Faculty Profiles - YANAI Hiroyuki

Papers - YANAI Hiroyuki

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High-grade Endometrial Carcinoma With a Hepatoid Carcinoma-like Component. Reviewed International journal

Kenji Nishida, Tomohiro Toji, Kohei Taniguchi, Rei Shibata, Sawako Ono, Takehiro Tanaka, Tadashi Yoshino, Hiroyuki Yanai

International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists 42 ( 1 ) 63 - 67 2022.1

Authorship：Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

Endometrial carcinoma with hepatoid differentiation is rare and <20 reported cases have been reported as endometrial hepatoid carcinoma (EHC). We present a case of EHC associated with serous carcinoma in a 76-yr-old Japanese woman. The hepatoid component showed trabecular, pseudoglandular, and diffuse proliferation of hepatoid cells. The hepatoid cells were positive for α-fetoprotein, Hep-Per-1, glypican 3, and HNF-1β, weakly and focally positive for SALL4, and negative for PAX8. Both of the serous and hepatoid components showed overexpression of p53. The serum α-fetoprotein on postoperative day 5 was 3691 ng/mL. The postoperative course has remained uneventful for 4 yr. These findings suggested that EHC developed from serous carcinoma by acquiring hepatocytic features and losing Müllerian features. Both serous and hepatoid components showed p53 overexpression, suggesting they share a TP53 mutation as a common primary driver.

DOI： 10.1097/PGP.0000000000000852

DNA mismatch repair deficiency and p53 abnormality are age-related events in mixed endometrial carcinoma with a clear cell component. Reviewed International journal

Naoyuki Ida, Keiichiro Nakamura, Masayuki Saijo, Atsuko Nasu, Tadashi Yoshino, Hisashi Masuyama, Hiroyuki Yanai

Pathology, research and practice 220 153383 - 153383 2021.4

Authorship：Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

Mixed endometrial carcinoma (MEC) is defined as a tumor composed of two or more spatially distinct subtypes, at least one of which is serous or clear cell carcinoma. In this study, the clinicopathological features of 15 MEC cases containing a clear cell component (MEC-C) were investigated. The ages of patients ranged from 32 to 83 years (median, 61 years). The combinations of carcinoma components observed were endometrioid and clear cell in ten patients; endometrioid, clear cell and serous in three; and clear cell and serous in two. Immunohistochemically, nine had DNA mismatch repair (MMR) protein deficiency (MMR-d), nine had loss of ARID1A and three cases had aberrant p53 expression. MMR-d and loss of ARID1A showed a strong correlation. Only one case showed both MMR-d and aberrant p53 expression. The patients with MMR-d were younger than those without MMR-d (median; 58 years vs. 71 years). Loss of ARID1A also showed significant predilection for younger women than ARID1A intact cases. In conclusion, MMR-d was observed in 60 % of MEC-C, showed predilection for young women, and was associated with ARID1A loss. In contrast, non- MMR-d MEC-C occurred in elder women and some tumors may associate with TP53 mutation. These findings suggest that MEC-C develop via two different molecular mechanisms and they are age-related events.

DOI： 10.1016/j.prp.2021.153383

Histologic Appearance and Immunohistochemistry of DNA Mismatch Repair Protein and p53 in Endometrial Carcinosarcoma: Impact on Prognosis and Insights Into Tumorigenesis. Reviewed International journal

Saijo M, Nakamura K, Ida N, Nasu A, Yoshino T, Masuyama H, Yanai H

The American journal of surgical pathology 43 ( 11 ) 1493 - 1500 2019.11

Authorship：Last author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

Endometrial carcinosarcoma (ECS) is a rare and aggressive mixed-type epithelial and mesenchymal tumor. This study focused on the histologic appearance, loss of DNA mismatch repair (MMR) protein expression, and aberrant p53 expression in the epithelial component, and overall prognosis of 57 cases with ECS. Histologically, 21 and 36 cases exhibited low-grade (endometrioid grade 1 and 2) and high-grade (others) epithelial components, respectively. In a Kaplan-Meier analysis, patients with a high-grade epithelial component exhibited worse progression-free survival (PFS), compared with those with a low-grade component. Although the former group also exhibited worse overall survival, the difference was not significant. Thirty-six cases exhibited aberrant p53 expression. Of these, 5 cases exhibited focally aberrant p53 expression in carcinomatous components with diffuse aberrant p53 expression in mesenchymal components. Aberrant expression of p53 did not show significant association with prognosis. Six patients with MMR deficiency exhibited relatively better PFS. In conclusion, a low-grade epithelial component is a superior predictor of the PFS of ECS, compared with MMR protein and p53 expression status. In some cases of ECS, TP53 mutation may be a late event associated with histogenesis of the sarcomatous component.

DOI： 10.1097/PAS.0000000000001353

Quality indicators for cervical cancer care in Japan. Reviewed

Watanabe T, Mikami M, Katabuchi H, Kato S, Kaneuchi M, Takahashi M, Nakai H, Nagase S, Niikura H, Mandai M, Hirashima Y, Yanai H, Yamagami W, Kamitani S, Higashi T

Journal of gynecologic oncology 29 ( 6 ) e83 2018.11

Language：English Publishing type：Research paper (scientific journal) Publisher：KOREAN SOC GYNECOLOGY ONCOLOGY & COLPOSCOPY

Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan.Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected.Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for 'cystoscope or proctoscope for stage IVA' to 98.8% for 'chemotherapy using platinum for stage IVB'. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively.Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

DOI： 10.3802/jgo.2018.29.e83

Japan Society of Gynecologic Oncology guidelines 2015 for the treatment of vulvar cancer and vaginal cancer. Reviewed

Toshiaki Saito, Tsutomu Tabata, Hitoshi Ikushima, Hiroyuki Yanai, Hironori Tashiro, Hitoshi Niikura, Takeo Minaguchi, Toshinari Muramatsu, Tsukasa Baba, Wataru Yamagami, Kazuya Ariyoshi, Kimio Ushijima, Mikio Mikami, Satoru Nagase, Masanori Kaneuchi, Nobuo Yaegashi, Yasuhiro Udagawa, Hidetaka Katabuchi

International journal of clinical oncology 23 ( 2 ) 201 - 234 2018.4

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

BACKGROUND: Vulvar cancer and vaginal cancer are relatively rare tumors, and there had been no established treatment principles or guidelines to treat these rare tumors in Japan. The first version of the Japan Society of Gynecologic Oncology (JSGO) guidelines for the treatment of vulvar cancer and vaginal cancer was published in 2015 in Japanese. OBJECTIVE: The JSGO committee decided to publish the English version of the JSGO guidelines worldwide, and hope it will be a useful guide to physicians in a similar situation as in Japan. METHODS: The guideline was created according to the basic principles in creating the guidelines of JSGO. RESULTS: The guidelines consist of five chapters and five algorithms. Prior to the first chapter, basic items are described including staging classification and history, classification of histology, and definition of the methods of surgery, radiation, and chemotherapy to give the reader a better understanding of the contents of the guidelines for these rare tumors. The first chapter gives an overview of the guidelines, including the basic policy of the guidelines. The second chapter discusses vulvar cancer, the third chapter discusses vaginal cancer, and the fourth chapter discusses vulvar Paget's disease and malignant melanoma. Each chapter includes clinical questions, recommendations, backgrounds, objectives, explanations, and references. The fifth chapter provides supplemental data for the drugs that are mentioned in the explanation of clinical questions. CONCLUSION: Overall, the objective of these guidelines is to clearly delineate the standard of care for vulvar and vaginal cancer with the goal of ensuring a high standard of care for all women diagnosed with these rare diseases.

DOI： 10.1007/s10147-017-1193-z

Nestin is a wide-spectrum abluminal cell marker of salivary gland tumors Reviewed

Hiroyuki Yanai, Yasuharu Sato, Hitoshi Nagatsuka, Tadashi Yoshino

PATHOLOGY INTERNATIONAL 63 ( 10 ) 496 - 501 2013.10

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Nestin is an intermediate filament that was first identified in neural progenitor cells. It is expressed in various cell types in the nervous system as well as in other systems. In the present study, we investigated nestin expression in non-neoplastic salivary gland tissue and in salivary gland tumors. In non-neoplastic salivary glands, nestin expression was observed in only a few abluminal cells. In contrast, diffuse nestin staining was observed in the abluminal cells of pleomorphic adenoma (11 of 11 cases), basal cell adenoma (7 of 7 cases), and epithelial-myoepithelial carcinoma (2 of 2 cases). The stromal cells in basal cell adenoma also expressed nestin. In adenoid cystic carcinoma (6 of 7 cases) and polymorphous low-grade adenocarcinoma (3 of 3 cases), nestin positive cells were observed focally. Nestin was not detected in Warthin tumor (6 cases), classical acinic cell carcinoma (2 cases), mucoepidermoid carcinoma (5 cases), or salivary duct carcinoma (4 cases). Because the nestin expression pattern in each histological salivary gland tumor type is unique, nestin could be a very useful abluminal cell marker for the diagnosis of salivary gland tumors.

DOI： 10.1111/pin.12103

Association between the expression pattern of p16, pRb and p53 and the response to intravesical bacillus Calmette-Guerin therapy in patients with urothelial carcinoma in situ of the urinary bladder Reviewed

Masakazu Sato, Hiroyuki Yanai, Toshiaki Morito, Wakako Oda, Yoko Shin-no, Ichiro Yamadori, Tomoyasu Tshushima, Tadashi Yoshino

PATHOLOGY INTERNATIONAL 61 ( 8 ) 456 - 460 2011.8

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

There is limited data regarding the association between the expression of cell cycle-regulating molecules and the response of patients with urothelial carcinoma in situ (CIS) to bacillus Calmette-Guerin (BCG) therapy. To examine the relationship between p16, pRb and p53 expression in bladder CIS and patient response to initial BCG therapy, we performed immunohistochemical studies for 27 patients with bladder CIS. Overexpression of p16, pRb, and p53 was observed in 37%, 41%, and 48% of patients, respectively. Initial BCG therapy was effective in 21 patients (78%). Coexistence of papillary urothelial carcinoma, depth (pTa or pT1) and grade of coexisting papillary carcinoma did not affect the response to BCG therapy. pRb overexpression had a significant relationship to poor response to BCG therapy (P = 0.027). The results of this study indicate that overexpression of pRb in bladder CIS predicts poor response of intravesical BCG instillation and status of p16 and p53 may not be predictive of initial BCG failure.

DOI： 10.1111/j.1440-1827.2011.02694.x

Uterine leiomyosarcoma arising in leiomyoma: Clinicopathological study of four cases and literature review Reviewed

Hiroyuki Yanai, Yoji Wani, Kenji Notohara, Shin-ichi Takada, Tadashi Yoshino

PATHOLOGY INTERNATIONAL 60 ( 7 ) 506 - 509 2010.7

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

In this study we examined four cases of leiomyosarcoma (LMS) arising in leiomyoma (LM). The patients ranged from 40 to 64 years old. Symptoms were unspecific and preoperative diagnosis of LMS had not been made. Size of the tumors ranged from 4 cm to 20.5 cm. All patients were in stage I and no patients developed recurrent disease. Histologically, the LMS component showed moderate to severe cytological atypia and an increased mitotic count in all cases. Tumor cell necrosis in the LMS was seen in three cases. Associated LM component was cellular in one case. The LMS component showed p53 expression in three of four cases and p16 expression was seen in two cases. The LM component lacked p53 expression in all cases and demonstrated p16 expression in two cases, including one case of cellular LM. In all cases, Ki-67-positive cells were less than 5% in the LM component and more than 25-30% in the LMS component. This study reveals that: (i) malignant transformation can occur even in relatively small LM; (ii) patients with LMS with an LM component have a favorable prognosis; and (iii) immunohistochemical examination of p53, p16 and Ki-67 is useful for identification of malignant focus.

DOI： 10.1111/j.1440-1827.2010.02549.x

Immunohistochemistry of p63 in primary and secondary vulvar Paget's disease Reviewed

Hiroyuki Yanai, Narihisa Takahashi, Masako Omori, Wakako Oda, Ichiro Yamadori, Shin-ichi Takada, Hiroo Matsuura, Tadashi Yoshino

PATHOLOGY INTERNATIONAL 58 ( 10 ) 648 - 651 2008.10

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Vulvar Paget's disease (VPD) is classified into primary and secondary types. Differentiation of these subsets in biopsy specimen is important for appropriate therapy. Expression profile of cytokeratin (CK) 7 and CK20, gross cystic disease fluid protein-15 and uroplakin III has been reported as a differentiation marker of primary and secondary VPD. To examine the role of p63 immunostaining in differential diagnosis between primary VPD and VPD secondary to urothelial carcinoma (VPD-UC), expression of p63 was examined in nine cases of VPD. Paget cells in seven cases of VPD without UC did not express p63. In two cases of VPD associated with UC, Paget cells and UC cells had identical CK expression profile. UC cells were positive for p63 in both cases. In one case, Paget cells were positive for p63 and examination of the resected specimen showed that VPD was secondary to UC. In another case, Paget cells were negative for p63 and this was diagnosed as primary VPD independent of UC. This indicates that p63 is absent in Paget cells in primary VPD and is therefore useful in differentiating primary VPD from VPD-UC.

DOI： 10.1111/j.1440-1827.2008.02284.x

Perivascular epithelioid cell tumor of the jejunum Reviewed

H Yanai, H Matsuura, H Sonobe, S Shiozaki, K Kawabata

PATHOLOGY RESEARCH AND PRACTICE 199 ( 1 ) 47 - 50 2003

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：URBAN & FISCHER VERLAG

Certain HMB-45-positive epithelioid cell tumors have recently been categorized under a unified concept: perivascular epithelioid cell tumor (PEComa). In this report, we describe a jejunal PEComa arising in a 32-year-old woman without other tumors or stigmata of tuberous sclerosis. The tumor consisted of nests of epithelioid cells with clear to granular eosinophilic cytoplasm. The nests were separated by thin fibrovascular septa. The tumor cells were positive for HMB-45 and progesterone receptor, and negative for cytokeratin, epithelial membrane antigen, vimentin, desmin, a-smooth muscle actin and CD34. RT-PCR analysis failed to reveal fusion transcript ETW/ATF1, which is characteristic of clear cell sarcoma of the soft parts. She developed a recurrent tumor at the pelvic wall and the left ovary at 13 and 25 months after the first operation, respectively. Each tumor was resected surgically, and no additional therapy was performed. We think the tumor of this case is a malignant form of PEComa because of the clinical history of multiple recurrences and the size of the primary tumor. Our case underscores that to make a correct diagnosis, clinical information and immunohistochemical examination are essential.

DOI： 10.1078/0344-0338-00353

Immature teratoma of the ovary with a minor rhabdomyosarcomatous component and fatal rhabdomyosarcomatous metastases: The first case in a child Reviewed

H Yanai, H Matsuura, M Kawasaki, Y Takada, Y Tabuchi, T Yoshino

INTERNATIONAL JOURNAL OF GYNECOLOGICAL PATHOLOGY 21 ( 1 ) 82 - 85 2002.1

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

A case of ovarian immature teratoma with rhabdoniyosarcomatous recurrence in a 6-year-old girt is described. The primary tumor consisted of a dermoid cyst and a solid nodule composed of mature and immature mesenchymal tissue. The most immature mesenchymal cells showed no distinctive differentiation except for focal rhabdomyoblastic differentiation . The primary tumor was diagnosed as immature teratoma. grade 2, stage IIa. Despite left oophorectomy and excision of uterine serosal implants, chemotherapy. and radiation, four intrapelvic recurrences developed within 3 years. Although the primary tumor contained only a few, rhabdomyoblasts, the recur-rent rumors became increasingly rhabdomyosarcomatous. The patient died of systemic disease 3 years after presentation. This case and previous reports indicate that the prognosis of patients with ovarian immature teratoma with rhabdoniyosarcomatous recurrence is poor and similar to that of primary ovarian rhabdomyosarcoma.

Adult mesoblastic nephroma with ciliated epithelium. A case report Reviewed

H Yanai, A Ikeda, H Kadena, M Mizutani, M Kurihara, S Matsuki

PATHOLOGY RESEARCH AND PRACTICE 196 ( 4 ) 265 - 268 2000

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：URBAN & FISCHER VERLAG

A case of renal pelvic tumors occurring in a 44-year-old man is reported. There were two polypoid renal pelvic tumors which consisted of, glandular and stromal components. Some glands in the tumors had ciliated epithelium and were quite similar to the epididymal tubules. Other glands in the tumors resembled the collecting duct or the mesonephric remnant seen in female genitalia. Immunohistochemistry and electron microscopy revealed smooth muscle differentiation of the stromal cells of these tumors. Some psammoma bodies were seen in the glands of the tumors. We diagnosed these tumors as adult mesoblastic nephroma (MN). The patient has been followed up for 14 months, showing no evidence of recurrence. Differentiation of the tumors from angiomyolipoma, leiomyoma, and nephrogenic adenofibroma is discussed. Adult renal tumors that consist of epithelial and stromal components have been reported under various names. They constitute clinicopathologically different entities originating from pediatric MN. We suggest that these tumors should be termed "adult MN".

診断に苦慮した転移性腟腺癌(肺原発)の1例

和田弘輝, 福田由美子, 中桐智香子, 山代承子, 有安早苗, 表梨華, 園部宏, 柳井広之

日本臨床細胞学会雑誌 63 ( Suppl.2 ) 538 - 538 2024.10

新たながん遺伝子パネル検査 TruSight Oncology 500(TSO500)の臨床的意義(Clinical relevance of novel comprehensive genomic profiling assay - TruSight Oncology 500(TSO500))

遠西大輔, 冨田秀太, 松井啓隆, 藤野泰輝, 檜井孝夫, 杉本健樹, 川上耕史, 松本光史, 山本弥寿子, 曳野肇, 二宮貴一朗, 山本英喜, 柳井広之, 平沢晃, 豊岡伸一, 豊岡伸一

日本癌学会総会記事 83回 P - 2114 2024.9

Ectopic Breast Cancer Arising within an Axillary Lymph Node. Reviewed

Kei Toshima, Tadahiko Shien, Midori Filiz Nishimura, Yoko Suzuki, Shogo Nakamoto, Maya Uno, Ryo Yoshioka, Takahiro Tsukioki, Yuko Takahashi, Takayuki Iwamoto, Tsuguo Iwatani, Hiroyuki Yanai

Acta medica Okayama 78 ( 1 ) 89 - 93 2024.2

Language：English

We report our experience with the diagnosis and treatment of an ectopic breast cancer arising within an axillary lymph node. The patient was a 65-year-old woman diagnosed breast cancer and axillary lymph node metastasis. We performed a partial mastectomy and axillary lymph node dissection. Postoperative pathology revealed no malignant lesions in the breast; however, a nodule in one of axillary lymph nodes had mixed benign and malignant components, leading to a diagnosis of invasive ductal carcinoma derived from ectopic mammary tissue. This case represents a very rare form of breast cancer, and the malignancy was difficult to distinguish from metastasis.

DOI： 10.18926/AMO/66676

高頻度マイクロサテライト不安定性(MSI-High)胃癌にARID1A発現低下を合併した未分化癌の1例

表梨華, 田中健大, 柚木宏介, 濱野亮輔, 大塚眞哉, 園部宏, 柳井広之, 稲垣優

日本胃癌学会総会記事 96回 448 - 448 2024.2

ヒアルロン酸注入により下顎部に異物肉芽腫を生じた1例

坂田伽奈子, 神野泰輔, 川上佳夫, 森実真, 柳井広之

日本皮膚科学会雑誌 134 ( 2 ) 351 - 352 2024.2

Concordance Between Biopsy and Resection Diagnoses of Uterine Cervical Adenocarcinoma According to the Updated World Health Organization 2020 Classification: A Multi-Institutional Study Elucidating Real-World Practice in Japan. Reviewed International journal

Fumi Kawakami, Hiroyuki Yanai, Norihiro Teramoto, Yu Miyama, Masanori Yasuda, Sachiko Minamiguchi, Masami Iwamoto, Takako Kiyokawa, Yoshiki Mikami

Archives of pathology & laboratory medicine 2024.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Archives of Pathology and Laboratory Medicine

Context.—

Endocervical adenocarcinoma is divided into human papillomavirus (HPV)–associated (HPVA) and HPV-independent (HPVI) in the 5h edition of the World Health Organization (WHO) tumor classification launched in 2020. However, the validity of the morphological criteria used for biopsy specimens in real-world practice remains undetermined.

Objective.—

To validate the utility of the 5th edition of the WHO classification for biopsy samples, focusing on its diagnostic criteria with the aid of ancillary studies.

Design.—

We retrieved 217 cases of endocervical adenocarcinoma from 6 institutions, in which glass slides of both biopsy and resection specimens were available for review. Concordance between the biopsy and resection specimen diagnoses was evaluated. For discordant diagnoses, an algorithmic approach with ancillary studies proposed by the international group was applied to confirm their utility to improve the accuracy of biopsy diagnosis.

Results.—

The biopsy diagnosis matched the resection specimen diagnosis in 197 cases (concordance rate, 91%; κ = 0.75). The concordance rate was significantly higher for HPVA than HPVI (95% versus 81%, P = .001). There were no significant differences in the proportions of HPVA and HPVI or the accuracy of biopsy diagnosis between the participating institutions. All 19 discordant cases with unstained glass slides available were accurately recategorized as HPVA or HPVI using HPV in situ hybridization; p16 immunohistochemistry was positive in 3 of 9 cases of gastric-type HPVI that were negative by in situ hybridization.

Conclusions.—

The 5th edition of the WHO criteria for biopsy diagnosis of endocervical adenocarcinoma distinguishes HPVA from HPVI well when ancillary studies are adequately applied.

DOI： 10.5858/arpa.2023-0360-OA

Tectal glioma: clinical, radiological, and pathological features, and the importance of molecular analysis

Ryoji Imoto, Yoshihiro Otani, Kentaro Fujii, Joji Ishida, Shuichiro Hirano, Naoya Kemmotsu, Yasuki Suruga, Ryo Mizuta, Yasuhito Kegoya, Yohei Inoue, Tsuyoshi Umeda, Madoka Hokama, Kana Washio, Hiroyuki Yanai, Shota Tanaka, Kaishi Satomi, Koichi Ichimura, Isao Date

Brain Tumor Pathology 2024

Publishing type：Research paper (scientific journal)

Tectal glioma (TG) is a rare lower grade glioma (LrGG) that occurs in the tectum, mainly affecting children. TG shares pathological similarities with pilocytic astrocytoma (PA), but recent genetic analyses have revealed distinct features, such as alterations in KRAS and BRAF. We conducted a retrospective review of cases clinically diagnosed as TG and treated at our institute between January 2005 and March 2023. Six cases were identified and the median age was 30.5 years. Four patients underwent biopsy and two patients underwent tumor resection. Histological diagnoses included three cases of PA, one case of astrocytoma, and two cases of high-grade glioma. The integrated diagnosis, according to the fifth edition of the World Health Organization Classification of Tumours of the central nervous system, included two cases of PA and one case each of diffuse high-grade glioma; diffuse midline glioma H3 K27-altered; glioblastoma; and circumscribed astrocytic glioma. Among the three patients who underwent molecular evaluation, two had KRAS mutation and one had H3-3A K27M mutation. Our results demonstrate the diverse histological and molecular characteristics of TG distinct from other LrGGs. Given the heterogeneous pathological background and the risk of pathological progression in TG, we emphasize the importance of comprehensive diagnosis, including molecular evaluation.

DOI： 10.1007/s10014-024-00494-9

唾液腺分泌癌の細胞病理学的所見とギムザ染色の診断的有用性

植田向夏花, 錦織歩, 江草侑厘安, 錦織亜沙美, 西村碧フィリーズ, 柳井広之, 佐藤康晴

岡山県臨床細胞学会誌 41 43 - 43 2023.12

Huge Primary Cardiac Undifferentiated Pleomorphic Sarcoma. Reviewed

Ryo Karasudani, Norihiko Nakanishi, Masahiro Tabata, Hiroyuki Yanai

Internal medicine (Tokyo, Japan) 2023.11

S100P/Ki-67二重免疫染色は上部尿路細胞診断の補助手段になりえるか

有安早苗, 田中慎一, 福田由美子, 中桐智香子, 山代承子, 佐藤正和, 表梨華, 柳井広之

日本臨床細胞学会雑誌 62 ( Suppl.2 ) 541 - 541 2023.10

A Case of Uterine Tumor Resembling Ovarian Sex Cord Tumor With Prominent Myxoid Features. Reviewed International journal

Koki Ise, Zen-Ichi Tanei, Yoshitaka Oda, Satoshi Tanikawa, Hirokazu Sugino, Yusuke Ishida, Masumi Tsuda, Yuko Gotoda, Kunihiko Nishiwaki, Hiroyuki Yanai, Tadashi Hasegawa, Kazuo Nagashima, Shinya Tanaka

International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists 2023.6

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

Uterine tumor resembling ovarian sex cord tumor (UTROSCT) is a rare tumor with low malignant potential that commonly occurs in middle age. Although more than 100 cases have been reported to date, myxoid morphology is not well documented. Here, we present a 75-yr-old woman with abnormal vaginal bleeding, with an 8-cm mass in the uterine corpus detected by irregular, high-intensity signaling on T2-weighted imaging. The uterine mass had a glistening mucinous appearance on gross examination. Microscopically, most of the tumor cells were floating in the myxoid stroma. The tumor cells formed clusters or nests with abundant cytoplasm, while some exhibited trabecular or rhabdoid appearances. Immunohistochemically, tumor cells were positive for pancytokeratin (AE1/AE3), α-smooth muscle actin, CD10, progesterone receptor, and some sex cord markers such as calretinin, inhibin, CD56, steroidogenic factor-1. Electron microscopy demonstrated epithelial and sex cord differentiation. This tumor was negative for JAZF1-JJAZ1 fusion gene that is frequently found in low-grade endometrial stromal sarcoma. Fusion genes related to UTROSCT, including NCOA2/3, were not detected by reverse transcription polymerase chain reaction. The present case suggests that UTROSCT should be included in the differential diagnosis of myxoid uterine tumors.

DOI： 10.1097/PGP.0000000000000949

Utility of Comprehensive Genomic Profiling for Precise Diagnosis of Pediatric-Type Diffuse High-Grade Glioma. Reviewed

Keigo Makino, Yoshihiro Otani, Kentaro Fujii, Joji Ishida, Shuichiro Hirano, Yasuki Suruga, Kana Washio, Kenji Nishida, Hiroyuki Yanai, Shuta Tomida, Daisuke Ennishi, Isao Date

Acta medica Okayama 77 ( 3 ) 323 - 330 2023.6

Language：English

In the current World Health Organization classification of central nervous system tumors, comprehensive genetic and epigenetic analyses are considered essential for precise diagnosis. A 14-year-old male patient who presented with a cerebellar tumor was initially diagnosed with glioblastoma and treated with radiation and concomitant temozolomide chemotherapy after resection. During maintenance temozolomide therapy, a new contrast-enhanced lesion developed in the bottom of the cavity formed by the resection. A second surgery was performed, but the histological findings in specimens from the second surgery were different from those of the first surgery. Although genome-wide DNA methylation profiling was conducted using frozen tissue for a precise diagnosis, the proportion of tumor cells was insufficient and only normal cerebellum was observed. We then performed comprehensive genetic analysis using formalin-fixed paraffin-embedded sections, which revealed MYCN amplification without alteration of IDH1, IDH2, or Histone H3. Finally, the patient was diagnosed with pediatric-type diffuse high-grade glioma, H3-wildtype and IDH-wildtype. In conclusion, comprehensive genetic and epigenetic analysis should be considered in pediatric brain tumor cases.

DOI： 10.18926/AMO/65502

Like a shot-through manubrium: A rare presentation of skeletal tuberculosis. Reviewed International journal

Tomohiro Fujiwara, Hiroyuki Yanai, Hideharu Hagiya

Clinical case reports 11 ( 5 ) e7119 2023.5

Language：English

A 22-year-old Vietnamese woman presented with anterior chest swelling. Computed tomography revealed an osteolytic lesion in the manubrium, whereas MRI showed an extra-osseous expansion. A needle biopsy showed granuloma formation, whereas a 3-week mycobacterial culture indicated Mycobacterium tuberculosis infection. Manubrium/sternum involvement in tuberculosis is extremely rare but should be considered.

DOI： 10.1002/ccr3.7119

片側下腿に発生した多発性グロムス腫瘍の一例

徳田貴大, 藤原智洋, 近藤彩奈, 国定俊之, 中田英二, 西村碧フィリーズ, 柳井広之, 尾崎敏文

中国・四国整形外科学会雑誌 35 ( 1 ) 47 - 51 2023.4

Language：Japanese Publisher：中国・四国整形外科学会

症例は21歳男性で、左下腿脛骨外側部のグロムス腫瘍切除術後2ヵ月経過した時点で左下腿の疼痛が再燃した。MRIでは左脛骨前面、脛骨後面、脛腓間、腓骨周囲に多発性の腫瘤を認め、これら全病変を辺縁切除した。病理検査では全てグロムス腫瘍と診断され、術後1年の時点で疼痛の再燃や腫瘍の再発は認めず、趣味のダンスも再開している。

子宮頸部腺癌のWHO分類第5版(2020)は生検診断においても有効か

川上史, 柳井広之, 南口早智子, 美山優, 安田政実, 寺本典弘, 岩本雅美, 清川貴子, 三上芳喜

日本病理学会会誌 112 ( 1 ) 255 - 255 2023.3

Probability scoring system of intravascular large B-cell lymphoma for the application of random skin biopsy: A retrospective cohort study. Reviewed International journal

Mikiko Takigawa, Osamu Yamasaki, Hayato Nomura, Tomoko Miyake, Hiroyuki Yanai, Shin Morizane

JAAD international 9 146 - 152 2022.12

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

BACKGROUND: Intravascular large B-cell lymphoma (IVLBCL) is rare and fatal when diagnosed late in the disease course. Random skin biopsy (RSB) is useful for early diagnosis, but criteria for its application are not well established. OBJECTIVE: To develop an IVLBCL-probability scoring system for stratifying patients and investigate its feasibility and capability for RSB application. METHODS: A retrospective cohort of 77 consecutive patients with suspected IVLBCL who underwent RSB was included in this study. All patients were classified into 3 IVLBCL-probability groups according to the IVLBCL-probability scoring system comprising the following 4 components: general symptoms, organ-specific symptoms, serum soluble-interleukin-2 receptor levels, and serum lactate-dehydrogenase levels. RESULTS: The high (score 7-10), intermediate (score 4-6) and low (score 1-3) IVLBCL-probability groups contained 32, 30, and 15 patients, respectively. All 5 patients with IVLBCL were stratified into the high IVLBCL probability group. Accuracies in the diagnosis of IVLBCL were 100%, 100%, and 93.8% for the low, intermediate, and high IVLBCL-probability groups. The positive detection rate in the high IVLBCL-probability group increased to 9.4% from 3.9% across all groups. CONCLUSIONS: The newly-developed IVLBCL-probability scoring system has good capability for stratification of patients and could allow limiting application of RSB for diagnosis only to high-probability groups.

DOI： 10.1016/j.jdin.2022.09.005

A critical review of "uterine leiomyoma" with subsequent recurrence or metastasis: A multicenter study of 62 cases. Reviewed International journal

Sakiko Sanada, Kimio Ushijima, Hiroyuki Yanai, Yoshiki Mikami, Yoshihiro Ohishi, Hiroaki Kobayashi, Hironori Tashiro, Mikio Mikami, Shingo Miyamoto, Hidetaka Katabuchi

The journal of obstetrics and gynaecology research 48 ( 12 ) 3242 - 3251 2022.12

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

AIM: Histopathologic diagnosis of a subset of uterine smooth muscle tumors is challenging. We report a critical review regarding the clinicopathological point of view of 62 cases of subsequently recurred or metastasized leiomyoma. METHODS: Medical records and glass slides of 62 cases of uterine smooth muscle tumor diagnosed as leiomyoma, which subsequently recurred or metastasized, were critically reviewed by pathologists specializing in gynecologic pathology and oncology. RESULTS: In 47 (75.8%) of 62 cases, the diagnosis of leiomyoma was confirmed, including 11 intravascular leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML). In 29 cases (46.8%) laparoscopic surgery was performed, of which morcellator without a bag was employed in 23 cases. Fifteen cases (24.2%) appeared to be underestimated and were re-classified as smooth muscle tumor of uncertain malignant potential (STUMP), leiomyosarcoma, or other malignant mesenchymal tumors. Recurrences in seven cases (11.3%) were interpreted to be a malignant transformation, and one STUMP recurred as STUMP. CONCLUSION: The recurrence or metastasis in cases of "leiomyoma" is attributed to iatrogenic or under-evaluation of primary tumors, although a subset of cases is a rare example of biological progression.

