Cholesterol Crystals in the Retrieved Thrombus by Mechanical Thrombectomy for Cerebral Embolism: A Case Report and Literature Review.

There are only a few case reports in which cholesterol crystals were found in the thrombus retrieved by mechanical thrombectomy for cryptogenic stroke, leading to a definitive diagnosis. We herein report a case of aortogenic embolic stroke diagnosed by the presence of rich cholesterol crystals in the retrieved thrombus and review the previously reported cases. A woman in her 80s was transferred as an emergency due to consciousness disturbance, right conjugate deviation, and severe left hemiparesis.

Intralobular distribution of ovarian-like stroma in pancreatic mucinous cystic neoplasms: a discussion on its tumorigenesis.

Pancreatic mucinous cystic neoplasm (MCN) has two histological components: tumor epithelia and ovarian-like stroma (OLS). To examine the progression and changes in pancreatic MCNs, we analyzed the distribution, amount, immunohistochemical phenotype, presence of theca cells of OLS, and tumor epithelium in 45 surgically resected MCN cases, comparing them with tumor sizes. The OLS data of female MCN cases were also compared between those who were ≤ 51 years old and those > 51 years old to see the effect of menopause on MCN histology.

Immunotherapy against esophageal primary amelanotic malignant melanoma relapse.

Melanoma is a malignant tumor derived from melanocytes. Esophageal melanomas occur infrequently, especially primary amelanotic malignant melanoma of the esophagus (PAMME), which is extremely rare. Here, we report the case of a 74-year-old man with an esophageal amelanotic melanoma on the esophagogastric junction (EGJ) found on esophagogastroduodenoscopy.

Clinicopathological features of intraductal papillary neoplasms of the bile duct: a comparison with intraductal papillary mucinous neoplasm of the pancreas with reference to subtypes.

Intraductal papillary epithelial neoplasms of the pancreatobiliary system (intraductal papillary neoplasm of the bile duct (IPNB) and intraductal papillary mucinous neoplasm (IPMN)) seem to share many clinicopathological features; however, IPNB has not been fully characterized. In order to understand the clinicopathological/immunohistochemical features of IPNB better, we compared 52 cases of IPNB with 42 cases of IPMNs with mural nodules. The IPNB cases were divided into two groups according to their histological similarity and according to five key histological findings.

Characterization of intraductal papillary neoplasm of bile duct with respect to histopathologic similarities to pancreatic intraductal papillary mucinous neoplasm.

Intraductal papillary neoplasm of bile duct (IPNB) is a papillary tumor covered by well-differentiated neoplastic epithelium with fine fibrovascular cores in the dilated bile ducts. It reportedly shows similarities to intraductal papillary mucinous neoplasm of pancreas (IPMN), to various degrees. Herein, IPNB was pathologically analyzed by classifying 52 cases into 4 groups based on the histopathologic similarities to IPMN: group A (identical to IPMN, 19 cases), group B (similar to but slightly different from IPMN, 18 cases), group C (vaguely similar to IPMN, 5 cases), and group D (different from IPMN, 10 cases).

Report of a case: Retroperitoneal mucinous cystadenocarcinoma with rapid progression.

Introduction: Retroperitoneal mucinous cystic neoplasms are uncommon, and little is known about the etiology of the disease. Malignant forms of these are extremely rare. Here, we report a case of primary retroperitoneal mucinous cystadenocarcinoma (PRMC), which demonstrated unexpectedly aggressive progression despite finding only a limited area of adenocarcinoma.

Laparoscopic resection of schwannoma of the ascending colon.

Schwannomas of the colon are rare and difficult to diagnose preoperatively. We report a case of schwannoma of the ascending colon that was resected laparoscopically. A 64-year-old woman was referred to our hospital by her local clinic for further evaluation and management of a submucosal tumor of the ascending colon.

Gastric cancer with multiple intramural metastases and metastasis to the small intestine which eventually developed Trousseau's syndrome: report of a case.

Here we report a rare case of Trousseau's syndrome in a patient with gastric cancer with multiple intramural metastases and metastasis to the small intestine. A 70 year-old male complaining of appetite loss and weight loss of 7 kg within 3 months was admitted to hospital. Esophagogastroduodenal endoscopy revealed an advanced gastric cancer at the pylorus almost occluding the outlet of the stomach, and multiple ulcerative lesions throughout the stomach.

Amount of CD4+CD25+ regulatory T cells in autoimmune pancreatitis and pilonidal sinus.

Objectives: Infiltration of many IgG4-positive plasma cells (G4-Ps) is seen in IgG4-related diseases and in several "non-IgG4-related diseases," such as pilonidal sinus (PS) as well. The involvement of CD4+CD25+ regulatory T cells (CD4CD25 Tregs) in IgG4-related diseases has been reported. To see whether CD4+CD25+ Tregs are involved in autoimmune pancreatitis (AIP)/non-IgG4-related diseases with many G4-Ps, we investigated the amount of G4-Ps and CD4+CD25+ Tregs histologically in AIP/PS.

Development and congenital anomalies of the pancreas.

Understanding how the pancreas develops is essential to understand the pathogenesis of congenital pancreatic anomalies. Recent studies have shown the advantages of investigating the development of frogs, mice, and chickens for understanding early embryonic development of the pancreas and congenital anomalies, such as choledochal cysts, anomalous pancreaticobiliary junction, annular pancreas, and pancreas divisum. These anomalies arise from failure of complete rotation and fusion during embryogenesis.

Evidence of immunopathological traces in mucormycosis: an autopsy case.

A 77-year-old diabetic man newly contracted pulmonary mucormycosis. A rapidly progressing clinical course including severe worsening of pneumonia and renal failure culminated in death. This patient presented with hypocomplementemia and dermal vasculitis.

