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Yoshiteru Kakuno

Publications and source records attributed to Yoshiteru Kakuno.

5 recordsLinked to original sources

[A case of uterine cystic adenomatoid tumor mimicking malignant ovarian tumor on MR imaging].

We report a case of adenomatoid tumor of the uterus. MR images demonstrated a cystic mass with septae attached to the posterior wall of the uterus, making it difficult to distinguish from a malignant ovarian tumor. However, normal bilateral ovaries and beak sign continuing to the uterus were detected on MR images, enabling us to distinguish the cystic mass from a malignant ovarian tumor. Laparotomy demonstrated a subserosal mass of the uterine fundus. The macroscopic specimen showed a multilocular cystic mass, while the microscopic specimen showed cystic spaces lined with flattened and cuboidal cells admixed with smooth muscle, confirming the diagnosis of adenomatoid tumor of the uterus.

Adenomatoid Tumor↗

Nasal-type NK/T cell lymphoma of the orbit with distant metastases.

A case of a nasal-type NK/T cell lymphoma of the orbit with distant metastases is reported. The orbital lymphoma was angiodestructive with prominent necrosis and frequent apoptosis. Lymphoma cells were positive for CD56, cytotoxic molecules (granzyme B and TIA-1), and EBV. Despite local radiotherapy, the patient had a highly aggressive clinical course. A postmortem examination revealed distant metastases to the heart and lungs exhibiting angiocentric growth. TCR and Ig genes of a cardiac lesion were in germ line configuration. This case demonstrated that nasal-type NK/T cell lymphomas with a poor prognosis can occur in the orbit.

Aged↗

Chordoma in the sella turcica.

A 75-year-old man presented with a rare case of chordoma in the sella turcica of the skull base. He had been treated for hypertension and chronic renal failure since 1990. Computed tomography detected a tumor in the sella turcica in 1994, but the patient had no clinical complaints and the serum pituitary hormone levels were normal. He died of disseminated intravascular coagulation, myocardial infarction, pulmonary infection, and multiple cerebral infarctions in 2000. At autopsy, the tumor in the sella turcica was 3.1 cm in greatest diameter and had compressed the pituitary gland posteriorly. Histological examination found oval cells and vacuolated short spindle-shaped cells which showed morphological changes similar to myxoma cells. The tumor was lobulated by narrow connective tissues. The tumor did not contain any cartilaginous tissue components, and was stained positively for epithelial membrane antigen but negatively for S-100 protein. The final diagnosis was chordoma. There was no association between the tumor and the cause of death.

Aged↗

Ectopic thymus presenting as neck mass.

A 3-month-old girl presented with an asymptomatic soft tissue mass in the right neck. Her preoperative data were normal. CECT of the neck showed a 3-cm solid mass with homogeneous mild enhancement without mass effect. CECT of the thorax showed a normal thymus. MR images showed a right submandibular mass with signal intensity identical to that of the mediastinal thymus. Although it was difficult to make a correct preoperative diagnosis, surgical microscopic examination demonstrated normal thymic tissue. Because ectopic thymus can occasionally present with life-threatening symptoms, and malignant transformations have been documented, complete excision of cervical ectopic thymus was advocated.

Choristoma↗

Intrahepatic portosystemic venous shunt: occurrence in a child patient without liver cirrhosis.

There are multiple reports of intrahepatic portosystemic venous shunt (PSVS) cases in adult patients. We report the case of a 4-year-old child with PSVS and pulmonary arteriovenous malformation (PAVM). Abdominal sonography and computed tomography (CT) revealed the presence of PSVS. T1-weighted magnetic resonance imaging (MRI) demonstrated multiple intracranial hyperintense lesions, mainly in the globus pallidus, which suggested portosystemic encephalopathy. Tc-99m labeled microsphere study showed diffusely increased uptake in the thyroid and kidneys. The scan suggested the existence of PAVM. Pulmonary angiography was performed in order to evaluate pulmonary hypertension, and pulmonary venous pressure was slightly elevated. Contrast echocardiography suggested the presence of an intrapulmonary arteriovenous malformation with significant right-to-left shunt, as evidenced by rapid filling of the left atrium with dissolved bubbles. In this case, contrast echocardiography was helpful in diagnosing the patient's PAVM. In conclusion, we present the case of PSVS with PAVM in childhood. The incidence of PSVS is low, and data from the literature remain limited. However, further investigation is required to clarify the possible correlation between PSVS and PAVM.

Arteriovenous Fistula↗