Faculty Profiles - SATO Yasuharu

Papers - SATO Yasuharu

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Regulatory T-cell infiltration in tongue squamous cell carcinoma

Hiroyuki Hanakawa, Yorihisa Orita, Yasuharu Sato, Mai Takeuchi, Kyotaro Ohno, Yuka Gion, Kiyoaki Tsukahara, Ryo Tamamura, Toshihiro Ito, Hitoshi Nagatsuka, Kazunori Nishizaki, Tadashi Yoshino

ACTA OTO-LARYNGOLOGICA 134 ( 8 ) 859 - 864 2014.8

Language：English Publishing type：Research paper (scientific journal) Publisher：INFORMA HEALTHCARE

Conclusion: In tongue squamous cell carcinoma (SCC), high levels of regulatory T-cell (Treg) infiltration in tumor nests are observed in the cases with poor prognosis. Objectives: The role of Tregs in head and neck cancers remains unclear. The aim of this study was to observe the distribution of Tregs in different stages of tongue SCC and estimate the effects on prognosis. Methods: Thirty-four cases with tongue SCC were examined immunohistochemically for CD4, CD8, and Forkhead box P3 (Foxp3). Immunoreactive cells were counted in cancer stroma and nest regions, and relationships between cell numbers and disease-free survival rates were analyzed. Results: In the 34 cases, univariate analysis for disease-free survival indicated high-level infiltration of Tregs (CD4(+)Foxp3+) into both cancer nests and stroma and presence of helper T (CD4(+)Foxp3-) cells in cancer stroma as potential predictors of significantly worse prognosis. In early-stage cases (stage I/II), high-level infiltration of Tregs in cancer nests correlated significantly with poor disease- free survival rate. Multivariate analysis for disease-free survival found no independent variables.

DOI： 10.3109/00016489.2014.918279

T helper 2 and regulatory T-cell cytokine production by mast cells: a key factor in the pathogenesis of IgG4-related disease

Mai Takeuchi, Yasuharu Sato, Kyotaro Ohno, Satoshi Tanaka, Katsuyoshi Takata, Yuka Gion, Yorihisa Orita, Toshihiro Ito, Tomoyasu Tachibana, Tadashi Yoshino

MODERN PATHOLOGY 27 ( 8 ) 1126 - 1136 2014.8

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

IgG4-related disease is a systemic disorder with unique clinicopathological features and uncertain etiological features and is frequently related to allergic disease. T helper 2 and regulatory T-cell cytokines have been reported to be upregulated in the affected tissues; thus, the production of these cytokines by T helper 2 and regulatory T cells has been suggested as an important factor in the pathogenesis of IgG4-related disease. However, it is not yet clear which cells produce these cytokines in IgG4-related disease, and some aspects of the disorder cannot be completely explained by T-cell-related processes. To address this, we analyzed paraffin-embedded sections of tissues from nine cases of IgG4-related submandibular gland disease, five cases of submandibular sialolithiasis, and six cases of normal submandibular gland in order to identify potential key players in the pathogenesis of IgG4-related disease. Real-time polymerase chain reaction analysis confirmed the significant upregulation of interleukin (IL)4, IL10, and transforming growth factor beta 1 (TGF beta 1) in IgG4-related disease. Interestingly, immunohistochemical studies indicated the presence of mast cells expressing these cytokines in diseased tissues. In addition, dual immunofluorescence assays identified cells that were double-positive for each cytokine and for KIT, which is expressed by mast cells. In contrast, the distribution of T cells did not correlate with cytokine distribution in affected tissues. We also found that the mast cells were strongly positive for IgE. This observation supports the hypothesis that mast cells are involved in IgG4-related disease, as mast cells are known to be closely related to allergic reactions and are activated in the presence of elevated non-specific IgE levels. In conclusion, our results indicate that mast cells produce T helper 2 and regulatory T-cell cytokines in tissues affected by IgG4-related disease and possibly have an important role in disease pathogenesis.

