Faculty Profiles - YANAI Hiroyuki

Papers - YANAI Hiroyuki

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Contrast-enhanced Computed Tomography-Guided Percutaneous Cryoablation of Renal Cell Carcinoma in a Renal Allograft: First Case in Asia. Reviewed

Tsuboi I, Araki M, Fujiwara H, Iguchi T, Hiraki T, Arichi N, Kawamura K, Maruyama Y, Mitsui Y, Sadahira T, Kubota R, Nishimura S, Sako T, Takamoto A, Wada K, Kobayashi Y, Watanabe T, Yanai H, Kitagawa M, Tanabe K, Sugiyama H, Wada J, Shiina H, Kanazawa S, Nasu Y

Acta medica Okayama 73 ( 3 ) 269 - 272 2019.6

Language：English

Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up.

DOI： 10.18926/AMO/56871

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Successful Treatment of Metastatic Urothelial Carcinoma after Accurate Diagnosis by Immunohistochemistry. Reviewed

Makimoto G, Nishimori H, Kondo R, Yanai H, Sugimoto M, Oda N, Kubo T, Hotta K, Tabata M, Kiura K, Maeda Y

Acta medica Okayama 73 ( 3 ) 279 - 284 2019.6

Language：English

Urothelial carcinoma usually presents with hematuria, but cases of multiple lymphadenopathy with elevated S-pancreas-1 antigen (SPan-1) levels have not been reported. A 62-year-old Japanese man with lymphadenopathies was diagnosed with an adenocarcinoma of unknown origin and transferred to our hospital for further diagnosis. Serum carbohydrate antigen 19-9 and SPan-1 levels were extremely elevated. Uroplakin III immunostaining was positive in the inguinal lymph node, and cystoscopy revealed the presence of invasive urothelial carcinoma. Treatment with cisplatin and gemcitabine promoted a complete metabolic response for > 4 years. The detection of uroplakin III and serum SPan-1 might help diagnose urothelial carcinoma.

DOI： 10.18926/AMO/56873

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A Prospective Cohort Study to Define the Clinical Features and Outcome of Lung Cancers Harboring HER2 Aberration in Japan (HER2-CS STUDY). Reviewed

Ninomiya K, Hata T, Yoshioka H, Ohashi K, Bessho A, Hosokawa S, Ishikawa N, Yamasaki M, Shibayama T, Aoe K, Kozuki T, Harita S, Ueda Y, Murakami T, Fujimoto N, Yanai H, Toyooka S, Takata M, Hotta K, Kiura K, HER2-CS Network

Chest 156 ( 2 ) 357 - 366 2019.5

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

BACKGROUND: Human epidermal growth factor 2 (HER2) is a potential driver oncogene. Although HER2-targeted precision therapy has been tested in non-small cell lung cancer (NSCLC), the demographic characteristics of HER2-positive NSCLC have not been systematically defined.METHODS: Patients with pathologically confirmed stage IIIB/IV or recurrent NSCLC, Eastern Cooperative Oncology Group performance status 0 to 2, were prospectively registered. HER2 immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) assays were performed to screen patients. HER2 mutations were identified by using direct gene sequencing. The aim of this study was to clarify the frequency, characteristics, and outcome of HER2-positive NSCLC. HER2 was defined as positive if the tumor harbored IHC3+, IHC2+/FISH+, or exon 20 insertion mutations.RESULTS: Of the 1,126 tumors screened, 34 (3.0%) were IHC3+, and 34 (3.0%) were IHC2+/FISH+. Among the 724 epidermal growth factor receptor wild-type tumors, 21 (2.9%) were HER2-mutant tumors, including A775-G776insYVMA (n = 15). Interestingly, the IHC3+ tumors and mutant tumors were entirely exclusive. Female patients had HER2-mutant tumors more frequently, whereas both IHC3+ and IHC2+/FISH+ tumors were detected more often in male subjects and smokers. Patients with an HER2-aberrant tumor had a significantly worse prognosis than those with epidermal growth factor receptor-positive and anaplastic lymphoma kinase-positive tumors, possibly due to the low proportion that received HER2-targeted therapies (n = 15 [26%]) and low response rates of 0% and 14% in patients with HER2-overexpressing and HER2-mutant tumors, respectively.CONCLUSIONS: This prospective large-scale cohort study is the first to show comprehensively the frequency and clinical demographic characteristics of those with HER2-positive advanced lung tumors in detail, providing critical historical data for future drug development against HER2-positive NSCLC. Future treatment strategies would be developed stratified according to the types of HER2 aberrations.

