Kazuhisa Ishi

A Study of Tubo-Ovarian and Ovarian Abscesses, with a Focus on Cases with Endometrioma

Objective: To determine the incidence and causes of endometrioma‐associated tubo‐ovarian abscesses (TOAs) and ovarian abscesses.

Human papillomavirus localization in cervical adenocarcinoma and adenosquamous carcinoma using in situ polymerase chain reaction: Review of the literature of human papillomavirus detection in these carcinomas

Many studies have suggested that human papillomavirus (HPV) infection plays an important role in the carcinogenesis of the cervical adenocarcinoma. However, the prevalence of HPV infection in cervical adenocarcinoma and adenosquamous carcinoma varies among the studies. Cervical adenocarcinoma (24 cases) and adenosquamous carcinoma (16 cases), including the underlying non‐neoplastic epithelium were examined for HPV‐DNA using in situ polymerase chain reaction (PCR), which enabled visualization of the localization on a glass slide. In adenocarcinoma, HPV‐DNA was found in 13 cases (54%) and in eight cases in underlying non‐neoplastic epithelium, resulting in a total of 21 positive cases (88%). In adenosquamous carcinoma, HPV‐DNA was detected in 12 cases (75%) and and the HPV‐DNA localization of each component was pure adenocarcinoma, 28.6%; mixed, 54.5%; and pure squamous cell carcinoma, 83.3%. In the underlying non‐neoplastic epithelium, HPV‐DNA was found more frequently in the squamous epithelium (73.3%) than the cervical glands (6.3%). In conclusion, HPV‐DNA was detected in 54% of adenocarcinoma, and the rate was elevated by HPV localization in the underlying non‐neoplastic epithelium. HPV infection in the underlying squamous epithelium might be related to the carcinogenesis, even in cervical adenocarcinoma. HPV‐DNA localization was different in each component of adenosquamous carcinoma.

Small cell carcinoma of the prostate with hypercalcemia

Abstract We present a case of small cell prostate carcinoma with hypercalcemia in a 75‐year‐old man. He was diagnosed as having stage T3bN1M0 adenocarcinoma of the prostate. His serum prostate‐specific antigen level was reduced to below the normal range after a combination treatment of a luteinizing hormone‐releasing hormone agonist and flutamide for prostate carcinoma. He subsequently experienced increasing fatigue, poor appetite, short time loss of consciousness and pain in his lower abdomen. His serum calcium level and carcinoembryonic antigen were increased. He died 5 months from the start of treatment. The autopsy revealed small cell carcinoma of the prostate and multiple metastasis of the lung, liver, pancreas, lymph nodes and spine.

Sarcomatoid carcinoma and carcinosarcoma of the urinary bladder

Two cases, sarcomatoid carcinoma and carcinosarcoma, of the urinary bladder are reported. A 68‐year‐old man with sarcomatoid carcinoma underwent total cystectomy and was alive and had had no recurrence after 21 months. A 78‐year‐old woman with carcinosarcoma underwent total cystectomy, but she died from increasing multiple lung metastases 4 months after surgery. The histopathological characteristics of both neoplasms are reported and discussed.

Huge seminoma developed in a patient with testicular feminization

We report a 36‐year‐old patient who presented with primary amenorrhea and was found to have a giant abdominal tumor. There was a family history of primary amenorrhea in her two aunts. Physical and hormonal examinations as well as chromosomal analysis led to a diagnosis of testicular feminization. The patient underwent tumorectomy along with pelvic and para‐aortic lymphadectomy. The pathological diagnosis was bilateral seminoma of the testis with metastasis to para‐aortic lymph nodes. Nowadays, cases of undiagnosed seminoma developing into a huge abdominal mass in patients with testicular feminization are rarely encountered, since surgical castration is generally recommended as early as possible after puberty. In testicular feminization, the risk of malignant transformation of the dysgenetic male gonads increases substantially after puberty. Early and correct diagnosis together with careful follow‐up are critically important in managing testicular feminization, a rare congenital disorder.