DOI： 10.1038/modpathol.2013.236

Clinicopathological analysis of 17 primary cutaneous T-cell lymphoma of the gamma delta phenotype from Japan

Yuka Takahashi, Katsuyoshi Takata, Seiichi Kato, Yasuharu Sato, Naoko Asano, Tetsuro Ogino, Kimio Hashimoto, Yukie Tashiro, Shogo Takeuchi, Taro Masunari, Yasushi Hiramatsu, Yoshinobu Maeda, Mitsune Tanimoto, Tadashi Yoshino

CANCER SCIENCE 105 ( 7 ) 912 - 923 2014.7

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Primary cutaneous gamma delta T-cell lymphoma (PCGD-TCL) is an aggressive lymphoma consisting of clonal proliferation of mature activated gamma delta T-cells of a cytotoxic phenotype. Because primary cutaneous gamma delta T-cell lymphoma is a rare disease, there are few clinicopathological studies. In addition, T-cell receptor (TCR) gamma delta cells are typically immunostained in frozen sections or determined by TCR beta negativity. We retrospectively analyzed 17 primary cutaneous T-cell lymphomas of the gamma delta phenotype (CTCL-gamma delta) in a clinicopathological and molecular study using paraffin-embedded sections. Among 17 patients, 11 had CTCL-gamma delta without subcutaneous panniculitis-like T-cell lymphoma (SPTCL) features and six had CTCL-gamma delta with SPTCL features. Immunophenotypically, some significant differences were found in CD8 and CD56 positivity between our patient series of CTCL-gamma delta patients with SPTCL features and SPTCL-gamma delta patients described in the previous literature. A univariate analysis of 17 CTCL-gamma delta patients showed that being more than 60 years old, presence of visceral organ involvement, and small-to-medium cell size were poor prognostic factors. In addition, the 5-year overall survival rate was 42.4% for the CTCL-gamma delta patients without SPTCL features and 80.0% for those with SPTCL features. Consequently, there was a strikingly significant difference in overall survival among SPTCL, CTCL-gamma delta with SPTCL features and CTCL-gamma delta without SPTCL features (P = 0.0005). Our data suggests that an indolent subgroup may exist in CTCL-gamma delta. Studies on more cases, including those from other countries, are warranted to delineate the clinicopathological features and the significance in these rare lymphomas.

DOI： 10.1111/cas.12439

Epstein-Barr Virus-infected Cells in IgG4-related Lymphadenopathy With Comparison With Extranodal IgG4-related Disease

Mai Takeuchi, Yasuharu Sato, Hiroshi Yasui, Hiroaki Ozawa, Kyotaro Ohno, Katsuyoshi Takata, Yuka Gion, Yorihisa Orita, Tomoyasu Tachibana, Tomoo Itoh, Naoko Asano, Shigeo Nakamura, Steven H. Swerdlow, Tadashi Yoshino

AMERICAN JOURNAL OF SURGICAL PATHOLOGY 38 ( 7 ) 946 - 955 2014.7

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

IgG4-related lymphadenopathy with increased numbers of Epstein-Barr virus (EBV)-infected cells has been reported but not fully described. We analyzed 31 cases of IgG4-related lymphadenopathy and 24 cases of extranodal IgG4-related diseases for their possible relationship with EBV. Other types of reactive lymph nodes (22) and angioimmunoblastic T-cell lymphoma (AITL) (10) were also studied for comparison. EBV-encoded RNA (EBER) in situ hybridization revealed EBER+ cells in 18 of 31 cases (58%) of IgG4-related lymphadenopathy. Increased EBER+ cells were found in only 4 of 22 (18.1%) non-IgG4-related reactive lymphoid hyperplasia in patients of a similar age (P = 0.002) and in only 5 of 24 (21%) extranodal IgG4-related biopsies (P = 0.006). Interestingly, all patients with EBER+ progressively transformed germinal center-type IgG4-related lymphadenopathy had systemic lymphadenopathy and/or extranodal involvement. AITL also is associated with EBV, and IgG4-related lymphadenopathy sometimes mimics the morphology of AITL; however, the number of IgG4(+) cells in AITL was significantly less than that in IgG4-related lymphadenopathy (P < 0.001). Increased numbers of regulatory T cells are seen in IgG4-related disease; however, there was not a significant difference between the EBER+ and EBER- cases. In conclusion, the presence of increased numbers of EBV-infected cells in IgG4-related lymphadenopathy, compared with other reactive lymphadenopathy or extranodal IgG4-related disease, suggests that there may be a relationship at least between nodal IgG4-related disease and EBV. It is important to avoid overdiagnosing these cases as malignant lymphomas or EBV-related lymphoproliferative disorders.