DOI： 10.1016/j.chest.2019.01.011

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Dermoid cyst presenting as an intramuscular mass: CT and MRI features. Reviewed International journal

T Tanaka, R Inai, T Iguchi, H Yanai, S Kanazawa

Diagnostic and interventional imaging 100 ( 3 ) 195 - 196 2019.3

高位精巣摘除術後14年後に再発をきたしたStage I期セミノーマの1例(VERY LATE RELAPSE AND MANAGEMENT OF CLINICAL STAGE I SEMINOMA AFTER ORCHIECTOMY: A CASE REPORT)

和田里章悟, 定平卓也, 高本篤, 丸山雄樹, 光井洋介, 和田耕一郎, 谷本竜太, 杉本盛人, 小林泰之, 荒木元朗, 渡邉昌実, 渡邉豊彦, 那須保友, 柳井広之

西日本泌尿器科 81 ( 1 ) 45 - 48 2019.2

Language：English Publisher：西日本泌尿器科学会

Stage I期セミノーマの手術後には補助治療を行わず経過観察とするsurveillanceが現在の主流となっており、再発率は13〜20%と言われている。補助治療の有無によらず、再発の大半は手術後2年以内が占める。以降の再発は晩期再発と呼ばれ区別されているが、そのリスク因子は明確になっていない。手術後5年以降の再発は0.8%〜2.5%と報告されており、術後10年を超えての再発はさらに稀である。今回、我々は高位精巣摘除術14年後に発生したセミノーマ晩期再発を経験したので、若干の文献的考察を加え報告する。症例は40代、男性。右下腿浮腫、総腸骨リンパ節の腫大、骨盤内腫瘤を指摘され当科紹介受診した。患者は前医受診の14年前に右精巣腫瘍に対し高位精巣摘除術を行われており、セミノーマpT2N0M0 Stage IBとして術後6年間のフォローの後に終診となっていた。当科受診時にはLDH 667 U/l(120〜240U/l)、β-hCG 17.5mIU/l(<0.5mIU/l)と高値を認め、骨盤内腫瘤生検によりセミノーマの再発と診断、救済化学療法としてBEP3コース、VeIP療法を3コース施行した。VeIP療法施行後、骨盤内残存腫瘤の切除を行った。摘出標本は壊死組織のみでviable cellは認めず、術後7ヵ月時点では局所再発、転移は認めていない。(著者抄録)

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Burned-out Prostate Cancer ? Primary Metastatic Cancer Not Detected on Repeat Biopsy. Reviewed

Mitsui Y, Sadahira T, Maruyama Y, Wada K, Tanimoto R, Sugimoto M, Araki M, Watanabe M, Yanai H, Watanabe T, Nasu Y

Acta medica Okayama 72 ( 6 ) 605 - 609 2018.12

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

Metastatic prostate cancer (PCa) cases that cannot be detected on repeat prostate biopsy are extremely rare. Our patient was a 51-year-old Japanese man diagnosed as metastatic PCa by histopathological examination of lesions obtained bone biopsy and lymph node dissection. The primary tumor was not detected after repeated prostate biopsy. Metastatic PCa was diagnosed based on immunohistochemical staining: PSA, AR, P504S, and NKX3.1 of bone and lymph node with metastasis. We speculate that the primary PCa was "burned-out," demonstrating remote metastases with no apparent primary tumor in the prostate. Burned-out PCa may be difficult to diagnose and treat due to its rarity.

