JaLCDOI 10.18926/AMO/48966
フルテキストURL 66_5_417.pdf
著者 Horio, Takuya| Ogata, Sho| Tsujimoto, Hironori| Akase, Takayoshi| Takahata, Risa| Yaguchi, Yoshihisa| Maehara, Tadaaki| Hase, Kazuo|
抄録 Esophageal cancers usually exhibit lymph-node metastases. Although a solitary lymph-node metastasis is occasionally found, the involvement of an intrathoracic paraaortic node is rare. We present here an intrathoracic mid-esophageal cancer case in which an accompanying solitary retroaortic mass was found within the posterior mediastinum by integrated positron emission tomography/computed tomography. For diagnosis, thoracoscopic resection of the mass was performed from a left thoracic approach, and histology revealed it to be a squamous cell carcinoma metastasized from the esophageal cancer. Upon radical esophagectomy after neoadjuvant therapy as a T3N1M0 Stage IIIa (AJCC/UICC) cancer, the esophageal cancer was found to have invaded unexpectedly deeply in the vicinity of the descending aorta. Another lymph node within the paraaortic region was also involved (T4N1M0 Stage IIIc). The present case and other cases we review here inform our understanding of metastasis to intrathoracic paraaortic nodes as follows:1) its existence may indicate extensive lymph-node metastasis or direct tumor invasion nearby, and 2) it may be accompanied by other lymph-node involvements in this region, even if it appears solitary upon preoperative investigation. Thus, for radical esophagectomy, sufficient lymph-node dissection is required, even at locations not reached by the usual right thoracic approach. Definitive chemoradiotherapy may be a better choice for preoperatively recognized T3 esophageal cancer when the cancer is accompanied by paraaortic lymph node metastasis.
キーワード esophageal cancer intrathoracic paraaortic lymph node solitary metastasis
Amo Type Case Report
発行日 2012-10
出版物タイトル Acta Medica Okayama
66巻
5号
出版者 Okayama University Medical School
開始ページ 417
終了ページ 421
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23093060
Web of Sience KeyUT 000310253900006
JaLCDOI 10.18926/AMO/48690
フルテキストURL 66_4_351.pdf
著者 Ohara, Ichiyou| Ogata, Sho| Okusa, Yasushi| Ogawa, Tomomichi| Matsuzaki, Koji| Kaga, Hitoshi| Niihara, Naoko| Tominaga, Susumu| Hase, Kazuo|
抄録 In the duodenum, mixed exocrine-endocrine tumors exhibiting both neuroendocrine and glandular differentiations [cf. appendiceal goblet cell carcinoids (GCCs)] are rare. We present a Japanese case with a duodenal GCC that was found during pathologic examination of a gastrectomy specimen removed for gastric mucosal cancer. The tumor was widely distributed within both the first portion of the duodenum and the gastric antrum, although mucosal involvement was observed only in the duodenum. The tumor cells formed solid nests, trabeculae, or tubules, and some displayed a goblet cell appearance. They were immunoreactive against antibodies for both serotonin and somatostatin, and showed an argentaffin reaction (similar to a “midgut” enterochromaffin cell carcinoid). Ultra-structurally, the tumor cells had an amphicrine nature. Physicians encounter GCC in the duodenum only rarely, and its discovery may be incidental. Its diagnosis will be challenging and will require careful clinical and pathologic examinations.
