone and soft tissue tumors are usually reconstructed by autogenous bone grafting or allografting. PATIENTS AND METHODS: We treated 2 patients who had soft tissue sarcomas with bone involvement, the first by excision and reimplantation of the hemicortical autogenous cortical bone graft after autoclaving and the second with intraoperative irradiation. RESULTS: In both patients, postoperative follow-up radiographic studies showed incorporation of the implanted bones into the host bones within 12 months. Biopsy of the implanted bone performed 3 years after surgery showed many viable osteocytes, and blood vessel invasion into Harversian canals. No complications regarding the reconstructive techniques were observed during the postoperative period. CONCLUSION: The reimplantation of autogenous cortical bones after autoclaving or irradiation is a useful reconstructive method for partial bone defects in soft tissue tumor surgery.

Adult↗