Rieko Minami

Glut1 expression in T1 and T2 stage colorectal carcinomas: its relationship to clinicopathological features.

Glucose uptake is mediated by glucose transporter (Glut) proteins, which exhibit altered expression in a variety of malignant neoplasms. Glut1 expression is thought to be a potential marker for malignant transformation. The aim of the present study was to investigate the expression of Glut1 protein in colorectal adenomas, T1 and T2 stage carcinomas. Immunohistochemical detection of Glut1 protein was examined in 141 formalin-fixed and paraffin-embedded colorectal tumour specimens (57 adenomas, 84 carcinomas). The degree of Glut1 immunostaining of a specimen was graded according to the proportion of Glut1-positive cells in it; absent (positive cells are 0%), weakly positive (less than 10%), moderately positive (10-50%), and strongly positive (more than 50%). Glut1 expression was present in 18% of the adenomas with low-grade dysplasia, and in 63% of the adenomas with high-grade dysplasia. The positivity in such lesions was usually weak, but was moderate in 8% of the adenomas with high grade dysplasia. For the carcinomas, there were significant correlations between Glut1-positivity and depth of invasion (T1 45% versus T2 74%, P<0.01), histological differentiation (well 49% versus moderately to poorly 74%, P< 0.05) and morphological type (polypoid 42% versus depressed 73%, P< 0.05), if the cut-off value was set at 10% of cells. In conclusion, we clarified the relationship between Glut1 expression and clinicopathological features in T1 and T2 stage colorectal carcinomas, and our results suggested a high malignant potential of the depressed-type carcinoma.

Involvement of mutations in the DPC4 promoter in endometrial carcinoma development.

To define the target of chromosome 18q loss of heterozygosity, which is prevalent in endometrial carcinomas, we made a deletion map from 64 tumors. Loss of heterozygosity on 18q was found in 20 tumors. Among these, 14 tumors carried deletions at the 18q21.1 region, where the DPC4 gene is located. DPC4 transcription was disturbed in all six of the tumors with deletions at 18q21.1 examined, which sharply contrasted with the positive transcription in 12 tumors that retained heterozygosity at the 18q21.1 region. However, in the 14 tumors with the 18q21.1 deletions, the remaining allele had the wild‐type sequence of the DPC4 coding region instead of somatic mutations in the DPC4 coding region. We found a one‐ and two‐base substitutions in the DPC4 promoter in two of the six tumors that showed disturbed DPC4 transcription. Chloramphenicol acetyltransferase assays clearly demonstrated that the mutant promoters had the potential to suppress or silence DPC4 transcription, implicating the DPC4 gene in endometrial carcinoma. Mol. Carcinog. 25:64–72, 1999.

Coexisting Brenner tumor and struma ovarii in the right ovary: Case report and review of the literature

A bilateral ovarian tumor composed of mixed Brenner tumor and struma ovarii in the right ovary and mature cystic teratoma in the left ovary, is described. Mixed Brenner tumor and struma ovarii is rare; eight cases are reviewed. In this case, in addition to the typical Brenner tumor and struma ovarii, some nests composed of both Brenner tumor and struma ovarii in one nest were found in the right ovarian tumor. Immunohistochemically, the struma ovarii is stained for thyroglobulin, and Brenner nests showed various degrees of positive stain for thyroglobulin, which is a specific finding. Brenner tumor, in this case, may produce thyroglobulin or have a receptor to thyroglobulin or analog of thyroglobulin. The origin of mixed Brenner tumor and struma ovarii may be germ cell, as described in some literature, or the Brenner tumor may be of a metaplastic nature, although the Brenner tumor is fourfold the size of struma ovarii in the case presented.

Epithelioid leiomyosarcoma of the external deep soft tissue.

Epithelioid leiomyosarcoma in the external deep soft tissue is extremely rare. Most epithelioid leiomyosarcomas occur in the uterus. We present a case of epithelioid leiomyosarcoma occurring in the muscle of the thigh of a 78-year-old man. Histologically, the tumor predominantly consisted of round or polygonal cells arranged in sheets with a focal spindle cell component. Immunohistochemical analysis revealed that the tumor cells expressed vimentin, alpha-smooth muscle actin, and alpha-sarcomeric actin. The tumor was negative for desmin, S100 protein, glial fibrillary acidic protein, pan-keratin, epithelial membrane antigen, CAM 5.2, HMB-45, leukocyte common antigen, factor VIII-associated antigen, and CD34. Electron microscopically, some tumor cells contained abundant actin-type filaments in their cytoplasm.

Dedifferentiated liposarcoma with chondroblastic osteosarcomatous dedifferentiation

We describe a rare case of dedifferentiated liposarcoma with features resembling chondroblastic osteosarcoma in the dedifferentiated component. The tumor was removed from the left thigh in a 78‐year‐old male. It consisted of a well‐differentiated liposarcoma and an anaplastic component that contained numerous osteoid and cartilaginous tissues surrounded by high‐grade spindle cell sarcoma. To our knowledge, only two cases similar to the divergent chondroblastic osteosarcomatous dedifferentiation of this disease have been reported in the literature.

Fine needle aspiration cytology of the malignant variant of ossifying fibromyxoid tumor of soft parts: a case report.