DOI： 10.1097/PAS.0000000000000206

Low-grade B-cell lymphoma presenting primarily in the bone marrow

Kayoko Iwatani, Katsuyoshi Takata, Yasuharu Sato, Tomoko Miyata-Takata, Noriko Iwaki, Wei Cui, Seiko Sawada-Kitamura, Hiroshi Sonobe, Maiko Tamura, Katsuhiko Saito, Katsuya Miyatani, Rie Yamasaki, Ichiro Yamadori, Nobuharu Fujii, Yasushi Terasaki, Yoshinobu Maeda, Mitsune Tanimoto, Naoya Nakamura, Tadashi Yoshino

HUMAN PATHOLOGY 45 ( 7 ) 1379 - 1387 2014.7

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO-ELSEVIER INC

Cases of low-grade B-cell lymphoma presenting primarily in the bone marrow are rare, and its clinicopathology remains unclear. We retrospectively examined patients with low-grade B-cell lymphoma presenting primarily in the bone marrow. Fourteen patients met the inclusion criteria, including 5 with lymphoplasmacytic lymphoma (LPL), 3 with chronic lymphocytic leukemia/small lymphocytic lymphoma, 2 with follicular lymphoma (FL), and 4 with low-grade B-cell lymphoma not otherwise specified (LGBCL-NOS). The median age was 69.5 years (range, 42-89 years), and a slight male predominance was noted (9 men and 5 women, 1.8: 1). Immunohistochemically, all cases were positive for CD20. One case was positive for CD138. Both cases of FL were positive for CD10 and B-cell lymphoma 2 (BCL-2), and immunoglobulin heavy locus (IgH)/B-cell lymphoma 2 rearrangement was observed by fluorescence in situ hybridization. The myeloid differentiation primary response gene (88) leucine to proline mutation was observed in 3 of 5 LPL, 1 of 2 FL, and 2 of 4 LGBCL-NOS patients. Paraproteinemia was observed in 10 patients; IgM and IgG paraproteinemia were observed in 6 and 3 patients, respectively. In this patient series, 3 patients had died at a median follow-up of 36.5 months; the cause of death of 1 LPL patient was malignant lymphoma itself. Thus, low-grade B-cell lymphoma presenting primarily in the bone marrow has various subtypes, and approximately one-third of the patients had LGBCL-NOS. The immunophenotypic features and myeloid differentiation primary response gene (88) leucine to proline mutation data of LGBCL-NOS suggested that some cases present with characteristics similar to those of LPL or marginal zone lymphoma. (C) 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.humpath.2014.02.010

Duodenal follicular lymphoma: Comprehensive gene expression analysis with insights into pathogenesis

Katsuyoshi Takata, Motohiko Tanino, Daisuke Ennishi, Akira Tari, Yasuharu Sato, Hiroyuki Okada, Yoshinobu Maeda, Naoe Goto, Hiroshi Araki, Mai Harada, Midori Ando, Masaya Iwamuro, Mitsune Tanimoto, Kazuhide Yamamoto, Randy D. Gascoyne, Tadashi Yoshino

CANCER SCIENCE 105 ( 5 ) 608 - 615 2014.5

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Follicular lymphoma (FL) of the gastrointestinal tract, particularly duodenal follicular lymphoma (DFL), is a rare variant of FL with indolent clinical behavior, and this disease is included in the 2008 World Health Organization classification system. In contrast to nodal follicular lymphoma (NFL), DFL occurs most frequently in the second part of the duodenum, lacks follicular dendritic cell meshworks and has memory B-cell characteristics. However, its molecular pathogenesis is still unclear. In the present study, we examined 10 DFL, 18 NFL and 10 gastric MALT lymphoma samples using gene expression analysis. Quantitative RT-PCR experiments and immunohistochemical analysis for 72 formalin-fixed, paraffin-embedded tissues from an independent series, including 32 DFL, 19 gastric MALT lymphoma and 27 NFL samples, were performed for validation of microarray data. Gene expression profiles of the three lymphoma types were compared using 2918 differentially expressed genes (DEG) and results suggested that DFL shares characteristics of MALT lymphoma. Among these DEG, CCL20 and MAdCAM-1 were upregulated in DFL and MALT but downregulated in NFL. In contrast, protocadherin gamma subfamily genes were upregulated in DFL and NFL. Quantitative RT-PCR and immunohistochemical studies demonstrated concordant results. Double immunofluorescence studies revealed that CCL20 and CCR6 were co-expressed in both DFL and MALT. We hypothesize that increased expression of CCL20 and MAdCAM-1 and co-expression of CCL20 and CCR6 may play an important role in tumorigenesis.

