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Biomedical subjects

Tetsuji Yamamoto

Publications and source records attributed to Tetsuji Yamamoto.

At least 37 records · Page 2Linked to original sources

Neurilemmoma in the foot as a cause of heel pain: a report of two cases.

Two cases of deep-seated neurilemmoma that arose from plantar branches of the posterior tibial nerve and caused chronic heel pain are described. At the initial examination, one case was misdiagnosed as tarsal tunnel syndrome and the other was overlooked as plantar fasciitis; both cases were treated for long periods prior to operation. Deep-seated neurilemmomas in the foot can easily be overlooked and misdiagnosed as tarsal tunnel syndrome or plantar fasciitis because of the rarity, absence of palpable mass, and similarity of symptoms to those of other frequently encountered foot disorders. Magnetic resonance imaging provides the best modality for differential diagnosis. In the present cases, surgical excision of the tumors resulted in immediate and complete relief of chronic heel pain. Surgeons should consider neurilemmoma as a cause of persistent chronic heel pain despite the rarity of the disease.

Aged↗

Multimodality imaging features of primary xanthoma of the calcaneus.

Secondary xanthomatous features are histologically observed in various bone lesions, but primary xanthoma of bone is rare. We present a primary xanthoma of the right calcaneus in a 51-year-old woman who had no aberrant lipid metabolism. Roentgenograms showed a small osteolytic lesion in the calcaneal triangle, partially surrounded by bone sclerosis. Computed tomographic scans of the calcaneus showed multiple osteolytic areas, with an irregular trabecular pattern in the surrounding sclerotic bone. T1-weighted magnetic resonance images showed a lesion with central low signal intensity, surrounded by a peripheral ring with high signal intensity. The entire lesion showed high signal intensity on T2-weighted images, partially surrounded by areas with low signal intensity, concordant with reactive bone sclerosis. Histologically, the lesion consisted of numerous lipid-laden histiocytes arranged in sheets, scattered multinucleated giant cells and lymphocytes, and granulation tissues. There was no evidence of pre-existing lesions. Total excision of the tumor was curative.

Bone Diseases↗

Fine-needle aspiration biopsy of solid aneurysmal bone cyst in the humerus.

We report the fine-needle aspiration biopsy (FNAB) cytology findings of a solid aneurysmal bone cyst in the left humerus of a 69-yr-old woman. Radiographically, the lesion showed an extensive, relatively well-defined osteolysis in the diaphysis, with a pathologic fracture. FNAB smears of the lesion consisted of benign, mononuclear cells and numerous osteoclast-like multinucleated giant cells. Some clusters of the mononuclear cells were closely associated with dense, homogeneous, extracellular, matrix material. To our knowledge, the FNAB features of solid ABC of the long bones have not been described previously in the English-language literature. The cytologic features are indistinguishable from those of giant cell tumors of bone and brown tumors of hyperparathyroidism.

Aged↗

An intraligamentous ganglion cyst of the anterior cruciate ligament after a traumatic event.

An unusual case of intraligamentous ganglion cyst of the anterior cruciate ligament after a traumatic event in a 12-year-old boy is presented. Magnetic resonance imaging was helpful in delineating the lesion. An arthroscopic aspiration of the cyst material resulted in resolution of symptoms to preserve satisfactory knee function. The patient remains asymptomatic 25 months after surgery.

Accidental Falls↗

Extraabdominal desmoid tumor in a surgical scar of a patient with Sprengel's deformity.

Patients with an extraabdominal desmoid tumor have multiple minor bone abnormalities. The authors describe a rare case of an extraabdominal desmoid tumor that developed in a scar 2 years after surgery for Sprengel's deformity of the right shoulder in an 8-year-old girl. The association between the tumor and Sprengel's deformity has never been reported previously. Antecedent surgical trauma might play a role in the development of this tumor.

Back↗

Solitary intra-articular tumoral calcinosis of the knee.

An unusual case of symptomatic, solitary, intra-articular tumoral calcinosis of the knee in a 39-year-old man is presented. This is the first reported case of intra-articular tumoral calcinosis with no associated underlying systemic diseases. Magnetic resonance imaging was helpful in delineating the lesion. Surgical excision resulted in resolution of symptoms and was not followed by recurrence of the lesion.

Adult↗

Isolated suprapatellar bursitis: Computed tomographic and arthroscopic findings.

A rare case of compartmentalized suprapatellar bursitis in the left knee of an 80-year-old man is presented. Computed tomographic (CT) scans following intravenous administration of contrast media showed a cystic mass between the quadriceps tendon and the anterior surface of the femur. Multiplanar reconstruction CT scans showed a mass superior to the patella, the wall of which was enhanced. Arthroscopic examination of the knee revealed a complete suprapatellar septum that separated the suprapatellar bursa from the knee joint cavity. Surgical excision of the bursa was curative. To our knowledge, multiplanar reconstruction CT and arthroscopic features of the isolated suprapatellar bursitis have not been illustrated previously.

Aged↗

Ischiogluteal bursitis: multimodality imaging findings.