DOI： 10.18926/AMO/56380

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A Case of Multiple Segmental Schwannomas

Mariko KAWATA, Osamu YAMASAKI, Aya TAKEHARA, Daisuke UZUKI, Keiji IWATSUKI, Hiroyuki YANAI

Nishi Nihon Hifuka 80 ( 5 ) 446 - 449 2018.10

分節性に多発した神経鞘腫の1例

河田真理子, 山崎修, 竹原彩, 鈴木大介, 岩月啓氏, 柳井広之

西日本皮膚科 80 ( 5 ) 446 - 449 2018.10

Language：Japanese Publisher：日本皮膚科学会-西部支部

59歳、女性。小児期から左側腹部に限局して、軟らかい小型の結節を数個認めていた。3年前から徐々に硬化、増大し、発赤、圧痛を伴ってきたため当科を受診した。限局性に結節が多発し、神経線維腫症1型や2型の他症状はなく、臨床的には分節型神経線維腫症を考えた。生検にて悪性末梢神経鞘腫瘍の合併を疑い、拡大切除した。全摘標本では多発する結節は神経鞘腫の多彩な組織像を示した。術後7年間、再発や転移を認めなかった。(著者抄録)

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01003&link_issn=&doc_id=20181026390008&doc_link_id=10.2336%2Fnishinihonhifu.80.446&url=https%3A%2F%2Fdoi.org%2F10.2336%2Fnishinihonhifu.80.446&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

中枢神経系腫瘍 RELA fusionを伴うependymosarcoma

柳井広之, 田中健大, 田中顕之, 都地友紘

日本小児血液・がん学会雑誌 55 ( 1 ) 86 - 86 2018.6

β-catenin (CTNNB1) mutation and LEF1 expression in sinonasal glomangiopericytoma (sinonasal-type hemangiopericytoma) Reviewed

Yuka Suzuki, Shu Ichihara, Tomonori Kawasaki, Hiroyuki Yanai, Satoshi Kitagawa, Yoshie Shimoyama, Shigeo Nakamura, Masato Nakaguro

Virchows Archiv 1 - 5 2018.5

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

Sinonasal glomangiopericytoma (SN-GPC) is an uncommon mesenchymal tumor with myoid differentiation. Recently, mutations in exon 3 of the gene coding for β-catenin (CTNNB1) and its nuclear expression were discovered in SN-GPC. β-catenin protein is a key regulatory molecule of the canonical Wnt signaling pathway. The expression of β-catenin target proteins is not well characterized in SN-GPC. We examined three SN-GPCs by immunohistochemistry and CTNNB1 mutation analysis. All cases expressed nuclear β-catenin. We identified CTNNB1 exon 3 mutations in two analyzable cases. Lymphoid enhancer-binding factor 1 (LEF1), a protein downstream from β-catenin, was also expressed in all cases. Our results further characterized the activation of the Wnt signaling pathway caused by CTNNB1 exon 3 mutation and suggest the utility of LEF1 immunohistochemistry in the differential diagnosis of SN-GPC.

DOI： 10.1007/s00428-018-2370-9

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Oncological impact of neoadjuvant hormonal therapy on permanent iodine-125 seed brachytherapy in patients with low- and intermediate-risk prostate cancer Reviewed

Atsushi Takamoto, Ryuta Tanimoto, Kensuke Bekku, Motoo Araki, Takuya Sadahira, Koichiro Wada, Shin Ebara, Norihisa Katayama, Hiroyuki Yanai, Yasutomo Nasu

International Journal of Urology 25 ( 5 ) 507 - 512 2018.5

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

Objectives: To determine whether neoadjuvant hormonal therapy improves oncological outcomes of patients with localized prostate cancer treated with permanent brachytherapy. Methods: Between January 2004 and November 2014, 564 patients underwent transperineal ultrasonography-guided permanent iodine-125 seed brachytherapy. We retrospectively analyzed low- or intermediate-risk prostate cancer based on the National Comprehensive Cancer Network guidelines. The clinical variables were evaluated for influence on biochemical recurrence-free survival, progression-free survival, cancer-specific survival and overall survival. Results: A total of 484 patients with low-risk (259 patients) or intermediate-risk disease (225 patients) were evaluated. Of these, 188 received neoadjuvant hormonal therapy. With a median follow up of 71 months, the 5-year actuarial biochemical recurrence-free survival rates of patients who did and did not receive neoadjuvant hormonal therapy were 92.9% and 93.6%, respectively (P = 0.2843). When patients were stratified by risk group, neoadjuvant hormonal therapy did not improve biochemical recurrence-free survival outcomes in low- (P = 0.8949) or intermediate-risk (P = 0.1989) patients. The duration or type of hormonal therapy was not significant in predicting biochemical recurrence. In a multivariate analysis, Gleason score, pretreatment prostate-specific antigen, clinical T stage, and prostate dosimetry, primary Gleason score and positive core rate were significant predictive factors of biochemical recurrence-free survival, whereas neoadjuvant hormonal therapy was insignificant. Furthermore, neoadjuvant hormonal therapy did not significantly influence progression-free survival, cancer-specific survival or overall survival. Conclusions: In patients with low- or intermediate-risk disease treated with permanent prostate brachytherapy, neoadjuvant hormonal therapy does not improve oncological outcomes. Its use should be restricted to patients who require prostate volume reduction.