DOI： 10.1111/jog.15426

腫瘍用人工骨頭による股関節置換術を施行した転移性前立腺癌の1例

和田里章悟, 久住倫宏, 藤原智洋, 山本哲也, 柳井広之, 白石裕雅, 徳永素, 窪田理沙, 市川孝治, 津島知靖

西日本泌尿器科 85 ( 2 ) 47 - 51 2022.12

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は57歳,男性。腰部と右大腿部の痛みを主訴に近医を受診した。単純X線写真での骨硬化像とPSA高値から骨転移を伴う前立腺癌を疑われ当科紹介となった。初診時,PSAは433ng/dLであり直腸診で前立腺は石様硬に触れた。画像検査では腰椎,仙骨,恥骨,右大腿骨頸部から転子部にかけて転移を疑う像を認めたが,リンパ節腫大と他臓器の占拠性病変はなかった。初診より7日目に経直腸式前立腺生検の迅速病理で腺癌の組織を確認し,即時の外科的去勢術を施行した。病理結果を以てGleason score 4+5の前立腺癌cT3bN0M1bと診断した。腰椎及び仙骨と右大腿骨の転移性骨腫瘍にはそれぞれ30Gyの放射線治療とビスフォスフォネート製剤の投与を行い,外来通院でアビラテロン内服を開始した。初診より5ヵ月後,PSAは低下傾向にあったが,右大腿骨頸部の病的骨折により入院となった。Activities of Daily Livingが著しく低下し,骨腫瘍切除術と腫瘍用人工骨頭による再建術を施行した。荷重部の転移性骨腫瘍については切迫骨折のリスクを評価し,免荷を指示するかあるいは,病的骨折を発症する前の外科的介入も検討する必要がある。(著者抄録)

特徴的な細胞所見が確認できた胃癌子宮転移の一例 Reviewed

安村早優美, 山口祐菜, 那須篤子, 今井みどり, 本山由紀子, 田中健大, 柳井広之

岡山県臨床細胞学会誌 40 24 - 26 2022.12

Language：Japanese Publisher：岡山県臨床細胞学会

背景:子宮内膜の二次性腫瘍は子宮外を原発とする腫瘍の子宮内膜への転移であり,極めて稀である.二次性腫瘍としては婦人科原発や乳癌の小葉癌,胃癌が多い.今回,特徴的な細胞所見が確認できた胃癌子宮転移の一例を報告する.症例:40代,女性.3型進行胃癌の疑いで精査のために他院より紹介受診した.CTにて胃体下部から胃角部大彎を中心に約7cm大の壁肥厚病変や卵巣の低度腫大が認められ,胃生検,子宮腟部細胞診,子宮体部細胞診が施行された.胃生検では,卵円形に腫大した核と粘液に富む胞体をもつ異型細胞が索状あるいは孤在性に増殖しており,印環細胞癌と診断された.子宮腟部,子宮体部細胞診では異型が強く,細胞質内に粘液を大量に含み,核が偏在し,いわゆる印環細胞癌の特徴を示す異型細胞が多数存在しており,これらの所見と既往歴から,胃癌の子宮転移と推定した.結語:子宮の二次性腫瘍の中でも,細胞診標本中に腫瘍細胞を認めることは稀であるが,今回の症例では子宮腟部,子宮体部細胞診にて胃生検と同様に印環細胞型の異型の強い腺癌細胞が孤在性または集塊で出現しており,臨床情報と併せて転移性腫瘍の診断が可能であった.(著者抄録)

S100P/Ki-67二重免疫染色は上部尿路細胞診の補助手段になりえるか組織学的基礎検討

有安早苗, 田中慎一, 福田由美子, 中桐智香子, 山代承子, 佐藤正和, 表梨華, 柳井広之

日本臨床細胞学会雑誌 61 ( Suppl.2 ) 533 - 533 2022.10

The utility of DNA methylation analysis in elderly patients with pilocytic astrocytoma morphology. Reviewed International journal

Yasuki Suruga, Kaishi Satomi, Yoshihiro Otani, Kentaro Fujii, Joji Ishida, Atsuhito Uneda, Nobushige Tsuboi, Keigo Makino, Shuichiro Hirano, Naoya Kemmotsu, Ryoji Imoto, Ryo Mizuta, Yusuke Tomita, Takao Yasuhara, Kana Washio, Hiroyuki Yanai, Yuko Matsushita, Yuko Hibiya, Akihiko Yoshida, David Capper, Koichi Ichimura, Isao Date

Journal of neuro-oncology 160 ( 1 ) 179 - 189 2022.9

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

PURPOSE: Pilocytic astrocytoma (PA) is a circumscribed low-grade astrocytic glioma, generally considered to be associated with a good prognosis. However, a subset of PA patients shows unfavorable outcomes. In this study, we retrospectively reviewed PA patients and performed further molecular analysis, such as DNA methylation profiling, to identify prognostic factors. METHODS: We analyzed 29 histologically-confirmed PA patients from a single center from 2002 to 2021 and conducted integrated molecular analyses among elderly PA patients since age was an independent prognostic factor for poor outcomes. RESULTS: The median age at diagnosis was 14 years (range 3-82 years) and 4 patients (14%) were elderly (patients ≥ 60 years old). Age over 60 was associated with poor progression-free survival and overall survival. We performed DNA methylation analysis on 2 of the 4 elderly patients. Both cases were histologically diagnosed as PA, but DNA methylation profiling revealed one as high-grade astrocytoma with piloid features (all methylation class scores were below 0.3 in both v11b4 and v12.5) and the other as glioblastoma, IDH-wildtype (score was over 0.5 in both v11b4 and v12.5), using the German Cancer Research Center methylation profiling classifiers and t-SNE analysis. CONCLUSIONS: Elderly patients with PA morphology showed unfavorable outcomes in this cohort. In those patients, further molecular analysis and DNA methylation profiling revealed the possibility of high-grade astrocytic tumors, including newly defined entities.

DOI： 10.1007/s11060-022-04131-3

Site-specific differences in T lymphocyte composition of the gastric mucosa after Helicobacter pylori eradication. Reviewed International journal

Masaya Iwamuro, Takahide Takahashi, Natsuki Watanabe, Makoto Abe, Hiroyuki Sakae, Yoshiyasu Kono, Hiromitsu Kanzaki, Takehiro Tanaka, Seiji Kawano, Fumio Otsuka, Yoshiro Kawahara, Hiroyuki Yanai, Hiroyuki Okada

Medicine 101 ( 34 ) e30241 2022.8

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

In our earlier work, we revealed that inflammation of the lesser curvature of the gastric body and antrum could constitute independent risk factors for gastric cancer development, while inflammation of the greater curvature was not. The aims of this study were as follows: first, to reveal the differences between T lymphocyte populations of the gastric antrum and the greater and lesser curvatures of the gastric body in patients after Helicobacter pylori eradication; second, to analyze the correlation between the composition of the stomach-resident T lymphocytes and time from H. pylori eradication; and third, to evaluate the sex differences in T lymphocyte subsets after H. pylori eradication. To investigate site-specific differences in stomach-resident T lymphocytes after H. pylori eradication, we performed flow cytometry analysis on samples taken from the gastric antrum, greater curvature of the gastric body, and lesser curvature of the gastric body of 20 patients. We also analyzed the correlation between the composition of the stomach-resident T lymphocytes and the time from H. pylori eradication. The lymphocyte subsets of the antrum and lesser curvature of the body were similar. In contrast, compared to those in the greater curvature of the gastric body, CD4+/CD3+ lymphocyte subsets (43.8 ± 19.4% vs 31.7 ± 14.6%) were elevated in the lesser curvature of the body, whereas CD8+/CD3+ (67.1 ± 21.3% vs 80.4 ± 12.0%), CD7+/CD3+ (91.2 ± 4.6% vs 93.7 ± 3.8%), CCR4+/CD3+ (7.7 ± 8.1% vs 10.4 ± 7.0%), CD45RA+/CD3+CD4+ (27.2 ± 24.8% vs 39.5 ± 20.8%), and CD45RA+/CD3+CD4- (14.2 ± 11.1% vs 18.7 ± 11.5) were lower. Linear regression analysis showed a negative correlation between the time after H. pylori eradication and CD4+/CD3+ (P < .05, R2 = 0.198). There were no significant differences between men and women with respect to the lymphocyte populations. These results indicate that there are site-specific differences in lymphocyte composition in the stomach after H. pylori eradication.

DOI： 10.1097/MD.0000000000030241

Genomic Profiling of a Case of Glioneuronal Tumor with Neuropil-like Islands. Reviewed

Nobushige Tsuboi, Joji Ishida, Yosuke Shimazu, Hisanori Edaki, Atsuhito Uneda, Yoshihiro Otani, Kentaro Fujii, Kazuhiko Kurozumi, Daisuke Ennishi, Hiroyuki Yanai, Isao Date

Acta medica Okayama 76 ( 4 ) 473 - 477 2022.8

Language：English

Glioneuronal tumor with neuropil-like islands (GNTNI) is a very rare subtype of glioneuronal tumor. We present a case of a 62-year-old man with GNTNI. Two adjacent lesions in the left parietal lobe were removed by left parietal craniotomy. The histological findings were glial cell proliferation and scattered rosettes consisting of synaptophysin-positive and NeuN-positive cells, leading to the diagnosis of GNTNI. Target sequencing revealed a genetic alteration similar to glioblastoma, IDH-wild type, which suggested adjuvant therapies. There are few previous reports on the treatment of this disease, and the patient should be followed carefully.

DOI： 10.18926/AMO/63907

18F-FDG-PET/CTで集積の乏しい低異型度子宮内膜間質肉腫の1例

丸山拓夢, 蟹江悠一郎, 丸川洋平, 檜垣文代, 児島克英, 柳井広之, 依田尚之, 平木隆夫

臨床放射線 67 ( 8 ) 887 - 891 2022.8

Language：Japanese Publisher：金原出版(株)

症例は40歳代女性で、検診目的に産婦人科を受診し、子宮腫瘍を指摘されたため、精査加療目的に当院紹介となった。MRIではT1強調像で均一な低信号、T2強調像で均一な中間的高信号、拡散強調像で高信号、ADCの低下を認めた。MRI上、低異型度子宮内膜間質肉腫(low-grade ESS)を疑ったが、当院受診2ヵ月前に全身検索目的で撮像された18F-FDG-PET/CTにて腫瘤に異常高集積を認めなかったため、静脈内平滑筋腫症を否定できなかった。肉腫の可能性を考慮して開腹子宮全摘術、両側付属器切除術を施行した。病理所見では、細胞質の乏しい短紡錘形細胞の増殖がみられ、螺旋動脈様の小血管が規則的に介在しており、部分的に筋層に分け入るような浸潤像も認められ、low-grade ESSに特徴的な所見であった。

Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J01565&link_issn=&doc_id=20220823130017&doc_link_id=10.18888%2Frp.0000002037&url=https%3A%2F%2Fdoi.org%2F10.18888%2Frp.0000002037&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

A Case of a Solitary Cortical Tuber with No Other Manifestations of Tuberous Sclerosis Complex Mimicking Focal Cortical Dysplasia Type II with Calcification. Reviewed

Kakeru Hosomoto, Tatsuya Sasaki, Koji Kawai, Yosuke Okazaki, Yuki Hyodo, Takashi Shibata, Susumu Sasada, Takao Yasuhara, Katsuhiro Kobayashi, Hiroyuki Yanai, Isao Date

Acta medica Okayama 76 ( 3 ) 323 - 328 2022.6

Language：English

Cortical tubers are one of the typical intracranial manifestations of tuberous sclerosis complex (TSC). Multiple cortical tubers are easy to diagnose as TSC; however, a solitary cortical tuber without any other cutaneous or visceral organ manifestations can be confused with other conditions, particularly focal cortical dysplasia. We report a surgical case of refractory epilepsy caused by a solitary cortical tuber mimicking focal cortical dysplasia type II, and describe the radiological, electrophysiological, and histopathological findings of our case.

DOI： 10.18926/AMO/63742

Regulatory T cells induce a suppressive immune milieu and promote lymph node metastasis in intrahepatic cholangiocarcinoma. Reviewed International journal

Daisuke Konishi, Yuzo Umeda, Kazuhiro Yoshida, Kunitoshi Shigeyasu, Shuya Yano, Tomohiro Toji, Sho Takeda, Ryuichi Yoshida, Kazuya Yasui, Tomokazu Fuji, Kazuyuki Matsumoto, Hiroyuki Kishimoto, Hiroyuki Michiue, Fuminori Teraishi, Hironari Kato, Hiroshi Tazawa, Hiroyuki Yanai, Takahito Yagi, Ajay Goel, Toshiyoshi Fujiwara

British journal of cancer 127 ( 4 ) 757 - 765 2022.5

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

BACKGROUND: Emerging evidence indicates that immunogenicity plays an important role in intrahepatic cholangiocarcinoma (ICC). Herein, we systematically evaluated the clinical relevance of immunogenicity in ICC. METHODS: Highly immunogenic ICCs identified in the public dataset and the Cancer Immunome Atlas (TCIA) were assessed to determine the prognostic impact of immunogenicity in ICC and key components after curative resection. We also investigated the clinical relevance of the immune milieu in ICC. RESULTS: Using the Gene Expression Omnibus dataset 89749 and TCIA, we identified CD8+/forkhead box P3 (FoxP3)+ tumour-infiltrating lymphocytes (TILs), T-cell immunoglobulin and mucin domain 3 (TIM-3) and human leukocyte antigen-A (HLA-A) in highly immunogenic ICCs. Immunohistochemical analysis of the in-house cohort showed that intratumoral FoxP3+ TILs correlated with CD8+ TILs (P = 0.045, Fisher's exact test) and that high FoxP3+/CD8+ ratio (FCR) was an important marker for poor survival (P < 0.001, log-rank test). Furthermore, the FCR was higher in tumour-free lymph nodes in ICCs with lymph node metastases than in those without lymph node metastases (P = 0.003, Mann-Whitney U test). CONCLUSIONS: FCR should be considered an important biomarker that represents the immune environment of ICC based on its potentially important role in tumour progression, especially lymph node metastasis.

DOI： 10.1038/s41416-022-01838-y

AYA世代の脳腫瘍病理小児、AYA世代の脳腫瘍に対する網羅的メチル化解析を用いた診断の有用性と限界

大谷理浩, 藤井謙太郎, 石田穣治, 坪井伸成, 鷲尾佳奈, 柳井広之, 里見介史, 市村幸一, 伊達勲

Brain Tumor Pathology 39 ( Suppl. ) 076 - 076 2022.5

甲状腺sclerosing mucoepidermoid carcinoma with eosinophiliaの一例

園部宏, 福田由美子, 中桐智香子, 村本将太, 山代承子, 表梨華, 柳井広之

日本臨床細胞学会雑誌 61 ( Suppl.1 ) 213 - 213 2022.5

Resection and immediate reconstruction of two pediatric intraosseous capillary mandibular malformations Reviewed

Hiroshi Matsumoto, Tomoyuki Ota, Sho Komagoe, Yohei Noda, Takuma Makino, Seiko Takeda, Nobuyoshi Mizukawa, Kohei Taniguchi, Tomoka Ikeda, Hiroyuki Yanai, Yoshihiro Kimata

European Journal of Plastic Surgery 45 ( 5 ) 831 - 839 2022.1

Cytopathological Findings of Secretory Carcinoma of the Salivary Gland and the Diagnostic Utility of Giemsa Staining. Reviewed International journal

Yuria Egusa, Midori Filiz Nishimura, Satoko Baba, Kengo Takeuchi, Takuma Makino, Tomoyasu Tachibana, Asami Nishikori, Azusa Fujita, Hiroyuki Yanai, Yasuharu Sato

Diagnostics (Basel, Switzerland) 11 ( 12 ) 2021.12

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

Secretory carcinoma is a salivary gland neoplasm first described as a mammary analogue secretory carcinoma by Skalova and redesignated as a secretory carcinoma in the 2017 World Health Organization Classification of Head and Neck Tumors. Secretory carcinoma diagnosis is reliant on specific cytological and histological findings and the detection of an ETV6-NTRK3 fusion gene. Here, we examined the clinical and cytopathological features of four cases of secretory carcinoma occurring in three males and a female, aged between 39 and 74 years. All four tumors involved the parotid gland, and were found to have the ETV6-NTRK3 fusion gene. Fine-needle aspiration-based cytology smears of all tumors displayed papillary and/or dendritic pattern clusters, some of which were associated with blood vessels. The neoplastic cells displayed enlarged nuclei with fine chromatin and small, distinct, single nucleoli. Furthermore, several neoplastic cells with a characteristic vacuolated cytoplasm were identified in each specimen. Giemsa staining revealed cytoplasmic vacuolation, intracytoplasmic metachromatic secretions and/or various sized metachromatic granules, and a background of metachromatic mucin in all four specimens. Given this, we conclude that these cytological findings, especially those of the Giemsa staining, might be helpful in the diagnosis of secretory carcinoma.

DOI： 10.3390/diagnostics11122284

Retroperitoneal leiomyosarcoma in a female patient with a germline splicing variant RAD51D c.904-2A > T: a case report Reviewed

Mashu Futagawa, Hideki Yamamoto, Mariko Kochi, Yusaku Urakawa, Reimi Sogawa, Fumino Kato, Mika Okazawa-Sakai, Daisuke Ennishi, Katsunori Shinozaki, Hirofumi Inoue, Hiroyuki Yanai, Akira Hirasawa

Hereditary Cancer in Clinical Practice 19 ( 1 ) 2021.12

Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

<title>Abstract</title><sec>
<title>Background</title>
<italic>RAD51D</italic> (RAD51 paralog D) is an intermediate cancer susceptibility gene for primary ovarian cancer, including fallopian tube and peritoneal carcinomas and breast cancer. Although gynecological non-epithelial tumors such as uterine sarcomas are associated with genomic instability, including <italic>BRCA</italic> impairment, there is no clear evidence of the relationship between <italic>RAD51D</italic> variants and the risk of sarcoma development.

</sec><sec>
<title>Case presentation</title>
A Japanese woman in her 50s underwent multiple surgical resections and several regimens of chemotherapy for tumors that originated in the retroperitoneum and recurred in the peritoneum over a clinical course of approximately 4 years. The peritoneal tumor was histologically diagnosed as a leiomyosarcoma and was genetically identified to show a splice variant of <italic>RAD51D</italic> c.904-2A > T [NM_002878] through tumor profiling performed as a part of cancer precision medicine. The confirmatory genetic test performed after genetic counseling revealed that the <italic>RAD51D</italic> splicing variant detected in her tumor was of germline origin. In silico analyses supported the possible pathogenicity of the detected splice variant of <italic>RAD51D</italic> with a predicted attenuation in mRNA transcription and truncated protein production due to frameshifting, which was attributed to a single-nucleotide alteration in the splicing acceptor site at the 3′-end of intron 9 of <italic>RAD51D</italic>. Considering her unfavorable clinical outcome, which showed a highly aggressive phenotype of leiomyosarcoma with altered <italic>RAD51D</italic>, this case provided novel evidence for the relationship of a <italic>RAD51D</italic> splicing variant with malignant tumor development or progression. We report the findings of this rare case with possible involvement of the germline variant of <italic>RAD51D</italic> c.904-2A > T as a potential predisposing factor for malignant tumors, including leiomyosarcoma.

</sec><sec>
<title>Conclusions</title>
We present the findings of a case of leiomyosarcoma in the peritoneum of a female patient with a novel germline splicing variant of <italic>RAD51D</italic> as potential evidence for the pathogenicity of the variant and its involvement in the risk of sarcoma etiology and/or development. To the best of our knowledge, this is the first case report describing a leiomyosarcoma carrying a germline <italic>RAD51D</italic> splicing variant and elucidating its pathogenicity on the basis of computational prediction of the impairment of normal transcription and the presumed loss of functional protein production.

</sec>

DOI： 10.1186/s13053-021-00205-x

Other Link： https://link.springer.com/article/10.1186/s13053-021-00205-x/fulltext.html

長期にわたって乳房腫瘤を自覚していた若年乳癌の一例

中川里沙子, 宇野摩耶, 岩本高行, 三又明日香, 間森智加, 安部優子, 鳩野みなみ, 西村碧フィリーズ, 高橋侑子, 河内麻里子, 都地友紘, 枝園忠彦, 平成人, 柳井広之, 土井原博義

日本臨床外科学会雑誌 82 ( 増刊 ) S1220 - S1220 2021.10

Presence of decoy cells for 6 months on urine cytology efficiently predicts BK virus nephropathy in renal transplant recipients. Reviewed International journal

Takanori Sekito, Motoo Araki, Kasumi Yoshinaga, Yuki Maruyama, Takuya Sadahira, Shingo Nishimura, Koichiro Wada, Masami Watanabe, Toyohiko Watanabe, Katsuyuki Tanabe, Hidemi Takeuchi, Hiroshi Morinaga, Masashi Kitagawa, Shinji Kitamura, Hitoshi Sugiyama, Jun Wada, Hiroyuki Yanai, Yasutomo Nasu

International journal of urology : official journal of the Japanese Urological Association 28 ( 12 ) 1240 - 1246 2021.9

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

OBJECTIVES: To investigate the association between duration of consecutive presence of decoy cells on urine cytology and BK virus nephropathy after kidney transplantation. METHODS: In total, 121 kidney transplant recipients were retrospectively evaluated. The best duration of consecutive presence of decoy cells that could be used to predict BK virus nephropathy was analyzed using the area under the curve for each duration, and recipients were divided into two groups based on the best predictive performance. The effectiveness of SV40 immunostaining on urinary cytology was also analyzed. RESULTS: In total, 2534 urine specimens as well as SV40 immunostaining in 2241 urine specimens were analyzed. Six consecutive months of decoy cell positivity had the best predictive performance for BK virus nephropathy (area under the curve = 0.832). The incidence of BK virus nephropathy in recipients with positive decoy cells for 6 months or more consecutive months (5/44) was significantly higher than in those who had positive decoy cells for less than 6 months (0/77; P = 0.005). Decoy cell positivity had a sensitivity, specificity, positive predictive value, and negative predictive value for BK virus nephropathy of 100%, 66%, 11%, and 100% respectively. SV40 immunostaining provided slightly better specificity (68%) and positive predictive value (12%). CONCLUSIONS: The detection of decoy cells at 6 months or more on urine cytology had high predictive value for BK virus nephropathy in kidney transplant recipients. SV40 immunostaining on urine cytology added minimal diagnostic accuracy.

DOI： 10.1111/iju.14679

Pulmonary lymphatic involvement in metastatic uterine sarcomas: imaging and pathological appearance. Reviewed International journal

Takahiro Kitayama, Takashi Tanaka, Takao Hiraki, Shinichi Toyooka, Hiroyuki Yanai, Susumu Kanazawa

Radiology case reports 16 ( 9 ) 2460 - 2462 2021.9

Language：English

Pulmonary lymphatic involvement of sarcomas is an extremely rare form of metastases. We report the computed tomography (CT) features of pathologically confirmed pulmonary lymphatic involvement from metastatic uterine sarcomas. The CT illustrated smooth or nodular thickenings of the interlobular septa and bronchovascular bundle. Moreover, ground-glass opacity along the interlobular septa was also detected. These findings suggest that lymphatic involvement has diagnostic value for detecting this rare form of metastatic sarcomas. We also discuss possible differential diagnoses in this case and review previous cases reporting pulmonary lymphatic involvement in metastatic sarcomas. To the best of our knowledge, this is the first report describing pulmonary lymphatic involvement in metastatic uterine sarcomas. Pulmonary lymphatic spread of sarcomas is a rare form of metastatic sarcomas, but it should be considered when these findings suggesting lymphatic involvement are detected on CT.

DOI： 10.1016/j.radcr.2021.05.076

Lymphoepithelial Carcinoma in the Lateral Tongue: The Case Report Reviewed

Sawako Ono, Hidenori Marunaka, Hiroyuki Yanai, Hotaka Kawai, Kiyofumi Takabatake, Kenji Nishida, Tomohiro Toji, Keisuke Nakano, Hitoshi Nagatsuka, Tadashi Yoshino

Reports 4 ( 3 ) 24 - 24 2021.8

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Lymphoepithelial carcinoma (LEC) of the tongue is a rare subtype of squamous cell carcinoma. Histologically, it is an undifferentiated carcinoma with rich lymphocyte and plasma cell infiltration. The most common location for LEC in the head and neck is the salivary glands, and LEC of the oral cavity is extremely rare. The second case report of LEC in the lateral tongue is presented. In addition, a review of the literature was performed, and the relationship between LEC and Epstein–Barr virus infection was considered.

DOI： 10.3390/reports4030024

Pathological and clinical effects of interleukin-6 on human myocarditis. Reviewed International journal

Naofumi Amioka, Kazufumi Nakamura, Tomonari Kimura, Keiko Ohta-Ogo, Takehiro Tanaka, Tomohiro Toji, Satoshi Akagi, Koji Nakagawa, Norihisa Toh, Masashi Yoshida, Toru Miyoshi, Nobuhiro Nishii, Atsuyuki Watanabe, Ryotaro Asano, Takeshi Ogo, Yoshikazu Nakaoka, Hiroshi Morita, Hiroyuki Yanai, Hiroshi Ito

Journal of cardiology 78 ( 2 ) 157 - 165 2021.8

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

BACKGROUND: Numerous basic studies have shown a relationship between interleukin-6 (IL-6) and the development or severity of myocarditis. However, there has been no study in which the effect of IL-6 levels in patients with myocarditis was evaluated. METHODS: We enrolled control patients (n = 12) and consecutive patients with acute myocarditis (n = 13), including lymphocytic, eosinophilic, and giant cell myocarditis, and investigated the pathological and clinical effects of IL-6 on human myocarditis. RESULTS: The serum IL-6 level in patients with myocarditis (16.7 [9.9, 103.8] pg/mL) was significantly higher than that in the control patients (1.4 [1.0, 1.9] pg/mL) (P<0.001). Immunohistochemical analysis showed that IL-6 was expressed in infiltrating inflammatory cells of endomyocardial biopsy samples from all patients with myocarditis. Moreover, the log-transformed value of serum IL-6 level showed significant positive correlations with serum creatine kinase (CK) level, CK-MB level, peak CK level, peak CK-MB level and C-reactive protein level (all P ≤ 0.005) and a negative correlation with the left ventricular (LV) ejection fraction (p = 0.014). We divided the patients with myocarditis into a low IL-6 group (9.9 [4.5, 14.2] pg/dL, n = 7) and a high IL-6 group (108.9 [51.1, 130.9] pg/dL, n = 6). The degree of infiltration of IL-6-expressing inflammatory cells in myocardial samples obtained from patients in the high IL-6 group was significantly more severe than that in samples obtained from patients in the low IL-6 group. Furthermore, patients in the high IL-6 group significantly more frequently received catecholamine therapy (P = 0.005), venoarterial extracorporeal membrane oxygenation (P = 0.029), and artificial respirator support (P = 0.021) in the acute phase of myocarditis. CONCLUSION: The results suggest that there is a strong impact of IL-6 on cardiac injury and dysfunction in patients with myocarditis.

DOI： 10.1016/j.jjcc.2021.03.003

腎部分切除術を施行した巨大類上皮型腎血管筋脂肪腫の1例

横山周平, 富永悠介, 高本篤, 定平卓也, 関戸崇了, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 柳井広之, 那須保友

西日本泌尿器科 83 ( 3 ) 175 - 180 2021.8

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は41歳,女性。2008年に結節性硬化症,両側腎血管筋脂肪腫およびIgA腎症と診断され,経過観察されていた。2015年に右腎血管筋脂肪腫より出血を認め緊急経カテーテル的動脈塞栓術を施行し,左腎血管筋脂肪腫に対しても待機的に経カテーテル的動脈塞栓術を施行した。2017年にCTで右腎尾側に新たに腫瘤を指摘され,2年の経過で12cmから20cm大に急速に増大したため2019年3月にCTガイド下針生検を実施し類上皮型腎血管筋脂肪腫と診断された。2019年5月に術前TAE後に開腹右腎部分切除術を施行した。2019年9月よりエベロリムスを開始したが,腎機能障害とHbA1cの上昇を認めたため中止した。その後,術後12ヵ月まで再発および転移を認めず経過している。(著者抄録)

腎門部に発生した粘液嚢胞腺癌の1例

三宅修司, 岩田健宏, 長尾賢太郎, 河田達志, 富永悠介, 定平卓也, 西村慎吾, 高本篤, 佐古智子, 和田耕一郎, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 久保寿夫, 柳井広之, 那須保友

西日本泌尿器科 83 ( 2 ) 100 - 105 2021.6

Language：Japanese Publisher：(一社)西日本泌尿器科学会

症例は79歳,男性。2年前に検診にて左腎嚢胞と診断され近医で経過観察となっていたが,増大傾向であったため当科紹介となった。造影CT検査でBosniak分類category IVの左嚢胞性腎癌を疑い,腹腔鏡下左腎摘除術を施行した。術後病理結果から,粘液嚢胞腺癌(Mucinous cystadenocarcinoma)と診断した。術後補助化学療法は行わずに経過観察としていたが,術後3ヵ月後に多発肺転移が出現し,化学療法(カルボプラチン+パクリタキセル)を開始した。5コース投与後の肺転移はSDであったため,一旦化学療法中止で経過観察の方針としたが,5ヵ月後に肺転移は増大傾向を認めたため術後14ヵ月目よりニボルマブの投与を開始した。ニボルマブ2コース投与後のCTで肺転移は縮小し,5コース投与後もPRを維持しているため現在も投与継続中である。(著者抄録)

移植後シクロホスファミドを用いた血縁者間HLA半合致移植後に最重症遅発性肝類洞閉塞症候群を合併した非定型慢性骨髄性白血病

北村亘, 藤井伸治, 大西秀樹, 高須賀裕樹, 大山矩史, 村上裕之, 木村真衣子, 近藤匠, 松田真幸, 池川俊太郎, 藤原英晃, 淺田騰, 遠西大輔, 西森久和, 藤井敬子, 松岡賢市, 木口亨, 柳井広之, 吉野正, 前田嘉信

臨床血液 62 ( 6 ) 654 - 655 2021.6

Linked Color Imaging (LCI) Emphasizes the Color Changes in the Gastric Mucosa After Helicobacter pylori Eradication. Reviewed International journal

Hiroyuki Sakae, Hiromitsu Kanzaki, Takuya Satomi, Shotaro Okanoue, Yuka Obayashi, Kenta Hamada, Makoto Abe, Yoshiyasu Kono, Ko Miura, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai, Hiroyuki Okada

Digestive diseases and sciences 67 ( 6 ) 2375 - 2384 2021.5

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

BACKGROUND: Diffuse redness is a characteristic endoscopic finding that indicates current infection of Helicobacter pylori, which is reduced after successful eradication. Linked color imaging (LCI) has been reported to improve the visibility of diffuse redness compared to white light imaging (WLI); however, quantitative evaluation has not been reported. AIMS: This study aimed to objectively evaluate the color change of the gastric mucosa after H. pylori eradication. METHODS: Images of the greater curvature of the antrum and corpus were captured, and the sites were biopsied during esophagogastroduodenoscopy (EGD) before and 1 year after eradication. The region of interest (ROI) was set around the biopsied area on the images. The color difference (ΔE) before and after eradication was calculated using the CIE L*a*b* color space. The association between the histological evaluation and the color value of the corresponding ROI was determined. RESULTS: At the antrum, there was no significant color change with either mode. At the corpus, the a* value, which reflected redness, decreased significantly after eradication with both modes (WLI: 41.2 to 36.0, LCI: 37.5 to 25.5); the b* value, reflecting yellowish, decreased with WLI, but increased significantly with LCI (WLI: 44.6 to 41.6, LCI: 23.9 to 29.2). The ΔE was significantly larger with LCI than with WLI (16.5 vs. 8.6). The a* values at the corpus were generally associated with histological neutrophil infiltration. CONCLUSIONS: Quantitative evaluation revealed that LCI emphasizes the change in color of the gastric mucosa due to the reduction in diffuse redness.

DOI： 10.1007/s10620-021-07030-1

Best practices for the extraction of genomic DNA from formalin-fixed paraffin-embedded tumor tissue for cancer genomic profiling tests. Reviewed International journal

Hirofumi Inoue, Shuta Tomida, Shigeru Horiguchi, Hironari Kato, Hiromi Matsuoka, Etsuko Sanehira, Masashi Matsuoka, Hiroyuki Yanai, Akira Hirasawa, Shinichi Toyooka

Pathology international 71 ( 5 ) 360 - 364 2021.5

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

Recently, two cancer genomic profiling tests have been approved in Japan and implemented in routine clinical practice: the FDA-approved FoundationOne CDx test, and the OncoGuide NCC Oncopanel test. The quality and quantity of DNA significantly affects the sequencing results; therefore, preparing a sufficient amount of high-quality DNA for clinical cancer genomic profiling tests is important. We examined the best practices for the extraction of cancer genomic DNA from formalin-fixed paraffin-embedded (FFPE) tumor tissues of pancreatic, lung and colon cancer specimens. We found that the quality of cancer genomic DNA extracted from 10-μm-thick FFPE samples improved significantly, compared with that from 4-μm-thick FFPE samples, suggesting that 10-μm-thick FFPE samples are preferable for clinical cancer genomic profiling tests. For convenience, we created a quick reference table for calculating the required number of FFPE slides.

DOI： 10.1111/pin.13086

診断に難渋したglioneuronal tumor with neuropil-like islandの一例

坪井伸成, 島津洋介, 枝木久典, 石田穣治, 藤井謙太郎, 黒住和彦, 柳井広之, 伊達勲

Brain Tumor Pathology 38 ( Suppl. ) 109 - 109 2021.5

Secretory carcinoma of the skin with lymph node metastases and recurrence in both lungs: A case report. Reviewed International journal

Kohei Taniguchi, Hiroyuki Yanai, Tatsuya Kaji, Toshio Kubo, Daisuke Ennishi, Akira Hirasawa, Tadashi Yoshino

Journal of cutaneous pathology 48 ( 8 ) 1069 - 1074 2021.4

Language：English

Secretory carcinoma of the skin is an extremely rare adnexal tumor, histopathologically identical to homologous lesions in the salivary glands and breast tissue. Although this tumor was previously reported as indolent, we report a case of secretory carcinoma of the skin with metastases and recurrence. The patient, a 31-year-old women, had a subcutaneous mass in the right axilla. The resected specimen contained a circumscribed mass, with proliferating tumor cells that exhibited prominent nucleoli. They exhibited glandular and papillary growth patterns and there were amphophilic secretions in the glands. Immunohistochemically, the tumor cells were positive for mammaglobin and S100. The tumor was surrounded by sweat glands and there was no mammary glandular tissue, suggesting that it was derived from axillary sweat glands. Accordingly, we made a diagnosis of secretory carcinoma of the skin. Four years after the operation, there were metastases in both lungs. The resected specimen revealed a tumor identical to that of the original skin tumor. Next-generation sequencing-based multiplex gene assay performed on the metastatic tissue revealed an ETV6-NTRK3 fusion gene. This is a rare case report of secretory carcinoma of the skin with lymph node metastases and recurrence in both lungs.