Unusual fusion between ventral and dorsal primordia causes anomalous pancreaticobiliary junction.

Anomalous pancreaticobiliary junction (APBJ) is a congenital anomaly in which the pancreatic duct joins the common bile duct proximal to the sphincter of Oddi. Anatomical and immunohistochemical examination of the pancreas with APBJ has rarely been performed. A 72-year-old woman with gallbladder cancer and APBJ died of respiratory failure.

Expression of transforming growth factor beta by small duct epithelium in chronic, cancer-associated, obstructive pancreatitis: an in situ hybridization study and review of the literature.

Objectives: Transforming growth factor beta (TGF-beta) is a dominant mediator of pancreatic fibrosis. The objective of this study was to identify cellular sources of TGF-beta mRNA and compare the results with previous immunohistochemical/in situ hybridization studies.

Methods: In situ hybridization of TGF-beta was conducted for 9 human tissues of chronic obstructive pancreatitis (COP) and 2 control specimens.

Two distinct pathways of p16 gene inactivation in gallbladder cancer.

Aim: To examine the mechanism of inactivation of the p16 gene in gallbladder cancer, and to investigate p16 alterations and their correlation with clinicopathological features.

Methods: Specimens were collected surgically from 51 patients with gallbladder cancer. We evaluated the status of protein expression, loss of heterozygosity (LOH), homozygous deletion and promoter hypermethylation using immunohistochemistry, microsatellite analysis, quantitative real-time polymerase chain reaction (PCR) and methylation-specific PCR, respectively.

Pathology of autoimmune pancreatitis and tumor-forming pancreatitis.

The most frequently recognized presentation of autoimmune pancreatitis (AIP) is that mimicking pancreatic cancer. It is also known that at some stage during the disease process chronic pancreatitis clinically presents as a tumorous swelling, often suspected of being a carcinoma. In Japan, this stage has also been proposed clinically to be tumor-forming pancreatitis.

Activated perilobular, not periacinar, pancreatic stellate cells contribute to fibrogenesis in chronic alcoholic pancreatitis.

The authors investigated the role of activated perilobular, not periacinar, pancreatic stellate cells, in fibrogenesis in chronic pancreatitis, based on the distribution of myofibroblasts. Twenty-four patients with clinically diagnosed chronic alcoholic pancreatitis were studied histopathologically, immunohistochemically and quantitatively. In all cases, fibrosis was patchily distributed in the perilobular, or interlobular, areas, accompanied by a cirrhosis-like appearance; it had extended into the intralobular area in advanced cases.

Autoimmune pancreatitis can be classified into early and advanced stages.

Objectives: Although a number of pathological studies using various names/synonyms for autoimmune pancreatitis (AIP) have been reported, they do not mention the pathological staging related to origin/pathogenesis. Here, we propose a pathological staging for AIP lesions.

Methods: We histopathologically examined pancreatic tissue specimens of 31 AIP patients (14 pancreatectomized and 17 needle-biopsied materials) provided by 15 hospitals in Japan and studied the relevance of clinical manifestations to the pathological stage of AIP.

Pancreatic segmentation on an embryological and anatomical basis.

Limited resection of the pancreas is recommended for low-grade malignancies such as mucin-producing tumors. We propose a system of segmentation of the pancreas for the purposes of limited resection. The proposed system has an anatomical and embryological basis, and divides the pancreas into four segments, namely the anterior head, posterior head, body and tail.

Primary pleomorphic liposarcoma of bone: MRI findings and review of the literature.

Primary liposarcoma of bone is exceedingly rare. We report a case of primary pleomorphic liposarcoma in the humerus of a 38-year-old female. Radiographs demonstrated an expansile and osteolytic lesion extending from the head to the proximal part of the shaft in the right humerus.

Histopathologic characteristics of autoimmune pancreatitis based on comparison with chronic pancreatitis.

Objectives: To clarify the histopathologic characteristics of autoimmune pancreatitis (AIP), based on comparison with both chronic alcoholic pancreatitis (CAP) and chronic obstructive pancreatitis (COP).

Methods: Three AIP patients, 17 CAP patients, and 19 COP patients were studied histopathologically.

Results: There was a dense lymphoplasmacytic infiltrate, especially within and around the pancreatic ducts, and fibrosis associated with AIP, while there was fibrosis accompanied by mild inflammatory infiltration in both CAP and COP.

Distended glands or overreplacement of ampullary mucosa at the papilla of Vater.

Background/purpose: The role of the ampullary mucosa, especially its distended glands at the papilla of Vater, has not been fully explored.

Methods: Twenty-nine pancreatoduodenectomized specimens from pancreatobiliary diseases and 44 autopsied cases, as controls, were studied histopathologically and immunohistochemically.

Results: In 12 out of the 29 pancreatoduodenectomized cases the ampullary mucosa was in contact with the duodenal mucosa just at the outlet of the ampulla.

Case of combined adrenal cortical adenoma and myelolipoma.

We report a case of myelolipoma 10 mm in size within a functional cortical adenoma that was 33 x 22 x 17 mm in size. A 29-year-old woman was referred to hospital for transient hypertension. A right adrenal tumor was detected by computed tomography (CT) scan and magnetic resonance imaging (MRI).

Histopathologic difference between chronic pancreatitis animal models and human chronic pancreatitis.

Objectives: There are many experimental models for chronic pancreatitis. However, it remains unclear which animal models of pancreatic fibrosis can be categorized as chronic pancreatitis models. We compared the histologic features of some animal models of pancreatic fibrosis/chronic pancreatitis and chronic pancreatitis in humans.