キーワード amphicrine tumor duodenum goblet cell carcinoid serotonin somatostatin
Amo Type Case Report
発行日 2012-08
出版物タイトル Acta Medica Okayama
66巻
4号
出版者 Okayama University Medical School
開始ページ 351
終了ページ 356
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2012 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 22918208
Web of Sience KeyUT 000307918900008
JaLCDOI 10.18926/AMO/41327
フルテキストURL 64_6_407.pdf
著者 Ogata, Sho| Horio, Takuya| Sugiura, Yoshiaki| Shimazaki, Hideyuki| Saito, Hiroki| Aiko, Satoshi| Nakanishi, Kuniaki| Kawai, Toshiaki|
抄録 Sarcoidosis is a systemic granulomatous inflammation of unknown etiology, and seems to involve the liver parenchyma in most cases. However, sarcoidosis-associated hepatocellular carcinoma is rare. We report here a case in which a hepatocellular carcinoma occurred within the liver, which was probably involved as a result of systemic sarcoidosis. A 57-year-old Japanese man had been followed up for 2 years because of diabetic nephropathy and sarcoidosis. On admission for pneumonia, imaging studies revealed an unexpected hepatic tumor. Histology revealed a hepatocellular carcinoma accompanied by T-lymphocytic infiltration and marked granulomatous inflammation, which was surrounding some tumor nodules. The background liver parenchyma exhibited a moderate degree of fibrosis with granulomatous inflammation. The patient had no other apparent liver disease such as viral hepatitis, steatohepatitis, or primary biliary cirrhosis. Therefore, in the present case, sarcoidosis may be considered the probable background etiology for hepatocarcinogenesis.
キーワード granuloma hepatocellular carcinoma lymphocytic infiltration sarcoidosis
Amo Type Case Report
発行日 2010-12
出版物タイトル Acta Medica Okayama
64巻
6号
出版者 Okayama University Medical School
開始ページ 407
終了ページ 410
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 21173811
Web of Science KeyUT 000285664200008
JaLCDOI 10.18926/AMO/32860
フルテキストURL fulltext.pdf
著者 Ogata, Sho| Kimura, Akifumi| Hatsuse, Kazuo| Yamamoto, Junji| Shimazaki, Hideyuki| Nakanishi, Kuniaki| Kawai, Toshiaki|
抄録 <p>Poorly differentiated adenocarcinoma without papilla or tubule formation of the extrahepatic bile duct is rare. Here we present a case (a 42-year-old Japanese woman) without either pancreatobiliary maljunction or liver disease. The patient had obstructive jaundice. Imaging studies revealed a bile duct tumor obstructing the common bile duct and invading the surrounding tissues. Pathologic examination revealed a dense periductal growth of poorly differentiated adenocarcinoma containing signet-ring cells, but without papilla or tubule formation in the extrahepatic bile duct. The tumor cells directly invaded the pancreatic parenchyma and the portal vein. In the extrahepatic bile duct, poorly differentiated adenocarcinoma may be established as a distinct clinicopathologic entity if the tumors are characterized by:1) the absence of papilla or tubule formation, 2) Asian preponderance, 3) occurrence at a younger age than is usual for patients with biliary cancers, and 4) an aggressive mural invasiveness.</p>
キーワード adenocarcinoma bile duct cancer signet-ring cell carcinoma
Amo Type Case Report
発行日 2010-02
出版物タイトル Acta Medica Okayama
64巻
1号
出版者 Okayama University Medical School
開始ページ 63
終了ページ 65
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 20200586
Web of Sience KeyUT 000274868300009
JaLCDOI 10.18926/AMO/31839
フルテキストURL fulltext.pdf
著者 Ogata, Sho| Suganuma, Toshiyuki| Okada, Chizuko| Inoue, Kimitoshi| Kinoshita, Akio| Sato, Kimiya|