DOI： 10.1111/cup.14028

Risk Factors for Gastric Cancer after the Eradication of Helicobacter pylori Evaluated Based on the Background Gastric Mucosa: A Propensity Score-matched Case-control Study. Reviewed

Yuka Obayashi, Seiji Kawano, Hiroyuki Sakae, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Masaya Iwamuro, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 60 ( 7 ) 969 - 976 2021.4

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

Objective The eradication of Helicobacter pylori (H. pylori) reduces the risk for gastric cancer (GC) development, but it cannot prevent GC completely. We investigated the risk factors of early GC development after the eradication of H. pylori, based on the histological characteristics of gastric mucosa. Methods Sixty-one patients who underwent endoscopic submucosal dissection for early GC after successful H. pylori eradication (Group A) and 122 patients without developing a gastric neoplasm over 3 years after successful H. pylori eradication (Group B) were analyzed. We compared the histological findings of the patients enrolled in Group A and Group B before and after the propensity score-matching. Results Comparing the characteristics of two the groups, Group A consisted predominantly of males, had significantly more elderly patients, and the years after successful eradication tended to be longer. We performed score matching for these three factors to reduce the influence of any confounding factors. After matching, the scores of inflammation for Group A (n=54) was significantly higher than those of Group B (n=54) at the greater curvature of the antrum, the lesser curvature of the corpus, and the greater curvature of the corpus. According to a multivariate analysis, inflammation of the greater curvature of the antrum and lesser curvature of the corpus were found to be independent risk factors. The risk ratio and 95% CI were 5.92 (2.11-16.6) (p<0.01), and 3.56 (1.05-13.2) (p=0.04), respectively. Conclusion A continuous high level of inflammation of the background gastric mucosa may be a risk factor for gastric cancer onset after H. pylori eradication.

DOI： 10.2169/internalmedicine.5486-20

A second opinion pathology review improves the diagnostic concordance between prostate cancer biopsy and radical prostatectomy specimens Reviewed

Takanori Maehara, Takuya Sadahira, Yuki Maruyama, Koichiro Wada, Motoo Araki, Masami Watanabe, Toyohiko Watanabe, Hiroyuki Yanai, Yasutomo Nasu

Urology Annals 13 ( 2 ) 119 - 124 2021.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Wolters Kluwer Medknow Publications

Objectives: The Gleason scoring system is an essential tool for determining the treatment strategy in prostate cancer (PCa). However, the Gleason grade group (GGG) often differs between needle-core biopsy (NCB) and radical prostatectomy (RP) specimens. We investigated the diagnostic value of a second opinion pathology review using NCB specimens in PCa. Materials and Methods: We retrospectively evaluated 882 patients who underwent robot-assisted RP from January 2012 to September 2019. Of these, patients whose original biopsy specimens were obtained from another hospital and reviewed by the urological pathology expert at our institution were included in the study. Patients who received neoadjuvant hormonal therapy were excluded from the study. Weighted kappa (k) coefficients were used to evaluate the diagnostic accuracy of each review. Results: A total of 497 patients were included in this study. Substantial agreement (weighted k = 0.783) in the GGG between initial- and second-opinion diagnoses based on NCB specimens was observed in 310 cases (62.4%). Although diagnoses based on a single opinion showed moderate agreement with the GGG of RP specimens (initial: 35.2%, weighted k = 0.522
second opinion
38.8%, weighted k = 0.560), matching initial and second opinion diagnoses improved the concordance (42.9%, 133/310 cases) to substantial agreement (weighted k = 0.626). Conclusions: A second opinion of PCa pathology helps to improve the diagnostic accuracy of NCB specimens. However, over half of diagnoses that matched between the initial and second opinions differed from the diagnosis of RP specimens.

DOI： 10.4103/UA.UA_81_20

A Case Report of Spindle Cell Carcinoma with Osteoid and Cartilage Formation in the Tongue Reviewed

Sawako Ono, Takuma Makino, Hiroyuki Yanai, Hotaka Kawai, Kiyofumi Takabatake, Keisuke Nakano, Kenji Nishida, Kohei Taniguchi, Tomohiro Toji, Hitoshi Nagatsuka, Tadashi Yoshino

Reports 4 ( 1 ) 5 - 5 2021.2

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Spindle cell carcinoma (SCSCC) with osteoid and/or cartilage formation in the head and neck is rare; only one case was reported in the tongue. Herein, we report an SCSCC with osteoid and cartilage formation of the tongue developed in an 85-year-old man, and then review the report.

DOI： 10.3390/reports4010005

神経線維腫症1型に合併した後腹膜悪性末梢神経鞘腫瘍の1例

宗田大二郎, 岩田健宏, 定平卓也, 富永悠介, 片山聡, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友, 中田英二, 柳井広之

西日本泌尿器科 82 ( 6 ) 596 - 600 2021.2

Language：Japanese Publisher：西日本泌尿器科学会

症例は30代,女性。過去に左腋窩皮膚生検で神経線維腫と診断され,特徴的な皮膚所見や家族歴などから神経線維腫症1型(NF-1;von Recklinghausen病)を疑われていたが放置していた。20XX年2月に右大腿部痛,背部痛を主訴に近医を受診しMRI,造影CTで約13cm大の後腹膜腫瘤を指摘され,L2神経根からの発生と脊柱管内の浸潤も疑われ,神経線維腫の疑いとして手術目的に当科紹介された。合同での手術が必要と考えられたため,整形外科に紹介しMRIガイド下生検で悪性末梢神経鞘腫瘍の可能性を示唆された。同年6月に腫瘍の動脈塞栓術施行後に右後腹膜腫瘍摘出術を施行し,病理結果から悪性末梢神経鞘腫瘍と診断された。術後10ヵ月現在再発認めず,外来通院中である。後腹膜原発腫瘍において悪性末梢神経鞘腫瘍は極めて稀な症例であり,有効な治療法は確立されていない。今回,後腹膜原発の悪性末梢神経鞘腫瘍の1例を経験したので,若干の文献的考察を加えて報告する。(著者抄録)

Spinal Cord Diffuse Midline Glioma, H3K27M- mutant Effectively Treated with Bevacizumab: A Report of Two Cases. Reviewed

Satoru Yabuno, Satoshi Kawauchi, Michiari Umakoshi, Atsuhito Uneda, Kentaro Fujii, Joji Ishida, Yoshihiro Otani, Yasuhiko Hattori, Nobushige Tsuboi, Shohei Kohno, Mai Noujima, Tomohiro Toji, Hiroyuki Yanai, Takao Yasuhara, Isao Date

NMC case report journal 8 ( 1 ) 505 - 511 2021

Language：English

"Diffuse midline glioma (DMG), H3K27M-mutant" was newly classified in the revised World Health Organization (WHO) 2016 classification of central nervous system tumors. Spinal cord DMG, H3K27M-mutant is relatively rare, with poor prognosis, and there are no effective treatment protocols. In this study, we report two cases of spinal cord DMG, H3K27M-mutant treated with bevacizumab. The two patients were women in their 40s who initially presented with sensory impairment. MRI showed spinal intramedullary tumors, and each patient underwent laminectomy/laminoplasty and biopsy of the tumors. Histological examination initially suggested low-grade astrocytoma in case 1 and glioblastoma in case 2. Upon further immunohistochemical examination in case 1 and molecular examination in case 2, however, both cases were diagnosed as DMG, H3K27M-mutant. Case 1 was treated with radiation therapy and temozolomide (TMZ) chemotherapy, which induced a transient improvement of symptoms; 3 months after surgery, however, the patient's symptoms rapidly deteriorated. MRI showed tumor enlargement with edema to the medulla. Triweekly administration of bevacizumab improved her symptoms for the following 12 months. Case 2 was treated with bevacizumab from the beginning because of acute deterioration of breathing. After bevacizumab administration, both cases showed tumor regression on MRI and drastic improvement of symptoms within a few days. Although spinal cord DMG, H3K27M-mutant has an aggressive clinical course and poor prognosis, bevacizumab administration may offer the significant clinical benefit of alleviating edema, which improves patient's capacity for activities of daily life.

DOI： 10.2176/nmccrj.cr.2021-0033

腎移植後の尿細胞診で6ヶ月以上持続するDecoy細胞陽性所見はBKウイルス腎症の発症予測に有効である

関戸崇了, 荒木元朗, 吉永香澄, 丸山雄樹, 定平卓也, 西村慎吾, 和田耕一郎, 渡部昌実, 渡邉豊彦, 田邊克幸, 竹内英実, 和田淳, 柳井広之, 那須保友

移植 56 ( Supplement ) s441 - s441 2021

Language：Japanese Publisher：一般社団法人日本移植学会

【目的】腎移植後患者において、尿細胞診のDecoy細胞陽性所見の持続期間とBKウイルス腎症 (BKVN)発症予測の関連性を検討した。【方法】対象は2012年05月から2020年07月までに当院で腎移植を行った121例。尿細胞診は、腎移植後6ヶ月間は1ヶ月毎、その後の6ヶ月は1から2ヶ月毎、以降は1から3ヶ月毎に行なっている。BKVN発症予測に最適な陽性持続期間をAUC曲線にて解析し、その最適な陽性期間の持続の有無で患者を2群に分け、BKVN発症率を比較検討した。SV40免疫染色の有効性も併せて比較検討した。【結果】尿検体数は計2,534検体、SV40免疫染色は計2,241検体であった。BKVN発症予測に最適な陽性持続期間は6ヶ月であった（AUC = 0.819）。Decoy細胞陽性が6ヶ月以上持続した（decoy≧6M）群および持続が6ヶ月未満であった（decoy<6M）群に分け、decoy≧6M群 47例、SV40<6M群 74例であった。decoy ≧6M群はdecoy <6M群に比べ、BKVNの発症率は有意に高かった（5 vs 0, p=0.008）。decoy細胞によるBKVN発症予測の感度、特異度、陽性的中率、陰性的中率はそれぞれ100%, 64%, 11%, 100%であり、SV40免疫染色は感度、陰性的中率は同等で、特異度は68%, 陽性的中率は12%であった。【結語】6ヶ月以上のDecoy細胞陽性持続の所見はBKVN発症予測に有用である可能性が示唆された。SV40免疫染色追加に伴うBKVN発症予測精度はごくわずかに向上した。

DOI： 10.11386/jst.56.supplement_s441

Impact of HER2 expression on EGFR-TKI treatment outcomes in lung tumors harboring EGFR mutations: A HER2-CS study subset analysis. Reviewed International journal

Kadoaki Ohashi, Kiichiro Ninomiya, Hiroshige Yoshioka, Akihiro Bessho, Takuo Shibayama, Keisuke Aoe, Nobuhisa Ishikawa, Toshiyuki Kozuki, Haruyuki Kawai, Shoichi Kuyama, Seigo Miyoshi, Kazunori Fujitaka, Hideto Obata, Yukari Tsubata, Yoshikazu Awaya, Masaaki Inoue, Koji Inoue, Naokatsu Horita, Hiroyuki Yanai, Katsuyuki Hotta, Katsuyuki Kiura

Lung cancer (Amsterdam, Netherlands) 150 83 - 89 2020.12

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

OBJECTIVES: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are standard treatment for EGFR-mutated non-small-cell lung carcinoma (NSCLC); however, a biomarker to predict their efficacy has not been established. Although human epidermal growth factor receptor-2 (HER2) aberrations constitute a potential mechanism for acquired resistance to EGFR-TKIs, the impact of HER2 on EGFR-TKI treatment outcomes has not been systematically evaluated. In this post-hoc subgroup study, we examined the impact of HER2 on the effect of EGFR-TKIs in patients with NSCLC harboring EGFR mutations. MATERIALS AND METHODS: Of 1126 patients with NSCLC enrolled into a prospective cohort study (HER2-CS study), we analyzed data of 356 (32 %) patients with EGFR-mutant tumors. HER2 protein expression levels were determined by immunohistochemistry (IHC) with the gastric cancer criteria. Patients were divided either to an HER2-P group (HER2-IHC2+/3+) or an HER2-N group (HER2-IHC0/1+). We primarily assessed differences in the time-to-treatment failure (TTF) of EGFR-TKI between the groups. RESULTS: The HER2 scoring was as follows: IHC0 (n = 76, 21 %), IHC1+ (n = 199, 56 %), IHC2+ (n = 72, 20 %), and IHC3+ (n = 9, 3 %). The patients' demographics were similar in the HER2-P and HER2-N groups. The HER2-P group showed a significantly shorter EGFR-TKI TTF than the HER2-N group (hazard ratio [HR]: 1.657, 95 % confidence interval [CI]: 1.076-2.552; median: 13.3 vs. 19.1 months). The magnitude of the negative impact of TTF was especially dependent on performance status (PS). HER2 expression significantly deteriorated the TTF in the subgroup with PS 2 (HR: 5.497, 95 % CI: 1.510-20.02), but not in that with better PS (HR: 1.437, 95 % CI: 0.899-2.298) (pinteraction = 0.015). CONCLUSION: In the current cohort, HER2 protein expression in EGFR-mutant NSCLC may have a negative impact on the effect of EGFR-TKIs, the effect of which was PS dependent.

DOI： 10.1016/j.lungcan.2020.09.024

What Are the Results of Resection of Localized Dedifferentiated Liposarcomas in the Extremities? Reviewed

Eiji Nakata, Toshiyuki Kunisada, Joe Hasei, Ryuichi Nakahara, Hiroyuki Yanai, Tomohiro Toji, Hirofumi Inoue CT, Toshifumi Ozaki

Clinical Orthopaedics & Related Research 478 ( 11 ) 2550 - 2561 2020.11

Fibrosis or Necrosis in Resected Lymph Node Indicate Metastasis Before Chemoradiotherapy in Lung Cancer Patients. Reviewed International journal

Yuta Takahashi, Junichi Soh, Kazuhiko Shien, Hiromasa Yamamoto, Masaomi Yamane, Katsuyuki Kiura, Susumu Kanazawa, Hiroyuki Yanai, Shinichi Toyooka

Anticancer research 40 ( 8 ) 4419 - 4423 2020.8

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

BACKGROUND/AIM: The histological features of lymph nodes (LNs) treated by chemoradiotherapy (CRT) in non-small cell lung cancer (NSCLC) have not been well studied. The purpose of this study was to evaluate the histological findings of LNs affected by CRT. PATIENTS AND METHODS: Among 107 clinically N2 NSCLC patients who underwent induction CRT followed by surgery from 1999 to 2017, 24 patients who received pathological evaluation of mediastinal LN before CRT were enrolled in this study. Postoperatively, we histologically reviewed all resected LNs (n=117) of the station evaluated before CRT. RESULTS: Fibrosis and/or necrosis were observed in all investigated LN stations. Histological observation of fibrosis and/or necrosis in the resected LNs after CRT indicated the presence of LN metastasis before CRT. CONCLUSION: The metastatic LNs that responded to CRT showed specific histological features, which enabled us to know the accurate clinical stage of the patient even though cancer cells were not found in the post-treated LNs.

DOI： 10.21873/anticanres.14447

術者の立ち位置を交互に変換した腹腔鏡下前立腺全摘除術の手術成績

長谷川泰久, 松崎信治, 村田大城, 上野剛志, 宮本克利, 久留優子, 岩根亨輔, 金岡隆平, 柳井広之, 三田耕司, 水谷雅巳

泌尿器科紀要 66 ( 8 ) 251 - 257 2020.8

Language：Japanese Publisher：泌尿器科紀要刊行会

2013年2月〜2018年7月に単一術者が立ち位置を1例ずつ左右交互に変えて執刀した腹腔鏡下前立腺全摘除術(LRP)184例の治療成績を後方視的に検証した。全症例の平均年齢は69.9±5.4歳、観察期間は平均44.8±17.3ヵ月であり、D'Amico分類では低リスク26例(14.1%)、中リスク45例(24.5%)、高リスク113例(61.4%)であった。陰茎海綿体神経温存は82例(44.6%)に、術前ホルモン療法は10例(5.4%)に施行した。手術時間は平均203.5±45.5分、尿込み出血量は平均437.6±428.3ml、尿道カテーテル留置期間は平均5.0±3.7日であり、周術期合併症はClavien-Dindo分類でIIIaを1例(0.5%)、IIIbを2例(1.1%)に認めた。切除断端陽性(RM1)は41例(23.6%)に認め、術者の立ち位置から遠方となるサイドの断端陽性が29例(70.7%)と高率であった。前立腺特異抗原非再発率は5年で81.4%、尿禁制回復は12ヵ月で84.8%であった。術者の立ち位置による手術成績への影響は認めなかった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01269&link_issn=&doc_id=20200902470001&doc_link_id=http%3A%2F%2Fhdl.handle.net%2F2433%2F254167&url=http%3A%2F%2Fhdl.handle.net%2F2433%2F254167&type=%8B%9E%93s%91%E5%8Aw%81F%8B%9E%93s%91%E5%8Aw%8Aw%8Fp%8F%EE%95%F1%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80028_3.gif

鑑別に苦慮した成人型顆粒膜細胞腫の1例

大槻花穂, 坪井有加, 長尾良太, 田中高志, 正岡佳久, 平木隆夫, 柳井広之, 金澤右

臨床放射線 65 ( 6 ) 593 - 597 2020.6

Language：Japanese Publisher：金原出版(株)

症例は40歳代前半女性で、腹痛の精査目的で施行されたCT検査で左卵巣に4cm大の腫瘤を認め、当院婦人科に紹介となった。骨盤部MRIでは左卵巣から外方性に発育した約4.2cm大の充実性腫瘤を認めた。辺縁はほぼ平滑で境界明瞭、内部はT2強調像でやや低信号で拡散低下を示していた。Dynamic MRIでは漸増性に子宮筋層と同程度の造影効果を認めた。子宮内膜に肥厚は認めなかった。臨床、画像所見から腫瘤の鑑別として悪性リンパ腫や性索間質性腫瘍が挙げられた。左付属器切除術が施行され、術中迅速病理組織検査で成人型顆粒膜細胞腫と診断され、腹式単純子宮全摘術、右付臓器切除術、大網切除術が追加された。腫瘍細胞は比較的均一でN/C比は高く、円形または楕円形の核の一部に核溝がみられ、成人型顆粒膜細胞腫と診断された。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01565&link_issn=&doc_id=20200629120014&doc_link_id=10.18888%2Frp.0000001264&url=https%3A%2F%2Fdoi.org%2F10.18888%2Frp.0000001264&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Intracranial Mesenchymal Chondrosarcoma Lacking the Typical Histopathological Features Diagnosed by HEY1-NCOA2 Gene Fusion. Reviewed

Atsuhito Uneda, Kazuhiko Kurozumi, Atsushi Fujimura, Atsunori Kamiya, Takanori Hirose, Hiroyuki Yanai, Isao Date

NMC case report journal 7 ( 2 ) 47 - 52 2020.4

Language：English

Intracranial mesenchymal chondrosarcoma (MCS) is a rare neoplasm. The diagnosis of MCS is confirmed by the presence of a biphasic pattern on histological examination, comprising undifferentiated small round cells admixed with islands of well-differentiated hyaline cartilage; however, a differential diagnosis may be challenging in some cases. A 28-year-old woman with a 2-month history of headache was referred to our hospital. Radiologic studies showed an extra-axial lobulated mass composed of calcified and uncalcified areas occupying the left middle fossa. Surgical resection was planned, but her headache suddenly worsened before her planned hospital admission and she was admitted as an emergency. Radiologic studies showed an acute hemorrhage in the uncalcified part of the mass. The mass was resected via the left zygomatic approach after embolization of the feeder vessels. The most likely histopathological diagnosis was MCS. However, the typical bimorphic pattern was not identified in our surgical samples; each undifferentiated area and well-differentiated area was observed separately in different tissue specimens, and no islands of well-differentiated hyaline cartilage were identified within the undifferentiated areas in the same specimen. Molecular assays confirmed the presence of HEY1-NCOA2 fusion. IRF2BP2-CDX1 fusion and IDH1/2 mutations were negative. The final diagnosis of MCS was made based on the presence of HEY1-NCOA2 gene fusion. MCS should be included in the differential diagnosis when radiologic studies show an extra-axial lobulated mass with calcification. Furthermore, molecular demonstration of HEY1-NCOA2 gene fusion may help make a precise diagnosis of MCS, especially in surgical samples lacking the typical histopathological features.

DOI： 10.2176/nmccrj.cr.2019-0123

Factors predicting pathological upgrading after prostatectomy in patients with Gleason grade group 1 prostate cancer based on opinion-matched biopsy specimens. Reviewed International journal

Yuki Maruyama, Takuya Sadahira, Motoo Araki, Yosuke Mitsui, Koichiro Wada, Acosta Gonzalez Herik Rodrigo, Kazuaki Munetomo, Yasuyuki Kobayashi, Masami Watanabe, Hiroyuki Yanai, Toyohiko Watanabe, Yasutomo Nasu

Molecular and clinical oncology 12 ( 4 ) 384 - 389 2020.4

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

The present study investigated the concordance between Gleason scores assigned to prostate biopsy specimens by outside pathologists and a urological pathology expert, and determined the risk of upgrading between opinion-matched Gleason grade group (GGG) 1 biopsy specimens and radical prostatectomy specimens. Between January 2012 and May 2018, 733 patients underwent robot-assisted radical prostatectomy. Patients whose original biopsy specimens from outside hospitals were reviewed by a urological pathology expert Okayama University Hospital were included. Patients who had received neoadjuvant hormonal therapy were excluded. Logistic regression analysis was used to identify predictors of upgrading among GGG 1 diagnoses. A total of 403 patients were included in the present study. Agreement in GGG between initial and second-opinion diagnoses was present in 256 cases (63.5%). Although opinion-matched cases improved concordance between biopsy and prostatectomy specimen GGG compared with single-opinion cases (initial, 35.2%; second-opinion, 36.5%; matched, 41.4%), 71% (56/79) of cases classified as GGG 1 were upgraded after prostatectomy. Multivariate analysis revealed that prostate-specific antigen density and Prostate Imaging Reporting and Data System version 2 score were significant predictors of upgrading (odds ratio, 1.10; P=0.01; and odds ratio, 1.88; P=0.03, respectively). In conclusion, the GGG concordance rate between needle-core biopsy and radical prostatectomy specimens was higher in opinion-matched cases; however, 71% of opinion-matched GGG1 cases were upgraded after robot-assisted radical prostatectomy. Urologists should propose treatment strategies or further biopsy rather than active surveillance for patients with GGG1 and a high PSAD and/or PI-RADS score.

DOI： 10.3892/mco.2020.1996

Juvenile Granulosa Cell Tumor with an Unusual Clinical Course: A Late-onset and Late Recurrent Case. Reviewed

Thar Htet San, Yoko Ota, Soichiro Fushimi, Masayoshi Fujisawa, Hiroyuki Yanai, Hiroko Toda, Tadayoshi Kunitomo, Keisuke Kodama, Akihiro Matsukawa

Acta medica Okayama 74 ( 2 ) 159 - 163 2020.4

Language：English

Juvenile granulosa cell tumors (JGCTs) are rare ovarian tumors with overall good prognoses. They differ from adult granulosa cell tumors (AGCTs), which are well known for late recurrence. Most JGCTs (～97%) occur in individuals <30 years old. We report a recurrent JGCT in a 40-year-old woman 5 years after initial presentation. The histological appearance and lack of 402C>G missense point mutation of FOXL2 gene (characteristic of AGCT but absent in JGCT) allowed differentiation from AGCT. This is the first comprehensive report of JGCT with late recurrence. Although rare, late recurrence of JGCT can occur; long-term surveillance is suggested.

DOI： 10.18926/AMO/58275

Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report. Reviewed International journal

Yoko Suzuki, Kohei Taniguchi, Minami Hatono, Yukiko Kajiwara, Yuko Abe, Kengo Kawada, Takahiro Tsukioki, Mariko Kochi, Keiko Nishiyama, Takayuki Iwamoto, Hirokuni Ikeda, Tadahiko Shien, Naruto Taira, Masahiro Tabata, Hiroyuki Yanai, Hiroyoshi Doihara

Surgical case reports 6 ( 1 ) 25 - 25 2020.1

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

BACKGROUND: Angiosarcoma of the breast is very rare and can be divided into primary and secondary angiosarcoma. Radiation-induced angiosarcoma (RIAS) is classified as secondary angiosarcoma. Diagnosis of RIAS is difficult due to its rarity, and the interpretation of pathological imaging is complicated. In the National Comprehensive Care Network (NCCN) guidelines, the first choice of treatment is surgery with negative margins. Adjuvant radiotherapy (RT) for close soft tissue margins should be considered. Preoperative or adjuvant chemotherapy of nonmetastatic disease is not recommended for angiosarcoma. We report a case of RIAS, which was impossible to diagnose with core needle biopsy (CNB) but was diagnosed by excisional biopsy. The patient was then administered adjuvant chemotherapy using conjugated paclitaxel (PTX). CASE PRESENTATION: A 62-year-old woman noticed a tumor in her right breast. She had a history of right breast cancer and had undergone breast-conserving surgery, RT, and tamoxifen therapy 8 years previously. CNB, which was performed twice, was inconclusive. The tumor was surgically excised and pathological analysis yielded a diagnosis of angiosarcoma. She then underwent a right mastectomy. One month after she underwent right mastectomy, a nodule reappeared on the skin of her right breast, and excisional biopsy revealed recurrence of angiosarcoma. A few weeks later another nodule reappeared near the post-operative scar and excisional biopsy revealed recurrence of angiosarcoma. We assumed that surgical therapy was insufficient because the patient experienced relapse of angiosarcoma after complete mastectomy. After the second recurrence, we treated her with systemic chemotherapy using PTX. There was no evidence of recurrence 8 months after chemotherapy. CONCLUSION: Although angiosarcoma is difficult to diagnose, many patients have a poor prognosis. Therefore, prompt treatment intervention is desired. Moreover, there is little evidence regarding adjuvant therapy of angiosarcoma since it is a rare disease. We consider that adjuvant therapy helped to effectively prevent recurrence in the patient after complete excision.

DOI： 10.1186/s40792-020-0790-7

Differentiation of Small (≤ 4 cm) Renal Masses on Multiphase Contrast-Enhanced CT by Deep Learning. Reviewed International journal

Tanaka T, Huang Y, Marukawa Y, Tsuboi Y, Masaoka Y, Kojima K, Iguchi T, Hiraki T, Gobara H, Yanai H, Nasu Y, Kanazawa S

AJR. American journal of roentgenology 214 ( 3 ) 1 - 8 2020.1

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

OBJECTIVE. This study evaluated the utility of a deep learning method for determining whether a small (≤ 4 cm) solid renal mass was benign or malignant on multiphase contrast-enhanced CT. MATERIALS AND METHODS. This retrospective study included 1807 image sets from 168 pathologically diagnosed small (≤ 4 cm) solid renal masses with four CT phases (unenhanced, corticomedullary, nephrogenic, and excretory) in 159 patients between 2012 and 2016. Masses were classified as malignant (n = 136) or benign (n = 32). The dataset was randomly divided into five subsets: four were used for augmentation and supervised training (48,832 images), and one was used for testing (281 images). The Inception-v3 architecture convolutional neural network (CNN) model was used. The AUC for malignancy and accuracy at optimal cutoff values of output data were evaluated in six different CNN models. Multivariate logistic regression analysis was also performed. RESULTS. Malignant and benign lesions showed no significant difference of size. The AUC value of corticomedullary phase was higher than that of other phases (corticomedullary vs excretory, p = 0.022). The highest accuracy (88%) was achieved in corticomedullary phase images. Multivariate analysis revealed that the CNN model of corticomedullary phase was a significant predictor for malignancy compared with other CNN models, age, sex, and lesion size. CONCLUSION. A deep learning method with a CNN allowed acceptable differentiation of small (≤ 4 cm) solid renal masses in dynamic CT images, especially in the corticomedullary image model.

DOI： 10.2214/AJR.19.22074

Pilot evaluation of a HER2 testing in non-small-cell lung cancer. Reviewed International journal

Hotta K, Yanai H, Ohashi K, Ninomiya K, Nakashima H, Kayatani H, Takata M, Kiura K

Journal of clinical pathology 73 ( 6 ) 353 - 357 2019.12

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

AIMS: HER2-positivity pattern in the specimens of immunohistochemistry (IHC) and ﬂuorescence in situ hybridisation (FISH) has been hardly reported in non-small-cell lung cancer (NSCLC). METHODS: We evaluated the characteristics of HER2-positivity pattern in formalin-ﬁxed parafﬁn-embedded samples using IHC and FISH in 15 patients enrolled in a larger prospective cohort study to survey a HER2-positive NSCLC. RESULTS: As for the immunostaining pattern, most specimens (79%) demonstrated incomplete or mixed-typed membranous immunoreactivity with heterogeneity, resembling that observed in gastric cancer rather than breast cancer. Concordance between IHC-positivity and FISH-positivity was 87.5% according to the criteria for breast cancer scoring system. On application of the gastric cancer scoring system to the examined tumours, the IHC score increased in the seven (43.8%) specimens, and the concordance between IHC positivity and FISH positivity rose to 93.8%. CONCLUSIONS: In our pilot series, the pattern of IHC reactivity closely resembled that observed in gastric cancer rather than breast cancer. TRIAL REGISTRATION NUMBER: 000017003.

DOI： 10.1136/jclinpath-2019-206204

整形外科外来の出張細胞診にて胞巣状軟部肉腫を疑った1例

實平悦子, 今井みどり, 松岡博美, 井上博文, 那須篤子, 山口祐菜, 松岡昌志, 都地友紘, 柳井広之

岡山県臨床細胞学会誌 38 44 - 47 2019.12

Language：Japanese Publisher：岡山県臨床細胞学会

【はじめに】胞巣状軟部肉腫(以下ASPS)は、若年成人の下肢、上肢、頭頸部に好発する比較的まれな悪性軟部腫瘍である。今回、我々は出張細胞診でASPSを推定が可能であった症例を経験したので細胞像と臨床所見について報告する。【症例】10歳代女性。学校入学時検診の胸部X線検査にて異常陰影を指摘され、当院受診。MRI検査で、右大腿部に約10cm大の腫瘤を認め、質的診断目的にて整形外科外来で腫瘍生検が施行された。出張細胞診で行ったヘマカラー染色では、類円形核を有する異型細胞が孤立散在性に豊富に出現していた。腫瘍細胞の核は著明な核小体を1から数ヶ所有し、細胞質は淡く裸核状に見られるものもあった。パパニコロウ染色にて大型の異型細胞集塊を認め、集塊の周りに間質細胞の核が付着しているように見られた。孤立性に出現している細胞の細胞質は豊富でライトグリーンに好性で微細顆粒状であった。細胞質の辺縁は明瞭な細胞や境界不明瞭な細胞も混在していた。核クロマチンは、粗顆粒状で著明な核小体を認めた。PAS反応にてジアスターゼ抵抗性の針状結晶は認めなかった。病理組織像では、血管性の隔壁に囲まれた胞巣状の比較的均一な好酸性細胞が見られた。細胞質は顆粒状で、PAS反応は細胞質に陽性であった。免疫組織染色にてTFE3が核に陽性であったことよりASPSと診断された。【まとめ】出張細胞診で、豊富な類円形細胞と、若年の女性で肺に転移巣があるという臨床所見より、ASPSの推定が可能であった症例を経験した。(著者抄録)

Fumarate hydratase(FH)欠損腎細胞癌によるリンパ節転移に対して、イピリムマブ+ニボルマブ併用療法が奏功した一例

関戸崇了, 高本篤, 小林泰之, 三井將雄, 和田里章吾, 窪田理沙, 岩田健宏, 枝村康平, 佐古智子, 荒木元朗, 渡邉豊彦, 柳井広之, 那須保友

西日本泌尿器科 81 ( 増刊 ) 151 - 151 2019.10

Evaluation of the Usefulness and Convenience of the Kyoto Classification of Gastritis in the Endoscopic Diagnosis of the Helicobacter pylori Infection Status. Reviewed International journal

Sakae H, Iwamuro M, Okamoto Y, Obayashi Y, Baba Y, Hamada K, Gotoda T, Abe M, Kono Y, Kanzaki H, Kawano S, Kawahara Y, Tanaka T, Yanai H, Okada H

Digestion 101 ( 6 ) 1 - 8 2019.9

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

BACKGROUND/AIMS: The Kyoto Classification of Gastritis was published in 2014. Although this classification is now widely used in Japan, its usefulness and convenience have not been sufficiently evaluated. This study aimed to evaluate the usefulness and convenience of this classification in the endoscopic diagnosis of Helicobacter pylori infection. METHODS: We made a test for the endoscopic diagnosis of H. pylori infection comprising 30 cases who had representative endoscopic features of non-, active, or inactive gastritis. Thirty-eight participants took the test before and after a brief mini-lecture on the Kyoto Classification of Gastritis. Eighteen participants took the test again 3 months later. We investigated the accuracy before, just after, and 3 months after the mini-lecture. RESULTS: The accuracy of endoscopists after the lecture was significantly improved in comparison to before the lecture (77.6 vs. 83.3%). Medical students also showed significantly improved accuracy after the lecture (56.7 vs. 71.7%). Among endoscopists, this improvement was maintained after 3 months. Before the lecture, the accuracy of diagnosing non-gastritis was 90.3%; it tended to be further improved 3 months later (96.5%). A >10% point increase was observed in diagnosing active (72.7-83.3%) and inactive gastritis (73.2-84.3%) at 3 months after the lecture in comparison to before the lecture. CONCLUSION: A brief mini-lecture on the Kyoto Classification of Gastritis improved the accuracy in the endoscopic diagnosis of gastritis, indicating that understanding this classification is useful for the prompt diagnosis of H. pylori infection during esophagogastroduodenoscopy.

