Multiple pancreatic metastases from clear cell renal carcinoma: diagnosis with chemical shift magnetic resonance imaging before surgery.

We present a case in which multiple pancreatic tumours were diagnosed as metastatic clear cell renal carcinomas with chemical shift MRI (CSI) before surgery. Radiologists may be unable to recognize the loss of intensity on CSI macroscopically. We believe that it is useful to make subtraction images and calculate signal intensity on CSI, even if the lesions are multiple metastatic tumours.

Primary osteosarcoma of the breast.

We report a case of primary osteosarcoma of the breast, which is a rare histological type of all breast tumors. A 58-year-old woman had noticed a right breast mass long before presenting to our hospital because it had gradually increased in size. The mass was bony-hard, 90 x 70 mm in size, and was located mainly in the upper outer quadrant of the left breast.

Primary carcinoid tumor arising in a retroperitoneal mature teratoma in an adult.

An extremely rare case of a primary carcinoid tumor arising in a mature retroperitoneal teratoma is reported. A 53-year-old woman was admitted for further examination of an incidental retroperitoneal mass with calcification. Computed tomography scans demonstrated a tumor with fat, soft tissue and bone densities on the left renal hilum.

Rapidly growing leiomyoma in a postmenopausal woman.

We present here a case of a rapidly growing leiomyoma occurring after menopause. The tumor weighed 4329 g, suggesting the rapid accumulation of 'hyaline fibrosis'. A small amount of proliferative activity was detected as evidenced by Ki-67 antigen immunoreactivity.

The relationship between endometrial carcinoma and coexistent adenomyosis uteri, endometriosis externa and myoma uteri.

The relationship between endometrial carcinoma and coexistent adenomyosis uteri, endometriosis externa and myoma uteri has been reported in only a few studies. We studied the characteristics of the endometrial carcinomas accompanied by these benign diseases. The total number of endometrial carcinoma cases was 179, consisting of 29 (16%) endometrial carcinomas with adenomyosis uteri, 12 (7%) with endometriosis externa, 51 (28%) with myoma uteri, and 87 controls (49%) without these benign diseases.

[Mixed epithelial and stromal tumor growing with polypoid pattern in the renal pelvis].

A 68-year-old woman was found incidentally to have right hydronephrosis and a renal pelvic mass by abdominal ultrasonography. Radiographic examinations revealed a heterogeneous renal pelvic tumor, and right nephroureterectomy was performed. The tumor was well circumscribed yellow-whitish solid mass with scattered cysts.

Treatment of huge uterine tumors thought to be benign in post-menopausal women.

Background: When we find a huge uterine myoma-like tumor after menopause, we are hesitant whether to recommend surgery or not.

Material/methods: In order to treat huge uterine tumors after menopause, we surgically removed a total of 25 uterine tumors over 10 cm in diameter from 25 post-menopausal women, and examined these tumors microscopically.

Results: Clinical assessments of the 25 tumors before surgery indicated that 24 were myomas and one was a sarcoma, based on cytology-, sonography- and MR imaging-examinations.

Two kinds of endometrial neoplasia arising from different origins in the uterine corpus: comparison of p53 expression and sex steroid receptor status.

This study presents a case of endometrial clear cell adenocarcinoma complicated by complex atypical glandular hyperplasia surrounded by adenomyosis in the uterine myometrium. The former was immuno-negative for estrogen receptor (ER) and positive for p53, whereas both of the latter were immuno-positive for ER and negative for p53. Therefore, there were two kinds of neoplasia arising from different origins in the uterine corpus.

Expression of thyroid transcription factor-1 in strumal carcinoid and struma ovarii: an immunohistochemical study.

Strumal carcinoid is an ovarian teratoma composed of thyroid tissue and carcinoid, intimately admixed in variable proportions. To further elucidate the histogenesis of strumal carcinoid, the expression pattern of thyroid transcription factor-1 (TTF-1) was evaluated in two cases of strumal carcinoid using immunohistochemical techniques. TTF-1 is a nuclear transcription protein that is selectively expressed in the thyroid and respiratory epithelium, and is thought to be expressed specifically in pulmonary and thyroid neoplasms.

