Nobuo Takeichi

Salivary gland neoplasms following atomic radiation: Additional cases and reanalysis of combined data in a fixed population, 1957–1970

A reappraisal was made of the relationship between exposure to atomic radiation in 1945 and the occurrence of salivary gland tumors in heavily exposed survivors. This was made possible by the discovery of 8 additional patients; the total now reported consists of 30 cases. In those exposed to 300+ rads, the number of cases was significantly (p < .01) greater than expected. This was found for the combined group and for malignant types, but not for histologically benign tumors. Our prior conclusion regarding the high‐dose radiation effect upon salivary gland neoplasia remains unchanged in the reanalysis; however, our suggestion that younger persons were at significantly greater risk is weakened.

Salivary gland tumors in atomic bomb survivors, Hiroshima, Japan. II. Pathologic study and supplementary epidemiologic observations

A pathological investigation was undertaken in Hiroshima on cases seen between 1945 and 1971 to determine the relationship between salivary gland tumors and exposure to atomic (A) bomb radiation. Of the 208 cases of histologically confirmed salivary gland tumors, 62 were A‐bomb survivors and 146 were nonexposed. The relative risk based on the rate in the nonexposed for malignant tumors of salivary glands among the exposed in Hiroshima Prefecture was 11.0, while that of the submaxillary gland was 13.8 and that of the parotid gland was 9.8. They were all highly significant by X2 test (P < 0.001). The latent period of malignant salivary gland tumors was shorter in the exposed than in the nonexposed. Four cases of benign salivary gland tumor, all being benign mixed tumors of the parotid gland, were observed in children whose parents had been exposed. The incidence of mixed tumors of the salivary gland among the exposed in Hiroshima City was 2.0 times higher than that among the nonexposed and showed a tendency to increase with proximity to the hypocenter (P < 0.01). Cancer 52:377‐385, 1983.

Salivary gland tumors in atomic bomb survivors, Hiroshima, Japan. I. epidemiologic observations

An epidemiologic investigation was undertaken in Hiroshima to study the relationship of salivary gland tumors to exposure to ionizing radiation. Two hundred and eleven cases examined between 1953–1971 were confirmed by a review of histologic specimens. Of these, 66 cases occurred in residents of Hiroshima City who were born before the A‐bomb: 30 among A‐bomb‐exposed, and 36 in non‐exposed individuals. The incidence of salivary gland tumors among the exposed individuals was significantly higher, 2.6 times greater than that among the nonexposed individuals for all tumors, and 10 times greater for malignant tumors. The incidence increased with proximity to the hypocenter for the directly exposed. An increased incidence was also found among early entrants, particularly those entering the city within 3 days of the A‐bomb.

Diffuse Sclerosing Variant of Papillary Carcinoma of the Thyroid. A Histopathological Study of Four Cases

We present four cases of an unusual diffuse sclerosing variant of papillary carcinoma of the thyroid occurring in Japanese women ranging in age from 17 to 42 years. Macroscopically, both lobes of the thyroid were involved, being diffusely enlarged and firm. Histologically, the tumor was characterized by squamous metaplasia of tumor cells, numerous psammoma bodies, extensive stromal fibrosis. severe lvmphocvtic infiltration with formation of lymph follicles, and thin bundles of smooth muscle cells in the fibrous stroma. The tumor islands were located mainly within the dilated lymphatic vessels and the metastatic tumor involved the bilateral cervical lymph nodes in all cases. It is assumed that papillary carcinoma of this type invades the thyroid lymphatics during the early stage and, without forming nodular lesions, disseminates to both lobes with extensive metastasis to the cervical lymph nodes. It should be noted that papillary carcinoma of this type often suggests chronic thyroiditis clinically because of the symmetrical enlargement of the thyroid and frequent positive anti‐thyroid antibodies in the serum. Some workers have reported the prognosis to be unfavorable because of extensive lymphatic involvement, but the prognosis of this variant has not yet been defined. Acta Pathol Jpn 40: 193‐198, 1990.