DOI： 10.1159/000502573

Metastatic ureteral tumor arising from gastrointestinal cancer: A report of two cases

Kasumi Kawamura, Motoo Araki, Takuya Sadahira, Yuki Maruyama, Yosuke Mitsui, Shingo Nishimura, Atsushi Takamoto, Koichiro Wada, Ryuta Tanimoto, Morito Sugimoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu, Hiroyuki Yanai

Nishinihon Journal of Urology 81 ( 4 ) 461 - 466 2019.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The West Japan Urological Association

We report two cases where gastrointestinal cancer gave rise to a metastatic ureteral tumor. Case one was a 64-year-old man who was operated on for descending colon cancer in September, 2007. In 2014, he was referred to our hospital because computed tomography (CT) scan showed a tumor of the right ureter. Ureteroscopic biopsy showed a metastatic ureteral tumor arising from descending colon cancer. The patient underwent open tumor resection. Transurethral resection of a bladder tumor (TUR- BT) was required three times for treatment of tumor recurrence from the ureteral stump in an effort to control gross hematuria Case two was a 62-year-old man who underwent pylorus-preserving gastrectomy for gastric cancer in December, 2014. Follow-up CT showed right hydronephrosis and thickening of the right ureteral wall in 2017. Selective urine cytology of the right ureter revealed urothelial carcinoma, class V. Ureteroscopic biopsy of the right ureter revealed invasive urothelial carcinoma. The patient underwent retroperitoneal laparoscopic nephroureterectomy. Histological examination revealed the right ureteral tumor to be metastasis of gastric cancer.

消化器癌による転移性尿管腫瘍の2例

河村香澄, 荒木元朗, 定平卓也, 丸山雄樹, 光井洋介, 西村慎吾, 高本篤, 和田耕一郎, 谷本竜太, 杉本盛人, 小林泰之, 渡部昌実, 渡辺豊彦, 那須保友, 柳井広之

西日本泌尿器科 81 ( 4 ) 461 - 466 2019.8

Language：Japanese Publisher：西日本泌尿器科学会

消化器癌を原発とする転移性尿管腫瘍の2例を経験したため報告する。【症例1】64歳、男性。2007年9月、下行結腸癌に対して下行結腸切除術を施行した。2014年、術後のCTで右尿管腫瘍を指摘され当科へ紹介となった。右尿管鏡検査時の生検病理結果より下行結腸癌の尿管転移と診断し、開腹腫瘍摘出術を行った。術後4ヵ月の時点で肝転移を認めたためTS-1 120mg内服療法を14ヵ月行い、様々な変更を経て現在はXELIRI + Bevacizumab療法8コース目を行っている。肝転移は緩徐に増大中である。【症例2】62歳、男性。2014年12月、多発胃癌に対して幽門側胃切除術、胆嚢摘出術およびRoux-en-Y再建術を施行し、術後TS-1 100mg内服療法を1年間行った。2017年、CTで右水腎症と尿管壁肥厚を指摘され、右尿管鏡検査を行うも狭窄が強く組織は採取できず、検査時の分腎尿細胞診はclass IVであった。再施行した右尿管鏡検査において狭窄尾側を生検したところ浸潤性尿路上皮癌の診断であったため、後腹膜鏡下右腎尿管摘除術を施行した。右尿管は腹膜およびS状結腸と著しく癒着し、漿膜ごと摘除した。病理結果は胃癌の右尿管転移であった。術後weekly PTX 100mgを開始したが骨転移の出現や腹膜転移の進行を認め、PTX + Ramucirumab 1コース施行した後に抗PD-1抗体180mgを5コース行ったが全身状態は徐々に悪化した。術後7ヵ月で緩和療法に移行し、術後11ヵ月で永眠された。転移性尿管腫瘍は術前生検しても診断が難しい場合がある。予後不良な疾患であり、悪性疾患の既往のある尿管腫瘍は転移性尿管腫瘍も鑑別に挙げる必要がある。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01004&link_issn=&doc_id=20190823210008&doc_link_id=%2Fer9niuro%2F2019%2F008104%2F008%2F0461-0466%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fer9niuro%2F2019%2F008104%2F008%2F0461-0466%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

A Comprehensive Review of Ovarian Serous Carcinoma. Reviewed

Hatano Y, Hatano K, Tamada M, Morishige KI, Tomita H, Yanai H, Hara A

Advances in anatomic pathology 2019.7

High-grade glioneuronal tumor with an ARHGEF2-NTRK1 fusion gene. Reviewed

Kazuhiko Kurozumi, Yoshiko Nakano, Joji Ishida, Takehiro Tanaka, Masatomo Doi, Junko Hirato, Akihiko Yoshida, Kana Washio, Akira Shimada, Takashi Kohno, Koichi Ichimura, Hiroyuki Yanai, Isao Date

Brain tumor pathology 36 ( 3 ) 121 - 128 2019.7

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

Here, we report a highly unusual case of high-grade glioneuronal tumor with a neurotrophic tropomyosin receptor kinase (NTRK) fusion gene. A 13-year-old girl presented with headache and vomiting and MRI detected two cystic lesions bilaterally in the frontal areas with surrounding edema. The left larger tumor was removed by left frontal craniotomy. The tumor was diagnosed as a high-grade glioneuronal tumor, unclassified. Methylation profiling classified it as a diffuse leptomeningeal glioneuronal tumor (DLGNT) with low confidence. This tumor showed genotypes frequently found in DLGNT such as 1p/19q codeletion without IDH mutation and, however, did not have the typical DLGNT clinical and histological features. RNA sequencing identified an ARHGEF2 (encoding Rho/Rac guanine nucleotide exchange factor 2)-NTRK1 fusion gene. The presence of recurrent NTRK fusion in glioneuronal tumors has an important implication in the clinical decision making and opens up a possibility of novel targeted therapy.

DOI： 10.1007/s10014-019-00345-y

Cavernous hemangioma of the rib mimicking a chondrosarcoma: Diagnostic value of delayed phase MRI Reviewed

T. Tanaka, Y. Masaoka, S. Sugimoto, T. Iguchi, T. Hiraki, H. Yanai, S. Kanazawa

Diagnostic and Interventional Imaging 100 ( 7-8 ) 455 - 457 2019.7

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

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

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

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)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01004&link_issn=&doc_id=20190222240009&doc_link_id=%2Fer9niuro%2F2019%2F008101%2F009%2F0045-0048%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fer9niuro%2F2019%2F008101%2F009%2F0045-0048%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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

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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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

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

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

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

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

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)

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

Biphenotypic sinonasal sarcomaの1例 Reviewed

林詠子, 祇園由佳, 藤澤真義, 能島舞, 田中顕之, 田中健大, 柳井広之, 吉野正

診断病理 34 ( 4 ) 293 - 298 2017.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本病理学会

患者は50代女性。半年前から徐々に増悪する右鼻閉を訴えていた。画像検査にて頭蓋底に浸潤する右鼻腔・右篩骨洞腫瘤を指摘され、摘出術が施行された。組織学的に上皮下に紡錐形核を有する均一な細胞が束状に増殖しており、staghorn patternを示す血管がみられた。細胞異型や核分裂像に乏しく、壊死はみられなかった。免疫組織化学的に紡錐形細胞はS100蛋白(+)、α-smooth muscle actin(+)、Ki-67陽性率は1%以下であった。電子顕微鏡にて細胞質内にfocal dense plaqueを、RT-PCRにてPAX3-FOXO1融合遺伝子産物が認められた。以上より近年sinonasal tractに発生する新しい腫瘍の一つとして提唱された、biphenotypic sinonasal sarcomaと診断した。(著者抄録)

増大する皮下腫瘤を呈した結核性胸壁膿瘍の一例

三好智子, 草野展周, 久保寿夫, 大重和樹, 江原弘貴, 頼冠名, 柳井広之, 大塚文男

日本病院総合診療医学会雑誌 13 ( 2 ) 27 - 28 2017.9

Language：Japanese Publisher：(一社)日本病院総合診療医学会

74歳男。右肋弓部の増大する皮下腫瘤を主訴とした。右第12肋骨下極に皮下腫瘤を触知し、腹部超音波検査では内部不均一な腫瘤を認め、MRI・CTでは右下位肋軟骨骨折を伴う胸腔側と胸壁外にまたがる膿瘍様の病変を認めた。胸部CTでは胸膜石灰化を認めるのみであった。既往歴に2型糖尿病があるものの血糖コントロールは良好で、クォンティフェロンは陽性、膿瘍穿刺液中の抗酸菌塗抹検査では結核菌は検出しなかったが、小切開にて摘出した膿瘍の抗酸菌塗抹検査および培養では結核菌を認め、結核菌による胸壁膿瘍と診断した。病理検査では乾酪壊死を伴った類上皮肉芽腫であった。胸壁膿瘍に対し、抗結核薬内服治療開始となった。

Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue with Plasma Cell Differentiation: Periodic Acid-Schiff Reaction-Positive Dutcher Body is a Diagnostic Clue to Distinguish it from Plasmacytoma Reviewed

Atsuko Nasu, Takuro Igawa, Hiaki Sato, Hiroyuki Yanai, Tadashi Yoshino, Yasuharu Sato

DIAGNOSTIC CYTOPATHOLOGY 45 ( 6 ) 547 - 551 2017.6

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

We herein report a case of primary parotid extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with Dutcher bodies. An 82-year-old man presented with a 4 cm x 2.5 cm mass in the left parotid region. Positron emission tomography/computed tomography (PET/CT) showed localized abnormal fluorodeoxyglucose (FDG) uptake in the left parotid gland and lymph nodes of the left cervical region. Fine needle aspiration (FNA) cytology of the left parotid gland showed lymphoplasmacytoid cells with periodic acid-Schiff (PAS)-positive Dutcher bodies. A subsequent excisional biopsy showed sheets of small- to medium-sized neoplastic B cells with abundant IgM in the cytoplasm as detected by immunohistochemistry. A diagnosis of stage II MALT lymphoma was made, but the patient did not receive therapeutic intervention. As previously reported, Dutcher bodies are mainly observed in B-cell neoplasms with IgM production. Because these characteristic intranuclear inclusions can be easily observed by PAS staining, the presence of PAS reaction-positive Dutcher bodies in FNA cytology can serve as a clue to differentially diagnose MALT lymphoma from plasmacytoma. (C). 2017 Wiley Periodicals, Inc.

DOI： 10.1002/dc.23691

ラブドイド細胞を主体とした耳下腺筋上皮癌の1例

那須篤子, 畠榮, 藤田勝, 濱田香菜, 今井みどり, 田中健大, 柳井広之

日本臨床細胞学会雑誌 56 ( 3 ) 137 - 142 2017.5

Language：Japanese Publisher：(公社)日本臨床細胞学会

背景:耳下腺に発生したラブドイド細胞を主体とした筋上皮癌の1例を経験したので細胞所見を中心に報告する。症例:60歳代、男性。左耳前部腫瘤を主訴として近医を受診後、当院を紹介受診。CTにて左耳前部に内部壊死様で辺縁不整を示す腫瘤影を認めた。耳下腺穿刺吸引細胞診では、壊死物質を背景にライトグリーン好性の豊富な細胞質と偏在核を有するラブドイド細胞が散在性あるいは小集塊状に出現していた。悪性を除外しえないため、耳下腺腫瘍摘出術ならびにリンパ節郭清術が施行された。組織所見および免疫組織化学的所見より筋上皮癌と診断した。結論:唾液腺腫瘍の細胞診において、ラブドイド細胞を認めた場合には、まれではあるが筋上皮癌も念頭におき検索する必要があると考えられた。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01209&link_issn=&doc_id=20170915320003&doc_link_id=%2Few5saibo%2F2017%2F005603%2F004%2F0137-0142%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Few5saibo%2F2017%2F005603%2F004%2F0137-0142%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Verification of Implant Surface Modification by a Novel Processing Method Reviewed

Yoshiki Okada, Nobuhiro Abe, Noriyuki Hisamori, Toshiaki Kaneeda, Shigeaki Moriyama, Hitoshi Ohmori, Masayoshi Mizutani, Hiroyuki Yanai, Yoshio Nakashima, Yusuke Yokoyama, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 71 ( 1 ) 49 - 57 2017.2

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Metals have been used clinically as biomaterials, especially in the orthopaedic and dental fields. Metals used as implants wear at contact surfaces, producing metal particles and metal ions that may be harmful. Newly developed metal implants and methods of implant surface modification are currently under scrutiny. We evaluated the use of electrolytic in-process dressing (ELID) as a surface finishing method for metal implants. Metal implants processed using the ELID method (ELID group) or not processed (Non-ELID group) were inserted surgically into rabbit femurs. The rabbits were sacrificed postoperatively over a 24-week period. We assessed the concentrations of the cytokines, interleukin (IL)-1 beta, IL-6, and tumor necrosis factor-a, the resistance to implant pull-out, and histopathology at the implant site. There was no significant difference between the groups regarding the cytokine concentrations or implant pull-out resistance. Many particles indicating wear around the implant were noted in the Non-ELID group (n=10) but not the ELID group (n=13), while a fibrous membrane adhering to the every implant was noted in the ELID group. The formation of a fibrous membrane rather than metal particles in the ELID group may indicate improved biocompatibility, and it suggests that ELID may prevent corrosion in the areas of contact.

Trastuzumab Emtansine in HER2+Recurrent Metastatic Non-Small-Cell Lung Cancer: Study Protocol Reviewed

Kadoaki Ohashi, Katsuyuki Hotta, Taizo Hirata, Keisuke Aoe, Toshiyuki Kozuki, Kiichiro Ninomiya, Hiroe Kayatani, Hiroyuki Yanai, Shinichi Toyooka, Shiro Hinotsu, Minoru Takata, Katsuyuki Kiura

CLINICAL LUNG CANCER 18 ( 1 ) 92 - 95 2017.1

Language：English Publishing type：Research paper (scientific journal) Publisher：CIG MEDIA GROUP, LP

The treatment outcome has been unsatisfactory for patients with non small-cell lung cancer (NSCLC) refractory to standard first-line chemotherapy. Trastuzumab emtansine (T-DM1), an anti-HER2 antibody conjugated with a vinca alkaloid, has been approved for clinical use in HER2+ breast cancer in many countries. Approximately 5% of NSCLC tumors possess HER2 alterations, and T-DM1 has shown excellent antitumor effects against HER2+ lung cancer cell lines in preclinical models. Therefore, we hypothesized that T-DM1 could significantly inhibit the growth of HER2+ lung cancers. We have launched a nonrandomized phase II trial of T-DM1 monotherapy for patientg with HER2+ lung cancers. The major eligibility criteria are as follows: age >= 20 years, pathologically diagnosed NSCLC with documented HER2 positivity (immunohistochemistry 3+, both immunohistochemistry 2+ and fluorescence in situ hybridization positive, or exon 20 insertion mutation), and previous chemotherapy. Thirty patients will receive T-DM1 3.6 mg/kg every 3 weeks. The primary endpoint is the overall response rate. This trial will provide information on whether T-DM1 monotherapy is effective against HER2+ lung cancer. (C) 2016 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.cllc.2016.06.014

Comparative study on driver mutations in primary and metastatic melanomas at a single Japanese institute: A clue for intra- and inter-tumor heterogeneity Reviewed

Tatsuya Kaji, Osamu Yamasaki, Minoru Takata, Masaki Otsuka, Toshihisa Hamada, Shin Morizane, Kenji Asagoe, Hiroyuki Yanai, Yoji Hirai, Hiroshi Umemura, Keiji Iwatsuki

JOURNAL OF DERMATOLOGICAL SCIENCE 85 ( 1 ) 51 - 57 2017.1

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

Background: Searching for driver mutations in melanoma is critical to understanding melanoma genesis, progression and response to therapy.
Objectives: We aimed to investigate the frequency and pattern of driver mutations in Japanese primary and metastatic melanomas including cases of unknown primary origin, in relation to their clinicopathologic manifestations.
Methods: Seventy-seven samples from 60 patients with melanoma were screened for 70 driver mutations of 20 oncogenes by Sequenom MelaCarta MassARRAY, and the results for primary and metastatic melanomas were compared.
Results: Of 77 tissue samples, BRAFV60 OE was detected in 21 samples (27%), CDK4 R24C in 7, EPHB6 G404S in 6, BRAF V600 K in 2, NEK10 E379 K in 2, and CDK4 R24H, NRAS Q61 K, NRAS Q61R, KRAS GI2A, KIT L576P, KIT V559A, ERBB4 E452 K, and PDGFRA E996 K in one sample each. No driver mutations related to the MAPK cascade including MS and BRAF were detected in the chronically sun-damaged (CSD) group of melanoma. Dual or triple driver mutations were found in four of 40 (10%) samples from the primary melanomas, and three of 37 (8%) of the metastatic melanomas. Fourteen of 26 (54%) samples of non-CSD melanoma, and 3 of 6 (50%) melanomas of unknown primary origin had the BRAF V600E mutation. Mutations in membrane-bound receptors including KIT, ERBB4 and EPHB6 were detected in 8 of 77 (10%) samples. Of 17 pairs of primary and metastatic melanomas from the same patient, the primary mutation pattern was changed to a novel one in three cases, and only one of the plural mutations in the primary melanoma was found in the metastatic lesions in two cases.
Conclusions: BRAF V600E is a predominant mutation in non-CSD melanoma and melanomas of unknown primary origin. Mutational heterogeneity may exist in the primary melanoma (intra-tumor heterogeneity), and between the primary and metastatic lesions (inter-tumor heterogeneity). (C) 2016 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.jdermsci.2016.10.006

治療に難渋した壊死性好酸球性心筋炎の１例

小出祐嗣, 中村一文, 木村朋生, 中川晃志, 三好亨, 西井伸洋, 伊藤浩, 大澤晋, 笠原慎吾, 田中健大, 柳井広之, 安藤翠, 大郷恵子, 山中俊明

心臓 49 ( Suppl.1 ) 159 - 167 2017

Language：Japanese Publisher：(公財)日本心臓財団

症例は16歳男性。血圧低下をきたし前医搬送。冠動脈造影・左室造影・心筋生検を施行。好酸球性心筋炎と診断し3日間メチルプレドニゾロン(m-PSL)1g/日投与。その後PSLを減量するも好酸球数再増加を伴う血行動態悪化を認め、計3度のmPSL大量投与、γ-glb大量療法およびアザチオプリン投与を併用することで好酸球増多は認めなくなり心筋炎は改善した。その後PSL漸減可能となった。第27病日、感染契機に頻脈、血圧低下しPCPS挿入。第29病日PCPS挿入側の右下肢腫脹を認め減張切開施行。第45病日右下肢壊疽に対して右大腿切断術施行。第57病日小腸穿孔による急性汎発性腹膜炎をきたたし緊急手術を施行し小腸切除、ストーマ造設。その後感染コントロールが付いた後にPSLを漸減。PSL 5mgまで減量し、第188日ストーマ閉鎖。第211病日、リハビリ目的に前医転院となった。その後復学し現在外来通院中。ステロイド単剤では治療に難渋したが、アザチオプリンを追加投与することで治療し得た。(著者抄録)

乳児Atypical teratoid/rhabdid tumorに対する放射線治療および分子生物学的分類と予後との関連について.

大谷理浩, 市川智継, 黒住和彦, 安原隆雄, 鷲尾佳奈, 嶋田明, 片山敬久, 勝井邦彰, 柳井広之, 伊達勲

脳神経外科 45 ( 2 ) 147 - 154 2017

A case of Alpha-Fetoprotein producing hepatoid adenocarcinoma of the uterine corpus

35 ( 1 ) 35 - 42 2017

[Prognostic Impact of Radiation Therapy and Molecular Classification of Infant Atypical Teratoid/Rhabdoid Tumors]. Reviewed

Yoshihiro Otani, Tomotsugu Ichikawa, Kazuhiko Kurozumi, Takao Yasuhara, Kana Washio, Akira Shimada, Norihisa Katayama, Kuniaki Katsui, Hiroyuki Yanai, Isao Date

No shinkei geka. Neurological surgery 45 ( 2 ) 147 - 154 2017

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

Atypical teratoid/rhabdoid tumor(AT/RT)is a rare and lethal childhood cancer. Although radiation therapy in children less than three years of age is generally deferred because of its neural toxicity, recent studies have shown that multimodal therapies, including radiation therapy, are effective in pediatric patients with AT/RT less than three years of age. We treated four infant AT/RT patients and investigated the impact of radiation therapy and genetic classification on the prognosis. The mean age at the time of the operation was 9.3 months and all patients were female. All patients underwent surgical resection. Of the four patients, two received combined irradiation and chemotherapy. Specifically, one patient received conformal craniospinal radiation therapy and the other received craniospinal irradiation with proton beams. Immunohistochemical analyses of tumor specimens revealed that the two patients were positive for ASCL1, a regulator of Notch signaling. Patients who received radiation therapy and exhibited ASCL1-positive tumors had a better prognosis. We conclude that radiation therapy may prolong survival in AT/RT patients who are less than 3 years of age. However, further study is required to evaluate long-term functional outcomes.

DOI： 10.11477/mf.1436203466

前頭葉に発生し、てんかん原性を示した髄膜腫合併髄膜血管腫症の1例 Reviewed

河原明奈, 伏見聡一郎, 板倉淳哉, 藤澤真義, 小林勝弘, 林裕美子, 伊達勲, 上利崇, 柳井広之, 松川昭博

診断病理 34 ( 1 ) 46 - 50 2017

Language：Japanese Publisher：(一社)日本病理学会

17歳、男性。てんかん発作を幼少期より繰り返していた。3歳時の頭部CTでは病変を指摘されなかったが、13歳時に左中前頭回の脳表に石灰化を伴う病変を認めた。発作頻度が増したため、17歳時に病変とその直下のてんかん焦点を含む左前頭葉部分切除術が施行された。脳表側では砂粒体と渦巻き状に紡錘形細胞が認められ、移行性髄膜腫であった。大脳側では血管が網目状に増生し、血管周囲には髄膜皮細胞が取り巻く髄膜血管腫症であった。症状や画像の経過より髄膜血管腫症が先行し、その後髄膜腫が合併したと考えられた。(著者抄録)

Adenovirus vector carrying REICIDKK-3 gene: neoadjuvant intraprostatic injection for high-risk localized prostate cancer undergoing radical prostatectomy Reviewed

H. Kumon, Y. Ariyoshi, K. Sasaki, T. Sadahira, M. Araki, S. Ebara, H. Yanai, M. Watanabe, Y. Nasu

CANCER GENE THERAPY 23 ( 11 ) 400 - 409 2016.11

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

As the First-In-Human study of in situ gene therapy using an adenovirus vector carrying the human REIC (reduced expression in immortalized cell)/Dkk-3 gene (Ad-REIC), we conducted neoadjuvant intraprostatic injections in patients with high-risk localized prostate cancer undergoing radical prostatectomy (RP). Patients with recurrence probability of 35% or more within 5 years following RP, as calculated by Kaftan's nomogram, were enrolled. Patients received two ultrasound-guided intratumoral injections at 2-week intervals, followed by RP 6 weeks after the second injection. After confirming the safety of the therapeutic interventions with initially planned three escalating doses of 1.0 x 10(10), 1.0 x 10(11) and 1.0 x 10(12) viral particles (vp) in 1.0-1.2 ml (n=3, 3 and 6), an additional higher dose of 3.0 x 10(12) vp in 3.6 ml (n=6) Was further studied. All four DLs including the additional dose level-4 (DL-4) were feasible with no adverse events, except for grade 1 or 2 transient fever. Laboratory toxicities were grade 1 or 2 elevated aspartate transaminase/alanine transaminase (n=4). Regarding antitumor activities, cytopathic effects (tumor degeneration With cytolysis and pyknosis) and remarkable tumor-infiltrating lymphocytes in the targeted tumor areas were detected in a clear dose-dependent manner. Consequently, biochemical recurrence-free survival in DL-4 was significantly more favorable than in patient groups DL-1+2+2:

DOI： 10.1038/cgt.2016.53

CD10 down expression in follicular lymphoma correlates with gastrointestinal lesion involving the stomach and large intestine Reviewed

Nobuhiko Ohnishi, Katsuyoshi Takata, Tomoko Miyata-Takata, Yasuharu Sato, Akira Tari, Yuka Gion, Mai Noujima-Harada, Kohei Taniguchi, Tetsuya Tabata, Keina Nagakita, Shizuma Omote, Hiroyuki Takahata, Masaya Iwamuro, Hiroyuki Okada, Yoshinobu Maeda, Hiroyuki Yanai, Tadashi Yoshino

CANCER SCIENCE 107 ( 11 ) 1687 - 1695 2016.11

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

Follicular lymphoma (FL) shows co-expression of B-cell lymphoma 2 (BCL2) and CD10, whereas downexpression of CD10 is occasionally experienced in gastrointestinal (GI) FL with unknown significance. Gastrointestinal FL is a rare variant of FL, and its similarity with mucosa-associated lymphoid tissue lymphoma was reported. We investigated the clinicopathological and genetic features of CD10 downexpressed (CD10(down)) GI-FL. The diagnosis of CD10(down) FL was carried out with a combination of pathological and molecular analyses. The incidence of CD10(down) GI-FL was shown in 35/172 (20.3%) cases, which was more frequent than nodal FL (3.5%, P < 0.001). The difference was additionally significant between GI-FL and nodal FL when the analysis was confined to primary GI-FL (55.2% vs 3.5%, P < 0.001). Compared to CD10(+) GI-FL, CD10(down) GI-FL significantly involved the stomach or large intestine (P = 0.015), and additionally showed the downexpression of BCL6 (P < 0.001). The follicular dendritic cell meshwork often showed a duodenal pattern in the CD10(down) group (P = 0.12). Furthermore, a lymphoepithelial lesion was observed in 5/12 (40%) gastric FL cases, which indicated caution in the differentiation of mucosa-associated lymphoid tissue lymphoma. Molecular analyses were undertaken in seven cases of CD10(down) GI-FL, and an identical clone was found between CD10(down) follicles and CD10(+)BCL2(+) neoplastic follicles. In the diagnosis of cases with CD10(down) BCL2(+) follicles, careful examination with molecular studies should be carried out.

DOI： 10.1111/cas.13031

Histological spectrum of angiofibroma of soft tissue: histological and genetic analysis of 13 cases Reviewed

Yuichi Yamada, Hidetaka Yamamoto, Kenichi Kohashi, Takeaki Ishii, Kunio Iura, Akira Maekawa, Hirofumi Bekki, Hiroshi Otsuka, Kyoko Yamashita, Hiroyuki Tanaka, Tsubasa Hiraki, Munenori Mukai, Atsuko Shirakawa, Yoko Shinnou, Mari Jinno, Hiroyuki Yanai, Kenichi Taguchi, Yoshihiko Maehara, Yukihide Iwamoto, Yosinao Oda

HISTOPATHOLOGY 69 ( 3 ) 459 - 469 2016.9

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

AimsAngiofibroma of soft tissue (AFST) is a rare soft tissue neoplasm characterized by a fibroblastic cytomorphology and a prominent vascular structure. AFSTs possess a novel fusion gene, i.e. NCOA2-AHRR/AHRR-NCOA2 or GTF2I-NCOA2, providing a useful approach to diagnosing AFST. Morphologically, AFSTs span a wide spectrum, making diagnosis a challenge. The aim of this study was to review AFST cases and to report previously unknown histological features, which we confirmed by genetic analysis.
Methods and resultsWe reviewed 276 cases diagnosed as solitary fibrous tumours/haemangiopericytomas (232 cases), unclassified tumours of fibroblastic differentiation (36 cases), and recently diagnosed AFSTs (eight cases), and retrieved 13 cases compatible with AFST. Immunohistochemical staining was performed for these cases, all 13 of which were analysed by reverse transcription polymerase chain reaction and fluorescence in-situ hybridization. The histological findings were as follows: amianthoid fibres, extravasation of red blood cells, haemosiderin deposition, aggregates of foamy histiocytes, cystic change, necrosis, and haemorrhage. Immunohistochemically, the tumour cells were positive for epithelial membrane antigen (four of 13 cases), desmin (six of 13 cases), CD163 (13 of 13 cases), CD68 (seven of 13 cases), oestrogen receptor (13 of 13 cases), progesterone receptor (three of 13 cases), and STAT6 (one of 13 cases, weak nuclear staining), but they were negative for CD34, -smooth muscle actin, muscle-specific actin, S100, pan-cytokeratin, MDM2, and CDK4. The AHRR-NCOA2 fusion gene was detected in eight cases, and NCOA2 gene rearrangement in nine cases.
ConclusionWe revealed the previously unreported histological variation and immunohistochemical findings of AFST, and confirmed them by using genetic methods. The results suggested that AFST should be considered in the diagnosis of fibrous or fibrohistiocytic tumours with the above histological features.

DOI： 10.1111/his.12943

A Case of Focal Bone Marrow Reconversion Mimicking Bone Metastasis: The Value of (111)Indium Chloride Reviewed

Takashi Tanaka, Hideo Gobara, Ryota Inai, Toshihiro Iguchi, Akihiro Tada, Shuhei Sato, Hiroyuki Yanai, Susumu Kanazawa

ACTA MEDICA OKAYAMA 70 ( 4 ) 285 - 289 2016.8

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

We present a case of a 66-year-old man with esophageal carcinoma. (18)Fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for evaluating distant metastasis and staging revealed F-18-FDG uptake in the third lumbar vertebra and other vertebrae. Magnetic resonance imaging could not differentiate bone metastases from benign bone lesions. We considered the possibility of bone marrow reconversion. (111)Indium chloride (In-111-Cl-3 ) scintigraphy with single-photon emission computed tomography/computed tomography (SPECT/CT) revealed erythroid bone marrow components in the bone lesions. The diagnosis of bone marrow reconversion was pathologically confirmed by a bone biopsy of the third lumbar vertebra. The patient underwent esophagectomy and has remained disease-free in the 2 years since. To the best of our knowledge, this is the first report to describe the usefulness of In-111-Cl-3 with SPECT/CT for the diagnosis of bone marrow reconversion.

DOI： 10.18926/AMO/54505

Expansion of epigenetic alterations in EFEMP1 promoter predicts malignant formation in pancreatobiliary intraductal papillary mucinous neoplasms Reviewed

Kazuhiro Yoshida, Takeshi Nagasaka, Yuzo Umeda, Takehiro Tanaka, Keisuke Kimura, Fumitaka Taniguchi, Tomokazu Fuji, Kunitoshi Shigeyasu, Yoshiko Mori, Hiroyuki Yanai, Takahito Yagi, Ajay Goel, Toshiyoshi Fujiwara

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY 142 ( 7 ) 1557 - 1569 2016.7

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

Although limited understanding exists for the presence of specific genetic mutations and aberrantly methylated genes in pancreatobiliary intraductal papillary mucinous neoplasms (IPMNs), the fundamental understanding of the dynamics of methylation expansion across CpG dinucleotides in specific gene promoters during carcinogenesis remains unexplored. Expansion of DNA methylation in some gene promoter regions, such as EFEMP1, one of the fibulin family, with tumor progression has been reported in several malignancies. We hypothesized that DNA hypermethylation in EFEMP1 promoter would expand with the tumor grade of IPMN.
A sample of 65 IPMNs and 30 normal pancreatic tissues was analyzed. IPMNs were divided into the following three subsets according to pathological findings: 31 with low-grade dysplasia (low grade), 11 with high-grade dysplasia (high grade), and 23 with associated invasive carcinoma (invasive Ca). Mutations in the KRAS or GNAS genes were analyzed by Sanger sequencing, and methylation status of two discrete regions within the EFEMP1 promoter, namely region 1 and region 2, was analyzed by bisulfite sequencing and fluorescent high-sensitive assay for bisulfite DNA (Hi-SA). Expression status of EFEMP1 was investigated by immunohistochemistry (IHC).
KRAS mutations were detected in 39, 55, and 70 % of low-grade, high-grade, and invasive Ca, respectively. GNAS mutations were observed in 32, 55, and 22 % of low-grade, high-grade, and invasive Ca, respectively. The methylation of individual regions (region 1 or 2) in the EFEMP1 promoter was observed in 84, 91, and 87 % of low-grade, high-grade, and invasive Ca, respectively. However, simultaneous methylation of both regions (extensive methylation) was exclusively detected in 35 % of invasive Ca (p = 0.001) and five of eight IPMNs (63 %) with extensive methylation, whereas 20 of 57 (35.1 %) tumors of unmethylation or partial methylation of the EFEMP1 promoter region showed weak staining EFEMP1 in extracellular matrix (p = 0.422). In addition, extensive EFEMP1 methylation was particularly present in malignant tumors without GNAS mutations and associated with disease-free survival of patients with IPMNs (p < 0.0001).
Extensive methylation of the EFEMP1 gene promoter can discriminate invasive from benign IPMNs with superior accuracy owing to their stepwise accumulation of tumor progression.

