Noboru Arimizu

Intraperitoneal hyperthermic perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding

Fifteen patients with far-advanced gastric cancer were given surgical treatment followed by intraperitoneal hyperthermic perfusion (IPHP) with mitomycin C (MMC) and misonidazole (MIS), a thermosensitizing drug. Immediately after extensive resection of the abdominal tumors, a 2-hour IPHP was performed at the inflow temperature of 44.7 to 48.7 C, using equipment designed for treatment of cancerous peritoneal seeding as a closed circuit, and under hypothermie general anesthesia at 30 to 31 C. In nine of the 15 patients with peritoneal seeding and/or ascites, cancerous ascites was absent after this treatment. In all cases, repeated cytologie examinations of the lavage from Douglass pouch were negative. The postoperative courses were uneventful except for Patients 1 and 10, in whom slight leakage occurred. All patients were discharged and are in good health at the time of this writing, 7.2 ± 4.6 months after the treatment. The Case 4 Patient recently died in a traffic accident. In all patients, transient hepatic dysfunction and hypoproteinemia occurred after the operation. This extensive surgery combined with IPHP using MMC and MIS was well tolerated and is a safe antitumor treatment for gastric cancer with peritoneal dissemination. Neurotoxicity due to MIS was nil.

FDG-PET for predicting the prognosis of malignant lymphoma

To evaluate the usefulness of FDG-PET as a predictor of prognosis, 34 patients with untreated malignant lymphoma in the head and neck region were studied. After FDG-PET and treatment, they were observed from 15 to 50 months. Tumors which were aggressive and resistant to treatment tended to show high uptake of FDG. The survival rate of patients with high uptake of FDG, DAR > 8, was lower than the rate of the other patients. It is considered to be useful to add FDG uptake of the tumor to other prognostic factors for predicting the prognosis.

Radiation Therapy in Kimura's Disease

Kimuras disease is a rare disorder which predominantly involves the head and neck region and causes eosinophilia in peripheral blood. It often responds well to corticosteroid therapy but some patients can be resistant; in these patients symptomatic radiation therapy can be of value. We reviewed 10 patients with Kimuras disease who received radiation therapy from 1975 through 1981 in the Department of Radiology, Chiba University Hospital. Nineteen tumors were irradiated and 15 of them locally controlled. In 5 patients, steroid therapy could be withdrawn. For local control, 25 to 30 Gy seemed to be adequate.

Non-Hodgkin's lymphoma confined to the nasal cavity: Its relationship to the polymorphic reticulosis and results of radiation therapy

From 1975 through 1988, nine patients with locally confined nasal non-Hodgkins lymphoma (NHL) were treated with radiation therapy in the Department of Radiology, Chiba University Hospital. Immunohistochemical study disclosed that all NHLs have T-lineage. Additionally, unique histological pictures of polymorphism, angiodestruction, and necrosis were seen in most of cases. These three findings are the histological features of polymorphic reticulosis (PMR), which is the main cause of lethal midline granuloma and has recently been shown to belong to T-cell malignancy. Therefore, it is concluded that the nasal T-cell NHL and PMR are really a single disease entity. The predominance of the T-cell lymphoma in the nasal cavity as well as its histological distinctness clearly indicate that the head and neck extranodal NHL cannot be discussed together. Although the disorder was considered to be locally limited at presentation, only 3 of the 9 patients with nasal NHL could be induced into long-term remission with involved field radiotherapy. The distant extranodal spread was the primary cause of failure. Multimodality treatment using intensive chemotherapy might improve the prognosis of nasal NHL.

MR imaging of primary adrenal lymphoma

We describe a patient with non-Hodgkins B-cell lymphoma of diffuse large cell type, which involved both adrenal glands without adrenocortical insufficiency. Magnetic resonance showed bilateral adrenal tumors with some enhancing septa.

Tumor blood flow measured using dynamic computed tomography.

Hattori H, Miyoshi T, Okada J, Yoshikawa K, Arimizu N, Hattori N. Tumor blood flow measured using dynamic computed tomography. RATIONALE AND OBJECTIVES.A method for measuring the tumor blood flow (TBF) by means of dynamic computed tomography (DCT) was devised and investigated. METHODS.Twenty–seven patients with superficial tumors underwent measurement of TBF by the new DCT method. For all of the 27 patients, the thermal clearance method was employed to measure the relative tumor blood flow (RTBF). For 16 patients, TBF was measured by oxygen–15–gas positron–emission tomography (PET). The TBF values measured by DCT were compared with the RTBF by the thermal clearance method and the TBF by PET. RESULTS.The results demonstrated a linear relationship. CONCLUSIONS.The newly devised DCT method yields reliable data in measuring TBF.

Retroperitoneal ganglioneuroma extending across the midline: MR features.

A rare adult case of retroperitoneal ganglioneuroma in which magnetic resonance imaging (MRI) clearly demonstrated unusual extension of the tumor across the midline is reported. Dynamic MR imaging was very useful to distinguish benign ganglioneuroma from other retroperitoneal tumors, especially neuroblastoma and pheochromocytoma.

Large epidermal cyst involving the ischiorectal fossa: MR demonstration

A large subcutaneous mass was noted in the buttock of a 79-year-old man. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a thin-walled cystic mass that involved the ischiorectal fossa. The content appeared hyperintense on T1-weighted images. T2-weighted images demonstrated a considerable amount of debris. At surgery an epidermal cyst with markedly keratinized squamous epithelium was found. It contained much keratin and cholesterin.

Increased activity on radiocolloid scintigraphy in splenic hamartoma

A higher uptake of radiocolloid in a splenic tumor than in the rest of the spleen was observed in a 17-year-old boy. The pathologic diagnosis of the surgically resected tumor was hamartoma composed of anomalous mixtures of splenic elements, and radiocolloid was considered to be distributed to reticuloendothelial cells in the tumor. Radiocolloid scintigraphy, which can demonstrate the function of the reticuloendothelial system, is helpful in the diagnosis of splenic hamartoma.

FDG-PET for the evaluation of tumor viability after anticancer therapy.

To evaluate positron emission tomography with18F-fluorodeoxy glucose (FDG-PET) as an diagnostic tool to determine tumor viability after anticancer therapy, fourteen patients were examined by FDG-PET after the end of the treatment. The lesions with residual viable tumor cells showed higher uptake of FDG than surrounding normal soft tissue. The lesions, in which tumor viability was lost or very low, showed higher uptake of FDG in four cases and similar uptake to normal soft tissue in three cases. The residual increased uptake of FDG was considered to be caused by remaining tumor cells and/or inflammatory reaction to anticancer treatment. FDG-PET after anticancer treatment should be interpreted by considering the reaction due to the treatment and the partial volume artifact of PET caused by the limited spatial resolution.