BACKGROUND Ossifying fibromyxoid tumor (OFMT) of soft parts is a rare, recently defined, fibroosseous neoplasm, generally regarded as clinically benign; however, one-third of cases recur locally, and several malignant examples have been reported. Fine needle aspiration (FNA) cytology of the tumor is rarely described in the literature. We provide the first cytomorphologic study of the malignant variant. CASE A 70-year-old man presented with an intramuscular mass in the right buttock. Computed tomography revealed ossification within the mass and multiple pulmonary nodules. FNA biopsy showed round and polygonal to spindled tumor cells, arrayed singly, cordlike or in small aggregates, with scattered dense stromal fragments and a slightly myxoid background. The nuclei showed significant pleomorphism accompanied by coarse chromatin with clumping, irregular contours, and one to two distinct nucleoli. The tumor cells were recognizable as sarcoma, with no evidence of high grade malignancy. The tumor was totally excised, histopathologically confirmed as the malignant variant of OFMT of soft parts, and immunohistochemically and ultrastracturally analyzed as of neural origin. CONCLUSION The FNA specimen revealed that the cytomorphology was consistent with the histologic features of the malignant variant of OFMT, but several characteristic histologic parameters, such as multilobular proliferation and peripherally placed mature, bony trabeculae, were not reflected in the aspirates. Although FNA cytologic findings may be of limited diagnostic utility in OFMT, radiographic evidence of calcification/ossification suggests that OFMT should be subjected to differential diagnosis with fine needle aspiration biopsy of soft tissue tumors. Additional studies will be required for further clarification.

Codon 201Arg/Gly Polymorphism of DCC (Deleted in Colorectal Carcinoma) Gene in Flat- and Polypoid-Type Colorectal Tumors

Recent studies have identified the distinctexistence of flat-type colorectal tumors. The lowincidence of ras gene mutations in these tumors suggeststhat their genetic pathways of tumor progression may be different from those of the polypoid type.To elucidate further genetic alterations in flat-typecolorectal tumors, codon 201Arg/Glypolymorphism in the DCC (deleted in colorectalcarcinoma) gene was analyzed in normal tissue (normal colonicmucosa or peripheral lymphocytes) and in tumor tissuefrom 191 patients with colorectal tumors (36 patientswith flat-type colorectal tumors, 81 patients withpolypoid-type colorectal tumors, and 74 patients withadvanced carcinomas). For normal controls, 30 samplesobtained from patients who had neither colorectal tumors(confirmed by total colonoscopy) nor a family history of colorectal carcinoma were analyzed. DCC genecodon 201Arg/Gly polymorphism wasinvestigated by polymerase chain reaction-basedrestriction fragment length polymorphism analysis,fluorescence-based dideoxy sequencing, or both. For the flat type, thefrequency of codon 201Gly of the DCC gene was64% and 54% in the normal tissue of patients withadenoma with high-grade dysplasia and submucosalcarcinoma, respectively. It was 49%, 52%, and 49% in the normal tissueof patients with polypoid-type adenoma with high-gradedysplasia, submucosal carcinoma, and advanced carcinoma,respectively. In the normal tissue, codon 201Gly of the DCC gene was more frequentlyobserved in patients with flat-type adenoma withlow-grade dysplasia (67%) than in those withpolypoid-type adenoma with low-grade dysplasia (18%) orin normal controls (17%, P < 0.05, χ2test). Codon 201Arg/Gly polymorphism in tumortissues did not differ from that in the correspondingnormal tissues, except for 10 cases of carcinoma withloss of heterozygosity (LOH). In carcinomas with LOH, preferentialloss of the codon 201Arg allele was noted(9/10 cases). These results suggest that codon201Gly of the DCC gene is not only associatedwith flat-type colorectal tumors, but that it may serve as a usefulgenetic marker for identifying groups at higher risk forcolorectal cancer.

Hepatocellular Carcinoma with a Sarcomatous Appearance : Report of a Case

Abstract A 59-year-old man was admitted with general fatigue, an epigastric mass, and remittent fever. Radiological examinations disclosed a huge solid-to-cystic mass in the right lobe of the liver, and the mass severely compressed the right diaphragm, the inferior vena cava, and the right atrium. In addition, the patient suffered from chronic hepatitis; however, the serum α-fetoprotein, carcinoembryonic antigen, and PIVKA II levels were all within the normal ranges. The serum C-reactive protein level was 7.71 mg/dl. With a clinical diagnosis of a malignant hepatic tumor invading the right diaphragm, surgery was performed. The tumor originated from segments IV and VII of the liver, was well defined, and grew extrahepatically. The tumor was resected using an ultrasonic cavitational aspirator together with the infiltrated right diaphragm. The resected tumor measured 23 × 13 × 23 cm in size and weighed 3 700 g. Histologically, the tumor was found to consist of hepatocellular carcinomatous component and sarcomatous component. In the sarcomatous component, spindle-shaped cells which were positive for the immunohistochemical localization of vimentin, α-smooth muscle actin, and keratin were identified. The postoperative course was uneventful. The value of the serum C-reactive protein returned to within the normal range, and the patient became afebrile. The patient received a postoperative combination chemotherapy (etoposide, epirubicin, and cisplatin), and remains well with no signs of recurrence 12 months after the operation.

Pigmented neurofibroma: report of two cases and literature review.

Two cases of pigmented neurofibroma of the skin are reported. In case 1, the tumor was removed from the back of a 55‐year‐old man with no associated neurofibromatosis. In case 2, the tumor was removed from the abdominal wall of a 21‐year‐old woman with neurofibromatosis. Both tumors consisted of benign, short spindle cells and multiple foci of scattered melanin‐laden cells. In case 1, the spindle cells were arranged in a storiform pattern, resembling features of dermatofibrosarcoma protuberans. Immunohistochemically, the spindle cells of both cases were demonstrated to be positive for S‐100 protein and CD34. The melanin‐laden cells stained positively for HMB‐45. This report describes an additional two cases of pigmented neurofibroma that conform to the new diagnostic criteria for this disease.

Subcutaneous malignant epithelioid schwannoma with cartilaginous differentiation

Background: Malignant epithelioid schwannoma is a rare tumor. The aim of this study is to describe a case of subcutaneous malignant epithelioid schwannoma with cartilaginous differentiation.