DOI： 10.1007/s00432-016-2164-x

A Case of Metastatic Urachal Cancer Including a Neuroendocrine Component Treated with Gemcitabine, Cisplatin and Paclitaxel Combination Chemotherapy Reviewed

Shin Ebara, Yasuyuki Kobayashi, Katsumi Sasaki, Motoo Araki, Morito Sugimoto, Koichirou Wada, Kei Fujio, Atsushi Takamoto, Toyohiko Watanabe, Hiroyuki Yanai, Yasutomo Nasu

ACTA MEDICA OKAYAMA 70 ( 3 ) 223 - 227 2016.6

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

The present case report describes a case of recurrent and advanced urachal carcinoma including neuroendocrine features with iliac bone metastasis after partial cystectomy and adjuvant chemotherapy consisting of irinotecan and cisplatin in a 32-year-old man. He received gemcitabine/cisplatin/paclitaxel (GCP) combination chemotherapy, consisting of gemcitabin (1,000mg/m(2)) on day 1, 8, cisplatin (70mg/m(2)) on day 1, and paclitaxel (80mg/m(2)) on day 1 and 8. After three cycles of chemotherapy, PET-CT showed complete regression of the disease. So the patient underwent total cystoure-threctomy, and histological examination showed an almost complete pathological response. External beam radiation therapy was also given to the ileac bone metastasis regions. However, PET-CT taken 17 months after the external beam radiation showed multiple lung metastases. He received GCP chemotherapy again, which resulted in a complete response again after three cycles of chemotherapy. This is the first report on GCP chemotherapy used not only as a salvage chemotherapy but also as a rechallenge regimen for metastatic urachal cancer including a neuroendocrine component.

DOI： 10.18926/AMO/54423

Hypocomplementemic urticarial vasculitis arising in a patient with immunoglobulin G4-related disease Reviewed

Mariko Takao, Toshihisa Hamada, Tatsuya Kaji, Kazuko Ikeda-Mizuno, Chinatsu Takehara-Yasuhara, Kouichi Ichimura, Hiroyuki Yanai, Tadashi Yshino, Keiji Iwatsuki

INTERNATIONAL JOURNAL OF DERMATOLOGY 55 ( 4 ) 430 - 433 2016.4

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

BackgroundHypocomplementemic urticarial vasculitis (HUV) has been defined as a syndrome associated with urticarial lesions caused by leukocytoclastic vasculitis. It has been observed in patients with systemic lupus erythematosus and related conditions. Immunoglobulin G4 (IgG4)-related disease is a lymphoproliferative disorder characterized by sclerosing pancreatitis, retroperitoneal fibrosis, sclerotic cholangitis, acute interstitial nephritis, and Mikulicz's disease, and associated with elevated levels of IgG4 and hypocomplementemia. Various cutaneous lesions may occur in IgG4-related disease.
MethodsWe report a 74-year-old woman with HUV, followed by systemic organ involvement suggestive of IgG4-related disease. Symptoms included submandibular gland swelling, lymphadenopathy, interstitial nephritis, and a thyroid nodule. Laboratory examinations revealed an elevated serum IgG4 level of 637mg/dl in a total IgG level of 2176mg/dl, and the production of autoantibodies such as rheumatoid factor and antiphospholipid antibodies. In the swollen lymph node, neither clonal proliferation of T or Bcells nor Epstein-Barr virus infection was detected, although the structure had been destroyed by the infiltration of lymphocytes and plasma cells. Among total IgG-producing cells, approximately 40% were positive for IgG4.
ResultsAll symptoms and abnormal laboratory findings improved in response to oral prednisolone.
ConclusionsHypocomplementemic urticarial vasculitis may represent a clinical symptom of IgG4-related disease.

DOI： 10.1111/ijd.12868

Three histologically distinct cancers of the uterine corpus: A case report and review of the literature. International journal

Hisashi Masuyama, Junko Haraga, Takashi Nishida, Chikako Ogawa, Tomoyuki Kusumoto, Keiichiro Nakamura, Noriko Seki, Hiroyuki Yanai, Yuji Hiramatsu

Molecular and clinical oncology 4 ( 4 ) 563 - 566 2016.4

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

Collision tumors, which are characterized by the coexistence of two or more completely distinct and independent tumors in the uterine corpus, are very rare. A collision tumor is mainly composed of two distinct tumor types, epithelial and mesenchymal. To the best of our knowledge, there has only been a single case in which a choriocarcinoma with an endometrial carcinoma were coexistent but histologically distinct. We herein report the first case of a collision tumor in a 52-year-old woman, with a history of two pregnancies and two deliveries. The collision tumor was composed of three histologically distinct neoplasms in the uterine corpus, namely an endometrioid carcinoma, an undifferentiated carcinoma and a choriocarcinoma. The patient underwent hysterectomy, bilateral adnexectomy and pelvic lymph node dissection, followed by six cycles of adjuvant chemotherapy with paclitaxel/carboplatin due to the high risk of endometrial cancer, and an additional five cycles of chemotherapy with methotrexate, as the β-human chorionic gonadotropin level was beyond the normal range. Following adjuvant chemotherapy, the tumor markers were within normal limits and no relapses of the cancer have been observed during 1 year of follow-up. Diagnosing a collision tumor prior to surgery is difficult if the neoplasms are in close proximity, or if one of the tumors predominates. Careful pathological examination is crucial for accurately diagnosing the neoplasms in a collision tumor and ensuring appropriate management and a favorable prognosis.

Ectopic thyroid tissue in the adrenal gland: CT and MRI findings Reviewed

A. Tada, T. Tanaka, A. Takamoto, H. Yanai, S. Sato, S. Kanazawa

DIAGNOSTIC AND INTERVENTIONAL IMAGING 97 ( 3 ) 371 - 373 2016.3

Actual Status of Involvement of Helicobacter pylori Infection That Developed Gastric Cancer from Group A of ABC (D) Stratification - Study of Early Gastric Cancer Cases That Underwent Endoscopic Submucosal Dissection Reviewed

Ko Miura, Hiroyuki Okada, Yoshiyasu Kouno, Hiromitsu Kanzaki, Masaya Iwamuro, Keisuke Hori, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai

DIGESTION 94 ( 1 ) 17 - 23 2016

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

Background/Aims: Patients who are Helicobacter pylori antibody negative and have normal pepsinogen (PG) levels (group A of ABC (D) stratification) are considered unlikely to develop gastric cancer. This study aimed to clarify the involvement (uninfection, present infection or previous infection) of H. pylori in group A patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) by examining their background gastric mucosa endoscopically and histologically. Methods: This study included 166 patients with gastric cancer who were treated by ESD. Patients were classified according to PG levels and H. pylori antibody titers. Three biopsies (greater curvature of the antrum, lesser curvature of the middle corpus and greater curvature of the middle corpus) from group A were histologically analyzed and compared with those of groups B, C, D and after eradication). Results: In group A (34 patients), 32 patients had endoscopic atrophy (group A'). Histological neutrophil activity, chronic inflammation and atrophy scores were lower in group A' than in other groups. Group A' scores were similar to those of the after eradication group. Conclusion: Most of the group A patients with early gastric cancer were not uninfected with H. pylori, but had previous infections, thus carrying carcinogenic risk. (C) 2016 S. Karger AG, Basel

DOI： 10.1159/000446771

Two Cases of Mucinous Adenocarcinoma, Minimal Deviation Type, with Peutz-Jeghers Syndrome Reviewed

34 ( 2 ) 134 - 143 2016

A case of ovarian endometrioid adenocarcinoma resembling sex-cord stromal tumor with hyperandrogenism, hyperestrogenism and pseudo-Meigs syndrome Reviewed

34 ( 2 ) 112 - 118 2016

耳下腺に発生した mammary analogue secretory carcinoma の 1 例 ― 形態的特徴と鑑別診断を中心に― Reviewed

那須篤子, 畠榮, 藤田勝, 山内豊子, 中村聡子, 田中健大, 市村浩一, 柳井広之

日本臨床細胞学会雑誌 55 ( 2 ) 112 - 118 2016

Language：Japanese Publisher：(公社)日本臨床細胞学会

背景:耳下腺に発生したmammary analogue secretory carcinoma(以下MASC)の1例を経験したので細胞像を中心に報告する。症例:60歳代、男性。左耳前部の腫脹を主訴に他院を受診。超音波検査にて左耳下腺内に約3cmの腫瘍を認め、穿刺吸引細胞診を施行、悪性判定となり、手術目的で当院紹介受診となった。穿刺吸引細胞診では、乳頭状構造を示す細胞集塊やライトグリーン淡染性で豊富な細胞質を有する細胞が疎な結合性を呈し散見された。これらの細胞の核は偏在し、一部の細胞では細胞質内小腺腔(intracytoplasmic lumina、以下ICL)を認めた。ICLや腺腔内の貯留物質は、パパニコロウ染色では淡い桃色を呈し、Hema-color染色では、異染性を呈した。細胞学的には、腺房細胞癌や低悪性度篩状嚢胞腺癌、腺癌の鑑別が困難であった。結論:腺房細胞癌や低悪性度篩状嚢胞腺癌、腺癌の鑑別が困難であったが、MASCというまれな組織型と診断された。腺房細胞癌様の細胞が認められた場合は、鑑別診断の一つとしてMASCを念頭に置くことが肝要であると考えられた。(著者抄録)

DOI： 10.5795/jjscc.55.112

Other Link： https://search.jamas.or.jp/default/link?pub_year=2016&ichushi_jid=J01209&link_issn=&doc_id=20160824210005&doc_link_id=%2Few5saibo%2F2016%2F005502%2F006%2F0112-0116%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Few5saibo%2F2016%2F005502%2F006%2F0112-0116%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

前眼房水に浸潤した節外性 NK/T 細胞リンパ腫鼻型の 1 例 Reviewed

那須篤子, 市村浩一, 畠榮, 柳井広之, 藤田勝, 濵田香菜, 田中健大, 吉野正

日本臨床細胞学会雑誌 55 ( 2 ) 89 - 93 2016

Language：Japanese Publisher：(公社)日本臨床細胞学会

背景:前眼房水に浸潤した節外性NK/T細胞リンパ腫、鼻型(extranodal NK/T cell lymphoma、nasal type、以下ENKL)の1例を経験したので細胞所見を中心に報告する。症例:50歳代、男性。発熱、食思不振、全身倦怠感を主訴として他院を受診。肝生検にて、ENKL、Stage IVBと診断され、当院を紹介受診。その後、左前眼房の混濁があり、前眼房水の細胞診が施行された。検体量が少量なためCyto Richを用いて液状化検体細胞診(liquid based cytology、以下LBC法)で標本を作製した。標本には長く伸びた核を有し、核の切れ込みなどの異型を示すリンパ球様細胞が多く認められた。また細胞質の一方が突起様に伸びたhand mirror様の形態を呈した細胞も観察された。肝生検、骨髄clot sectionの免疫組織化学的検索でCD3ε、CD56が陽性、ISHでEBERが陽性であり、前眼房水検体の免疫細胞化学的検索でも同様の結果であったためENKLの浸潤と診断した。結論:ENKLの細胞は細胞診形態でHand mirror cellとして出現することがある。ENKLの診断は、免疫染色とあわせて総合的に判断することが必要であり、LBC法はそのために有効であった。(著者抄録)

DOI： 10.5795/jjscc.55.89

Other Link： https://search.jamas.or.jp/default/link?pub_year=2016&ichushi_jid=J01209&link_issn=&doc_id=20160824210001&doc_link_id=%2Few5saibo%2F2016%2F005502%2F002%2F0089-0093%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Few5saibo%2F2016%2F005502%2F002%2F0089-0093%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

小児の頭蓋内髄膜腫術後肺転移の一例

今井みどり, 濱田香菜, 那須篤子, 井上博文, 藤田勝, 田中健大, 柳井広之

岡山県臨床細胞学会誌 35 30 - 33 2016

Language：Japanese Publisher：岡山県臨床細胞学会

背景髄膜腫は中年女性に多く15歳未満の小児に起こる割合は0.57%と稀である。一般的に、髄膜腫は摘出によって完治の期待できる生物学的悪性度の低い腫瘍として扱われているが、極めて稀に遠隔転移をすることがある。今回我々は小児の頭蓋内髄膜腫術後肺転移の一例を経験したので、文献的考察を加えて報告する。症例患者は10歳未満の女児。てんかん発作、左下肢麻痺を主訴に来院。右前頭葉に直径5.5cmの腫瘍を認め、開頭術を施行し乳頭型髄膜腫と診断された。頭蓋内に2回の再発を繰り返し、他院にてサイバーナイフを施行。初発から3年後、胸部CTにて両肺野に多発性結節を認め、胸腔鏡下で右肺2ヶ所切除し、髄膜腫の転移と診断された。その後2回の化学療法を受け、翌年に右肺区域切除、3ヵ月後に左肺部分切除。その後経過観察中である。右肺区域切除時の迅速検査材料から捺印標本を作製した。腫瘍細胞は上皮様結合を示し、島状の集塊で観察された。細胞質は好酸性、核は類円形で明瞭な核小体を有し、粗顆粒状のクロマチンが均等に分布していた。迅速組織標本では、淡明な卵円形核と好酸性細胞質を有する細胞の増殖が観察された。腫瘍細胞は血管を含む結合織で区画されたwhorl formationを呈し、散在性に砂粒体を認める髄膜皮性髄膜腫の像であった。結論髄膜腫の頭蓋外に遠隔転移をする割合は0.1%と言われている。稀とはいえ、髄膜腫の遠隔転移が起こりうる可能性を認識しておく必要がある。(著者抄録)

涙腺から発生したと考えられた導管癌の1例 Reviewed

田中顕之, 田中健大, 松本洋, 柳井広之, 吉野正

診断病理 33 ( 3 ) 254 - 258 2016

Feasibility of Neoadjuvant Ad-REIC Gene Therapy in Patients with High-Risk Localized Prostate Cancer Undergoing Radical Prostatectomy Reviewed

Hiromi Kumon, Katsumi Sasaki, Yuichi Ariyoshi, Takuya Sadahira, Motoo Araki, Shin Ebara, Hiroyuki Yanai, Masami Watanabe, Yasutomo Nasu

CTS-CLINICAL AND TRANSLATIONAL SCIENCE 8 ( 6 ) 837 - 840 2015.12

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

In a phase I/IIa study of in situ gene therapy using an adenovirus vector carrying the human REIC/Dkk-3 gene (Ad-REIC), we assessed the inhibitory effects of cancer recurrence after radical prostatectomy (RP), in patients with high risk localized prostate cancer (PCa). After completing the therapeutic interventions with initially planned three escalating doses of 1.0 x 10(10), 1.0 x 10(11), and 1.0 x 10(12) viral particles (VP) in 1.0-1.2 mL (n = 3, 3, and 6), an additional higher dose of 3.0 x 10(12) VP in 3.6 mL (n = 6) was further studied. Patients with recurrence probability of 35% or more within 5 years after RP as calculated by Kattan's nomogram, were enrolled. They received two ultrasound-guided intratumoral injections at 2-week intervals, followed by RP 6 weeks after the second injection. Based on the findings of MRI and biopsy mapping, as a rule, one track injection to the most prominent cancer area was given to initial 12 patients and 3 track injections to multiple cancer areas in additional 6 patients. As compared to the former group, biochemical recurrence-free survival of the latter showed a significantly favorable outcome. Neoadjuvant Ad-REIC, mediating simultaneous induction of cancer selective apoptosis and augmentation of antitumor immunity, is a feasible approach in preventing cancer recurrence after RP. (199)

DOI： 10.1111/cts.12362

エトポシドとシスプラチンの併用療法(EP療法)が著効し組織学的CRが得られた肝原発小細胞癌の1切除例

秋元悠, 堤康一郎, 加藤博也, 幡英典, 榮浩行, 内田大輔, 友田健, 松本和幸, 野間康宏, 山本直樹, 堀口繁, 原田亮, 岡田裕之, 柳井広之, 八木孝仁, 山本和秀

日本消化器病学会雑誌 112 ( 11 ) 2024 - 2034 2015.11

Language：Japanese Publisher：(一財)日本消化器病学会

52歳女性。主訴は右上腹部痛。巨大な肝腫瘤と多発性肝腫瘤、胆嚢壁肥厚を認め、EUS-FNAにて小細胞癌と診断。エトポシド、シスプラチン併用療法が著効したため、根治目的に肝中央二区域・胆管切除術、胆嚢摘出術施行。病理では泡沫細胞の集簇を認め、viableな腫瘍細胞は認めなかった。画像、病理所見より、肝原発小細胞癌と最終診断した。化学療法著効後に根治切除でき、組織学的CRが得られた貴重な1例である。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J01118&link_issn=&doc_id=20151113150011&doc_link_id=130005107579&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130005107579&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

[Radical surgery after successful chemotherapy in a case of primary small cell carcinoma of the liver]. Reviewed

Yutaka Akimoto, Koichiro Tsutsumi, Hironari Kato, Hidenori Hata, Hiroyuki Sakae, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Ryo Harada, Hiroyuki Okada, Hiroyuki Yanai, Takahito Yagi, Kazuhide Yamamoto

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 112 ( 11 ) 2024 - 34 2015.11

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

A 52-year-old woman was admitted to our hospital with right upper quadrant pain with gallbladder wall thickening and multiple liver tumors. Endoscopic ultrasound-guided biopsy revealed small cell carcinomas of both the gallbladder and liver. After 10 cycles of chemotherapy with etoposide and cisplatin, marked shrinkage of the tumors was evident on computed tomography. The patient subsequently underwent hepatectomy and resection of the extrahepatic bile duct and gallbladder with curative intent. Although no viable tumor cells were found in the resected specimens, we confirmed phagocytosis of tumor cells killed by chemotherapy in the resected liver specimen. Therefore, we suspected that the patient had primary small cell carcinoma of the liver that had been successfully treated. This is a rare case of primary small cell carcinoma of the liver that showed pathological complete response to chemotherapy with etoposide and cisplatin.

DOI： 10.11405/nisshoshi.112.2024

Diagnostic value of Thallium-201 scintigraphy in differentiating malignant bone tumors from benign bone lesions Reviewed

Ryota Inai, Takayoshi Shinya, Akihiro Tada, Shuhei Sato, Tomohiro Fujiwara, Ken Takeda, Toshiyuki Kunisada, Hiroyuki Yanai, Toshifumi Ozaki, Susumu Kanazawa

ANNALS OF NUCLEAR MEDICINE 29 ( 8 ) 674 - 681 2015.10

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

This retrospective study aims to evaluate the diagnostic capacity of thallium-201 (201Tl) scintigraphy for differentiating malignant bone tumors from benign bone lesions.
Between January 2006 and December 2012, 279 patients with bone lesions (51 malignant and 228 benign) underwent 201Tl scintigraphy before treatment. To evaluate 201Tl uptake, we investigated tumor-to-background contrast (TBC) as well as TBC washout rate (WR). The differences of TBC on early and delayed images and WR were estimated by the Mann-Whitney U test. Receiver operating characteristic (ROC) analyses were used to determine the cut-off TBC values for differentiating malignant bone tumors from benign bone lesions.
There were statistically significant differences in median TBC between malignant tumors and benign lesions. These differences occurred for early imaging (1.57 vs. 0.09, p < 0.001) as well as for delayed imaging (0.83 vs. 0.07, p < 0.001). However, there was no statistical difference in WR between malignant tumors and benign lesions (44 vs. 43 %, NS). The chosen TBC cut-off value was 0.68 for early imaging and 0.38 for delayed imaging. Using these cut-off values, the prediction of malignancy had a 77 % sensitivity, 74 % specificity, and 75 % accuracy for early imaging and an 80 % sensitivity, 76 % specificity, and 77 % accuracy for delayed imaging.
201Tl scintigraphy may have the ability to distinguish malignant bone tumors from benign bone lesions.

DOI： 10.1007/s12149-015-0990-6

Xp11.2転座型腎癌の3例

井上陽介, 高本篤, 佐々木克己, 森聰博, 有吉勇一, 小林泰之, 荒木元朗, 江原伸, 渡邉豊彦, 那須保友, 柳井広之, 黒田直人

西日本泌尿器科 77 ( 増刊 ) 142 - 142 2015.10

超音波内視鏡下穿刺吸引法(EUS-FNA)における採取材料の色調と細胞学的特異性

井上博文, 藤田勝, 松岡博美, 今井みどり, 那須篤子, 浜田香菜, 原田和恵, 伏見聡一郎, 市村浩一, 田中顕之, 田中建大, 大森昌子, 柳井広之

日本臨床細胞学会雑誌 54 ( Suppl.2 ) 587 - 587 2015.10

胸水に出現したEwing肉腫の一例

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

日本臨床細胞学会雑誌 54 ( Suppl.2 ) 628 - 628 2015.10

腎盂原発明細胞腺癌の一例

浜田香菜, 那須篤子, 今井みどり, 松岡博美, 原田和恵, 井上博文, 藤田勝, 田中顕之, 田中健大, 市村浩一, 大森昌子, 柳井広之

日本臨床細胞学会雑誌 54 ( Suppl.2 ) 692 - 692 2015.10

Clinicopathological heterogeneity in ovarian clear cell adenocarcinoma: a study on individual therapy practice Reviewed

Yuji Matsuo, Hironori Tashiro, Hiroyuki Yanai, Takuya Moriya, Hidetaka Katabuchi

MEDICAL MOLECULAR MORPHOLOGY 48 ( 3 ) 146 - 154 2015.9

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

Ovarian clear cell adenocarcinoma (CCA) has been believed to be a lethal histological subtype of an epithelial ovarian adenocarcinoma (EOA); its precursor has been assumed to be endometriosis. However, it has been reported that CCAs occasionally exhibit different clinical behaviors, suggesting that CCAs might not belong to a single category. We focused on CCAs combined with other histological types of EOAs; we re-evaluated the pathology of 46 CCAs and divided them into two subgroups: 35 CCAs alone (pure-type CCAs); and 11 CCAs with other histological types, endometrioid adenocarcinomas (EAs) or/and serous adenocarcinomas (SAs) (mixed-type CCAs). Immunohistochemical analysis for expression of ARID1A, p53, PTEN, Annexin 4, hepatocyte nuclear factor-1 beta (HNF-1 beta), and WT-1 was employed. We identified that patients with endometriosis were younger than those without endometriosis in pure-type CCAs (P < 0.005). In mixed-type CCAs, the immunohistochemical-staining patterns revealed internal transition of each histological component. In pure-type CCAs, expressions of ARID1A and p53 were mutually altered, and altered expression of p53 was associated with worse prognosis than that of ARID1A (P < 0.001). Our results provide evidence that CCAs would have clinicopathological heterogeneity, determining the patient's prognosis. Furthermore, immunohistochemical analysis may shed light on the selection of appropriate treatment, including chemotherapy.

DOI： 10.1007/s00795-014-0090-z

Both a visual and a semiquantitative analysis for differentiating benign from malignant chondrogenic bone tumors using Tc-99m (V) DMSA scintigraphy: a prospective study Reviewed

Takayoshi Shinya, Shuhei Sato, Toshiyuki Kunisada, Ryota Inai, Hiroyuki Yanai, Toshifumi Ozaki, Susumu Kanazawa

NUCLEAR MEDICINE COMMUNICATIONS 36 ( 8 ) 802 - 807 2015.8

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

ObjectiveThe aims of this prospective study were to assess the relationship between tumor aggressiveness and Tc-99m (V) dimercaptosuccinic acid (DMSA) uptake in chondrogenic bone tumors and the value of Tc-99m (V) DMSA scintigraphy for differentiating benign from malignant tumors.MethodsTwenty-four patients with chondrogenic tumors (19 benign and five malignant) underwent Tc-99m DMSA (V) scintigraphy. Radiopharmaceutical uptake was classified using a three-point scale to allow a visual-only analysis, and a tumor-to-background contrast (TBC) was computed using regions of interest to provide a semiquantitative analysis. Spearman's correlation coefficient was used to assess the correlation between tumor aggressiveness and TBC. The difference in TBC between benign and malignant tumors was analyzed with the Mann-Whitney U-test. An appropriate cutoff value of TBC was chosen for the diagnosis of malignancy of a tumor using receiver operating characteristic analysis.ResultsSix benign tumors showed negative uptake (uptake score 0), whereas 13 benign tumors showed positive uptake (n=10 uptake score 1; n=3 uptake score 2). All chondrosarcomas showed positive uptake (n=2 uptake score 1; n=3 uptake score 2). A significant correlation was found between tumor aggressiveness and TBC. A significant difference was seen in TBC between benign and malignant tumors. With the chosen cutoff value of TBC equal to 0.611, the sensitivity was 80.0%, specificity was 78.9%, the positive predictive value was 50.0%, and the negative predictive value was 93.8%.ConclusionTc-99m (V) DMSA scintigraphy may have the potential to improve diagnostic methods for detecting chondrosarcomas using visual and/or semiquantitative analyses.

DOI： 10.1097/MNM.0000000000000328

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

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

CYTOPATHOLOGY 26 ( 4 ) 250 - 255 2015.8

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

BackgroundMethods for determining the origin of BK virus (BKV)-infected cells (decoy cells) in clinical urine samples have not been established although they could enhance the diagnosis of BKV infection in immunocompromised patients.
MethodsWe performed simultaneous immunostaining with anti-S100P (a urothelial marker) and anti-SV40 antibodies in 66 clinical urine samples exhibiting SV40 positivity and a decoy-cell appearance on Papanicolaou staining. The clinical voided urine samples included seven cases of renal transplantation, 47 cases of cancer therapy and 12 cases of non-neoplastic disease. SurePath liquid-based cytology was used for the urine samples.
ResultsBKV-infected cells were categorized as SV40(+)/S100P(+) and SV40 (+)/S100p(-). SV40(+)/S100P(-) cells were found in 55 cases (83.4%); nine cases (13.6%) carried both SV40(+)/S100P(-) and SV40(+)/S100P(+) cells. The former were identified as BKV infection in renal tubules and the latter in both the renal tubules and urothelial epithelia. The remaining two cases (3.0%) had only SV40(+)/S100P(+) cells of urothelial origin.
ConclusionSimultaneous immunostaining with anti-S100P and anti-SV40 is a useful method for determining the origin of BKV-infected cells in clinical urine samples from immunocompromised patients such as renal transplantation recipients.

DOI： 10.1111/cyt.12213

A Paraganglioma in a Hypertensive Patient with Unilateral Renal Hypoplasia Reviewed

Tomohiro Terasaka, Hideharu Hagiya, Kosuke Kimura, Takahiro Nada, Eri Nakamura, Yoshihisa Hanayama, Hitoshi Sugiyama, Yasuyuki Kobayashi, Hiroyuki Yanai, Fumio Otsuka

ACTA MEDICA OKAYAMA 69 ( 2 ) 119 - 122 2015.4

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

We report the case of a 46-year-old hypertensive Japanese female with renal insufficiency related to unilateral renal hypoplasia. The patient was found to have developed paraganglioma in the retroperitoneal space over a 5-year period. Catecholamine-producing tumors are not usually recognized as conditions associated with renal hypoplasia. Our long-term observation of the patient eventually led us to the diagnosis of paraganglioma. In hypertensive patients with chronic kidney disease, not only the renin-angiotensin-aldosterone system but also catecholamine activity may be involved, particularly in the patients whose cases are complicated with unilateral renal hypoplasia.

DOI： 10.18926/AMO/53341

Ad-REIC gene therapy: Promising results in a patient with metastatic CRPC following chemotherapy Reviewed

Hiromi Kumon, Katsumi Sasaki, Yuichi Ariyoshi, Takuya Sadahira, Shin Ebara, Takao Hiraki, Susumu Kanazawa, Hiroyuki Yanai, Masami Watanabe, Yasutomo Nasu

Clinical Medicine Insights: Oncology 9 ( 9 ) 31 - 38 2015.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Libertas Academica Ltd.

A 63-year-old man with metastatic castration-resistant prostate cancer (CRPC) was successfully treated for two years with in situ gene therapy using an adenovirus vector carrying the human REIC/Dkk‑3 gene (Ad-REIC), following chemotherapy. Ad-REIC mediates simultaneous induc-tion of cancer-selective apoptosis and augmentation of antitumor immunity, and a Phase I/IIa clinical study on Ad-REIC has been conducted at Okayama University Hospital since January 2011. At the time of enrollment in December 2012, the patient presented with rapid progression of lymph node (LN) metastases. Two scheduled Ad-REIC injections and 10 additional Ad-REIC injections into metastatic pelvic and para-aortic LNs under CT guidance, with an average four weeks’ interval, exhibited the potent direct and indirect effects of Ad-REIC as a therapeutic cancer vaccine. During the next 12 months, three additional injections into para-aortic LNs showing regrowth achieved adequate control of all metastatic LNs with prostate-specific antigen (PSA) decline, without any particular adverse events.

DOI： 10.4137/CMO.S23252

A case of cardiac amyloidosis with ventricular flutter of first symptom

Ono Tamaki, Morita Hiroshi, Kimura Tomonari, Tokioka Koji, Nakagawa Kouji, Nishii Nobuhiro, Nagase Satoshi, Nakamura Kazuhumi, Ito Hiroshi, Tanaka Takehiro, Yanai Hiroyuki, Ando Midori, Yutani Chikao

Shinzo 47 ( suppl-1 ) 33 - 37 2015

膀胱粘膜下傍神経節腫の2例

小田晋輔, 伏見聡一郎, 山口隆廣, 伊藤利洋, 大枝忠史, 市川孝治, 柳井広之, 國友忠義, 中本周, 松川昭博

鳥取医学雑誌 42 ( 3-4 ) 147 - 152 2014.12

Language：Japanese Publisher：(公社)鳥取県医師会

われわれは膀胱に発生した傍神経節腫の2例を経験した。症例1は90歳代女性。血尿の精査中、膀胱鏡で右壁に3cm大の粘膜下腫瘍が認められ、経尿道的膀胱腫瘍切除術(transurethral resection of bladder tumor:TURBT)を施行された。症例2は70歳代男性。胸部大動脈瘤術後の経過観察中に、Computed tomography(CT)検査にて膀胱腫瘍を指摘され、膀胱鏡を行ったところ新たに別の粘膜下腫瘍が認められTURBTを施行された。2例とも病理組織学的に傍神経節腫と診断された。膀胱に発生する傍神経節腫はまれであり、文献的考察を加えて報告する。(著者抄録)

切除縁評価法の問題点切除縁評価法の問題点悪性骨腫瘍

国定俊之, 武田健, 藤原智洋, 柳井広之, 尾崎敏文

日本整形外科学会雑誌 88 ( 9 ) 588 - 594 2014.9

Language：Japanese Publisher：(公社)日本整形外科学会

2005年〜2011年に治療した初診時遠隔転移を認めない高悪性骨腫瘍52例を対象に、最近の症例について検討し、悪性骨腫瘍の切除縁評価法に関する疑問点・問題点について検討した。組織型は骨肉腫34例、軟骨肉腫12例、Ewing肉腫3例等であった。52例の切除縁評価は2cm wide margin以上45例、1cm wide margin 4例、marginal margin以下3例であった。1cm wide marginとなった4例は血管温存目的(2例)および術前化学療法効果著効例での関節温存目的(2例)であった。marginal margin以下となった3例は骨盤発生、脊椎発生、大腿骨巨大腫瘍で、広範囲切除縁確保が困難であった。再発は4例に認め、2cm wide margin以上1例、marginal margin以下3例であった。最初の問題点は反応層の定義で、反応層をもう少し詳細に分類する必要がある。2番目の問題点は術前画像での切除縁設定の基準を決めることで、全国で統一した安全な切除縁設定の基準を決める必要があると思われた。

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01133&link_issn=&doc_id=20141006030026&doc_link_id=%2Ffj2ortho%2F2014%2Fs08809%2F005%2F0588-0594%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffj2ortho%2F2014%2Fs08809%2F005%2F0588-0594%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Fatal glioblastoma after Gamma Knife radiosurgery for arteriovenous malformation in a child Reviewed

Koichi Yoshida, Tomotsugu Ichikawa, Kazuhiko Kurozumi, Hiroyuki Yanai, Keisuke Onoda, Isao Date

JOURNAL OF CLINICAL NEUROSCIENCE 21 ( 8 ) 1453 - 1455 2014.8

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

We describe a fatal case of glioblastoma multiforme that was induced by Gamma Knife radiosurgery (GKS; Elekta AB, Stockholm, Sweden) for an arteriovenous malformation (AVM). A 4-year-old girl presented with repeated convulsions. Imaging studies revealed an AVM located in the right thalamus. One year after initial symptoms, GKS was performed to obliterate the nidus. The maximum and marginal radiation doses were 32 and 16 Gy, respectively. Seventy months after GKS, the patient represented with severe headache. MRI showed a poorly demarcated tumor with heterogeneous gadolinium enhancement in the right thalamus and adjacent to the white matter of the temporal lobe. After a generalised convulsion, the patient deteriorated into a deep coma. CT scans showed severe brain swelling with intratumoral hemorrhage. An emergency craniotomy was performed, and the hematoma was removed. During this surgery, a tumor mass, which was found adjacent to the hematoma, was resected. Microscopic examination revealed glioblastoma multiforme. Despite intensive treatment, the patient died 1 month after surgery. A GKS-induced secondary tumor is a rare but serious complication. It is important to be aware of the adverse effects of GKS, including secondary neoplasms, before its clinical application, especially in young patients. (C) 2014 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jocn.2013.10.039

直腸癌術後尿管再発の１例

松本聖, 稲田涼, 近藤喜太, 母里淑子, 岸本浩行, 江原伸, 戸田博子, 柳井広之, 永坂岳司, 藤原俊義

癌の臨床 60 ( 5 ) 549 - 554 2014

Language：Japanese Publisher：(株)篠原出版新社

尿管再発は大腸癌において頻度の低い再発形式である。今回直腸癌術後に血尿を契機に発見された左尿管再発を経験したので報告する。患者は80代男性。2007年1月、上部直腸癌に対して低位前方切除術を施行。病理診断にて中分化管状腺癌(pT4aN0M0、pStage II)と診断。2011年9月、血尿を認め、膀胱および左尿管に腫瘍を指摘。膀胱腫瘍に対してはTUR-BTを、また尿管腫瘍に対しては左腎尿管摘出術を施行。組織診断では膀胱腫瘍は、原発性尿路上皮癌と診断。また尿管腫瘍は腸管由来の分化型腺癌を認め、直腸癌の尿管再発と診断。その後、膀胱癌の局所再発および直腸癌の肺・膀胱内再発をきたすも、2012年5月、癒着性イレウスによる嘔吐に伴う誤嚥性肺炎により永眠された。(著者抄録)

Other Link： https://search.jamas.or.jp/default/link?pub_year=2014&ichushi_jid=J00297&link_issn=&doc_id=20141203210011&doc_link_id=%2Fad7gnrsc%2F2014%2F006005%2F011%2F0549-0554%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fad7gnrsc%2F2014%2F006005%2F011%2F0549-0554%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

膵Solid-pseudopapillary neoplasm(clear cell variant)の一例

濱田香菜, 那須篤子, 井上博文, 今井みどり, 松岡博美, 藤田勝, 市村浩一, 柳井広之

日本臨床細胞学会岡山支部会誌 32 29 - 32 2013.12

Language：Japanese Publisher：岡山県臨床細胞学会

背景超音波内視鏡下穿刺吸引細胞診(以下EUS-FNA)において、膵solid-pseudopapillary neoplasm(以下SPN)のclear cell variantを経験したので報告する。症例 40歳代、男性。造影CTにて膵尾部に約17mm大の腫瘤を指摘。EUS-FNAが施行され、比較的均一な、小型類円形の偏在核を有する形質細胞様の腫瘍細胞が、単在性あるいは小集塊で多数認められた。多くの腫瘍細胞の細胞質に細胞質内空胞が見られ、集塊内部や腫瘍細胞近傍にライトグリーン好染性の球状無構造物が観察された。集塊の結合性は緩く、一部でロゼット様配列を示し、細い血管結合織を軸とする集塊も見られた。以上の所見より細胞診では膵神経内分泌腫瘍が疑われた。組織学的検索においても、生検材料、手術材料ともに膵神経内分泌腫瘍との診断を得たが、その後の再検討により、SPN(clear cell variant)と診断された。結論 SPNは男性に発生する頻度は低く、組織学的にも膵神経内分泌腫瘍と鑑別困難な場合があり、細胞診判定に苦慮した。本亜型の特徴所見である細胞質内空胞を認識することが組織型推定への手がかりとなる。(著者抄録)

Predictive factors for acute and late urinary toxicity after permanent interstitial brachytherapy in Japanese patients Reviewed

Ryuta Tanimoto, Kensuke Bekku, Norihisa Katayama, Yasuyuki Kobayashi, Shin Ebara, Motoo Araki, Mitsuhiro Takemoto, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

International Journal of Urology 20 ( 8 ) 812 - 817 2013.8

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

To describe the frequency of and to determine predictive factors associated with Radiation Therapy Oncology Group urinary toxicity in prostate brachytherapy patients. Methods: From January 2004 to April 2011, 466 consecutive Japanese patients underwent permanent iodine-125-seed brachytherapy (median follow up 48 months). International Prostate Symptom Score and Radiation Therapy Oncology Group toxicity data were prospectively collected. Prostate volume, International Prostate Symptom Score before and after brachytherapy, and postimplant analysis were examined for an association with urinary toxicity, defined as Radiation Therapy Oncology Group urinary toxicity of Grade1 or higher. Logistic regression analysis was used to examine the factors associated with urinary toxicity. Results: The rate of Radiation Therapy Oncology Group urinary toxicity grade1 or higher at 1, 6, 12, 24, 36 and 48 months was 67%, 40%, 21%, 31%, 27% and 28%, respectively. Grade2 or higher urinary toxicity was less than 1% at each time-point. International Prostate Symptom Score was highest at 3 months and returned to normal 12 months after brachytherapy. On univariate analysis, patients with a larger prostate size, greater baseline International Prostate Symptom Score, higher prostate V100, higher prostate V150, higher prostate D90 and a greater number of seeds had more acute urinary toxicities at 1 month and 12 months after brachytherapy. On multivariate analysis, significant predictors for urinary toxicity at 1 month and 12 months were a greater baseline International Prostate Symptom Score and prostate V100. Conclusions: Most urinary symptoms are tolerated and resolved within 12 months after prostate brachytherapy. Acute and late urinary toxicity after brachytherapy is strongly related to the baseline International Prostate Symptom Score and prostate V100. © 2013 The Japanese Urological Association.