Relation between Estrogen Receptor and Malignancy of Thyroid Cancer

The relationship between the histological grade of dedifferentiation of thyroid cancer and estrogen receptors (ER) was examined immunohistochemically. Thyroid cancers were from postmenopausal females of almost the same mean age (69‐73 years old) and within the same period of time (1974–1983). ER immunoreactivity located in the nucleus of the epithelium was found in all 6 well differentiated papillary cancers, and 5 of them (83.3%) showed ER‐immunoreactive (ER‐IR) cells amounting to 20 or more per visual field (x 100) under a light microscope. Of the 6 cases of poorly differentiated papillary cancer, 5 (83.3%) had 1‐19 ER‐IR cells per visual field. ER‐IR cells were negative in 5 out of 6 cases (83.3%) of anaplastic cancers. Thus, the number of ER‐IR cells tended to decrease with the degree of atypism of thyroid cancer (P < 0.001).

The significance of immunochemically staining calcitonin and CEA in fine-needle aspiration biopsy materials from medullary carcinoma of the thyroid.

A review of ten surgical cases of medullary carcinoma of the thyroid (MCT) demonstrates the usefulness of establishing a preoperative cytological diagnosis through the immunochemical staining of calcitonin (CT) and CEA in fine-needle aspiration (FNA) biopsy smears. If MCT is suspected after routinely performing May-Grünwald-Giemsa stained cytology of an FNA biopsy in the outpatient clinic, then CT and CEA staining is recommended for confirmation of MCT. The advantages of this immunochemical staining include that it can be carried out in the outpatient clinic within one day and also that it is much less costly than measuring serum CT and CEA.

A parathyroid cyst effectively treated with a sclerosing agent

Sclerosing solution was injected into a parathyroid cyst through a needle used for aspiration biopsy cytology. One year has passed without a recurrence and a cure is expected.

Aspiration biopsy cytology a highly diagnostic procedure for assessing neck masses, excluding thyroid tumors.

Aspiration biopsy cytology (ABC) was done on one hundred and forty-five patients with cervical tumors, excluding primary tumors of the thyroid and local metastasis of thyroid cancer, during the period of 44 months from 1981–85. Surgery was done on a total of fifty-five patients with lesions evaluated to be malignant and requiring resection. A correlation was determined between the histological diagnosis based on permanent paraffin sections and the diagnosis made by aspiration biology cytology in order to evaluate ABC in terms of accuracy together with its complications and limitations. The false positive rate was 6.6 per cent and the false negative rate was 8.3 per cent. Histologic diagnosis was predictable by ABC in eighty per cent of cases, but difficulty was experienced in predicting the histologic diagnosis in cases of a poorly differentiated malignancy. A few cases of slight subcutaneous bleeding occurred, but seeding implantation of cancer cells was nil. It was confirmed that ABC is a highly diagnostic procedure for assessing cervical tumors. The method is simple, safe and economical.

Bilateral resection and reconstruction of internal jugular vein for thyroid carcinoma

Two patients with thyroid carcinoma infiltrating bilateral internal jugular veins were treated. In reconstruction of the internal jugular vein by implantation of an autogenous venous segment or Gore-Tex artificial vessel, the repaired area soon became obstructed. The repaired area with the Impra-Flex artificial vessel became obstructed again one month after the implantation. In the reconstruction by ipsilateral end-to-end anastomosis between the internal and external jugular veins, good circulation was apparent even 2 years after the operation. The internal-external jugular vein anastomosis is expected to increase the safety of single-stage bilateral excision of the internal jugular vein, as an adjunct to total thyroidectomy, in the surgical treatment of thyroid carcinoma.

Disorder of Endothelia Vessels` Functional State with Malignant Tumors in Patients Exposed Anthropogenic Radiation

The aim of this research is to determine the characteristics of endothelial factors and the hemostatic system conditions with malignant neoplasms patients, which were exposed to ionizing radiation. Total number of examined people is 223, 153 of them are patients with gastrointestinal tract oncopathology. The article presents the results of the analysis of numerical indicators of endothelial condition and platelet hemostasis of patients, who had cancer. They lived in the regions of Kazakhstan, subjected to contamination of radionuclides as a result of nuclear weapons tests, which took place in this region from 1949 to 1989. These results then were compared to cancer patients and healthy individuals with no radiation risk. The study revealed the presence of higher levels of endothelial dysfunction and following trigger of the hemostatic system in patients with malignant tumors of the gastrointestinal tract. In particular, the defined high degree of endothelial dysfunction include endothelium- dependent vasodilation, content desquamated endothelial cells in peripheral blood and von Willebrand factor. These indicators have a clear correlation with the degree of disorder of studied parameters of the hemostasis, which can cause the development of thrombotic complications.