DOI： 10.1111/iju.13555

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日本産科婦人科学会婦人科腫瘍委員会プロジェクト(パート1) 性成熟期の女性に発症する疾患の発症と臨床的対応転移、再発を来した子宮筋腫症例の検討臨床的事項を中心に

牛嶋公生, 片渕秀隆, 小林裕明, 田代浩徳, 三上幹男, 宮本新吾, 柳井広之, 遠隔再発, 遠隔転移を来した子宮間葉系腫瘍の臨床病理学的検討に関する小委員会

日本婦人科腫瘍学会雑誌 36 ( 2 ) 177 - 180 2018.4

ヒト卵巣癌における線維芽細胞の由来

藤澤真義, 柳井広之, 和仁洋治, 伏見聡一郎, 松川昭博

日本病理学会会誌 107 ( 1 ) 389 - 389 2018.4

Gastric neuroendocrine tumor arising from heterotopic pancreas Reviewed

Takehiro Tanaka, Rika Omote, Noriko Okazaki, Hiroyuki Yanai, Tadashi Yoshino

Clinical Journal of Gastroenterology 11 ( 1 ) 34 - 37 2018.2

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

There are few English reports on secondary tumors from heterotopic pancreas. Here, we describe a case of gastric neuroendocrine tumor (NET) arising from heterotopic pancreas. A 72-year-old woman underwent esophagogastroduodenoscopy as part of a general health check-up. An endoscopic examination revealed a submucosal tumor on the greater curvature of the gastric body. Laparoscopic and endoscopic cooperative surgery was performed. Histological diagnosis concluded that it was a Grade 1 NET arising from heterotopic pancreas. We report this extremely rare case of a NET presenting as a submucosal tumor, considered to have originated from heterotopic pancreatic tissue.

DOI： 10.1007/s12328-017-0795-3

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Histopathological and genetic review of phosphaturic mesenchymal tumours, mixed connective tissue variant. Reviewed International journal

Yuichi Yamada, Izumi Kinoshita, Kohashi Kenichi, Hidetaka Yamamoto, Takeshi Iwasaki, Hiroshi Otsuka, Masato Yoshimoto, Shin Ishihara, Yu Toda, Yuki Kuma, Nokitaka Setsu, Yuki Koga, Yumi Honda, Takeshi Inoue, Hiroyuki Yanai, Kyoko Yamashita, Ichiro Ito, Mitsuru Takahashi, Shouichi Ohga, Masutaka Furue, Yasuharu Nakashima, Yoshinao Oda