DOI： 10.1111/cas.12392

CHARACTERISTIC PATHOLOGY OF IgG4-RELATED KIDNEY DISEASE

Nagata Michio, Hara Satoshi, Mizushima Ichiro, Kawano Mitsuhiro, Saeki Takako, Ubara Yoshifumi, Ohara Nobuya, Sato Yasuharu, Yamada Kazunori, Nakashima Hitoshi, Nishi Shinichi, Yamaguchi Yutaka, Hisano Satoshi, Yamanaka Nobuaki, Saito Takao

NEPHROLOGY 19 11 - 12 2014.5

Novel and simple prognostic index for nasal natural killer/T- cell lymphoma

Hiroyuki Hanakawa, Yorihisa Orita, Yasuharu Sato, Soshi Takao, Hidenori Marunaka, Tokiwa Morishita, Yasuhiko Yamashita, Yasutaka Hori, Shuhei Domae, Ikuo Inokuchi, Seiko Akagi, Eisei Kondo, Noriko Iwaki, Kana Motomiya, Hirokazu Okumura, Tadashi Yoshino, Kazunori Nishizaki

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 36 ( 4 ) 551 - 556 2014.4

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

BackgroundFew studies have investigated the prognostic factors for nasal natural killer (NK)/T-cell lymphoma.
MethodsThis was a retrospective multicenter clinical study. The clinical records of 36 patients with nasal NK/T-cell lymphoma who had been first treated between 1996 and 2011 were collected from 12 hospitals.
ResultsHigh serum levels of C-reactive protein (1.0 mg/dL), lactate dehydrogenase (350 IU/L), and soluble interleukin-2 receptor (sIL-2R; 600 U/mL) were associated with worse prognosis. A prognostic score was devised by totaling the number of these 3 predictors: 0 or 1 = score 0; and 2 or 3 = score 1. As for tumor invasion, local invasion beyond the nasal cavity was associated with poor prognosis, and a prognostic score was devised as: tumor restricted to nasal cavity, yes = score 0; no = score 1. A novel prognostic index (NPI) was established based on these scores from 0 to 2. Disease-specific survival rates at 5 years were: 90.0% for NPI = 0; 29.3% for NPI = 1; and 0.0% for NPI = 2.
ConclusionOur NPI is valid for anticipating prognosis of nasal NK/T-cell lymphoma. (c) 2013 Wiley Periodicals, Inc. Head Neck36: 551-556, 2014

DOI： 10.1002/hed.23322

Leriche operation for parotid gland pathology

Yorihisa Orita, Toshiaki Ogawara, Ryutaro Endo, Sayaka Fuji, Kentaro Miki, Misato Hirai, Yohei Noda, Hidenori Marunaka, Tomoyasu Tachibana, Yasuharu Sato, Kazunori Nishizaki

ACTA OTO-LARYNGOLOGICA 134 ( 4 ) 413 - 415 2014.4

Systemic IgG4-related disease with extensive peripheral nerve involvement that progressed from localized IgG4-related lymphadenopathy: an autopsy case

Masayoshi Fujii, Yasuharu Sato, Nobuya Ohara, Kenji Hashimoto, Haruhiko Kobashi, Yoshinobu Koyama, Tadashi Yoshino

DIAGNOSTIC PATHOLOGY 9 ( 1 ) 41 2014.2

Language：English Publishing type：Research paper (scientific journal) Publisher：BIOMED CENTRAL LTD