Mental state as a possible independent prognostic variable for survival in patients with advanced lung carcinoma.

Background: Although psychologic factors have been reported to influence the progression of cancer, this theory remains controversial. A prospective study of patients with advanced lung carcinoma was performed to explore the influence of the patient's mental state on survival.

Methods: The patient's mental state was assessed with the Tokyo University Egogram.

Multiple primary pleomorphic adenomas in a single parotid gland: report of a new case.

The development of multiple primary pleomorphic adenomas in a single parotid gland is extremely rare in previously untreated patients, as only nine cases have been previously reported. In this article, we report the tenth such case, which occurred in an 87-year-old Japanese women. We also report the results of our 7-plus-year review of the types of parotid tumors seen at our institution.

[Five cases of nonepisodic angioedema with eosinophilia].

The syndrome of episodic angioedema associated with eosinophilia (EAE), originally identified by Gleich et al., is characterized by recurrent attacks of angioedema, urticaria, fever, increased body weight, and eosinophilia of unknown origin. Five young (aged 23-32 years) female patients were referred to our hospital because of eosinophilia (4,900-10,400/microliter).

[Severe Klebsiella pneumonia improved by endotoxin adsorption and continuous hemodiafiltration].

A 57-year-old man who had past history of alcoholic hepatitis was admitted to our hospital because of fever, general malaise and dyspnea. Chest X-ray films and computed tomographic scans disclosed lobar pneumonia of the right upper lobe. Laboratory tests showed hypoxemia and renal dysfunction.

[Pulmonary nocardiosis associated with nephrotic syndrome].

A 70-year-old man treated for 6 months with prednisolone for nephrotic syndrome, was referred to our pulmonary division because of a nodule in the right lower lung field. Nocardia asteroides was isolated from the culture of the percutaneous lung aspiration, and the case was diagnosed as pulmonary nocardiosis. The lesion disappeared after 2 months of therapy with sulfamethoxazole/trimethoprim (1,600 mg/320 mg once a day).

[A case of mucoid impaction of bronchi (MIB) due to Schizophyllum commune].

A 51-year-old woman was admitted because of a productive cough. Atelectasis of the left upper lobe and eosinophilia were noted. The atelectasis was resolved after bronchoscopic removal of the mucous plug.

[A case of rheumatoid lung disease in which lung involvement preceded arthritis].

A 75-year-old man was admitted because of dyspnea on exertion and diffuse pulmonary interstitial shadows. An open lung biopsy revealed unclassified interstitial pneumonia. The abnormal shadow subsided spontaneously.

[A case report of lung abscess caused by Capnocytophaga gingivalis infection].

A 48-year-old male was admitted to our hospital because of fever, cough and of loss appetite. Chest X-P revealed an abnormal shadow in the left upper lobe. Bronchoscopy was performed and Capnocytophaga gingivalis was cultured from the bronchial lavage and bronchial curreting fluid.

Pseudoleukocytosis without pseudothrombocytopenia induced by the interaction of EDTA and IgG(2)-kappa M-protein.

We encountered a patient who showed ethylenediaminetetraacetic acid (EDTA)-induced pseudoleukocytosis without pseudothrombocytopenia. The patient had IgG-kappa type monoclonal (M) gammopathy. The total protein concentration was 77 g/l, and the gamma-globulin fraction containing M-protein was 23.

Multivariate analysis of prognostic determinants after surgery for renal cell carcinoma at Himeji National Hospital.

A clinico-pathological study was performed retrospectively on 62 patients who underwent surgery for renal cell carcinoma between January 1992 and October 1998 at Himeji National Hospital to clarify the prognostic determinants for survival. The median follow-up period was 32 months and the cause-specific survival rates at 1, 3 and 5 years were 86.7, 81.

Video-assisted transsternal radical esophagectomy: three-field lymphadenectomy without thoracotomy for esophageal cancer.

To reduce the invasiveness of radical esophagectomy, we developed a new approach: video-assisted transsternal radical esophagectomy (VATRE). This article presents the operative techniques and our initial results. In our new procedure, cervical U-shaped and longitudinal sternoabdominal incisions are made, and a complete midline sternotomy is carried out.