Histopathology 72 ( 3 ) 460 - 471 2018.2

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

AIMS: Phosphaturic mesenchymal tumour, mixed connective tissue variant (PMT-MCT), is a tumour of uncertain differentiation, characterised by 'smudgy/grungy' calcification and vitamin D-resistant phosphaturic osteomalacia. Fibroblast growth factor (FGF)23 is recognised as a reliable marker of PMT-MCT, but quantitative evaluation has never been performed. We reviewed cases of tumour-associated osteomalacia or histologically definitive PMT-MCT without osteomalacia using histological, immunohistochemical and genetic methods and evaluated the diagnostic significance of these findings. METHODS AND RESULTS: A total of 19 tumours from 14 cases diagnosed previously as PMT-MCT were retrieved, on which immunohistochemical staining, reverse transcription-polymerase chain reaction (RT-PCR) and fluorescence in-situ hybridisation (FISH) analysis were performed. Histologically, fibrous capsule, calcification and giant cell reaction tended to be observed in soft-tissue PMT-MCT, while PMT-MCT of bone and multiple PMT-MCT showed an infiltrative growth pattern. The immunohistochemical results were as follows: the tumour cells were positive for FGF23 (nine of 12, 75%), FGFR1 (11 of 11, 100%), CD56 (12 of 14, 85.7%) and E26 oncogene homologue (ERG) (5 of 13, 38.4%). The sole malignant tumour was positive for p53. FGF23 mRNA was detected in seven of 14 formalin-fixed paraffin-embedded (FFPE) specimens and all five frozen specimens by RT-PCR. The level of FGF23 mRNA, which was determined by real-time PCR, varied among the phosphaturic cases. Two of 17 tumours were positive for FGFR1 gene rearrangement. CONCLUSIONS: It was considered that PMT-MCT is a histopathological entity with or without phosphaturia, with varying levels of FGF23 mRNA, and with or without fibronectin 1 (FN1)-FGFR1 fusion gene. The authors propose that the histology of PMT-MCT differs depending on its location, such as bone or soft tissue, which could complicate the differential diagnosis.

DOI： 10.1111/his.13377

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A rare manifestation of extraskeletal myxoid chondrosarcoma with a huge expanding hematoma Reviewed

Toshinori Omori, Tomohiro Fujiwara, Toshiyuki Kunisada, Ken Takeda, Joe Hasei, Aki Yoshida, Hiroyuki Yanai, Toshifumi Ozaki

Journal of Orthopaedic Science 24 ( 2 ) 377 - 381 2018

Japan Society of Gynecologic Oncology guidelines 2015 for thetreatment of vulvar cancer and vaginal cance Reviewed

T. Saito, T. Tabata, H. Ikushima, H. Yanai, H. Tashiro, H. Niikura, T. Minaguchi, T. Muramatsu, T. Baba, W. Yamagami, K. Ariyoshi, K. Ushijima, M. Mikami, S. Nagase, M. Kaneuchi, N. Yaegashi, Y. Udagawa, H. Katabuchi

International Journal of Clinical Oncology 23 201 - 234 2018

Clinicopathologic Diversity of Undifferentiated Sarcoma With BCOR-CCNB3 Fusion: Analysis of 11 Cases With a Reappraisal of the Utility of Immunohistochemistry for BCOR and CCNB3 Reviewed

Atsuji Matsuyama, Eisuke Shiba, Yoshihisa Umekita, Kanae Nosaka, Takihiro Kamio, Hiroyuki Yanai, Chika Miyasaka, Reiko Watanabe, Ichiro Ito, Tomoko Tamaki, Shinichi Hayashi, Masanori Hisaoka

AMERICAN JOURNAL OF SURGICAL PATHOLOGY 41 ( 12 ) 1713 - 1721 2017.12

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

Undifferentiated sarcoma harboring the BCOR-CCNB3 fusion is characterized by its predilection to affect skeletons of adolescent males, cellular small round/spindle cell morphology, and CCNB3 immunoreactivity. We analyzed 11 cases of BCOR-CCNB3 sarcoma, 10 of which were identified in a reverse transcription-polymerase chain reaction-based screen of 85 patient samples recorded in our database as unclassified small round or spindle cell sarcomas. BCOR rearrangements were confirmed by fluorescence in situ hybridization in 8 tumors. All patients were males aged between 6 and 31 years. In addition to 5 tumors in soft tissue and 4 in the axial or appendicular skeletons, which are typical locations, a tumor was located in the paranasal sinus and another in the lung. Microscopically, the tumors comprised proliferating atypical spindle and/or small round cells with diverse morphologic features such as small concentric whorls, myxoid stroma, a hemangiopericytomatous appearance, and/or hyalinized collagen resembling a solitary fibrous tumor, and angiomatous or slit-like spaces containing extravasated erythrocytes. Tumor cells were immunoreactive to CCNB3 (9/11), BCOR (10/10), TLE1 (6/10), bcl-2 (9/11), CD99 (8/10), CD56 (8/10), c-kit (4/10), and cyclin D1 (10/10). In an immunohistochemical analysis of an additional 412 small round or spindle cell tumors, CCNB3 was detected in 6 (1.5%) and BCOR in 18 (4.4%). Our analysis highlights the varying clinicopathologic features of this tumor, which partially overlap with other small round or spindle cell tumors, including solitary fibrous tumor and vascular tumors. Because CCNB3 and BCOR immunohistochemistry lacks adequate sensitivity and specificity, a molecular genetic approach remains essential for diagnosis.