A 77-year-old man, with a lengthy medical history of chronic dysuria, constipation, hypertension, myocardial infarction, and a submandibular lymphadenopathy that was excised 3 years ago, was hospitalized due to elevated liver enzyme levels. He demonstrated hypergammaglobulinemia, hyperproteinemia, high levels of IgG and IgG4, eosinophilia, sclerosing cholangitis, and retroperitoneal fibrosis. He was diagnosed with IgG4-related disease (IgG4-RD). While hospitalized, he had several episodes of syncope while standing and was diagnosed with autonomic nerve dysfunction. Thirty days after hospitalization, he died of nonocclusive mesenteric ischemia (NOMI). Post-mortem, his submandibular lymphadenopathy lesion was diagnosed with progressively transformed germinal center (PTGC)-type IgG4-related lymphadenopathy. At autopsy, small and large intestines showed mucosal necrosis and the wall muscles of the transverse to sigmoid colon were necrotic. The sigmoid colon was fibrotic and infiltrated with numerous IgG4(+) plasma cells and eosinophils; infiltration into Auerbach's plexus was also observed. The IgG4-RD lesions were also detected in the mesentery of the sigmoid colon, retroperitoneal soft tissue, abdominal aorta, liver, extrahepatic bile duct, bilateral lungs, bilateral kidneys, urinary bladder, prostate, epicardium, bilateral coronary arteries, and lymph nodes. Interestingly, infiltration into the lesions was most notable around the peripheral nerves in every organ. Thus, this case describes an IgG4-RD that progressed from PTGC-type IgG4-related lymphadenopathy to systemic IgG4-RD, suggesting that IgG4-RD may affect many organs through peripheral nerve involvement. Virtual slide: The virtual slides for this article can be found here: http://www.diagnosticpathology. diagnomx.eu/ vs/ 9995992971155224.

DOI： 10.1186/1746-1596-9-41

Lymph node lesions Reviewed

Yasuharu Sato, Tadashi Yoshino

Igg4-Related Disease 187 - 193 2014.1

Language：English Publishing type：Part of collection (book) Publisher：Springer Japan

Pathological examination of involved tissue occupies an extremely important place in establishing the diagnosis of IgG4-related disease (IgG4-RD). However, the histological picture in IgG4-RD can vary significantly from organ to organ in this disease even while adhering to basic tenets. Consequently, the pathological diagnosis of this condition is often challenging even in the setting of adequate tissue specimens. This is particularly true with regard to the assessment of lymph nodes in patients who may have IgG4-RD. The diagnosis of IgG4-related lymphadenopathy is complicated owing to a great histological diversity. At least five histological subtypes have already been identified. Lymph node biopsies are often performed because of suspicion that the lymphadenopathy might reflect a malignant lymphoma or other lymphoproliferative disorder. In general, if the IgG4+/IgG+ plasma cell ratio is ≥40 %, the possibility of IgG4-RD is high, but cases of patients with diagnosis other than IgG4-RD who fulfill this criterion are well described in the literature. In practice, patients with hyper-interleukin (IL)-6 syndromes such as multicentric Castleman’s disease, rheumatoid arthritis, and other immune-mediated conditions frequently show lymph node involvement and often fulfill the diagnostic criteria for IgG4-RD. For this reason, it is important that the diagnosis of IgG4-RD relies not only on the pathological findings, but be the result of a careful clinicopathologic collaboration that considers the overall clinical context and appropriate serologic (in particular, serum IL-6, C-reactive protein, IgG4 concentration) and radiologic data as well.

DOI： 10.1007/978-4-431-54228-5_27

IgG4-related disease involving the sclera

Kyotaro Ohno, Yasuharu Sato, Koh-ichi Ohshima, Katsuyoshi Takata, Midori Ando, Lamia Abd Al-Kader, Noriko Iwaki, Mai Takeuchi, Yorihisa Orita, Tadashi Yoshino

MODERN RHEUMATOLOGY 24 ( 1 ) 195 - 198 2014.1

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

A 49-year-old female patient previously treated for scleritis and uveitis-induced cataract in the right eye presented with a subretinal white lesion in the same eye. With a preliminary diagnosis of choroidal tumor, enucleation of the eyeball was performed in accordance with the patient's request. Histologic and immunohistologic examinations were consistent with immunoglobulin G4-related disease. The case demonstrates that it is important to consider IgG4-related disease in the differential diagnosis of an intraocular tumor.

