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Yosuke Izumi

Publications and source records attributed to Yosuke Izumi.

4 recordsLinked to original sources

Esophageal carcinoma: evaluation with high-resolution three-dimensional constructive interference in steady state MR imaging in vitro.

PURPOSE: To determine the usefulness of high-resolution three-dimensional (3D) constructive interference in steady state (CISS) MRI for evaluating mural invasion and morphologic features in esophageal carcinomas. MATERIALS AND METHODS: Twenty-four esophageal specimens with carcinomas were studied with a 1.5-T system using a 4-cm-diameter loop coil. High-resolution 3D-CISS MR images were obtained with a field of view (FOV) of 80 mm, matrix of 256 x 256, and section thickness of 0.5 mm (voxel size of 0.05 mm(3)). 3D-CISS MR images were compared with histopathologic findings, and virtual MR endoscopic images were compared with macroscopic findings at surgery. RESULTS: 3D-CISS MR images clearly depicted the normal esophageal wall as consisting of eight layers, which correlated well with the histologic layers. In 22 of 24 esophageal carcinomas (92%), the depth of mural invasion visualized with 3D-CISS MRI correlated well with the histopathologic staging. In all 24 carcinomas (100%), virtual MR endoscopic images clearly depicted the macroscopic types of the carcinomas, including adjacent lymph node swelling. CONCLUSION: High-resolution 3D-CISS MRI has a high diagnostic accuracy for evaluating mural invasion and macroscopic findings in esophageal carcinomas, and may be applicable to preoperative histopathologic staging and morphologic evaluation.

Aged↗

Gastric diverticulum preoperatively diagnosed as one of two left adrenal adenomas.

A 47-year-old man was diagnosed with primary aldosteronism due to two left adrenal adenomas, suggested on computed tomography (CT) to be located at the upper and lower adrenal portion. However, adosterol scintigraphy revealed negligible uptake at the upper portion of the left adrenal. Laparoscopic left adrenalectomy was performed, but macroscopic examination of the specimen revealed only one adrenal tumor. Continued surgical exploration detected another mass between the spleen and the stomach, which was demonstrated to be continuous with the stomach and was eventually diagnosed as a gastric diverticulum. Postoperatively, aldosteronism resolved and repeat CT revealed staining of the adrenal pseudotumor when oral contrast was administered. Since organs located near the adrenals can simulate adrenal tumors, caution must be exercised in interpreting suprarenal masses on CT. To our knowledge, this is the first reported case of concurrent pseudotumor and true tumor of the ipsilateral adrenal.

Adrenalectomy↗

[The study of the autopsies of six patients with progressive esophageal cancer to investigate complications caused by esophageal stents].

Endoscopic placement of metal stents are used widely for patients with esophageal obstruction and fistula due to progressive esophageal cancer, but cause high rate of severe complications associated with the immediate causes of death. To determine severe complications caused by stents, we studied clinical data and autopsy of six patients who had been treated with stents for inoperable progressive esophageal cancer. Occording to the clinical records only two patients had severe complications due to stents. But at autopsy, three patients had massive hemorrhage in the stent placement, one patient had mediastinitis, and one patient were in imminent danger of perforation whose stent had been incorporated into the adventitia of the wall. More severe complications were revealed than those expected clinically. Endoscopic placement of metal stents have a great deal for the improvement of quality of life. But we should carefully decide the indication because endoscopic placement of metal stents could cause severe complications associated with the immediate causes of death.

Aged↗

Superficial basaloid squamous carcinoma of the esophagus. A clinicopathological and immunohistochemical study of 12 cases.

Basaloid squamous carcinoma (BSC) is a rare variant of squamous cell carcinoma (SCC). In this study, clinicopathological and immunohistochemical characteristics of 12 superficial esophageal BSCs were examined and compared with those of typical superficial SCCs. Eight cases were classified into an elevated type, and the other four into a depressed type. High-grade intraepithelial neoplasia was not observed around the invasive lesions in five cases, and only BSC components were apparent. High-grade intraepithelial neoplasia was demonstrated in seven cases, five of which had both BSC and SCC components in the invasive lesion. A cribriform growth pattern, comedo-type necrosis, and hyaline deposits were conspicuous histological findings. CK14 was positively stained in 90% of the series, but the proportion of positive cells was small in most cases. Type IV collagen was increased or well preserved in the basement membrane in 70% of cases, but heparan sulfate was decreased in the majority. In comparison with SCCs, lymphatic permeation was observed less frequently. However, regarding the frequencies of venous permeation, nodal metastasis, p53 protein expression, and Ki-67 labeling index, no significant differences were noted. Thus, esophageal BSCs demonstrate the pathological features characteristic of an early stage, but pathological parameters related to biological behavior do not significantly vary from those typical of SCCs.

Aged↗