Tomotaka Awano

A comparison between ultrasonography and mammography, computed tomography and digital subtraction angiography for the detection of breast cancers.

Ultrasound (US) was compared with mammography (MMG), computed tomography (CT), and digital subtraction angiography (DSA) in its effectiveness to detect breast cancer masses and metastatic axillary nodes. Forty-seven breast cancer patients who all underwent MMG, US, CT, and DSA preoperatively in our institution between 1986 and 1990 were studied. US was able to detect tumors in all cases regardless of tumor size, whereas DSA detected T1-size tumors and MMG detected T2-size tumors in 40% and 64.7% of cases, respectively, being specifically inferior to US. It was found that MMG was least likely to detect papillotubular carcinoma, although microcalcification alone without a tumor mass on MMG improved detectability from 46.2% to 76.9%, according to the histological type. CT was found to be most sensitive to axillary node metastases (81.8%), followed by US (72.7%), but DSA was significantly unfavorable (42.9%). Thus, we concluded that US was superior to MMG, CT, and DSA for detecting breast cancer masses, but that CT was more advantageous than US, while DSA was of little value for evaluating axillary nodal status.

A Case of Collision Tumor with Leiomyoblastoma and Gastric Cancer.

胃癌と胃平滑筋芽細胞腫の併存例はまれであるが, 今回, 我々は両者の衝突腫瘍の1例を経験したので報告する. 症例は80歳の男性. 労作時呼吸困難と吐血にて緊急入院となった. 胃内視鏡検査で, 胃体部に3センチ大の粘膜下腫瘍と, 前庭部から胃体部にかけて4型の胃癌を認め, 胃亜全摘術+D2郭清術を施行した. 病理組織学的検索にて, 粘膜下腫瘍は平滑筋芽細胞腫, 4型胃癌は低分化型腺癌の像を呈し, 両成分は相接していたが交錯した像は認めず, 両者の衝突腫瘍と診断された. 文献的検索では, 胃平滑筋芽細胞腫260例中, 胃癌を合併したものは20例であり, うち衝突腫瘍は本症例を含め2例であり, 極めてまれな症例であると考えられた.