Jun Fujisawa

Histiocytoid breast carcinoma: Histological, immunohistochemical, ultrastructural, cytological and clinicopathological studies

Histiocytoid breast carcinoma (HBC) is a rare variant of breast carcinoma and often causes a diagnostic dilemma because of its histological similarities to some types of breast cancer and benign lesions. To elucidate the incidence of HBC and its biological properties, histological specimens from 1010 breast cancer patients treated at Yokohama Minami Kyosai Hospital between 1972 and 1996 were reviewed. Three cases of pure HBC and three cases of combined HBC (two with pleomorphlc lobular carcinoma and one with apocrine ductal carcinoma) were found, yielding an Incidence of 0.3% for each. Two of the three pure HBC cases contained foci of in situ lobular carcinoma. Targetoid and Indian file invasive patterns, the features characteristic of lobular carcinoma, were present in all three pure HBC cases and in two of the three combined HBC with pleomorphic lobular carcinoma. These results, together with those of previous studies, suggested that the majority of HBC are of lobular origin, although the apocrine ductai origin is also possible in a small number of HBC. Diastase‐resistant periodic add‐Schiff‐positive granules and granular immunoreactivities for gross cystic disease fluid protein‐15 (GCDFP‐15) were characteristic of the histiocytoid tumor cells in both the pure and combined HBC, suggesting the apocrine differentiation of tumor cells. All three pure HBC cases were in stage 1 and were free of the disease for up to 5 years and 1 month after the lumpectomy. Thus, the prognosis of HBC appears to be dependent on the stage of the disease and may not always be poor, as indicated by the original report mentioning a preferential eyelid metastasis.

An Improved Technique for Esophagojejunostomy after Total Gastrectomy with a Novel Anvil Grasping Forceps

D T i t c e t t n t c c a F i ircular stapler anastomosis has been widely used in esophgojejunostomy after total gastrectomy. Because tearing f an esophagojejunostomy can result in lethal complicaions, this anastomosis occupies an important step during he reconstruction procedure of total gastrectomy. But echnical problems associated with the procedure of the nastomosis remain because of the anatomic features round the abdominal esophagus, which is located in a eep and narrow region at the bottom of the upper abdomnal cavity. We present a new technique for esophagojejuostomy using a novel anvil grasping forceps, which has a orn head (Fig. 1).

Liver Infarction due to Liver Abscess

nosed segment III infarction due to liver abscess, because CT scan showed the cluster sign characteristic of a liver abscess [1, 2] . We performed an operation for lavage and drainage ( fig. 2 ). Nine days later, CT examination revealed that the abscess cavity had become smaller and the infarction area had a transformed abscess ( fig. 1 b). Five months later, CT examination revealed that the lateral segment of the liver was entirely reduced ( fig. 1 c). Case