DOI： 10.3109/14397595.2013.852842

Characteristic ultrasound features of mucosa-associated lymphoid tissue lymphoma of the salivary and thyroid gland

Yorihisa Orita, Yasuharu Sato, Nobuhiko Kimura, Hidenori Marunaka, Tomoyasu Tachibana, Yasuhiko Yamashita, Hiroyuki Hanakawa, Tadashi Yoshino, Kazunori Nishizaki

ACTA OTO-LARYNGOLOGICA 134 ( 1 ) 93 - 99 2014.1

Language：English Publishing type：Research paper (scientific journal) Publisher：INFORMA HEALTHCARE

Conclusion: The characteristic ultrasound appearance of mucosa-associated lymphoid tissue (MALT) lymphoma of the head and neck provides diagnostic information regarding masses or swellings in the head and neck region. Objectives: There are only a few reports about ultrasound features of malignant lymphoma (ML) of the head and neck. We have noticed that the ultrasound appearances of cases with MALT lymphoma resembled each other even when the appearances of other images like computed tomography were absolutely different. The objective of this study was to delineate the reliability of this characteristic ultrasound appearance of MALT lymphoma of the head and neck. Methods: The ultrasound examinations of 30 patients with histopathologically proven primary ML of the head and neck (15 cases of MALT) were reviewed. The ultrasound results of each case were independently compared to the results of the histopathological examination. Results: Two ultrasound patterns were observed for MALT lymphoma. The first was characterized by a marked hypoechoic area with interspersed linear echogenic strands (linear echogenic strands pattern), and the second was characterized by multiple, relatively large, hypoechoic segments (segmental pattern). Histopathologically, these patterns could be explained on the basis of the expansion of lymphoma cells demarcated by narrow or wide fibrous bands.

DOI： 10.3109/00016489.2013.831994

A condition closely mimicking IgG4-related disease despite the absence of serum IgG4 elevation and IgG4-positive plasma cell infiltration.

Hara S, Kawano M, Mizushima I, Yamada K, Fujita K, Harada K, Matsumura M, Yamagishi M, Sato Y, Yamaguchi Y, Nakanuma Y, Nagata M

Modern Rheumatology 2014

Simultaneous immunostaining with anti-S100P and anti-SV40 antibodies revealed the origin of BK virus-infected decoy cells in voided urine samples.

Ariyasu S, Yanai H, Sato M, Shino Y, Taniguchi K, Yamadori I, Miki Y, Sato Y, Yoshino T, Takahashi K

Cytopathology 26 ( 4 ) 250 - 255 2014

IgG4-related renal disease: clinical and pathological characteristics

Naoto Kuroda, Tomoya Nao, Hideo Fukuhara, Takashi Karashima, Keiji Inoue, Yoshinori Taniguchi, Mai Takeuchi, Yoh Zen, Yasuharu Sato, Kenji Notohara, Tadashi Yoshino

INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 7 ( 9 ) 6379 - 6385 2014

Language：English Publisher：E-CENTURY PUBLISHING CORP

IgG4-related disease is a recently established systemic condition. Tubulointerstitial nephritis is the most common renal manifestation. Glomerular lesions, particularly membranous glomerulonephritis, can develop simultaneously. Some patients present with serological renal dysfunction associated with elevated IgG or IgE levels and hypocomplementemia, while others are incidentally found to have abnormalities in kidneys on imaging. A majority of patients with IgG4-related kidney disease have similar lesions at other anatomical sites, which help us to suspect this condition. Serum IgG4 elevation (>135 mg/dL) is the most, although not entirely, specific marker for the diagnosis. Imaging findings varies from small nodules to bilateral diffuse abnormalities. In addition to the renal parenchyma, the renal pelvis and perirenal adipose tissue can be affected. Histological features include dense lymphoplasmacytic infiltration, storiform or "bird's eye" fibrosis (highlighted by PAM stain), and IgG4-positive plasma cell infiltration (>10 cells/high-power field and IgG4/IgG-positive cell ratio >40%). Immune complex deposition is detectable in the tubular basement membrane by immunofluorescence and/or electron microscopy. Patients usually respond well to corticosteroids, but highly active diseases may require other immunosuppressive therapies. Further investigations will be required to fully understand pathophysiology underlying this emerging condition.

Pathology of follicular lymphoma.

