Yoshihisa Morisaki

Adenoid cystic carcinoma of the esophagus: Report of a case and review of the Japanese literature

We report herein the case of a 79-year-old man with adenoid cystic carcinoma (ACC) of the esophagus. The tumor had a polypoid appearance and was covered by thin esophageal mucosa. As the biopsy specimens suggested a diagnosis of poorly differentiated adenocarcinoma, the patient underwent subtotal esophagectomy with reconstruction of the gastric tube via the posterior mediastinum. Histologically, the carcinoma contained basaloid cells, cribriform foci, and a certain amount of eosinophilic hyaline substance. Some of the basaloid cells were stained immunohistochemically for keratin, muscle actin, and S-100 protein, a pattern which was identical to the pattern of immunoreactivity of the myoepithelium. We reviewed 36 other cases of ACC of the esophagus reported in Japan, with special reference to the criteria for histological diagnosis.

Periosteal Chondroma Developing in a Rib at the Side of a Chest Wall Wound from a Previous Thoracotomy: Report of a Case

We describe herein the case of a 45-year-old man who developed a periosteal chondroma in a rib at the site of a thoracotomy that had been performed 24 years previously. To our knowledge, this is only the third case of a periosteal chondroma in a rib to be documented in the world literature. Some authors have suggested that trauma, including that of surgery, may induce chondroma formation and this association could have been an important contributing factor in the induction of the tumor in this patient.

Intrapulmonary cystic lymphangioma: Report of a case

We describe herein the case of a 52-year-old man found to have a solitary pulmonary lymphangioma. Computed tomography (CT) scan demonstrated a nodule with homogeneous density and a well-defined border in the lower lobe of the right lung. T2-Weighted magnetic resonance imaging (MRI) revealed a nodule with homogeneously high signal intensity. The tumor was removed by partial resection, and pathologic examination confirmed a diagnosis of primary lymphangioma of the lung.

PCNA immunostaining combined with AgNOR staining in esophageal squamous cell carcinoma to identify patients with a poor prognosis

Immunostaining of the proliferating cell nuclear antigen (PCNA) provides important information about cell kinetics and is easily performed on routinely obtained formalin-fixed, paraffin-embedded materials. We report herein the results of a retrospective study on PCNA staining in esophageal cancer undertaken to determine its significance. As this study indicated that immunoreactivity was preserved in specimens fixed within 24 h, only 31 specimens from surgical patients were available for this investigation. The mean PCNA index of the patients without invasion to the adventitia (35.7±17.9) was significantly lower than that of those with invasion to the adventitia or neighboring structures (49.7±14.5), while the PCNA index did not correlate with other clinicopathologic parameters such as histologic type, lymph node metastases, or prognosis. However, when an analysis of PCNA staining was combined with an analysis of argyrophilic nucleolar organizer region (AgNOR) staining, a correlation with prognosis was found. In fact, seven patients with a high PCNA index (≧44) and AgNOR count (≧6) had a significantly poorer prognosis than the remaining 22 (P=0.0014), and six of these seven patients died within 2 years. These results indicate that this combined evaluation may be useful for the identification of patients with a poor prognosis among those undergoing surgery for esophageal squamous cell carcinoma.

Successful combined resection of carcinoma of the esophagus and adrenal metastasis: Report of a case

We report herein the case of a 56-year-old man who underwent successful combined resection of carcinoma of the esophagus and an adrenal metastasis. The patient presented with carcinoma of the thoracic esophagus, and an adrenal tumor was incidentally detected by computed tomography(CT). Complete removal of the carcinoma was accomplished along with a combined resection of the thoracic esophagus and left adrenal gland. Surgery was followed by the administration of anticancer chemotherapeutic agents. He is currently doing well with a grade 1 performance status and no signs of recurrence 22 months after his operation. To our knowledge, no previous report of the successful simultaneous resection of esophageal carcinoma and an adrenal metastasis has been documented in the literature.

Basaloid Carcinoma of the Thymus : Report of a Case

We report a case of basaloid carcinoma of the thymus, confirmed by histopathological examination, in a 52-year-old man who underwent complete resection. Local recurrence and lung metastases developed, which were obliterated by radiation therapy. The patient survived for 81 months after surgery. We reviewed the 13 other cases of basaloid carcinoma of the thymus reported in the literature. Presumably, this tumor is radiosensitive and its metastatic route is blood-borne.

SIMULTANEOUS RESECTION OF GASTRIC CARCINOMA AND SPLENECTOMY IN A PATIENT WITH POLYCYTHEMIA VERA : REPORT OF A CASE

We report herein the case of a 57-year-old man who underwent resection of gastric carcinoma after being treated for polycythemia vera (PV) for 16 months. He was admitted with gastrointestinal bleeding; barium meal roentogenogram and endoscopic examination subsequently revealed a Borrmann type II carcinoma in the cardia of the stomach with extension into the lower esophagus. Thus, a lower esophagogastrectomy, distal pancreatectomy, splenectomy, and lymph node dissection were performed. Although an insufficiency of the esophagojejunal anastomosis occurred, the patient suffered no hematologic complications in the setting of careful myelosuppressive and antiplatelet coagulation therapy. He is currently doing well 5 years after his operation, with grade 1 performance status and no signs of recurrence or any hematologic complications.

Immunohistochemical Study of Esophageal Carcinomas Other Than Squamous Cell Carcinoma

It was previously thought that esophageal carcinomas other than squamous cell carcinoma were very rare; for example, Suzuki and Nagayo found 256 (2.1%) of 11,932 resected cases and 360 (7.2%) of 4995 autopsied cases of the esophagus [1]. However, recently some authors have indicated that these tumors were not so rare [2, 3]. We found 29 cases (12.7%) of these carcinomas among 229 resected cases of esophageal carcinoma from 1978 to 1991, we interested the histological origins of the 29 cases (12.7%) of non-squamous cell carcinoma. These tumors were immunohistochemically stained for the purpose of determination of their histological origin and/or differentiation.