DOI： 10.1111/iju.12050

Smear cytology findings of large cell neuroendocrine carcinoma of the uterine cervix Reviewed

Naoto Kuroda, Yukari Wada, Kaori Inoue, Masahiko Ohara, Keiko Mizuno, Makoto Toi, Azusa Tanaka, Yoji Wani, Hiroyuki Yanai

DIAGNOSTIC CYTOPATHOLOGY 41 ( 7 ) 636 - 639 2013.7

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

Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is a rare tumor. Moreover, there are only three reports to date that have focused on the cytologic findings of cervical LCNEC. We report the case of a 59-year-old Japanese woman with cervical LCNEC combined with small cell carcinoma (SmCC). Cytologic specimens from the uterine cervix demonstrated large cells with coarse chromatin and prominent nucleoli. Frequent mitotic figures were also observed. Curettage of the uterine endometrium revealed an endometrioid adenocarcinoma with squamous differentiation; i.e., an adenoacanthoma. Histologic examination of surgically resected uterine cervical tissue revealed LCNEC with minor foci of SmCC. Neuroendocrine differentiation in LCNEC was confirmed by immunohistochemistry for synaptophysin and CD56. Cytotechnologists or pathologists need to consider a differential diagnosis of LCNEC while examining cervical cytologic specimens; therefore, it is important to correctly identify the cytologic characteristics of this tumor. Diagn. Cytopathol. 2013. (c) 2011 Wiley Periodicals, Inc.

DOI： 10.1002/dc.21834

Clinicopathologic analysis of IgG4-related skin disease Reviewed

Yasuharu Sato, Mai Takeuchi, Katsuyoshi Takata, Kyotaro Ohno, Noriko Iwaki, Yorihisa Orita, Naoe Goto, Akira I. Hida, Toshiyuki Iwamoto, Naoko Asano, Toshihiro Ito, Hiroyuki Hanakawa, Hiroyuki Yanai, Tadashi Yoshino

Modern Pathology 26 ( 4 ) 523 - 532 2013.4

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

IgG4-related disease is a recently recognized systemic syndrome characterized by mass-forming lesions with lymphoplasmacytic infiltration, increase in the number of IgG4 + cells in affected tissues and elevation of serum IgG4 levels. In 2009, we were the first to report skin lesions in patients with IgG4-related disease, but no large case series has been reported and clinicopathological findings remain unclear. To clarify these features, we herein report 10 patients (9 men and 1 woman
median age, 64 years
age range, 46-81 years) with IgG4-related skin disease. All patients had erythematous and itchy plaques or subcutaneous nodules on the skin of the head and neck, particularly in the periauricular, cheek, and mandible regions, except for one patient, whose forearm and waist skin were affected. In addition, eight patients had extracutaneous lesions: these were found on the lymph nodes in six patients, the lacrimal glands in three patients, the parotid glands in three patients, and the kidney in one patient. Histologically examined extracutaneous lesions were consistent with IgG4-related disease
five of six lymph node lesions showed progressively transformed germinal centers-type IgG4-related lymphadenopathy. Cases of IgG4-related skin disease were classified into two histological patterns: those exhibiting a nodular dermatitis pattern and those with a subcutaneous nodule pattern. The infiltrate was rich in plasma cells, small lymphocytes, and eosinophils
the majority of the plasma cells were IgG4 +. The IgG4 + cell count was 49-396 per high-power field (mean±s.d., 172±129), with an IgG4 +/IgG + cell ratio ranging from 62 to 92%. Serum IgG4 levels were elevated in all examined patients. In conclusion, patients with IgG4-related skin disease had uniform clinicopathology. Lesions were frequently present on the skin of the periauricular, cheek, and mandible regions, and were frequently accompanied by IgG4-related lymphadenopathy. © 2013 USCAP, Inc. All rights reserved.

DOI： 10.1038/modpathol.2012.196

A case of synovial sarcoma with brain metastasis treated with surgical resection and stereotactic radiosurgery Reviewed

Yoshihiro Otani, Tomotsugu Ichikawa, Kazuhiko Kurozumi, Hiroyuki Yanai, Toshiyuki Kunisada, Toshifumi Ozaki, Isao Date

Neurological Surgery 41 ( 3 ) 255 - 262 2013.3

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

Synovial sarcomas compromise between 5 to 10% of all soft tissue sarcomas in adults. Synovial sarcoma commonly occurs in the vicinity of the large joints and cranial metastasis is rare. Here, we describe a case with intracranial metastases of a synovial sarcoma A 41-year-old woman was admitted to our department with sensory aphasia. She had a history of a left inguinal synovial sarcoma and underwent surgery and chemotherapy for primary and metastatic lesions Head MRI revealed three gadolinium-enhancing lesions in the left frontal, parietal and parietotemporal lobe Gross total resection was achieved in the left parietotemporal lesion and pathological diagnosis was synovial sarcoma. Two weeks after surgery, she received cyber-knife radiosurgery and her neurological deficit was almost completely resolved Intracranial metastatic synovial sarcoma is rare. Surgical resection and stereotaxic radiosurgery was very effective in the present case.

A case of synchronous thyroid papillary carcinoma and colon cancer of the neck node

Nomura Tsunehisa, Miyoshi Kazuya, Nishie Manabu, Iwakawa Kazuhide, Yanai Hiroyuki, Sonobe Hiroshi, Tanaka Katsuhiro

Official Journal of the Japan Association of Endocrine Surgeons and the Japanese Society of Thyroid Surgery 30 ( 3 ) 226 - 231 2013

１型神経線維腫症の異型神経線維腫を背景に発生した低悪性度悪性末梢神経鞘腫瘍の1例 Reviewed

田中梓菜, 黒田直人, 柳井広之, 岩田純

診断病理 30 ( 1 ) 19 - 22 2013

当院で治療した子宮体癌患者319症例の疫学的調査 Reviewed

春間朋子, 中村圭一郎, 福島千加子, 楠本知行, 関典子, 柳井広之, 平松祐司

日本婦人科腫瘍学会雑誌 31 ( 4 ) 137 - 142 2013

膣転移で発見された悪性傍神経節種の１例

多賀茂樹, 早瀬良二, 柳井広之

日本婦人科腫瘍学会雑誌 31 ( 1 ) 14 - 17 2013

乳頭状卵管過形成を伴う卵巣漿液性境界悪性腫瘍の一例

黒田直人, 田中梓菜, 柳井広之

日本婦人科病理学会誌 4 ( 2 ) 97 - 99 2013

胃底腺型胃癌の1例 Reviewed

田中健大, 市村浩一, 柳井広之, 吉野正

診断病理 30 ( 1 ) 62 - 65 2013

外科的摘出および定位放射線治療が有用であった転移性滑膜肉腫の1例

大谷理浩, 市川智継, 黒住和彦, 柳井広之, 国定俊之, 尾崎敏文, 伊達勲

Neurological Surgery 41 ( 3 ) 255 - 262 2013

A case of primary gallbladder choriocarcinoma with a rapidly aggressive course after surgery

Naoyuki Tokunaga, Masaru Inagaki, Yuji Kimura, Koji Kitada, Hiromi Iwagaki, Hiroyuki Yanai

Japanese Journal of Gastroenterological Surgery 46 ( 4 ) 268 - 274 2013

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

A 75-year-old man complaining of right upper quadrant abdominal pain visited another hospital, and the acute cholecystitis was suspected based on ultrasonogram (US) and computer tomography (CT) scans. He was introduced our hospital for further examination and surgical treatment. Enhanced CT scan showed a circumferential wall thickness in the middle third of the gallbladder, and revealed the abcess formation outside the gallbladder wall, too. The clinical diagnosis of suppurative cholecystitis was made, and an urgent cholecystectomy was performed. Histopathological examination incidentally showed a moderately or poorly differentiated adenocarcinoma mixed with multinucleated syncytial trophoblasts. Immunohistochemistry revealed positive staining for HCG in the trophoblastic-cell component. According to the pathological diagnosis, we performed second operation immediately for the necessity of additional hepatectomy and lymph node dissection, but radical excision was immposible because of diffuse peritoneal dissemination and multiple liver metastasis. The patient survived only about four months following the first surgery. Primary gallbladder choriocarcinoma is exceedingly rare, and the prognosis is poorer than typical gallbladder adenocarcinoma in the literature. We report a case of gallbladder choriocarcinoma which demonstrated a rapidly aggressive course after cholecystectomy. © 2013 The Japanese Society of Gastroenterological Surgery.

DOI： 10.5833/jjgs.2012.0195

Primary signet-ring cell/histiocytoid carcinoma of the axilla expressing human epidermal growth factor receptor 2 Reviewed

Tomoko Miyake, Osamu Yamasaki, Maho Sugiu, Toshihisa Hamada, Masaki Otsuka, Hiroyuki Yanai, Yoshiko Morishita, Keiji Iwatsuki

JOURNAL OF DERMATOLOGY 39 ( 12 ) 1038 - 1040 2012.12

超音波内視鏡下穿刺吸引細胞診(EUS-FNA)が有用であった胃粘膜下腫瘍の一例

本山由紀子, 井上博文, 今井みどり, 松岡博美, 藤田勝, 市村浩一, 柳井広之

日本臨床細胞学会岡山支部会誌 31 34 - 37 2012.12

Language：Japanese Publisher：岡山県臨床細胞学会

70代女。30年前に他院で胃噴門部大彎の粘膜下腫瘍を認められ、以来、年に一度の経過観察が行われていた。今回、CT検査で噴門部大彎腫瘤と胃体上部大彎腫瘤を認められ、精査目的で当院に紹介された。超音波検査を行ったところ、噴門部腫瘤は内部エコーがほぼ均一の低エコー像であるのに対し、体上部腫瘤は内部エコーが不均一な低〜等エコー像であったため、それぞれの腫瘤についてEUS-FNAを施行した。結果、噴門部腫瘤は核密度の低い緻密な細胞集塊で、核はクロマチン分布がほぼ均等・淡染性で長紡錘形を呈し、比較的整った配列を示した。体上部腫瘤は、噴門部腫瘤に比べて核密度の高い細胞集塊で、核形は主に楕円形〜紡錘形であり、一部に円形を呈する細胞もみられ、小型の核小体が観察されたが、明らかな核分裂像は認めなかった。両腫瘤間の最も顕著な相違点は核密度であり、体上部腫瘤の細胞所見からはGISTが強く示唆され、噴門部腫瘤はGIST以外の間葉系腫瘍である可能性が考えられた。組織学的検査により、噴門部腫瘤は平滑筋腫、体上部腫瘤はGISTと診断された。

Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma Reviewed

Takehiro Tanaka, Atsushi Fujimura, Koichi Ichimura, Hiroyuki Yanai, Yasuharu Sato, Katsuyohi Takata, Hiroyuki Okada, Seiji Kawano, Shunsuke Tanabe, Tadashi Yoshino

WORLD JOURNAL OF GASTROENTEROLOGY 18 ( 43 ) 6263 - 6268 2012.11

Language：English Publishing type：Research paper (scientific journal) Publisher：BAISHIDENG PUBL GRP CO LTD

AIM: To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett's adenocarcinoma in Japan.
METHODS: We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett's adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative patients.
RESULTS: HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett's adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients.
CONCLUSION: Our results suggest that HER2-positive Barrett's adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage. (C) 2012 Baishideng. All rights reserved.

DOI： 10.3748/wjg.v18.i43.6263

Carcinosarcoma of the Gallbladder Manifesting as Cholangitis Due to Hemobilia Reviewed

Hiroshi Sadamori, Hiroyasu Fujiwara, Takehiro Tanaka, Hiroyuki Yanai, Daisuke Satoh, Takahito Yagi, Toshiyoshi Fujiwara

JOURNAL OF GASTROINTESTINAL SURGERY 16 ( 6 ) 1278 - 1281 2012.6

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

Carcinosarcomas of the gallbladder are rare tumors that are characterized by malignant epithelial and mesenchymal components, and preoperative diagnosis of carcinosarcoma of the gallbladder remains difficult.
We recently encountered a case of carcinosarcoma of the gallbladder with osteoid and chondroid differentiation, manifesting as cholangitis due to hemobilia.
Preoperative computed tomography and magnetic resonance imaging indicated the cause of cholangitis and provided qualitative information regarding the two components of the tumor.

DOI： 10.1007/s11605-012-1836-3

The clinical impact of pathological review on selection the treatment modality for localized prostate cancer in candidates for brachytherapy monotherapy Reviewed

Ryo Kishimoto, Takashi Saika, Kensuke Bekku, Hiroyuki Nose, Fernando Abarzua, Yasuyuki Kobayashi, Motoo Araki, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

WORLD JOURNAL OF UROLOGY 30 ( 3 ) 375 - 378 2012.6

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

To evaluate the impact of pathological review by pathologist with genitourinary expertise (PGU) on treatment modality of localized prostate cancer, we analyzed Gleason grade (GG) migration and the final treatment decision in a cohort of patients designated for permanent prostate brachytherapy (PPB).
From February 2005 to July 2010, a total of 247 patients with localized prostate cancer diagnosed by local community hospitals were referred to our hospital for PPB monotheray. All pathologic slides of prostate biopsies were reviewed by a single PGU. Patients ultimately selected their treatment modality from our recommendations based on the review. Indication for PPB monotherapy was the NCCN classification of patients as good or intermediate risk. In addition, patient with Primary GG 4 was regarded as unadapted case.
Six cases were reinterpreted as no cancer (2.4%). GG change occurred in 94 cases (38.1%) of which 77 (81.9%) were upgraded and 17 (18.1%) downgraded. Of the total 247 patients, 86 (34.8%) changed therapies and 30 (12.1%) did so based on the pathologic slide review.
Pathological review of biopsy specimens is mandatory for the determination of treatment modality especially in candidates for monotherapy of permanent prostate brachytherapy.

DOI： 10.1007/s00345-011-0738-4

Gene therapy for prostate cancer - Research and development of a new immuno-gene therapy

Katsumi Sasaki, Ryuta Tanimoto, Shin Ebara, Hiromi Kumon, Yasutomo Nasu, Masami Watanabe, Haruki Kaku, Hiroyuki Yanai

Nishinihon Journal of Urology 74 ( 4 ) 197 - 202 2012.4

Language：Japanese Publishing type：Research paper (international conference proceedings)

We have performed three clinical studies for prostate cancer at Okayama University Hospital. In the first study (Suicide gene therapy using adenovirus vector (ADV) expressing herpes simplex virus-thymidine kinase gene and Ganciclovir), 9 castration-resistant prostate cancer (CRPC) patients without metastasis were treated from 2001 to 2005, demonstrating the safety profile and some clinical responses. In the second study (Immunogene therapy using ADV expressing the Interleukin-12 gene), 10 CRPC patients with or without metastasis were treated from 2008, demonstrating the safety profile and some immuno-clinical responses. The latest study (Gene therapy creating cancer vaccine using ADV expressing reduced expression in immortalized cells
REIC/Dkk-3 gene, which mediates simultaneous induction of cancer-selective apoptosis and augmentation of anti-tumor immunity), was initiated in Jan., 2011. The study category includes 2 groups: A, CRPC
and B, newly diagnosed high-risk localized cancer with indication for surgical resection (Neo-adjuvant). Four CRPC patients and 9 neo-adjuvant patients have been entered into the study with an excellent safety profile. Patients treated with the intermediate vector dose demonstrated modest clinical and/or immunological effects, and an increased vector dose showed remarkable immuno-pathological effects. Ad/REIODkk-3, a revolutionary gene-based medicine creating a cancer vaccine, could be a promising treatment option for prostate cancer.

Primary Gleason grade 4 impact on biochemical recurrence after permanent interstitial brachytherapy in Japanese patients with low- or intermediate-risk prostate cancer Reviewed

Tatsuya Uesugi, Takashi Saika, Kohei Edamura, Hiroyuki Nose, Makoto Kobuke, Shin Ebara, Fernand Abarzua, Norihisa Katayama, Hiroyuki Yanai, Yasutomo Nasu, Hiromi Kumon

International Journal of Radiation Oncology Biology Physics 82 ( 2 ) e219 - e223 2012.2

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

Purpose: To reveal a predictive factor for biochemical recurrence (BCR) after permanent prostate brachytherapy (PPB) using iodine-125 seed implantation in patients with localized prostate cancer classified as low or intermediate risk based on National Comprehensive Cancer Network (NCCN) guidelines. Methods and Materials: From January 2004 to December 2009, 414 consecutive Japanese patients with clinically localized prostate cancer classified as low or intermediate risk based on the NCCN guidelines were treated with PPB. The clinical factors including pathological data reviewed by a central pathologist and follow-up data were prospectively collected. Kaplan-Meier and Cox regression analyses were used to assess the factors associated with BCR. Results: Median follow-up was 36.5 months. The 2-, 3-, 4-, and 5-year BCR-free rates using the Phoenix definition were 98.3%, 96.0%, 91.6%, and 87.0%, respectively. On univariate analysis, the Gleason score, especially primary Gleason grade 4 in biopsy specimens, was a strong predicting factor (p &lt
0.0001), while age, initial prostate-specific antigen (PSA) level, T stage, and minimal dose delivered to 90% of the prostate volume (D90) were insignificant. Multivariate analysis indicated that a primary Gleason grade 4 was the most powerful prognostic factor associated with BCR (hazard ratio = 6.576, 95% confidence interval, 2.597-16.468, p &lt
0.0001). Conclusions: A primary Gleason grade 4 carried a worse BCR prognosis than the primary grade 3 in patients treated with PPB. Therefore, the indication for PPB in patients with a Gleason sum of 4 + 3 deserves careful and thoughtful consideration. © 2012 Elsevier Inc.

DOI： 10.1016/j.ijrobp.2011.04.018

Prostatic stromal tumor of uncertain malignant potential (STUMP) with unrecognized growth pattern Reviewed

Soichiro Fushimi, Tetsuya Ogino, Ken Aoki, Junya Itakura, Toshihiro Ito, Tadashi Oeda, Hiroyuki Yanai, Akihiro Matsukawa

PATHOLOGY INTERNATIONAL 62 ( 1 ) 69 - 71 2012.1

心臓原発malignant fibrous histiocytoma(MFH)の十二指腸転移の1例

沼田紀史, 中川昌浩, 岡本良一, 東玲治, 平尾謙, 小川恒由, 大江啓常, 植木亨, 高田晋一, 松浦博夫, 柳井広之, 水野元夫

胃と腸 2012

A case of esophageal carcinosarcoma with a component of small cell carcinoma

Tanabe Shunsuke, Fujiwara Toshiyoshi, Shirakawa Yasuhiro, Maeda Naoaki, Ohara Toshiaki, Noma Kazuhiro, Sakurama Kazufumi, Yanai Hiroyuki, Yamatsuji Tomoki, Naomoto Yoshio

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 124 ( 2 ) 145 - 148 2012

Language：Japanese Publisher：Okayama Medical Association

We experienced a case of esophageal carcinosarcoma with a component of small cell carcinoma. The patient was a 73-year-old man. We administered chemotherapy of CDDP+VP-16, and performed an operation after 2 courses of this chemotherapy. Subtotal esophagectomy and reconstruction with the small intestine was performed. More than three years after resection, he remains alive and recurrence-free. There are few cases of esophageal carcinosarcoma and small cell carcinoma. We report this rare case herein.

DOI： 10.4044/joma.124.145

Histopathological analysis for ovarian clear cell adenocarcinoma in stage Ia

MATSUO Yuji, MIYAHARA Yo, HONDA Ritsuo, OHTAKE Hideyuki, TASHIRO Hironori, YANAI Hiroyuki, MORIYA Takuya, KATABUCHI Hidetaka

30 ( 2 ) 129 - 134 2012

Thallium-201 Scintigraphy Is an Effective Diagnostic Modality to Distinguish Malignant From Benign Soft-Tissue Tumors Reviewed

Naoaki Kawakami, Toshiyuki Kunisada, Shuhei Sato, Yuki Morimoto, Masato Tanaka, Tsuyoshi Sasaki, Shinsuke Sugihara, Hiroyuki Yanai, Susumu Kanazawa, Toshifumi Ozaki

CLINICAL NUCLEAR MEDICINE 36 ( 11 ) 982 - 986 2011.11

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

Background: The aim of this study is to evaluate whether thallium-201 (201-Tl) scintigraphy can differentiate malignant from benign soft-tissue tumors.
Methods: Between April 1995 and December 2005, 192 patients with soft-tissue tumors (85 malignant and 107 benign) underwent 201-Tl scintigraphy before treatment. Isotope uptake was used as a proxy for tumor-to-background ratio (TBR). The accuracy of TBR on early and delayed imaging was evaluated using the Mann-Whitney U and chi(2) tests.
Results: There was a statistically significant difference in mean TBR on early and delayed imaging of malignant and benign soft-tissue tumors (124% +/- 109% vs. 22% +/- 42%, and 82% +/- 83% vs. 12% +/- 25%, P < 0.0001). A TBR cutoff of 20% indicated the probability of malignancy on early and delayed imaging (82% sensitivity and 77% specificity; 82% sensitivity and 84% specificity, P < 0.0001). Well-differentiated liposarcomas showed low isotope accumulation, while pigmented villonodular synovitis and giant cell tumors of the tendon sheath showed high isotope accumulation.
Conclusions: Thallium-201 scintigraphy can distinguish malignant from benign tumors with relatively high accuracy. With the exception of low grade liposarcomas and locally aggressive benign tumors, 201-Tl scintigraphy may be an effective diagnostic modality to differentiate malignant from benign soft-tissue tumors.

DOI： 10.1097/RLU.0b013e3182177407

Primary Germinoma in the Medulla Oblongata-Case Report Reviewed

Takao Yasuhara, Tomotsugu Ichikawa, Yasuyuki Miyoshi, Kazuhiko Kurozumi, Tomoko Maruo, Hiroyuki Yanai, Isao Date

NEUROLOGIA MEDICO-CHIRURGICA 51 ( 4 ) 326 - 329 2011.4

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN NEUROSURGICAL SOC

A 27-year-old woman presented with a case of primary medulla oblongata germinoma manifesting as sleep apnea, aspiration pneumonia, and left hemiparesis. Magnetic resonance (MR) imaging revealed a dorsal mass in the medulla oblongata with heterogeneous enhancement by gadolinium (Gd). Emergent biopsy and foramen magnum decompression with C1 laminectomy were performed because of rapid worsening of her symptoms. The histological diagnosis was germinoma. Subsequently she received chemoradiation therapy with subsequent amelioration of her neurological deficits and disappearance of enhancement on MR imaging with Gd. Primary medulla oblongata germinoma is rare and difficult to diagnose preoperatively. However, correct diagnosis and subsequent adequate chemoradiation therapy is possible by understanding the common characteristics of the disease. Germinoma should be included in the differential diagnosis of midline medullary lesion in young patients, and biopsy should be considered.

DOI： 10.2176/nmc.51.326

Long-Term Effect of External Beam Radiotherapy of Optic Disc Hemangioma in a Patient with von Hippel-Lindau Disease Reviewed

Toshihiko Matsuo, Kengo Himei, Kouichi Ichimura, Hiroyuki Yanai, Soichiro Nose, Tetsushige Mimura, Yasuyuki Miyoshi, Tomoyasu Tsushima

ACTA MEDICA OKAYAMA 65 ( 2 ) 135 - 141 2011.4

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

An 18-year-old woman with a 2-year history of hypertension and headache was diagnosed with noradrenal in-secreting bilateral adrenal pheochromocytomas with paragangliomas in the background of von Hippel-Lindau disease with family histories and a missense mutation, 712C to T (Arg167Trp) in the VHL gene. She had optic disc hemangioma in the left eye which gradually enlarged and caused serous retinal detachment on the macula in one year. Low-dose external beam radiation (20 Gy) was adminisitered to the left eye using a lens-sparing single lateral technique. She underwent craniotomy for cerebellar hemangioblastoma at the age of 22 years and total pancreatectomy for multiple neuroendocrine tumors at the age of 24 years. In the 6-year follow-up period after the radiotherapy, the optic disc hemangioma gradually reduced in size and its activity remained low, allowing good central vision to be maintained. External beam radiation is recommended as a treatment option for the initial therapy for optic disc hemangioma.

DOI： 10.18926/AMO/45273

A case of ovarian sex cord-stromal tumor, unclassified

56 ( 13 ) 1855 - 1859 2011

放射線療法が奏効した,H. pylori陰性胃MALTリンパ腫の1例

胃と腸 46 ( 9 ) 1300 - 1303 2011

A case of neuroendocrine sweat gland carcinoma

IKEDA Kazuko, OTSUKA Masaki, YAMASAKI Osamu, IWATSUKI Keiji, IWATANI Kayo, YANAI Hiroyuki, MORISHITA Yoshiko

Skin Cancer 26 ( 2 ) 153 - 156 2011

Language：Japanese Publisher：The Japanese Skin Cancer Society

A 69-year-old man presented with a 1-year history of a slowly growing solitary nodule on his left cheek. A dermatological examination revealed a reddish, elastic firm, dome-shaped nodule, measuring 23×20 mm. Histologic examination revealed nests of tumor cells in the dermis. The tumor cells showed pale, oval to polygonal cell types with mitoses and necrosis. Immunohistochemically, the tumor cells were positive for chromogranin A, gross cystic disease fluid protein 15, estrogen receptor, progesterone receptor, and negative for vimentin, CAM5.2, cytokeratin (CK)7, CK20, CEA and S-100. The tumor cells were partially positive for mucicarmine, suggesting mucin-production. No distant or lymph node metastasis was found in positron emission tomography-computed tomography (PET-CT) and enhanced CT. The diagnosis of neuroendocrine sweat gland carcinoma was made. Wide resection and sentinel node biopsy (SNB) were performed. SNB revealed micrometastases in the cervical lymph node. We therefore performed lymphadenectomy, and added irradiation at a total dose of 50Gy. No recurrence or metastasis of the tumor has been noticed for 6 months after lymphadenectomy.[Skin Cancer (Japan) 2011 ; 26 : 153-156]

DOI： 10.5227/skincancer.26.153

Other Link： http://search.jamas.or.jp/link/ui/2012038271

耳下腺上皮筋上皮癌の一例

那須篤子, 井上博文, 藤田勝, 濱田香菜, 松岡博美, 今井みどり, 田中健大, 市村浩一, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 30 40 - 42 2011

Language：Japanese Publisher：岡山県臨床細胞学会

80歳代男。頸部エコーで右耳下腺内に不整形腫瘤を認め、穿刺吸引細胞診を施行した。壊死物を伴う嚢胞内容を背景に、シート状ないし管状配列を示す小型で細胞質に乏しい上皮細胞集塊、小集塊〜散在性に出現する大型裸核状筋上皮細胞を認め、筋上皮細胞が粘液球を取り囲む構造がみられた。筋上皮細胞の核は裸核状で大型、不整形、クロマチン細顆粒状で、大型核小体を認めた。以上より腺様嚢胞癌と推定したが、組織学的に腫瘍は嚢胞内に上皮細胞と筋上皮細胞が明瞭な二層構造を示して乳頭状あるいは充実性に増生していたことから上皮筋上皮癌と診断した。腫瘍細胞には腺腔形成、偽腺腔形成を認めた。免疫組織化学的に上皮細胞はEMA陽性、筋上皮細胞はα-smooth muscle actin、p63陽性、偽腺腔、基底膜様物質がType IV collagen陽性であった。

子宮体部clear cell adenocarcinomaの2例

那須篤子, 井上博文, 藤田勝, 松岡博美, 今井みどり, 大森昌子, 田中健大, 市村浩一, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 29 15 - 16 2010.12

Language：Japanese Publisher：岡山県臨床細胞学会

症例1は59歳女で、出血持続の内膜細胞診classVで紹介となった。細胞所見は出血性背景の中に淡明な胞体を有する腫瘍細胞が孤立散在性から小集塊状、シート状に認められた。核は円形から一部不整形、大小不同を伴い、クロマチン細顆粒状・密で、著明な核小体と核縁肥厚が観察された。また、hobnail様構造も認めた。組織所見は淡明な胞体を有した乳頭状〜腺管増殖を示し、明細胞腺癌clear cell adenocarcinomaと診断し、一部にendometrioid adenocarcinoma像も認めた。症例2は71歳女で、不正出血のclassIVで紹介となった。細胞所見は壊死性背景の中に明るく豊富な細胞質を有する腫瘍細胞がシート状に認められた。核は円形から類円形、大小不同を伴い、クロマチン細顆粒状で、著明な核小体が確認された。また、ライト緑好性、オレンジG好性の基底膜様物質も認められた。組織所見は、一部に扁平上皮への分化を示す腫瘍細胞が管状〜充実性に増殖し、endometrioid adenocarcinoma G2相当像を認めた。明るい胞体を有する細胞の充実性増殖を認め、clear cell adenocarcinomaの成分が合併し、ER染色では類内膜腺癌で強陽性、明細胞腺癌で弱陽性、P53は明細胞腺癌で高陽性率が高かった。

肺腫瘍の病理小円形細胞腫瘍を中心に

田中健大, 藤田勝, 松岡博美, 今井みどり, 井上博文, 那須篤子, 市村浩一, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 29 1 - 3 2010.12

α-fetoprotein-producing endometrial adenocarcinoma without an obvious hepatoid component Reviewed

Junichi Kodama, Noriko Seki, Hiroyuki Yanai, Tomoyuki Kusumoto, Keiichiro Nakamura, Atsushi Hongo, Yuji Hiramatsu

Oncology Letters 1 ( 2 ) 243 - 245 2010.3

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

Endometrial carcinomas producing α-fetoprotein (AFP) are extremely rare. We report a case of AFP-producing, Grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. A 59-year-old multiparous woman presented with abdominal swelling. The serum level of AFP was 1292.8 ng/ml. Magnetic resonance images of the pelvis showed a markedly enlarged uterus, with a tumor growing exophytically within the endometrial cavity. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The histopathological examination demonstrated a Stage IIA, Grade 2 endometrioid adenocarcinoma without an obvious hepatoid component. The endometrioid adenocarcinoma cells were partly positive for AFP immunoreactivity. The patient received adjuvant chemotherapy and was disease-free 60 months after the operation. This case confirms the existence of AFP-producing endometrioid adenocarcinomas without hepatoid features.

