Hideyuki Koyama

A case of stromal sarcoma of the breast.

An 83-year-old woman visited our hospital with a mass on her right breast mass. Breast ultrasonography revealed a tumorous lesion approximately 30mm in diameter in the right E region. Fibrous tumor was suspected from core needle biopsy. Since surgery for definite diagnosis was not desired, she was followed. Seven months after the first visit, skin redness, pain, and rapid increase in tumor size was consciously recognized, which prompted a reconsultation. The tumor diameter rapidly increased to 74 mm, and a total right mastectomy was performed as a semi-emergency procedure. Necrotic and hemorrhagic lesions were mixed in a mottled state in the cleaved surface of the excised specimen, and the pathological diagnosis was stromal sarcoma mainly comprising of fibrosarcoma components. Stromal sarcoma of the breast lacks the epithelial component of a malignant phyllodes tumor, and effective systemic therapy has not been established; therefore, cases with local recurrence or distant metastasis result in poor prognosis. Since we encountered a case of stromal sarcoma of the breast that showed a rapid increase after several months, we will provide a report with some literature consideration.

A case report of undifferentiated carcinoma of the epipharynx with cytologic presentation of tumor cells in sputum.

症例は62歳の女性で, 血痰を主訴として来院し, 胸部X線に異常はなかったが喀痰細胞診で異型細胞が認められ, 精査の結果, 上咽頭腫瘍が発見された。生検組織診は, 未分化癌であった.喀痰細胞診では, 1) 腫瘍細胞は小集塊を形成し, リンパ球が混在した.2) 細胞質は類円形-多辺形でライトグリーン好染性であった.3) 核グロマチンの増量はほとんどなく, 好酸性の大型核小体を有する, などの特徴がみられた.肺病変が認められない患者において, 喀痰中に肺腺癌や扁平上皮癌と異なり, 核クロマチンの増量がなく, 明瞭な核小体を有する未分化上皮細胞がみられた場合, 本腫瘍を疑ってみる必要がある.