抄録 <p>Sporadic intestinal cryptosporidiosis is not easily diagnosed and might be overlooked. We present here a case of this disease in a 23-year-old Japanese military man with 3 days of abdominal pain, watery diarrhea, and nausea. The frequency of his diarrhea was more than 10 times per day. After his diarrheal bowel symptoms subsided, a colonoscopy was performed because inflammatory bowel disease was suspected. Although the endoscopic findings indicated non-specific ileitis, intestinal cryptosporidiosis was suspected from the histology of ileal biopsy specimens, and this was confirmed ultrastructurally. At that time, however, the patient was on active duty, and thus it was not possible to confirm this as a definitive diagnosis by an adequate stool examination for cryptosporidium. Routine practitioners should be encouraged to carefully inspect patients for this disease, supported by detailed knowledge of it and its diagnosis. If stool-examination results are negative or are not obtained at first, histological diagnosis by endoscopic biopsy could be a useful way to screen for intestinal cryptosporidiosis. Furthermore, stool or histological examination should be performed in recovered patients because the oocysts may continue to be shed for 1 to 4 weeks after the symptoms disappear. Therefore, endoscopic and histological examinations may be useful tools for the early diagnosis of intestinal cryptosporidiosis, although admittedly they are invasive procedures.</p>
キーワード intestinal cryptosporidiosis histology
Amo Type Case Report
発行日 2009-10
出版物タイトル Acta Medica Okayama
63巻
5号
出版者 Okayama University Medical School
開始ページ 287
終了ページ 291
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 19893605
Web of Science KeyUT 000271132000009
JaLCDOI 10.18926/AMO/31827
フルテキストURL fulltext.pdf
著者 Ohata, Yuichiro| Haga, Takayuki| Ogata, Sho| Nakanishi, Kuniaki| Kawai, Toshiaki|
抄録 <p>Melanoma metastasizing to the lungs is common, but primary pulmonary or pleural melanoma is extremely rare. We present an autopsy case of malignant melanoma of the pleura without primary skin lesion in a 49-year-old man. A mass found in the right chest was diagnosed as spindle cell sarcoma by antemortem fine-needle aspiration cytology. At autopsy, a yellow-white tumor located primarily in the right visceral pleura (diagnosed as an amelanotic melanoma) was found to have invaded into the right lung, right parietal pleura, and right diaphragm, and to have metastasized into the left lung and visceral pleura, thyroid, and left adrenal gland. No primary site was found. The tumor cells were positive for S100 and focally positive for HMB-45, but negative for other markers. Immuno-histochemical examination for S100 and HMB-45 would thus appear to be useful for the diagnosis of an amelanotic melanoma.</p>
キーワード amelanotic melanoma pleura immunohistochemistry S100 HMB-45
Amo Type Case Report
発行日 2009-12
出版物タイトル Acta Medica Okayama
63巻
6号
出版者 Okayama University Medical School
開始ページ 379
終了ページ 384
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 20035295
Web of Science KeyUT 000273145900010
JaLCDOI 10.18926/AMO/31818
フルテキストURL fulltext.pdf
著者 Higashiyama, Masaaki| Ogata, Sho| Adachi, Yoshikazu| Nishiyama, Junichiro| Ohara, Ichiyo| Okamura, Meri| Matsuzaki, Koji| Okusa, Yasushi| Sato, Kimiya| Hokari, Ryota| Miura, Soichiro|
抄録 <p>We present a middle-aged, heterosexual Japanese man with mixed infections including human intestinal spirochetosis, which led us to the detection of human immunodeficiency virus (HIV) infection. The patient had syphilis without related physical or neurological findings. An examination for the serum antibody for HIV performed 9 years previously was negative. In a complete medical checkup at the present time, human intestinal spirochetosis and unspecified entamebic cysts were suggested by histological examination of colonic biopsy material and parasitic examination of the intestinal fluid, respectively. Moreover, a serological test for the antibody for HIV was positive. In specimens obtained by colonoscopy, Brachyspira aalborgi was diagnosed by ultrastructural study and the polymerase chain reaction method for bacterial 16S ribosomal deoxyribonucleic acid. Although HIV infection remains at low prevalence in Japan, we recommend examination for HIV infection in patients with human intestinal spirochetosis, especially when other co-infections are apparent.</p>
キーワード Brachyspira entameba human immunodeficiency virus human intestinal spirochetosis syphilis
Amo Type Case Report
発行日 2009-08
出版物タイトル Acta Medica Okayama
63巻
4号
出版者 Okayama University Medical School
開始ページ 217
終了ページ 221
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 19727207
Web of Sience KeyUT 000269228400008