Tsujimoto M

Rare case of the hyaline vascular type of Castleman's disease of the kidney

Abstract:  Castlemans disease (CD) is a rare disorder characterized by a benign proliferation of lymphoid tissue. Most cases tend to present as a mediastinal mass. A few extrathoracic cases involving nodal and extranodal locations have previously been reported. To the best of our knowledge, however, only one case of CD of the kidney has been published in an English report. We herein report a rare case of CD presenting as a left renal tumor. A 70‐year‐old male was examined by computed tomography for a follow‐up for colonic diverticulitis and a left renal mass measuring 2.0 cm in diameter was incidentally found. The patient underwent a left partial nephrectomy for a left renal mass and a histopathological analysis demonstrated the hyaline vascular type of CD. Based on our findings, CD should be included in the differential diagnosis of renal tumors.

[Intravesical bacillus Calmette-Guerin instillation therapy for carcinoma in situ of the urinary bladder and prediction of effects by urinary cytologic examination].

PURPOSE We investigated the effects of intravesical BCG instillations for carcinoma in situ (CIS) of the urinary bladder. And we have retrospectively analyzed the prediction of effects by fresh urinary cytologic examinations before instillation. MATERIAL AND METHODS 33 patients were treated for bladder CIS (1991-1997) with a median follow-up of 30 months (range from 9 to 90 months). The patients (27 males and 6 females) ranged in age from 46 to 91 (average 71 years) and received 6 to 12 weekly BCG Tokyo 172 strain 80 mg instillations. They were divided into 3 groups based on tumor history: primary (9), secondary (15), concurrent (9). The prediction of effects were analyzed by scoring fresh urinary cytologic examinations before instillation. RESULTS 22 cases (67%) were responded and they have remained free of disease for follow-up period. The statistic evaluation proved to show the significance between the effects of treatment and the sum of scoring (cellular appearance and existence of large nuclear cells). CONCLUSION We confirmed the effects of this treatment. The prediction of effect of this treatment seemed to be indicative by fresh urinary cytologic examinations before instillation, especially cellular appearance and existence of large nuclear cells.

Metachronous bilateral testicular seminomas. A case report

A case of metachronous bilateral testicular seminomas on a 36-year-old male is reported. He had a history of right testicular typical seminoma treated with right high orchiectomy and adjuvant irradiation therapy 6 years previously. He returned to our clinic complaining of painless left testicular enlargement in August 1990, and under a diagnosis of testicular neoplasm left high orchiectomy was performed. Histopathological examination revealed anaplastic seminoma. DNA histograms of both testicles revealed almost the same aneuploid pattern. The patient was diagnosed as stage I seminoma, has been followed up closely. Recently genetic factors as human leukocyte antigens (HLA)-A24, B14, DR5 and DR7, have been shown to be important in the development of metachronous bilateral testicular tumors. HLA antigens were determined in our case, and HLA-A24 shown in our case was compatible with the review.