Ischiogluteal bursitis is a rare, infrequently recognized condition. Two cases of ischiogluteal bursitis in an 80-year-old man and a 75-year-old woman are presented. Both patients presented with a painful buttock mass. Contrast-enhanced multiplanar reconstruction computed tomography scans revealed a lesion with peripheral enhancement inferior to the ischial tuberosity. Magnetic resonance imaging revealed a lesion with low or intermediate signal intensity on T1-weighted images. T2-weighted images revealed a lesion with high signal intensity. Postcontrast magnetic resonance imaging scans revealed peripheral enhancement of the lesion. The multimodality imaging findings of ischiogluteal bursitis have not been described previously. Ischiogluteal bursitis should be considered in the differential diagnosis of a buttock mass.

Aged↗

Bone marrow edema syndrome associated with uterine myoma: a case report.

A patient with bone marrow edema syndrome of the hip associated with a uterine myoma is presented. A 51-year-old woman could not walk because of severe pain in both hips and had been referred to the authors' institute. Magnetic resonance imaging scans showed abnormal intensity on T1- and T2-weighted images in both femoral heads and a large mass arising from the uterus which was diagnosed as a uterine myoma. A 99mTc-methylene diphosphonate scintigraph showed diffuse uptake in both femoral heads. The pain in both hips decreased shortly after a hysterectomy and the patient could walk without crutches within 2 weeks after the gynecologic surgery. Magnetic resonance imaging scans taken 8 months after surgery showed high signal intensity on T1- and T2-weighted images, indicating normal bone marrow in the femoral heads. To the authors' knowledge, this is the first case report showing a bone marrow edema syndrome of the hip associated with uterine myoma. The pathophysiologic mechanisms for bone marrow edema syndrome of the hip in the current patient and in pregnancy may be identical. More specifically, a large intrapelvic mass may cause an increase of intrapelvic pressure and subsequent blood stasis in both conditions. The current case suggests the possible factors of bone marrow edema syndrome of the hip which need to be investigated.

Bone Marrow Diseases↗

Solitary fibrous tumor in the extremity: case report and review of the literature.

A solitary fibrous tumor is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that solitary fibrous tumors also affect extrathoracic regions. The current study presents a literature review with four additional patients with solitary fibrous tumor arising from the extremities to clarify clinicopathologic features. The current four patients were two males and two females, ranging from 17 to 60 years of age. Magnetic resonance imaging scans of the current patients showed inhomogeneous low to intermediate intensity signal on T1-weighted images and inhomogeneous intermediate to high intensity signal on T2-weighted images. Histologically, the tumors were composed of a haphazard proliferation of spindle cells, although cellularity was variable in each case. Two of the four tumors showed hypercellularity of spindle cells with focally myxomatous or hyaline changes, whereas myxomatous patterns with scattered spindle cells throughout the specimens were observed in the other two tumors. Immunohistochemically, all four patients showed positive immunoreactivity for CD34, and two tumors showed focally positive immunoreactivity for bcl-2 protein. During the followup of 12 to 54 months, neither local recurrence nor distant metastasis was detected after wide resection. Examination of the literature and the current patients suggests that solitary fibrous tumors in the extremities are likely to have a malignant potential, although most patients have a benign clinical course. Local wide resection and careful long-term followup are necessary for patients with solitary fibrous tumor in the extremities.

Adolescent↗

Granulocyte colony-stimulating factor-producing undifferentiated sarcoma occurring in previously fractured femur. A case report and review of the literature.

We examined the case of a 52-year-old man presenting with a sarcoma accompanied by severe leukocytosis, which developed many years after a femoral fracture. Histologic, histochemical, immunohistochemical, and ultrastructural analysis of the tumor revealed that the sarcoma could not be classified by any of the bone or soft tissue tumor classifications currently in use. The tumor cells were isolated from surgical specimens and subcultured in vitro. The concentration of granulocyte colony-stimulating factor in the culture medium was constantly elevated to considerably high levels during 20 cell passages. A genomic study using reverse transcription-polymerase chain reaction showed that the cells retained messenger RNA expression of granulocyte colony-stimulating factor. The aberrant overexpression of granulocyte colony-stimulating factor clearly represented a paraneoplastic phenomenon of the neoplastic cells.

Cell Differentiation↗

Cross-sectional area of a bone-patellar tendon-bone graft for anterior cruciate ligament reconstruction.

The cross-sectional area of the 10-mm wide patellar tendon graft was measured in 50 consecutive patients (31 males and 19 females) who underwent isolated anterior cruciate ligament (ACL) reconstruction and the relationship between the graft size and various factors such as physical characteristics was assessed. The effect of cross-sectional area of the implanted graft on postoperative stability of the reconstructed knee also was examined. Mean patient age at surgery was 22.3 years (range: 14-40 years). The cross-sectional area was measured using an instrumented area micrometer intraoperatively, and correlations between the measured value and various factors such as age, gender, height, body weight, and bony geometry were examined. Follow-up was performed 24 months postoperatively. The average cross-sectional graft area was 33.4 mm2. The measured cross-sectional area was larger in male patients and correlated with physical characteristics such as height, body weight, and femoral condyle width. No significant correlation between the size of the graft and postoperative stability was observed.

Adolescent↗