DOI： 10.3892/ol_00000043

Obstructive jaundice at the initial presentation in small-cell lung cancer. International journal

Nobuaki Ochi, Nagio Takigawa, Masayuki Yasugi, Etsuji Ishida, Hirofumi Kawamoto, Akihiko Taniguchi, Daijiro Harada, Eiko Hayashi, Hiroko Toda, Hiroyuki Yanai, Mitsune Tanimoto, Katsuyuki Kiura

International medical case reports journal 3 9 - 12 2010

Language：English

Obstructive jaundice sometimes may develop in association with advanced small-cell lung cancer (SCLC); however, SCLC initially presenting with obstructive jaundice is rare. This report presents the cases of two SCLC patients with obstructive jaundice at the initial diagnosis. A 64-year-old male presented with obstructive jaundice due to a tumor at the head of the pancreas. He was diagnosed with SCLC by transbronchial biopsy from a lung tumor in the left upper lobe. Another 74-year-old male was admitted with jaundice due to a tumor in the porta hepatis. He was also diagnosed with SCLC by a fine-needle aspiration biopsy of a lung tumor in the left lower lobe. Both cases were successfully treated with systemic chemotherapy after endoscopic retrograde biliary drainage.

Frequent downregulation or loss of CD79a expression in plasma cell myelomas: potential clue for diagnosis. Reviewed International journal

Takehiro Tanaka, Kouichi Ichimura, Yasuharu Sato, Katsuyoshi Takata, Toshiaki Morito, Maiko Tamura, Eisaku Kondo, Nobuya Ohara, Hiroyuki Yanai, Masaharu Sakai, Satoru Takahashi, Tadashi Yoshino

Pathology international 59 ( 11 ) 804 - 8 2009.11

Language：English

Plasma cell myeloma is a frequent hematogeneous disorder that occurs mainly in older people. Not only bone marrow smears but also clots and/or biopsied specimens are often taken for confirmation of pathological diagnosis. Some specimens show sheet-like plasma cell proliferation associated with immunoglobulin monotype on immunohistology, which readily leads to diagnosis, but many samples do not clearly show light-chain restriction. The aim of the present study was therefore to examine CD79a expression because some samples had reduced expression or none at all. The immunoreactivity of CD79a was categorized into three groups: positive, weakly positive and negative, compared with scattering non-neoplastic plasma cells in the same specimen. Out of 100 specimens of plasma cell myeloma, 48% were positive for CD79a, 15% were weakly positive, and 37% were negative. In contrast, overexpression of cyclinD1 was detected in 26% of examined samples. CD79a-negative cases had a significantly lower percentage of positive staining for cyclinD1 than CD79a-positive or weakly positive cases. Clinicopathological data showed that CD79a-negative expression was associated with decreased platelet numbers in patients. The present study indicates that downregulation or loss of CD79a and/or overexpression of cyclin D1, observed in 59% of neoplastic plasma cell samples, could provide a strong diagnostic clue without regard to the results of immunoglobulin light-chain restriction.

DOI： 10.1111/j.1440-1827.2009.02448.x

A case of immunotactoid glomerulopathy exhibiting nephrotic syndrome successfully treated with corticosteroids and antihypertensive therapy Reviewed

Masaru Kinomura, Yohei Maeshima, Ryo Kodera, Hiroshi Morinaga, Daisuke Saito, Kazushi Nakao, Hiroyuki Yanai, Kenei Sada, Hitoshi Sugiyama, Hirofumi Makino

CLINICAL AND EXPERIMENTAL NEPHROLOGY 13 ( 4 ) 378 - 384 2009.8

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

We report a case of immunotactoid glomerulopathy (ITG) with cerebral hemorrhage and hypocomplementemia, with successful therapeutic outcome following the corticosteroids and antihypertensive treatment. A 70-year-old man presented with facial edema in October 2006. One day prior to his referral, he experienced speech disturbance, headache, and vomiting, and on the next day he was referred to our hospital. The laboratory examination revealed massive proteinuria (11.3 g/day) and hematuria. The total serum hemolytic complement (CH50) was decreased to 23 U/ml and C4 component was decreased to 7.5 mg/dl, whereas C3 component remained within normal limits (82 mg/dl). Brain computed tomography scan showed high-density lesions in the left parieto-occipital area suggesting subcortical cerebral hemorrhage. Renal biopsy revealed diffuse subendothelial PAS-positive depositions. Immunofluorescence studies revealed intensive deposition of IgG, IgA, C3, C1q, Fibrinogen, and kappa light chain with granular pattern in the capillary and mesangial area. Electron microscopic examination revealed regularly arranged microtubular deposits, appearing as 21-33 nm in diameter. Based on these findings, this patient was diagnosed as ITG complicated with cerebral hemorrhage and hypocomplementemia. He received oral prednisolone (30 mg/day), resulting in reduction of proteinuria, improvement of hypocomplementemia, and prevention of renal functional deterioration. This case demonstrates that accurate diagnosis of ITG may result in successful therapeutic outcome.

DOI： 10.1007/s10157-009-0166-6

Infusion of Hypertonic Saline into the Lung Parenchyma during Radiofrequency Ablation of the Lungs with Multitined Expandable Electrodes: Results Using a Porcine Model Reviewed

Tatsuhiko Iishi, Takao Hiraki, Hidefumi Mimura, Hideo Gobara, Taichi Kurose, Hiroyasu Fujiwara, Jun Sakurai, Hiroyuki Yanai, Tadashi Yoshino, Susumu Kanazawa

ACTA MEDICA OKAYAMA 63 ( 3 ) 137 - 144 2009.6

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

The present study was performed to clarify the effect of hypertonic saline infusion into the lung parenchyma on radiofrequency ablation (RFA) of the lungs. A total of 20 ablation zones were created in 3 pigs. The ablation zones were divided into 3 groups. Group 1 (n = 6) consisted of ablation zones created by applying smaller radiofrequency (RF) power without saline infusion; group 2 (n = 5) zones were created by applying greater RF power without saline infusion; and group 3 (n = 9) zones were created by applying greater RF power with saline infusion. The techniques of saline infusion included administration of hypertonic saline 1 ml before RFA, followed by continuous administration at a rate of 1 ml/min during the first 2 min after the initiation of RFA. The ablation parameters and coagulation necrosis volumes were compared among the groups. Group 3 had a tendency toward smaller mean impedance than group 1 (p = 0.059) and group 2 (p = 0.053). Group 3 showed significantly longer RF application time than group 2 (p = 0.004) and significantly greater maximum RF power than group 1 (p = 0.001) and group 2 (p = 0.004). Group 3 showed significantly larger coagulation necrosis volume (mean, 1,421 mm(3)) than group 2 (mean, 858 mm(3), p = 0.039) and had a tendency toward larger necrosis volume than group 1 (mean, 878 mm(3), p = 0.077). Although this small study had limited statistical power, hypertonic saline infusion during RFA appeared to enlarge coagulation necrosis of the lung parenchyma.

DOI： 10.18926/AMO/31848

Immunohistochemical staining of liver grafts with a monoclonal antibody against HCV-Envelope 2 for recurrent hepatitis C after living donor liver transplantation Reviewed

Hiroshi Sadamori, Takahito Yagi, Hiromi Iwagaki, Hiroaki Matsuda, Susumu Shinoura, Yuzo Umeda, Nobuya Ohara, Hiroyuki Yanai, Tetsuya Ogino, Noriaki Tanaka

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 24 ( 4 ) 574 - 580 2009.4

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

We evaluated the expression of hepatitis C virus (HCV) antigen on liver grafts by immunohistochemical staining (IHS) using IG222 monoclonal antibody (mAb) against HCV-envelope 2 (E2).
The study material was 84 liver biopsy specimens obtained from 28 patients who underwent living donor liver transplantation (LDLT) for HCV infection. The biopsy samples were examined histopathologically, and by IHS using IG222 mAb against HCV-E2. Serum HCV-RNA level was measured in all patients. The IHS grades were compared among the three groups classified according to the time elapsed from LDLT (at 1-30, 31-179 and >= 180 days post-LDLT) and among four post-transplant conditions, including acute cellular rejection (ACR).
Immunoreactivity to IG222 was detected in 78.6% of the specimens obtained during the first month after LDLT, and there were no significant differences on the IHS grades between the three groups classified according to the time elapsed from LDLT. The IHS grades were significantly stronger in definite recurrent HCV (n = 12) and probable recurrent HCV (n = 7) than in definite ACR (n = 7) and other complications (n = 8). There were no significant differences in serum HCV-RNA levels among the four post-transplant conditions. There was no significant correlation between the IHS grades using IG222 mAb and serum HCV-RNA levels when data of 84 liver biopsy specimens were analyzed.
Constant HCV-E2 expression was observed in liver biopsy specimens obtained 1 month or longer. The strong HCV-E2 expression on liver grafts were associated with recurrent hepatitis C after LDLT, but the serum HCV-RNA levels were not.

DOI： 10.1111/j.1440-1746.2008.05638.x

A case of small early cancer of sigmoid colon, which recurred with liver metastasis 18 months after surgical resection Reviewed

Keita Harada, Jun Kato, Koji Takemoto, Toshio Uraoka, Sakiko Hiraoka, Hiroyuki Yanai, Kazuhide Yamamoto

Journal of Japanese Society of Gastroenterology 106 ( 5 ) 660 - 667 2009

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

A 74-year-old man was referred to our hospital with positive fecal occult blood test. Colonoscopic examination revealed a 7-mm 0-Is type polyp in the sigmoid colon. Endoscopic mucosal resection for this lesion completely removed the lesion and the histologic diagnosis was well differentiated adenocarcinoma. Cancer cells invaded the submucosa to a depth of 900μm, and vascular invasion was found. Therefore, the patient underwent additional surgical resection with lymph node dissection. During follow-up, however, serum CEA increased beyond the normal limit 18 months after surgical operation, and a 15-mm single liver metastasis was found through enhanced CT scan abdominal imaging, the FDG-PET scan, and ultrasonography. We have to pay attention to metachronous liver metastasis especially when the vascular invasion is suspected in the resected sample, even if the lesion is completely removed.

切除18ヵ月後に肝転移をきたした径7mmのS状結腸早期癌の1例

原田馨太, 加藤順, 竹本浩二, 浦岡俊夫, 平岡佐規子, 柳井広之, 山本和秀

日本消化器病学会雑誌 106 ( 5 ) 660 - 667 2009

Language：Japanese Publisher：(一財)日本消化器病学会

症例は74歳男性。便潜血陽性に対する精査目的の大腸内視鏡検査にて、S状結腸に径7mm大のO-Is型腫瘍を指摘され、内視鏡的粘膜切除術を施行した。切除標本の病理組織学的診断は高分化腺癌で、粘膜下浸潤と脈管侵襲が認められたため、追加切除を行った。しかし術後18ヵ月目にCEAの上昇を認め、腹部造影CT、FDG-PET、超音波エコー検査にて15mmの単発肝転移による異時性再発を診断された。(著者抄録)

DOI： 10.11405/nisshoshi.106.660

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J01118&link_issn=&doc_id=20090518090006&doc_link_id=10024850990&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F10024850990&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Frequent p16 inactivation by homozygous deletion or methylation is associated with a poor prognosis in Japanese patients with pleural mesothelioma Reviewed

Naruyuki Kobayashi, Shinichi Toyooka, Hiroyuki Yanai, Junichi Soh, Nobukazu Fujimoto, Hiromasa Yamamoto, Shuji Ichihara, Kentaro Kimura, Kouichi Ichimura, Yoshifumi Sano, Takumi Kishimoto, Hiroshi Date

LUNG CANCER 62 ( 1 ) 120 - 125 2008.10

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

This study examined the p16 expression status and the P16 gene deletion and methylation status in specimens from Japanese patients with malignant pleural mesothelioma (MPM). lmmunohistochemical staining for p16 protein and fluorescence in situ hybridization for the P16 gene were performed using specimens from 30 Japanese patients with primary MPM. The methylation status of the P16 gene was examined in 13 patients whose frozen tumor specimens were available using a methylation-specific PCR assay. Among the 30 patients, the toss of p16 protein expression was observed in 24 patients (80.0%). Twenty-one patients had homozygous deletions, and 9 patients retained the P16 gene. None of the patients with P16 homozygous deletions exhibited p16-positive expression, and 3 patients who retained the P16 gene did not exhibit p16-positive expression. Aberrant P16 methylation was present in two patients with an intact P16 gene but without p16 expression. These results suggest that either a homozygous deletion or methylation is responsible for P16 inactivation. Regarding the prognosis, patients with p16-negative expression had a significantly shorter survival. time than those with p16-positive expression (P=0.040). Our study showed that P16 inactivation by homozygous deletions or methylation is a frequent event in Japanese patients with MPMs, relating to poor prognosis. Homozygous deletion is the major cause of P16 inactivation, but methylation also lead to the inactivation of P16 when the P16 alleles are retained. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.lungcan.2008.02.013

Orbital exenteration after transarterial embolization in a patient with Wyburn-Mason syndrome: Pathological findings Reviewed

Toshihiko Matsuo, Hiroyuki Yanai, Kenji Sugiu, Susumu Tominaga, Yoshihiro Kimata

JAPANESE JOURNAL OF OPHTHALMOLOGY 52 ( 4 ) 308 - 313 2008.7

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

Background: We present the pathological findings at orbital exenteration in a patient with Wyburn-Mason syndrome who underwent transarterial embolization.
Case: A 31-year-old man with a 10-year history of gradual exacerbation of left exophthalmos and left cheek swelling was found to have facial and orbital arteriovenous malformations on the left side. There was no vascular malformation in the brain. The feeding arteries derived from the left internal maxillary artery, facial artery, and ophthalmic artery. He underwent several courses of transarterial embolization of the feeding arteries from the left internal maxillary artery and then from the facial artery, resulting in no reduction of the arteriovenous malformation. He finally elected to undergo ophthalmic artery embolization in the expectation of a reduction and with the understanding that he would lose sight in his left eye. Two years later, he requested lid-sparing orbital exenteration and reconstruction with cutaneous flap transfer and prosthesis for cosmetic reasons.
Observations: Pathologically, orbital vascular channels of varying sizes were filled with embolizing glue and had degenerating vascular wall cells surrounded by inflammatory cell infiltration. The central retinal artery in the optic nerve was also filled with the embolizing glue, and the retina lost the ganglion cell layer and inner nuclear layer but maintained the outer nuclear layer and outer segments.
Conclusions: Marked anastomoses and hence incomplete embolization among the feeding arteries of facial and orbital vascular malformations in Wyburn-Mason syndrome do not respond well to attempts at feeding vessel embolization, which result in unsuccessful closure of the malformation.

DOI： 10.1007/s10384-008-0563-5

Duodenal follicular lymphomas share common characteristics with mucosa-associated lymphoid tissue lymphomas Reviewed

Y. Sato, K. Ichimura, T. Tanaka, K. Takata, T. Morito, H. Sato, Y. Sato, E. Kondo, H. Yanai, N. Ohara, T. Oka, T. Yoshino

JOURNAL OF CLINICAL PATHOLOGY 61 ( 3 ) 377 - 381 2008.3

Language：English Publishing type：Research paper (scientific journal) Publisher：B M J PUBLISHING GROUP

Background: Follicular lymphomas occasionally arise in the extra-nodal organs and are frequently found in the duodenum. They are often localised tumours with multiple polyps around the ampulla of Vater.
Aims: To examine a IgH/bcl-2 hybrid gene and VH gene to investigate the nature of the lymphoma cells and how they differ from nodal follicular lymphomas and MALT lymphomas.
Methods: Of 40 patients reported previously, 35 with duodenal follicular lymphoma were studied in detail with respect to clinicopathological characteristics.
Results: 37/40 patients were in clinical stage I (n= 30) or stage II (n= 7). Clonal immunoglobulin gene rearrangement was detected in 53.3% of examined cases, and rearrangement of IgH/bcl-2 gene at the major break point was detected in 27% of cases. Three of 8 examined cases were VH4 (38%); 2 out of them were VH4-34. As VH4 deviation is one of the common characteristics of MALT lymphomas and 2/3 were identical, duodenal follicular lymphomas have a similar aetiology to MALT lymphomas. Clinical course was also similar to that of MALT lymphomas.
Conclusions: Results suggest that duodenal follicular lymphomas have intermediate characteristics of MALT lymphomas and nodal follicular lymphomas.

DOI： 10.1136/jcp.2007.049825

A rare tumor in the adrenal region: Neuron-specific enolase (NSE)-producing leiomyosarcoma in an elderly hypertensive patient Reviewed

Junko Goto, Fumio Otsuka, Ryo Kodera, Tomoko Miyoshi, Masaru Kinomura, Hiroyuki Otani, Yukari Mimura, Toshio Ogura, Hiroyuki Yanai, Yasutomo Nasu, Hirofumi Makino

ENDOCRINE JOURNAL 55 ( 1 ) 175 - 181 2008.2

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN ENDOCRINE SOC

A 73-year-old Japanese woman was referred for examination of right flank pain and progressive hypertension. Abdominal CT incidentally detected a right adrenal mass 8 cm in size. The tumor exhibited isodensity by CT and contained high-intense lesion by T2-weighted MRI. Scintigraphy with I-131-metaiodobenzylguanidine and I-131-adosterol showed no abnormal uptake by whole body scan. Positron emission tomography scan with F-18-2-fluoro-D-deoxyglucose demonstrated an exclusive uptake in the right adrenal mass. Adrenocortical hormone levels and catecholamine secretion were within normal range; however, the level of serum neuron-specific enolase (NSE) was found to be markedly high. After controlling systemic blood pressure with an alpha 1-blocker, the right adrenal tumor was surgically removed, along with the right kidney and inferior vena cava which adhered to it. The tumor was pathologically proven to be leiomyosarcoma, which was immunohistochemically positive with a-smooth muscle actin and negative with CD57, S-100 and c-kit proteins. Notably, NSE protein was massively expressed in the resected tumor. After surgery blood pressure was controlled with regular medication and serum NSE levels have since normalized. The possibility of leiomyosarcoma should be kept in mind in adrenal incidentalomas with rapid growth and atypical radiological images. Our findings suggest that circulating NSE levels may be clinically useful for early detection of recurrence.

DOI： 10.1507/endocrj.K07E-020

A novel variant apolipoprotein E Okayama in a patient with lipoprotein glomerulopathy Reviewed

Masaru Kinomura, Hitoshi Sugiyama, Takao Saito, Akira Matsunaga, Ken-ei Sada, Motoko Kanzaki, Yuki Takazawa, Yohei Maeshima, Hiroyuki Yanai, Hirofumi Makino

NEPHROLOGY DIALYSIS TRANSPLANTATION 23 ( 2 ) 751 - 756 2008.2

悪性転化を示したnuclear palisadingを伴う隆起性皮膚線維肉腫の1例 Reviewed

大森昌子, 柳井広之, 荻野哲也, 松川昭博, 吉野正

診断病理 25 ( 2 ) 72 - 76 2008

Language：Japanese Publisher：(一社)日本病理学会

症例は59歳女性。左膝窩部の皮膚から皮下組織におよぶ8×6cm大の腫瘍が存在し、腫瘍切除術が施行された。組織学的には、通常型の隆起性皮膚線維肉腫(dermatofibrosarcoma protuberans;DFSP)の領域から移行して明瞭なnuclear palisadingを示す部分が散在性に認められた。いずれの領域もCD34はびまん性に強陽性を示した。また線維肉腫に相当する高悪性度肉腫の領域が存在し、その部分ではCD34が減弱〜陰性化していた。Nuclear palisadingを示すDFSPから発生した稀なfibrosarcomaの1例を報告する。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J03623&link_issn=&doc_id=20080515230004&doc_link_id=%2Fcd9jjodp%2F2008%2F002502%2F004%2F0072-0076%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcd9jjodp%2F2008%2F002502%2F004%2F0072-0076%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

唾液腺導管癌の組織型を呈した耳下腺多形腺腫由来癌の1手術例

松浦博夫, 高田晋一, 江草憲太郎, 南波由紀, 柳井広之

広島市立広島市民病院医誌 24 4 - 7 2008

Risk factors for recurrence and unfavorable prognosis in patients with stage I non-small cell lung cancer and a tumor diameter of 20 mm or less Reviewed

Naruyuki Kobayashi, Shinichi Toyooka, Junichi Soh, Kouichi Ichimura, Hiroyuki Yanai, Hiroshi Suehisa, Shuji Ichihara, Masaomi Yamane, Motoi Aoe, Yoshifumi Sano, Hiroshi Date

JOURNAL OF THORACIC ONCOLOGY 2 ( 9 ) 808 - 812 2007.9

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

Background: The purpose of this study was to identify risk factors for disease recurrence and unfavorable prognosis after surgical resection for stage I non-small cell lung cancer in patients with tumor diameters of <= 20 mm.
Methods: One hundred sixty-three patients who had pathologic stage I non-small cell lung cancer with tumor diameters <= 20 mm and who had undergone a lobectomy with mediastinal lymph node dissection were retrospectively reviewed. The relationships between clinicopathologic factors and clinical outcomes, including recurrence and survival, were then examined. The clinicopathologic factors examined in this study were age, sex, smoking status, preoperative serum carcinoembryonic antigen level, pathologic tumor size, histologic subtype, histologic grade, and visceral pleural invasion.
Results: Among the clinicopathologic factors that were examined, the histologic grade of the carcinoma status was significantly related to a high risk of recurrence when analyzed using univariate (p = 0.01) and multivariate analyses (p = 0.049). Regarding survival, patients with poorly differentiated carcinomas showed a significantly unfavorable overall survival (p < 0.001), disease-specific survival (p = 0.003), and disease-free survival (p = 0.002) compared with patients with well-/moderately differentiated carcinomas according to univariate analyses. A Cox proportional hazards model indicated that a poorly differentiated carcinoma status was the only independent factor for an unfavorable overall survival (p = 0.02), disease-specific survival (p = 0.046), and disease-free survival (P = 0.04).
Conclusions: Poor differentiation of tumor was the only risk factor for recurrence and an unfavorable prognosis for stage I non-small cell lung cancer patients with tumor diameters of <= 20 mm.

DOI： 10.1097/JTO.0b013e31814617c7

Intraductal tubular adenoma, pyloric gland-type, of the pancreas Reviewed

H. Fukatsu, H. Kawamoto, K. Tsutsumi, H. Kato, K. Hirao, N. Kurihara, T. Ogawa, E. Ishida, Y. Okamoto, H. Okada, K. Sakaguchi, H. Yanai

ENDOSCOPY 39 ( Suppl 1 ) E88 - E89 2007.2

小児のトルコ鞍部に発生した肉芽腫性病変の一例.

神原啓和, 市川智継, 茶山公祐, 宮村能子, 大森昌子, 柳井広之, 伊達勲

瀬戸内脳神経外科懇話会会誌 15 20 - 24 2007

非定型奇形腫様／ラブドイド腫瘍 atypical teratoid/rhabdoid tumor (AT/RT)の１例. Reviewed

大森昌子, 柳井広之, 荻野哲也, 井上智, 市川智継, 松川昭博, 吉野正

診断病理 24 ( 1 ) 115 - 120 2007

Language：Japanese Publisher：(一社)日本病理学会

非定型奇形腫様/ラブドイド腫瘍(atypical teratoid/rhabdoid tumor(AT/RT))はrhabdoid cellの出現を特徴とした中枢神経に発生する胎児性腫瘍で予後はきわめて不良である。症例は生後6ヵ月、女児。頭囲の拡大、発達遅延を認め、近医にて水頭症を指摘された。腫瘍は松果体部、中脳被蓋部、第四脳室にかけて存在し、脊髄に播種性病変が存在した。組織学的に腫瘍はprimitive neuroectodermal tumor(PNET)様の小型未熟細胞の充実性増殖が主体をなし、小範囲にrhabdoid cellや索状配列を示す領域が存在した。AT/RTと診断し、腫瘍摘出後化学療法が施行されたが、5ヵ月後水頭症が悪化し死亡した。(著者抄録)

救命しえた劇症型好酸球性心筋炎の１例.

大郷恵子, 圓光賢希, 草野研吾, 桜木悟, 永瀬聡, 中村一文, 柳井広之, 大森昌子, 大家政志, 難波靖治, 津田佳穂, 大江透

心臓 39 ( Suppl.3 ) 112 - 117 2007

Language：Japanese Publisher：(公財)日本心臓財団

症例は19歳、男性。主訴は胸苦・胸痛。2006年4月29日午前2時ころ、胸苦・胸痛のため近医を受診、心電図上広範囲のST-T変化を認め急性心膜炎の疑いで入院となった。30日午前4時ころより血圧低下がみられたためdopamine点滴を開始され当科転院となった。転院時、血圧80mmHg、脈拍130/分で、奇脈、III音、頸静脈怒張を認めた。心エコーでの左室壁厚増大とびまん性の高度壁運動低下(左室駆出率23.8%)、多量の心嚢液貯留、CPKの上昇などから劇症型心筋炎による心原性ショックと診断した。機械的循環補助を行った上で、心臓カテーテル検査により冠動脈疾患を否定し、右室心内膜心筋生検を施行した。5月2日好酸球性心筋炎との組織診断によりステロイド投与を開始した。そのころより心機能の急速な回復がみられ、補助循環が離脱可能となった(離脱時に脳出血を合併)。その後ステロイドを漸減中止したが好酸球性心筋炎の再発やLoeffler心内膜炎への移行は認めていない。原因検索の結果、イヌ回虫に対する抗体が陽性であり、寄生虫感染に関連した好酸球性心筋炎と考えられた。今回著者等は劇症型心筋炎がイヌ回虫感染に伴う好酸球性心筋炎によるという稀な1例を経験し、ステロイド投与と機械的循環補助により救命しえたので報告する。(著者抄録)

DOI： 10.11281/shinzo1969.39.Supplement3_112

Other Link： https://search.jamas.or.jp/default/link?pub_year=2007&ichushi_jid=J00679&link_issn=&doc_id=20070820320022&doc_link_id=10.11281%2Fshinzo1969.39.Supplement3_112&url=https%3A%2F%2Fdoi.org%2F10.11281%2Fshinzo1969.39.Supplement3_112&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

TUR-BT前後におけるFollow up尿細胞診の意義について.

佐藤正和, 平本直美, 有安早苗, 山鳥一郎, 柳井広之, 吉野正

日本臨床細胞学会岡山支部会誌 26 29 - 31 2007

当院におけるテレパソロジーの現状.

森谷恭子, 藤村紀行, 羽原利幸, 櫛田あけみ, 園部宏, 柳井広之, 大森昌子

広島県臨床検査技師会誌 100 31 - 33 2007

高血圧の精査にて発見されたNSE産生性副腎平滑筋肉腫の一例.

後藤順子, 大塚文男, 小寺亮, 稲垣兼一, 三好智子, 大谷寛之, 鈴木二郎, 三村由香里, 小倉俊郎, 那須保友, 柳井広之, 槇野博史

日本内分泌学会雑誌 83 242 - 245 2007

化学療法が無効であったが、MPA療法が有効であった子宮体癌IVb期の一例.

清水美幸, 関典子, 児玉順一, 舛本明生, 松尾環, 中村圭一郎, 本郷淳司, 平松祐司, 柳井広之

日本産科婦人科学会中国四国合同地方部会雑誌 55 ( 3 ) 99 - 103 2007

Radiofrequency ablation of normal lungs after pulmonary artery embolization with use of degradable starch microspheres: Results in a porcine model Reviewed

Takao Hiraki, Hideo Gobara, Jun Sakurai, Hidefumi Mimura, Takashi Mukai, Soichiro Hase, Toshihiro Iguchi, Hiroyasu Fujiwara, Nobuhisa Tajiri, Hiroyuki Yanai, Tadashi Yoshino, Susumu Kanazawa

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 17 ( 12 ) 1991 - 1998 2006.12

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

PURPOSE: The present study was performed to evaluate the effect of pulmonary artery embolization on radiofrequency (RF) ablation of normal porcine lungs.
MATERIALS AND METHODS: RF ablation zones (n = 34) were created in the normal lungs of five domestic pigs (five zones in each of the first two pigs and eight zones in each of the remaining three pigs) with an expandable multitined electrode with use of bilateral thoracotomy. RF ablation was performed without pulmonary artery embolization (group 1, n = 8), immediately after embolization (group 2, n = 11),15 minutes after embolization (group 3, n = 7), and 30 minutes after embolization (group 4, n = 8) with degradable starch microspheres. Among them, 12 ablation zones were excluded from this study because they were considerably limited by the presence of the pleura or large bronchi. The remaining 22 zones were included (n = 7, n = 5, n = 4, and n = 6 in groups 1, 2, 3, and 4, respectively). Coagulation necrosis volumes in the ablation zones were measured and compared among the groups.
RESULTS: Coagulation necrosis volumes were 0.9 +/- 0.5 cm(3), 2.1 +/- 0.4 cm(3), 2.1 +/- 1.0 cm(3), and 1.9 +/- 0.6 cm(3) in groups 1, 2, 3, and 4, respectively. Groups 2-4 showed significantly larger coagulation volumes than group 1 (P = .012, P = .023, and P = .010 in groups 2, 3, and 4, respectively).
CONCLUSION: Pulmonary artery embolization contributed to larger volumes of coagulation necrosis after RF ablation of normal lungs.

DOI： 10.1097/01.RVI.0000251152.12254.AC

Follicular lymphoma frequently originates in the salivary gland. Reviewed International journal

Satoko Nakamura, Koichi Ichimura, Yumiko Sato, Shigeo Nakamura, Hirokazu Nakamine, Hiroshi Inagaki, Yoshito Sadahira, Koichi Ohshima, Sumie Sakugawa, Eisaku Kondo, Hiroyuki Yanai, Nobuya Ohara, Tadashi Yoshino

Pathology international 56 ( 10 ) 576 - 83 2006.10

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

The aim of the present study was to examine the clinicopathological presentations of follicular lymphomas (FL) of the salivary glands, as compared to mucosa-associated lymphoid tissue (MALT) lymphomas. A total of 27 primary salivary gland lymphomas were examined: 6 FL (five, grade 1; one, grade 2); 19 MALT lymphomas; and two diffuse large B-cell lymphomas. The FL patients ranged in age from 24 to 73 years, with a mean of 49 years, which was younger than that of MALT patients (mean: 64 years; P < 0.05). Four of the six FL arose from the submandibular gland, which was the origin of only five out of a total of 19 MALT lymphomas. One FL patient was in clinical stage (CS) IE, two in CS IIE, and two in CS III and IV. As regards the MALT lymphoma patients, 13 (68%) were in CS IE and five (26%) in CS IIE. None of the FL patients had clinical diagnosis of autoimmune disease but eight MALT lymphoma patients had autoimmune disease. The present study found a relatively high incidence of FL in the salivary glands. The observed differences in age of onset, background of autoimmune disease, and lesion site suggests that the pathogenesis of FL may differ from that of MALT lymphoma.

DOI： 10.1111/j.1440-1827.2006.02011.x

Calcifying fibrous tumor arising from the heart Reviewed

Hisayuki Shigematsu, Yoshifumi Sano, Shingo Kasahara, Hiroyuki Yanai, Hiroshi Date

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 132 ( 3 ) 2006.9

Accurate diagnosis of musculoskeletal lesions by core needle biopsy Reviewed

G Mitsuyoshi, N Naito, A Kawai, T Kunisada, A Yoshida, H Yanai, S Dendo, T Yoshino, S Kanazawa, T Ozaki

JOURNAL OF SURGICAL ONCOLOGY 94 ( 1 ) 21 - 27 2006.7

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

Background: Percutaneous needle biopsy has many advantages over open biopsy in the treatment of neoplasms. However, the accuracy of needle biopsy in the diagnosis of musculoskeletal lesions has not yet been established. Here, we evaluate the accuracy and limitations of the procedure for musculloskeletal lesions.
Methods: The diagnoses of 163 needle biopsies (bone, 91; soft tissue, 72) performed on 157 consecutive patients using a Jamshidi needle or an Ostycut needle for bone lesions, or a Tru-cut needle for soft tissue lesions were compared with the final diagnoses made by open biopsy and/or a definitive operation.
Results: One hundred forty-three specimens (88%) were determined to be adequate for histological examination. Obtaining undamaged cores from very hard bony lesions or sclerotic cyst walls proved difficult. A pathologist with experience in musculoskeletal lesions was able to differentiate malignant tumors from benign lesions in 97% of the cases (bone, 100%; soft tissue, 94%) and arrive at a specific diagnosis in 88% (bone, 96%; soft tissue, 78%) when adequate cores were obtained. Differentiating a well-differentiated liposarcoma from a benign lipoma and inflammatory lesions from benign tumorous conditions, was difficult. The overall accuracy was 77% (bone, 85%; soft tissue, 68%). There was no morbidity related to the procedure.
Conclusion: The results indicate that needle biopsy is safe and accurate for diagnosing musculoskeletal lesions.