DOI： 10.1097/PAS.0000000000000934

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MTX関連リンパ増殖性疾患の2例

濱田香菜, 那須篤子, 本山由紀子, 原田和恵, 井上博文, 今井みどり, 松岡博美, 藤田勝, 田中顕之, 田中健大, 柳井広之

岡山県臨床細胞学会誌 36 21 - 24 2017.12

Language：Japanese Publisher：岡山県臨床細胞学会

背景関節リウマチ(RA)の治療薬として広く用いられているメトトレキサート(MTX)は服用によりリンパ増殖性疾患を併発することがあり、MTX関連リンパ増殖性疾患(MTX-LPD)と呼ばれる。今回、RA治療中に発症したMTX-LPDの2例を経験したので報告する。症例症例1:70代男性。RAに対するMTX治療中、CT検査にて両肺に多発結節、全身リンパ節腫大がみられ、頸部リンパ節より穿刺吸引細胞診、針生検を施行。症例2:70代女性。RAに対するMTX治療中、右肩関節前面皮下腫瘤およびリンパ節腫大、乳房腫瘤がみられ、生検にてMTX-LPDの可能性が示唆され休薬、病変は縮小していたが、再度乳房腫瘤を自覚し穿刺吸引細胞診を施行。【細胞所見】いずれとも核小体明瞭で高度な異型の大型リンパ球がみられた。【組織診断】症例1:広範な壊死内部にCD20陽性を示す比較的大型のリンパ球が同定され、MTX-LPDの消退像と診断された。症例2:主に円形核を有するN/C比の高い中型細胞がびまん性に増殖するびまん性大細胞型B細胞性リンパ腫の像であった。結論 MTX-LPDは悪性リンパ腫との形態学的な鑑別が不可能であり、診断上、臨床情報が不可欠である。薬剤投与中止で腫瘍の退縮をみる症例もあり、RAの既往症例ではMTX使用の有無を確認することが重要である。(著者抄録)

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淡明細胞型腎細胞癌との鑑別にGiemsa染色が有用であった血管肉腫の1例 Reviewed

有安早苗, 柳井広之, 福田由美子, 中桐智香子, 佐藤正和, 園部宏

日本臨床細胞学会雑誌 56 ( 6 ) 297 - 302 2017.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(公社)日本臨床細胞学会

背景:穿刺吸引細胞診にて淡明細胞型腎細胞癌との鑑別が問題となった血管肉腫を経験し、その診断にGiemsa染色が有用であったので報告する。症例:患者は50歳代、男性。体調不良の精査時にCTにて後腹膜腫瘍および多発転移を認めた。転移リンパ節より穿刺吸引細胞診および組織生検が行われた。細胞診パパニコロウ染色標本では、N/C比が低く、細胞質がレース状で、核小体の目立つ明るい核を有する細胞が、上皮様結合を示す集塊で認められた。腎明細胞癌との鑑別が問題となったが、Giemsa染色標本では明瞭な赤血球内包像を認め、血管肉腫を疑った。生検組織は大型円形〜楕円形核をもつ細胞が密に増殖する像であった。免疫染色で腫瘍細胞はCD31、D2-40陽性を示し、血管肉腫と診断された。結論:血管肉腫はまれな腫瘍である。なかでも後腹膜血管肉腫は、画像診断が難しく、予後不良な腫瘍である。よって、穿刺吸引細胞診断は重要な位置づけにあり、精度の高い診断が望まれる。その細胞診断においてはGiemsa染色での赤血球内包像が有用であった。(著者抄録)

DOI： 10.5795/jjscc.56.297

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