CASE REPORT: Intra‐abdominal angiosarcomatosis after radiotherapy

Background: We report a case of a 61‐year‐old Japanese woman who developed intra‐abdominal angiosarcomatosis 20 years after receiving radiotherapy for squamous cell carcinoma of the cervix.

Prevalence of human immunodeficiency virus, hepatitis B and hepatitis C virus antibodies and hepatitis B antigen among commercial sex workers in Japan.

Objective: To investigate the prevalence of antibodies to human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV), and of hepatitis B surface (HBs) antigen in commercial sex workers (CSW) who attended a sexually transmitted disease (STD) clinic in Tokyo. Methods: Surveys were conducted on 308 CSW and 384 control subjects for HIV antibody or 241 control subjects for HBs antibody and antigen and HCV antibody. Results: HIV antibodywas not detected in either CSW or control subjects. The positive rates for HBs antigen and antibody were 0.6 and 23.4%, respectively, in the CSW group, and 0.4 and 71.8% in the control group. The HCV antibody positive rate was 3.2% in the CSW group and 0.4% in the control group. Conclusion: A statistically significant difference between the two groups was observed only in HCV antibody positive rate. STD checkup for CSW alone is inadequate – STD health education and screening for the general public are also required.

Cytodiagnosis of placental site trophoblastic tumor. A report of two cases.

BACKGROUND Placental site trophoblastic tumor (PSTT) is a rare form of trophoblastic neoplasm. Approximately 100 cases of PSTT have been reported, but we found no report on its cytodiagnosis. CASES Case 1, a 39-year-old female, came to the hospital because of abnormal genital bleeding. Case 2, a 36-year-old female came because of amenorrhea for a year. In both cases, endometrial smear and intrauterine curettage suggested trophoblastic disease, and hysterectomy was performed. Laboratory data revealed a mild increase in human chorionic gonadotropin (hCG) and beta-hCG but normal human placental lactogen (hPL). In the cytologic examination, the background contained some hemorrhagic and fibrinous areas but no necrosis. Most tumor cells stained light green, were round or polygonal, and contained abundant cytoplasm. Some were palely stained and had vacuoles. Some cells showed hyperchromatism, an irregular nucleus, fine-to-coarse chromatin granules and markedly different sizes. Most of the cells were hPL positive, and a few were hCG positive. CONCLUSION Both cases were considered benign because of rare mitoses despite cellular pleomorphism. However, careful follow-up is required. The differential diagnosis of PSTT is difficult from cytologic and biopsy specimens alone but may be achieved with additional magnetic resonance imaging findings and positive staining of hPL and hCG.

Prevalence of Human Papillomavirus Infection and Its Correlation with Cervical Lesions in Commercial-Sex Workers in Japan

Objective: To investigate the prevalence of the human papillomavirus (HPV) infection and its correlation with cervical lesions in commercial‐sex workers (CSWs) who attended a sexually transmitted disease (STD) clinic in an entertainment area in Tokyo.

Usefulness of Estrogen Receptor Detection Using Archival Papanicolaou-Stained Smears

OBJECTIVE To examine estrogen receptor (ER) detection using cytologic specimens and to compare the results with those obtained by the dextran-coated charcoal (DCC) method and enzyme immunoassay (EIA). STUDY DESIGN Immunocytochemical staining was conducted on 60 cases of breast cancer resected at our hospital between April 1993 and November 1997 in which ER had been measured by DCC or EIA. Specimens for immunocytochemical staining were prepared by a cell transfer method using archival Papanicolaou-stained imprint smears, and ER staining was performed by the labeled streptavidin method using an anti-ER monoclonal antibody. These results were compared with those obtained by DCC or EIA. RESULTS In immunocytochemical staining for ER, positive staining was observed in the nuclei of tumor cells. A good correlation was obtained between the immunocytochemical staining results and biochemical results. Five cases were positive in anti-ER staining but negative in biochemical tests, and two cases were negative in anti-ER staining and positive in biochemical tests. CONCLUSION Unlike biochemical assays, the immunocytochemical method does not necessitate use of fresh frozen materials and can be performed even using archival Papanicolaou-stained smears. Immunocytochemical study is a highly useful method for routine ER determination.