Takata K, Miyata-Takata T, Sato Y, Yoshino T

Jornal of Clinical Experimental Hematopathology 54 ( 1 ) 3 - 9 2014

Time-lag between symptom onset and laboratory findings in patients with subacute thyroiditis Reviewed

Tachibana T, Orita Y, Ogawara Y, Matsuyama Y, Abe I, Nakada M, Sato Y, Nishizaki K

Auris Nasus Larynx 41 ( 4 ) 369 - 372 2014

Publishing type：Research paper (scientific journal)

Objective: The objective of this study was to delineate the frequency of delayed diagnosis in cases of subacute thyroiditis (SAT) and intervals between onset of clinical symptoms and appearance of abnormal laboratory findings. Methods: We reviewed the medical records of 27 patients (7 men and 20 women) with SAT who visited our hospital between 2007 and 2013. Results: On presentation to the hospital, 5 of 27 SAT cases (18.5%) showed normal laboratory findings. Among these 5 cases, the mean interval between symptom onset and thyrotropin (TSH) suppression was 6.3 weeks, and the mean interval to elevation of fT4 was 6.7 weeks. The longest interval from symptom onset to appearance of an abnormal laboratory finding was 11 weeks. Conclusion: Sometimes time-lag exists between onset of clinical symptoms and the appearance of abnormal laboratory findings in patients with SAT. The possibility of this disease should not be excluded from the differential diagnoses for patients with clinical symptoms consistent with SAT but showing normal laboratory findings. © 2013 Elsevier Ireland Ltd.

DOI： 10.1016/j.anl.2013.11.003

Mucosa-associated lymphoid tissue lymphoma of the thyroid with abundant IgG4-positive plasma cells

Kentaro Miki, Yorihisa Orita, Yasuharu Sato, Iwao Sugitani, Misato Noyama, Sayaka Fuji, Shuhei Domae, Soichiro Nose, Kazuo Hamaya, Tadashi Yoshino, Kazunori Nishizaki

AURIS NASUS LARYNX 40 ( 6 ) 587 - 590 2013.12

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

A case of thyroidal mucosa-associated lymphoid tissue (MALT) lymphoma mimicking IgG4-related disease is described. A 54-year-old male presented with acute swelling of the anterior neck. Anaplastic thyroid carcinoma (ATC), malignant lymphoma (ML), or acute deterioration of Hashimoto's thyroiditis were initially suspected, and an emergent tracheostomy was required for progressive airway obstruction; a simultaneous biopsy from the thyroid tissue was performed. Histopathologically, the lesion consisted of sclerotic fibrosis and diffuse and dense infiltration by small lymphoid cells without atypia and plasma cells, many of which were IgG4-positive. Blood examination also revealed high serum IgG4 levels. Riedel's thyroiditis was suspected. However, despite medical treatments, a firm swelling of the thyroid still remained. In an in situ hybridization study, IgG4-negative plasma cells showed immunoglobulin light-chain restriction (kappa-monotype), and immunoglobulin heavy (IgH) chain gene monoclonal re-arrangement was detected by polymerase chain reaction. The lesion was finally diagnosed as MALT lymphoma. When IgG4-related disease is suspected, it is important to thoroughly exclude other possibilities. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2012.12.004

Cutting needle biopsy combined with imrnunohistochemical study of myeloperoxidase for the diagnosis of histiocytic necrotizing lymphadenitis

Hiroyuki Hanakawa, Yorihisa Orita, Yasuharu Sato, Mai Takeuchi, Kyotaro Ohno, Noriko Iwaki, Toshihiro Ito, Kazunori Nishizaki, Tadashi Yoshino

ACTA OTO-LARYNGOLOGICA 133 ( 12 ) 1328 - 1332 2013.12

Language：English Publishing type：Research paper (scientific journal) Publisher：INFORMA HEALTHCARE

Conclusion: Cutting needle biopsy (CNB) combined with immunohistochemical study of myeloperoxidase (MPO) is a useful minimally invasive diagnostic procedure for histiocytic necrotizing lymphadenitis (HNL). Objectives: HNL is mainly diagnosed by pathological findings of open surgical biopsy (OSB) specimens. Recently the appearance of anti-MPO positive histiocytes has been reported as a highly specific pathological diagnosis for HNL. Considering the cosmetic impact and burden on the patients, we performed CNB combined with immunohistochemical study of MPO for the diagnosis of HNL. Few studies have reported the utility of this method in the diagnosis of HNL. Methods: A retrospective study was conducted using clinical data from 20 HNL patients. Results: CNB was performed in 8 patients and OSB in 13 (OSB after CNB in 1). MPO-positive histiocytes were observed in all of the 20 cases. The accuracy of the diagnoses was finally confirmed by the clinical courses in all cases.

DOI： 10.3109/00016489.2013.824112

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