DOI： 10.1002/jso.20504

Mutations of epidermal growth factor receptor and K-ras genes in adenosquamous carcinoma of the lung Reviewed

S Toyooka, Y Yatabe, M Tokumol, K Ichimura, H Asano, K Tomii, H Yanai, H Date, T Mitsudomi, N Shimizu

INTERNATIONAL JOURNAL OF CANCER 118 ( 6 ) 1588 - 1590 2006.3

p53 protein transduction therapy: Successful targeting and inhibition of the growth of the bladder cancer cells Reviewed

Miyabi Inoue, Kazuhito Tomizawa, Masayuki Matsushita, Yun-Fei Lu, Teruhiko Yokoyama, Hiroyuki Yanai, Atsushi Takashima, Hiromi Kumon, Hideki Matsui

European Urology 49 ( 1 ) 161 - 168 2006.1

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

Introduction: Virus-mediated gene therapy for bladder cancer has some problems, such as efficiency of gene delivery and safety issues. We have reported that poly-arginine peptide (11R) has the ability to increase protein transduction in cells. Here, we show that p53 protein transduction using 11R is useful for targeting to bladder tumors and suppressing the growth of bladder cancer cells. Materials and methods: An 11R-fused p53 protein (11R-p53) was transduced in bladder cancer cell lines (J82 and T24) to evaluate the anti-tumor effect. Cell viability was assessed by performing the 4-[3-(4-iodophenyl)-2-(4- nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate (WST) assay. To investigate whether 11R-p53 enhanced the effect on anti-cancer drug-dependent apoptosis of bladder cancer cells, the cell lines were cotreated with 11R-p53 and cis-diaminedichloroplatinum (CDDP). Apoptotic cells were identified using Hoechst staining. To investigate the efficiency of protein transduction mediated by 11R in bladder tumors in vivo, SCID mice were transplanted with J82 cells in the bladder and 11R-GFP was transurethrally transduced into the bladder. The transduction of 11R-GFP in the tumor was examined by confocal microscopy. Results: 11R-p53 inhibited the growth of both J82 and T24 cells in a dose-dependent manner. The transduction of 11R-p53 enhanced CDDP-dependent induction of apoptosis. Transurethral application of 11R-GFP resulted in transduction of GFP in bladder tumors but not in the normal bladder epithelium or subepithelial tissues. Conclusion: The present results suggest that p53 protein transduction therapy may be a promising method for the treatment of bladder cancer. © 2005 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.eururo.2005.08.019

乳癌術前化学療法の効果判定における画像診断われわれが経験した病理判定と画像診断の不一致症例について

松岡順治, 田渕陽子, 伊藤充矢, 小野亮子, 今田孝子, 元木崇之, 松川啓義, 大森昌子, 柳井広之, 猶本良夫, 田中紀章

岡山医学会雑誌 2006

Expression of phosphorylated Ser70 of Bcl-2 correlates with malignancy in human colorectal neoplasms. Reviewed International journal

Eisaku Kondo, Takayoshi Miyake, Masao Shibata, Toshikazu Kimura, Hiromi Iwagaki, Shin-Ichi Nakamura, Takehiro Tanaka, Nobuya Ohara, Koichi Ichimura, Takashi Oka, Hiroyuki Yanai, Futoshi Shibasaki, Tadashi Yoshino

Clinical cancer research : an official journal of the American Association for Cancer Research 11 ( 20 ) 7255 - 63 2005.10

Language：English

PURPOSE: Bcl-2 is a model apoptosis suppressor postulated to promote tumorigenesis. Recently, it has been reported that Bcl-2 undergoes phosphoregulation of its Ser70 to substantially alter its molecular function. Previous studies further suggest that such phospho-Bcl-2 regulation may influence tumor progression in colorectal and other cancers; however, phosphorylation status of the Ser70 of Bcl-2 (pSer70) in vivo in tumors remains obscure. To elucidate this question that may suggest the biological role, we molecularly screened a panel of human colorectal adenomas and adenocarcinomas for endogenous expression of pSer70 Bcl-2. EXPERIMENTAL DESIGN: An antibody specific against pSer70 Bcl-2 was generated for thorough immunohistochemical examination of paraffin-embedded tumor specimens, allowing detection of the endogenously expressed antigen among a range of Bcl-2-positive colorectal neoplasms, including 75 tubular adenomas, 114 adenocarcinomas, and 15 cases of cancer in adenomas. RESULTS: Loss of pSer70 Bcl-2 expression was observed in adenocarcinomas in a differentiation-dependent manner (positivities: well differentiated 63%, moderately differentiated 52%, and poorly differentiated 12%), whereas tubular adenomas maintained their expression (positivity 88%). Interestingly, an inverse correlation was found between expression of pSer70 Bcl-2 and Ki-67 antigen in those cases of cancer in adenoma (P < 0.01). It was further observed that loss of pSer70 Bcl-2 expression was associated with significantly shorter survival (P < 0.05) and correlated with clinical stages and lymph node metastasis (P < 0.05 and P < 0.05, respectively). CONCLUSIONS: Loss of pSer70 Bcl-2 expression is closely linked to biological aggressiveness in colorectal tumors and represents a statistically significant molecular index for prognosis of patients with these tumors.

DOI： 10.1158/1078-0432.CCR-05-0274

A case of monoclonal immunoglobulin light- and heavy-chain deposition disease exhibiting atypical deposition with fibrillary structures, successfully treated with chemotherapy Reviewed

A Nakatsuka, Y Maeshima, A Sarai, H Yanai, H Sugiyama, Y Yamasaki, H Makino

CLINICAL NEPHROLOGY 64 ( 3 ) 221 - 227 2005.9

Language：English Publishing type：Research paper (scientific journal) Publisher：DUSTRI-VERLAG DR KARL FEISTLE

We report a case of light and heavy chain deposition disease (LHCDD), a rather rare monoclonal immunoglobulin deposition disease (MIDD) with successful therapeutic effect. A 58-year-old woman suffered from proteinuria and renal insufficiency (serum creatinine 1.0 mg/dl, creatinine clearance 49.2 ml/min) in February 2003. In serum and urine samples, monoclonal IgG-kappa was detected. A bone marrow aspiration showed a slightly hypocellular marrow and plasma cell population was increased to 7.0%. Renal histological findings revealed lobulated glomeruli with nodular lesions on light microscopy, characteristic findings of MIDD. Intense deposition of IgG heavy chains in the linear pattern in the glomerular and tubular basement membranes was observed. Immunohistochemistry revealed both kappa and lambda light chain depositions in glomeruli. Electron-microscopic examination revealed fine granular electron-dense deposits accompanied by microfibrils. Based on these findings, this patient was diagnosed as LHCDD. She received three courses of melphalan and prednisone chemotherapy, resulting in disappearance of proteinuria, prevention of renal functional deterioration and the decrease of monoclonal immunoglobulin. This case clearly demonstrates that the earlier and accurate diagnosis and initiation of chemotherapy at the early stage with serum creatinine level below 4.0 mg/dl are necessary to improve renal and patient outcome.

多発性の後腹膜神経節細胞腫(ganglioneuroma)の１例.

平木隆夫, 三村秀文, 柳井広之, 郷原英夫, 向井敬, 長谷聡一郎, 藤原寛康, 金澤右

臨床放射線 50 ( 3 ) 425 - 429 2005

Language：Japanese Publisher：金原出版(株)

31歳男.右側腹部痛を契機に腹部CTにて右後腹膜腫瘍を認めた.腫瘍マーカーに異常を認めず,副腎皮質ホルモン関連検査にも異常はなく,カテコラミン関連検査にも異常を認めなかった.CT所見では右腎臓と肝の間に12×8×12cmの境界明瞭,辺縁整で一部が分葉状の腫瘍を認め,周囲への浸潤傾向は認められなかった.MRIではT1強調像では内部均一,T2強調像では内部不均一な被膜様構造を持つ腫瘍像を呈し,血管造影所見では乏血管性で腫瘍血管の明らかな不整像は認めなかった.ガリウムシンチでは腫瘍への集積像は認められなかった.手術により2つの腫瘍が接して生じていたことが確認され,病理組織学的に神経節細胞腫と診断された

充実部分を伴う子宮広間膜腫瘍（いわゆる傍卵巣腫瘍）の二例.

関典子, 児玉順一, 中村洋二郎, 中村圭一郎, 本郷淳司, 水谷靖司, 平松祐司, 柳井広之

日本産科婦人科学会中国四国合同地方部会雑誌 53 264 - 269 2005

大腸癌1,026例の臨床病理学的検討

小野田正, 小林直広, 大野聡, 元木崇之, 原野雅生, 佐々木, 寛, 青木秀樹, 塩崎滋弘, 桧垣健二, 池田俊行, 二宮基樹, 高倉範尚, 柳井広之, 松浦博夫

広島医学 2003

Sentinel Node Biopsy(SNB)に基づいた腋窩非郭清手術の現状と問題点

桧垣健二, 黒田, 新士, 窪田, 康浩, 原野, 雅生, 佐々木, 寛, 二宮, 基樹, 高倉, 範尚, 影本正之, 柳井, 広之, 松浦, 博夫

乳癌の臨床 18 ( 6 ) 515 - 522 2003

Language：Japanese Publisher：(株)篠原出版新社

Sentinel Node Biopsy(SNB)に基づいた腋窩非郭清手術の現状と問題点を検討した.対象は,腫瘍径が3cm以下の臨床的に腋窩リンパ節がないと判断された乳癌195例であった.術中の迅速病理検査の転移陰性は149例で,腋窩の非郭清手術が施行され,術後のもどしHE染色検査で8例(4.1%)が転移陽性と修正された.最終的に141例(72.3%)が腋窩郭清を省略し,46例(23.6%)にレベル2の腋窩郭清が施行された.腋窩非郭清手術後に腋窩リンパ節の再発は認めず,遠隔転移を149例中1例(0.7%)に認め,乳房温存手術後の温存乳房再発は133例中1例(0.8%)で腋窩再手術が行われたが,摘出リンパ節に転移は認めなかった.偽陰性症例8例は放射線照射が選択された.術後の経過観察期間は3.5〜39.0ヵ月(平均19.0ヵ月)で全例健在である.SNBに基づいた非郭清手術の実施では偽陽性症例の減少させることが必要と考えられた

タモキシフェン投与中の女性に生じた子宮内膜ポリープ内carcinosarcoma.

柳井, 広之, 松浦, 博夫

岡山外科病理雑誌 2003

急性壊死性好酸球性心筋炎の一剖検例

柳井広之, 松浦博夫, 白神邦浩

病理と臨床 2002

Ovarian stromal tumor with minor sex cord elementsの１例

柳井広之, 松浦博夫

岡山外科病理雑誌 2002

卵巣外発生と考えられた莢膜細胞腫の１例

柳井広之

日本婦人科腫瘍学会雑誌 2002

根治性、機能性、整容性を兼ね備えた乳房温存術式

桧垣健二, 鵜垣伸也, 小野田正, 高倉範尚, 樋口富美, 影本正之, 柳井広之, 松浦博夫

乳癌の臨床 2002

進行・再発乳癌に対するHerceptinの使用経験

桧垣健二, 畝大, 藤原康弘, 鵜垣伸也, 原野雅生, 佐々木寛, 小野田正, 塩崎滋弘, 高倉範尚, 柳井広之, 松浦博夫

広島医学 2002

内視鏡的切除後に外科的追加切除を施行した早期大腸癌症例の検討

中川昌浩, 横田恭子, 岡本賢三, 仁科慎一, 久松倫子, 岡本裕子, 石井泰史, 有吉正憲, 河本博文, 長島不二夫, 杉原徹, 井上純一, 柴田醇, 柳井広之, 松浦博夫

社会保険広島市民病院医誌 17 ( 1 ) 106-113 2001.3

放射線治療が奏効し長期生存した噴門部進行胃癌の１例

谷為乃扶子, 影本正之, 樋口富美, 本山由紀子, 松浦明子, 太田辰, 浦島正喜, 柳井広之, 松浦博夫, 二宮基樹

広島医学 2001

Sentinel Node Biopsyによる腋窩非郭清手術の適応拡大

桧垣健二, 松川啓義, 今田孝子, 小野田正, 塩崎滋弘, 高倉範尚, 樋口富美, 影本正之, 柳井広之, 松浦博夫

乳癌の臨床 2001

MorbidityとQOLからみた乳癌に対する直視下腋窩郭清と内視鏡下腋窩郭清の比較検討

桧垣健二, 小野田正, 松川啓義, 徳永尚之, 清水秀二, 滝正樹, 高倉範尚, 影本正之, 柳井広之, 松浦博夫

乳癌の臨床 16 ( 1 ) 74 - 82 2001

乳癌に対する乳房温存手術の適応拡大を目指して

桧垣健二, 柳井広之, 松浦博夫

広島医学 2001

A case of intra-abdominal desmoplastic small round cell tumor

YANAI Hiroyuki, MATSUMOTO Manabu, FURUTANI Masumi

The Journal of the Japanese Society of Clinical Cytology 39 ( 4 ) 254 - 257 2000.7

S1667 小腸間膜病変（化骨性腸間膜炎）

松浦博夫, 柳井広之, 小林直広

病院病理 2000

乳癌に対する腋窩非郭清手術の術後成績

桧垣健二, 岡村進介, 森多克行, 吉鷹知也, 大崎悟, 小野田正, 塩崎滋弘, 影本正之, 柳井広之, 松浦博夫

乳癌の臨床 2000

空腸原発内分泌細胞癌の１例

竹中龍太, 友田純, 槙殿知穂, 村上敬子, 近藤淳一, 吉岡敏文, 坂田達朗, 廣田滋, 大川尚臣, 淵本定儀, 柳井広之

Gastroenterol Endosc 2000

Two Cases of Intracranial Metastatic Malignant Melanoma.

YAMASHITA Shiro, MORIYAMA Eiji, BECK Hiroichi, IWADO Eiji, YANAI Hiroyuki

Japanese Journal of National Medical Services 54 ( 8 ) 365 - 369 2000

Language：Japanese Publisher：Japanese Society of National Medical Services

Two cases of intracranial metastatic malignant melanoma are reported. Both patients were males of sixties with known primary skin malignant melanomas. Magnetic resonance imagings showed intracranial lesions, which were high intense in T1 WI, low intense in T2 WI and enhanced after Gd-DTPA adminisration. These findings were characteristic for intracranial malignat melanomas.<br>Treatment design consisted of intra-arterial chemotherapy with CDDP and ACNU, follwed by surgical resection and/or radiosurgery. In the first case, intratumoral hemorrhage occurred 40 hours after the intra-arterial chemotherapy and emergent craniotomy, instead of radiosurgery, was performed. The second patient underwent tumor removal on the following day after the chemotherapy. Both patients died of systemic metastases 2 and 3 months after the treatment, respectively.<br>Malignant melanomas are prone to metastasize to any organs including brain. Patients with malignant melanoma usually have short life expectancy, so the aim of treatment is focused on the maintenance of the QOL as long as possible. So, vigorous treatment should be carried out whenever necessary. Finally, spontaneous hemorrhage into intracranial malignant melanoma have been frequently observed. As shown in our case 1, treatment modalities might enhanced the risk of intratumoral hemorrhage. Care should be taken to avoid this serious complication

DOI： 10.11261/iryo1946.54.365

劇症型Ｇ群溶連菌感染症の１例

松浦博夫, 柳井広之, 藤井誠志

診断病理 2000

Cyno-EBV (EBV-related herpesvirus from cynomolgus macaques) induces rabbit malignant lymphomas and their tumor cell lines frequently show specific chromosomal abnormalities Reviewed

K Hayashi, HL Chen, H Yanai, TR Koirala, N Ohara, N Teramoto, T Oka, T Yoshino, K Takahashi, K Miyamoto, K Fujimoto, Y Yoshikawa, T Akagi

LABORATORY INVESTIGATION 79 ( 7 ) 823 - 835 1999.7

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

Malignant lymphoma (ML) induction in rabbits by Epstein-Barr virus (EBV)-related herpesvirus of cynomolgus (Cyno-EBV) is reported. Twenty-seven of 30 (90%) rabbits inoculated intravenously with Cyno-EBV-producing simian (cynomolgus) lymphocyte cell line (Ts-B6) cells developed ML between 45 and 115 days after inoculation. The peroral inoculation of Ts-B6 cells induced ML in only 2 of 10 (20%) rabbits (75 to 85 days). Five of 6 (83%) rabbits injected with cell-free pellets from Ts-B6 cultures also developed ML (27 to 122 days). Antibody response to the viral capsid antigen of EBV was also detected in sera from rabbits inoculated with Ts-B6. ML of the large cell or mixed type infiltrated diffusely in many organs, frequently involving the spleen, liver, kidneys, heart, and less frequently the lungs, lymph nodes, brain, eyes, gastrointestinal tract, thymus, and bone marrow. A chromosomal analysis of five lymphoma cell lines established from tumor-bearing rabbits revealed the rabbit karyotype. Three of these cell lines showed the chromosomal abnormalities with 12q- or t (7p+:12q-). EBV-encoded small RNA-1 and EBV-associated nuclear antigen 1 were expressed in Ts-B6 cells, the tumor tissues, and all rabbit cell lines by in situ hybridization and by immunofluorescence tests, respectively. EBV DNA was also detected in Ts-B6 cells and rabbit lymphoma cell lines by polymerase chain reaction and Southern blot analysis. The Southern blots of EBV termini revealed oligoclonal bands in the Cyno-EBV-induced rabbit lymphomas. No lymphoma was induced by the inoculation of B95-8 (EBV-producing cells) or peripheral leukocytes from normal cynomolgus (controls). These data suggest that the high rate of lymphoma induction in rabbits may be caused not by human EBV (B95-8) but by Cyno-EBV from Ts-B6 cells. A sequence analysis of the IR1 (BamHIW) region of Cyno-EBV revealed that this region is quite similar to that of herpesvirus Macaca fascicularis 1,which is a causative agent for a monkey model of AIDS-retated lymphomas. The present rabbit model of lymphoma with specific chromosomal abnormalities is very useful to clarify the role of EBV in human EBV-associated lymphoma and provides a means for studying prophylactic and therapeutic regimens.

Lymphoepithelioma-like carcinoma of the uterine crervix-Case Report-

HAYASE Ryoji, YAMAMOTO Masahiko, YANAI Hiroyuki

17 ( 1 ) 78 - 81 1999.6

CD95 ligand is expressed in Reed-Sternberg cells of Hodgkin's disease Reviewed

Sakuma, I, T Yoshino, K Omonishi, R Nishiuchi, N Teramoto, H Yanai, K Kawahara, Kubonishi, I, Y Matsuo, T Akagi

PATHOLOGY INTERNATIONAL 49 ( 2 ) 103 - 109 1999.2

Language：English Publishing type：Research paper (scientific journal) Publisher：BLACKWELL SCIENCE ASIA

Reed-Sternberg (RS) cells and their mononuclear variants, Hodgkin's (H) cells, are considered to be the neoplastic cells of Hodgkin's disease (HD). The cellular origin of H-RS cells remains the subject of considerable controversy, although most recent papers have claimed that H-RS cells are of B cell origin, Recently, however, it has been reported that some H-RS cells express granzyme B, as observed in cytotoxic T cells and/or natural killer cells, which also express CD95 ligand (FasL/APO-1L). In the present study, the expression of CD95L and granzyme B in H-RS cells of HD was investigated, CD95L was detected in H-RS cells in five of nine HD cases (one case of lymphocyte-rich classical HD, two of these cases of nodular sclerosis type, and two of four cases of mixed cellularity type), All three examined HD cell lines expressed CD95L in the cytoplasm, although cell surface expression was seen only in L428 cells, Three HD cases expressed both CD95L and granzyme B. It was concluded that CD95L is frequently expressed in H-RS cells, which is one of their notable characteristics; albeit it seems to be irrespective of cell lineage.

DOI： 10.1046/j.1440-1827.1999.00830.x

99mTc-GSA肝シンチの核医学指標と肝線維化との関連についての検討

河野良寛, 安藤由智, 生口俊浩, 中川富夫, 柳井広之, 平木祥夫

日本医学放射線学会雑誌 59 ( 2 ) S245 - S245 1999.2

Heterogeneity of dendritic cells in human superficial lymph node: In vitro maturation of immature dendritic cells into mature or activated interdigitating reticulum cells Reviewed

Kiyoshi Takahashi, Kenji Asagoe, Jin Zaishun, Hiroyuki Yanai, Tadashi Yoshino, Kazuhiko Hayashi, Tadaatsu Akagi

American Journal of Pathology 153 ( 3 ) 745 - 755 1998

Language：English Publishing type：Research paper (scientific journal) Publisher：American Society for Investigative Pathology Inc.

A two-color immunofluorescent analysis indicated that dendritic cells (DCs) in the human axillar lymph nodes (ie, lymph nodal DCs (LnDCs)) can be classified into three subsets. The first subset consists of CD1a+/CD86(- or dim)/CD83(- or dim) nondendriform DCs found mainly in lymph sinuses, the second is of CD1a-/CD86+/CD83+ dendriform DCs scattered in normal T zones, and the third is of large CD1a(bright)/CD86+/CD83+ dendriform DCs occasionally found in hyperplastic T zones. A three-color flow cytometric analysis, immunoperoxidase staining, and electron microscopic observation indicated that the majority of LnDCs corresponded to the first subset, which showed distinctive characteristics of DCs but did not fulfill the ultrastructural criteria for interdigitating reticulum cells (IDCs) and did not contain Birbeck granules. When LnDCs were cultured for 7 days, they became large CD1a(dim)/CD86+/CD83+ dendriform cells, which formed large complexes with many T cells and exhibited distinctive ultrastructural features of interdigitating reticulum cells, LnDCs cultured in the presence of granulocyte/macrophage colony-stimulating factor became markedly larger CD1a(bright)/CD86+/CD83+ dendriform cells forming large complexes with numerous T cells. These findings suggest that cells of the first subset represent immature LnDCs just migrating from epidermis, those of the second subset represent interdigitating reticulum cells, and those of the third subset represent interdigitating reticulum cells probably stimulated with certain immunostimulatory cytokines such as granulocyte/macrophage colony- stimulating factor. It is also suggested that either the second or the third subsets of LnDCs are derived from the first subset.

DOI： 10.1016/S0002-9440(10)65618-0

Analysis of the Genome of an Epstein-Barr-Virus (EBV)-Related Herpesvirus in a Cynomolgus Monkey Cell Line (Si-IIA) Reviewed

Hideo Ino, Kazuhiko Hayashi, Hiroyuki Yanai, Norihiro Teramoto, Tirtha Raj Koirala, Hong-Li Chen, Takashi Oka, Tadashi Yoshino, Kiyoshi Takahashi, Tadaatsu Akagi

Acta Medica Okayama 51 ( 4 ) 207 - 212 1997.8

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

A simian cell line, Si-IIA, harboring Epstein-Barr-virus (EBV) -related herpesvirus (Si-IIA-EBV), produces malignant lymphoma in rabbits when administered by intravenous inoculation. In this study, we analyzed the Si-IIA-EBV genome and compared it with human EBV and herpesvirus macaca fascicularis 1 (HVMF 1 ), which is associated with B-cell lymphoma developing in SIV-infected immunosuppressed monkeys. DNA from Si-IIA-EBV was amplified by the polymerase chain reaction using three different primer pairs complementary to human EBV (B95-8) DNA
two of the primer pairs covered part of the long internal repeat 1 region (IR 1) and the third covered part of the BRRF 1 region. Direct sequencing of the three PCR products revealed that Si-IIA-EBV DNA had about 82% nucleotide homology to the human EBV DNA in all three regions and 92.4% homology to HVMF1 in the IR1 region. The blotting pattern by Southern blot analysis was different between Si-IIA-EBV and human EBV.

Malignant lymphoma induction of rabbits with oral spray of Epstein-Barr virus-related herpesvirus from Si-IIA cells (HTLV-II-transformed Cynomolgus cell line): A possible animal model for Epstein-Barr virus infection and subsequent virus-related tumors in humans Reviewed

Tirtha Raj Koirala, Kazuhiko Hayashi, Hong-Li Chen, Hideo Ino, Naoyuki Kariya, Hiroyuki Yanai, Chitta Ranjan Choudhury, Tadaatsu Akagi

Pathology International 47 ( 7 ) 442 - 448 1997

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

Malignant lymphoma (ML) was induced in eight of nine rabbits inoculated by oral spray of the cell-free pellets from Si-IIA culture (HTLV-II- transformed leukocyte cell line of the Cynomolgus-producing Epstein-Barr virus (EBV)-related herpesvirus) after 64-141 days. None of the rabbits inoculated with EBV from B-95-8 cells or HTLV-II from MOT cells developed ML. Malignant lymphomas were usually of diffuse, large-cell or mixed type. HTLV- II infection was excluded by the polymerase chain reaction (PCR) and the particle agglutination teat. EBV-encoded RNA-1 and EBV-related DNA were detected in the tumor tissues by in situ hybridization and PCR, respectively. Anti-viral capsid antigen of EBV antibody (anti-VCA) was observed 3 weeks after oral inoculation of Si-IIA cell-free pellets. Polymerase chain reaction revealed continuous detection of EBV-related virus DNA in the peripheral blood leukocytes from 3 days after oral inoculation. These results show that ML induced orally with Si-IIA cell-free pellets was caused by EBV-related herpesvirus harbored by Si-IIA cells. Oral spray of EBV from B-95-8 also induced EBV infection in rabbits, which was confirmed both by the presence of anti-VCA and by PCR. These oral infection and malignant lymphoma induction systems of rabbit using EBV-related virus from Si-IIA or human EBV are useful animal models for the study of EBV infection and EBV-related lymphomas in humans.

DOI： 10.1111/j.1440-1827.1997.tb04522.x

Regulation of Interleukin-2 Receptor γ Chain mRNA Expression in Human Monocytic Cell Line THP-I Reviewed

Hiroyuki Yanai, Tadashi Yoshino, Kiyoshi Takahashi, Yoshifumi Ninomiya, Tadaatsu Akagi

Acta Medica Okayama 50 ( 3 ) 145 - 150 1996.6

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

The interleukin-2 receptor (IL-2R) γ chain (γc chain) is shared by IL-4R, IL-7R, IL-9R, and IL-15R and plays an important role in regulation of the immune system. However, its regulation in monocytic cell lines has not been well clarified. We examined the expression and regulation of the IL-2Rα, IL-2Rβ, γc chain, IL-4R and IL-7R mRNA in a human monoblastic leukemia cell line, THP-1. Unstimulated THP-1 cells constitutively expressed a low level of γc chain and IL-4R mRNA, Phorbol myristate acetate (PMA) induced macrophage-like differentiation and up-regulated the γc chain mRNA expression in THP-1 cells. This effect of PMA was suppressed by the protein kinase inhibitors H-7 and staurosporine. PMA did not affect the expression of the other IL-R mRNAs examined. 1 α, 25(OH)2D3 and interferon-γ also induced differentiation of THP-1 cells, but these reagents did not affect the expression of the IL-R mRNAs in THP-1 cells. These findings suggest that the expression of the γc chain mRNA is regulated by the PMA-dependent pathway and is not associated with that of the other IL-R mRNAs.

Metastatic potential of lymphoma/leukemia cell lines in SCID mice is closely related to expression of CD44 Reviewed

Nobuhiro Kawasaki, Yoshinobu Matsuo, Tadashi Yoshino, Hiroyuki Yanai, Takashi Oka, Norihiro Teramoto, Cao Liu, Eisaku Kondo, Jun Minowada, Tadaatsu Akagi

Japanese Journal of Cancer Research 87 ( 10 ) 1070 - 1077 1996

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Cancer Association

To investigate whether the lymphocyte homing receptors, adhesion molecules regulating normal lymphocyte traffic, influence the dissemination of lymphoma cells, 24 lymphoma/leukemia cell lines were inoculated into SCID mice subcutaneously, and the correlation between the expression of the adhesion molecules and the metastatic potential of the cell lines was examined. Among the six adhesion molecules examined (LFA-1, ICAM-1, CLA, VLA-4, L-selectin and CD44), L-selectin increased the incidence of lymph node metastasis, and CD44 expression was related to both lymph node and organ (hematogenous) metastasis. A monoclonal antibody to the standard form of CD44 (CD44s), Hermes-3, inhibited the local growth and remote metastasis of CD44+ cell lines. Thus, it is concluded that at least CD44s expression is important in both lymphatic and hematogenous metastasis.

DOI： 10.1111/j.1349-7006.1996.tb03112.x

Binding of human leukocytes to fibronectin is augmented by an anti-CD44 mAb (TL-1) and blocked by another anti-CD44 mAb (Hermes-3) but not by anti-VLA-4/VLA-5 mAbs Reviewed

Liu Cao, Tadashi Yoshino, Nobuhiro Kawasaki, Hiroyuki Yanai, Kunimitsu Kawahara, Eisaku Kondo, Kunihiro Omonishi, Kiyoshi Takahashi, Tadaatsu Akagi

Immunobiology 196 ( 5 ) 504 - 512 1996

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

Fibronectin (FN) forms meshworks in extracellular spaces, and it plays an important role in cellular trafficking. Lymphoid cells are activated by binding to FN of the VLA-4 and VLA-5 receptors. CD44 also acts as a receptor of FN, but the mechanism and physiologic regulation of their binding are poorly understood. We have developed an anti-CD44 monoclonal antibody (mAb) (TL-1) in which lymphoid cells are activated and form homotypic cell aggregation. In this study, we found that the adhesion of GEM, HSB2, and LAD lymphoid cells to FN was augmented by TL-1 treatment and was apparently blocked by another anti-CD44 mAb (Hermes-3), but TL-1 Fab' fragments treatment did not induce FN-binding. A similar phenomenon is reported in the binding of the CD44 molecule to HA. This augmentation was not inhibited by the CS1 and RGD peptides of FN or by anti-VLA-4 and -VLA-5 mAbs
it was energy-dependent and associated with cytoplasmic actin filaments. Tl-1 treatment did not alter the cell surface expression of CD44 molecules. These findings above suggested that activated and/or altered cell surface distribution of CD44 molecules via a conformational change augmented the avidity of its binding to FN, which may be similar to lymphocyte-hyaluronate and lymphocyte-endothelial cell binding. As the Hermes-3 binding site is also involved in the interaction between lymphocytes and endothelial cells, activation of lymphocytes via CD44 molecules may facilitate the binding of lymphocytes to endothelial cells, extravasation, and migration to inflammatory sites rich in FN.

Thrombotic Thrombocytopenic Purpura and Myoglobinuric Acute Renal Failure Following Radiation Therapy in a Patient with Polymyositis and Cervical Cancer Reviewed

Hirofumi Makino, Yoshio Nagake, Kazuhiko Moriwaki, Shuzo Hirakawa, Zensuke Ota, Takaaki Katayama, Hiroyuki Yanai, Kiyoshi Takahashi, Tadaatsu Akagi

Internal Medicine 34 ( 1 ) 24 - 27 1995

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

73-year-old woman was admitted to receive radiation treatment for uterine cervical cancer, however a complex series of events ensued, leading to death. She developed an acute exacerbation of polymyositis complicated by thrombotic thrombocytopenic purpura, rhabdomyolysis and acute renal failure. Radiation therapy may have produced an immune disturbance leading to the acute exacerbation of polymyositis. Auto-immune-mediated endothelial damage might have triggered a series of events leading to thrombotic thrombocytopenic purpura. Rhabdomyolysis seemed to be the main cause of acute renal failure. (Internal Medicine 34: 24-27, 1995). © 1995, The Japanese Society of Internal Medicine. All rights reserved.

DOI： 10.2169/internalmedicine.34.24

膀胱のcarcinosarcomaの一例

柳井広之, 岡本司, 松木暁

岡山外科病理雑誌 32 72 - 73 1995

Partial Purification and Chraracterization of Dendritic Cell Differentiation Factor

Miyatani Katsuya, Takahashi Kiyoshi, Yanai Hiroyuki, Yoshino Tadashi, Akagi Tadaatsu

Acta Medica Okayama 48 ( 2 ) 67 - 72 1994.4

卵巣の硬化性間質性腫瘍の1例

柳井広之, 岡本司, 平林光司, 早瀬良二, 赤木忠厚

岡山外科病理雑誌 31 33 - 36 1994

Induction of interdigitating reticulum cell-like differentiation in human monocytic leukemia cells by conditioned medium from IL-2-stimulated helper T-cells Reviewed

Kiyoshi Takahashi, Katsuya Miyatani, Hiroyuki Yanai, Ho Jong Jeon, Kotaro Fujiwara, Tadashi Yoshino, Kazuhiko Hayashi, Tadaatsu Akagi, Ken Tsutsui, Koichi Mizobuchi

Virchows Archiv B Cell Pathology Including Molecular Pathology 62 ( 1 ) 105 - 113 1992.12

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

Monocytic leukemia (MoL) cells were obtained from the peripheral blood of a patient in whom the leukemic cells infiltrating various lymphoreticular organs exhibited features intermediate between interdigitating reticulum cells (IDC) and ordinary phagocytic macrophages, whereas the leukemic cells in the peripheral blood were essentially monocytic and lacked such features. Peripheral blood CD4+ T-cells were established as an interleukin-2-dependent T-cell line. When the MoL cells were exposed for a few days to conditioned medium from the T-cell line, they extended several dendritic cytoplasmic projections and became intensely positive for HLA-DR antigen, cytoplasmic S-100β protein, and CD1 antigen. Functionally, the conditioned medium significantly down-regulated Fc-mediated and Fc-independent phagocytic activities, and the levels of lysosomal enzymes such as lysozyme and nonspecific esterase in the MoL cells. Moreover, the conditioned medium significantly up-regulated the accessory cell function of the MoL cells as measured by the primary allogenic mixed leukocyte reaction (MLR). Furthermore, the conditioned medium significantly down-regulated the expression of CD14 antigen. Biochemical analysis indicated that the factor responsible for these changes is a protein which is distinct from known human cytokines and whose molecular weight is approximately 31 kDa. These findings suggest that IDC are closely related the monocytic lineage and that helper T-cells play an important role in constructing the microenvironment of T-lymphoid tissues which is necessary for the differentiation and maturation of IDC. © 1992 Springer-Verlag.

DOI： 10.1007/BF02899671

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