Gen Emoto

Short arm of chromosome 1 aberration recurrently found in pigmented villonodular synovitis

Pigmented villonodular synovitis (PVNS) is a relatively uncommon benign lesion that is characterized by diffuse synovial proliferation, mainly occurring in knee joints. Cytogenetic reports about this lesion are few and they describe the presence of numerical and structural chromosome aberrations. We obtained PVNS tissue from the left knee joint of a 53-year-old female, and performed cytogenetic analysis. Fluorescence in situ hybridization (FISH) was also performed by using the formalin fixed, paraffin embedded PVNS tissue. Two seemingly unrelated clones were found: the first clone had structural abnormalities of chromosome 1, 3, and 18, and the second one had trisomy 7 as a sole numerical abnormality. FISH using a chromosome 7 specific alpha-satellite DNA probe revealed that interphase nuclei possessed two or three signals. We describe the clonal aberrations found in a case of PVNS. The deleted lesion of the chromosome 1 (1p10-1p31.3) includes the locus of coagulation factor III gene (1p22-p21), and the coagulation factor V (1q21-q25) locus includes another breakpoint that is 1q25. In addition, recurrent structural abnormalities at the short arm of chromosome 1 have been reported. These facts might play some role in the hemorrhagic tendency and histogenesis of these lesions.

Epithelioid sarcoma with an 18q aberration.

Epithelioid sarcoma is a peculiar soft-tissue neoplasm of uncertain origin, which is characterized by an epithelioid morphology of tumor cells coexpressing epithelial (keratin) and nonepithelial (vimentin) antigens. We herein report a new cytogenetic abnormality with der(22)t(18;22)(q11;p11.2) in a case of epithelioid sarcoma that occurred in the elbow of a 75-year-old man. Histologically, the tumor demonstrated a multinodular proliferation of epithelioid cells, with positive immunostaining for keratin, epithelial membrane antigen (EMA), and vimentin. Cultured tumor cells obtained from fresh surgical materials were frozen in plastic ampules and stocked in a liquid nitrogen freezer. Six years after surgery, the cells were recovered from the freezer and utilized for both morphologic and cytogenetic analyses. These cultured cells both before and after the freezing exhibited essentially the same epithelioid morphology and immunophenotypes as those of the original tumor. A chromosome analysis, together with fluorescence in situ hybridization (FISH), demonstrated a 61-67 modal population, and a characteristic clonal abnormality with der(22)t(18;22)(q11;p11.2). Other clonal abnormalities included numerical (-3, -4, +7, -13, -14, -16, -18, +20, -22) and structural (8p+, 9p+, 12p+, i(21q)) aberrations. Some variant clones also demonstrated i(18q). Since the breakpoint at 18q11 is similar to that reported in synovial sarcoma, this finding may support the presence of a histogenetic relationship between epithelioid sarcoma and synovial sarcoma. Our study thus indicates that the storage of frozen cells is useful for both morphologic and cytogenetic analyses of soft tissue tumors.

The blood supply to the greater trochanter

The blood supply to the greater trochanter was investigated in adult rabbits using a hydrogen washout technique. The control blood flow rate of the greater trochanter averaged 13.8 ml/minute per 100 g of tissue. Stripping of the origin of the vastus lateralis muscle did not cause significant decrease of blood flow rate. Blood flow rate was significantly decreased to 10.4 ml/minute per 100 g of tissue after an anterior trochanteric slide osteotomy. Surgical dissection of the proximal soft tissues including the gluteus medius and minimus tendons from the greater trochanter caused significant decrease of blood flow rate to 4.72 ml/minute per 100 g of tissue. The addition of surgical dissection of the proximal soft tissues to anterior trochanteric slide caused a complete arrest of blood flow in the greater trochanter. These results indicate that the greater trochanter receives >⅔ of its blood supply from the extraosseous vascular system in a rabbit model.

Os vesalianum as a cause of lateral foot pain: a familial case and its treatment.

This is a rare case of bilateral symptomatic os vesalianum in a 13-year-old girl whose mother had the same condition unilaterally. We performed osteosynthesis and bone grafting instead of a simple resection to preserve the peroneus brevis tendon, with excellent results.

Surgical management of a large Schwannoma

Magnetic resonance imaging is useful fr diagnosing bone and soft tissue tumors. We report a patient with a schwannoma which gradually grew into a huge mass over a 12 year period. The deagnosis was possible using CT imaging, MRI, amgiogrephy, scintigraphy, and biospy. We recommend that MRI (especially, Gd-enhanced MRI) is useful for detecting the solid area of a huge systic mass for biopsy.