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要約のみTohoku University永井大樹課

Gastric Schwannoma

Schwannomas, also known as neurinomas or neurilemmomas, are generally benign, slow-growing neoplasms originating in any nerve that has a Schwann cell sheath. These neoplasms are rare among the spindle cell mesenchymal tumors of the gastrointestinal tract, but develop most commonly in the stomach representing 0.2% of all gastric tumors. We present the case of a 57-year-old female patient with a large schwannoma in the stomach that was palpable in the abdomen. She underwent subtotal gastrectomy under suspicion of gastrointestinal stromal tumor (GIST), but post-operative histopathological and immunohistochemical findings showed a fascicular arrangement of spindle cell with pallisading nuclei, and positive for S-100 protein with negative smooth muscle actin (SMA). These results confirmed schwannoma as the diagnosis

Isolated primary schwannoma arising on the colon: report of two cases and review of the literature

Primary schwannoma of the large intestine is an extremely rare neoplasm. Here, we report two cases of colonic schwannoma confirmed pathologically after laparoscopic resection. A 52-year-old female and a 59-year-old female were referred by their general practitioners to our coloproctologic clinic for further evaluation and management of colonic submucosal masses. Colonoscopies performed in our institution revealed round submucosal tumors with a smooth and intact mucosa in the mid-ascending and descending colon, respectively. Computed tomography (CT) scans showed an enhancing soft tissue mass measuring 2 × 2 cm in the right colon and well-defined soft tissue nodule measuring 1.5 × 1.7 cm in the proximal descending colon, respectively. We performed laparoscopic right hemicolectomy and segmental left colectomy under the preoperative impression of gastrointestinal stromal tumors. Two cases were both diagnosed to be benign schwannoma of the colon after immunohistochemical stains (S-100 (+), smooth muscle actin (-), CD117 (-), and CD34 (-))

Benign Schwannoma of the Liver: A Case Report

A primary benign schwannoma of the liver is extremely rare. Only nine cases have been reported in the medical literature worldwide and no case has been reported in Korea previously. A 36-yr-old woman was admitted to our hospital with vague epigastric pain. The ultrasound and computed tomography scan revealed a multi-septated cystic mass in the right lobe of the liver. The mass was resected; it was found to be a 5 × 4 × 2 cm mass filled with reddish yellow fluid. The histological examination confirmed the diagnosis of a benign schwannoma, proven by positive immunoreaction with the neurogenic marker S-100 protein and a negative response to CD34, CD117 and smooth muscle actin. This is the first report of a benign schwannoma of the liver parenchyma in a Korean patient

Aortic thrombus in a patient with myeloproliferative thrombocytosis, successfully treated by pharmaceutical therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Thrombosis in myeloproliferative thrombocytosis occurs usually in the microvessels and medium-sized arteries and veins and only rarely in the aorta. Aortic thrombosis is usually treated with thrombectomy. Reported here is a rare case that was treated pharmacologically.</p> <p>Case presentation</p> <p>A 60-year-old Japanese woman presented with numbness of both lower extremities. Her platelet count was 1787 × 10³/μl. Through bone marrow examination, we diagnosed her condition as myelodysplastic and/or myeloproliferative disorder-unclassifiable. Abdominal ultrasonography and computed tomographic scan revealed aortic thrombosis. Her platelet count was controlled with hydroxyurea and ranimustine. Aspirin and ticlopidine improved the numbness in both lower limbs on the second day. Aortic thrombosis was not observed in a computed tomographic scan on the seventh day.</p> <p>Conclusion</p> <p>For aortic thrombosis, surgical management is usually adopted, but pharmacological management is also an option because of its immediate curative effects.</p

Extrahepatic Biliary Schwannomas: A Case Report

Benign schwannomas arise in neural crest-derived Schwann cells. They can occur almost anywhere in the body, but their most common locations are the central nervous system, extremities, neck, mediastinum, and retroperitoneum. Schwannomas occurring in the biliary tract are extremely rare and mostly present with obstructive jaundice. We recently experienced a case of extrahepatic biliary schwannomas in a 64-yr-old female patient who presented with intra- and extrahepatic bile duct and gallbladder stones during a screening program. To the best of our knowledge, extrahepatic biliary schwannomas associated with bile duct stones have not been reported previously in the literature

クウチュウ シャシン ハンドク ニ ヨル カンナミ ゲンセイリン ノ 40ネンカン ノ リンカン ヘンカ

冷温帯・暖温帯境界域における常緑広葉樹の過去から現在にかけての分布変化の検出の可能性を検証するため,落葉広葉樹林と常緑広葉樹林の接する函南原生林を対象に,異なる年次のオルソ空中写真を用いて樹冠の分布図を作成した。1976年秋と2005年秋の2時期の空中写真を単画像オルソ化し,標高600m,700m,800mの調査区内(150×150m)の樹冠を常緑広葉樹,落葉広葉樹,林冠ギャップの3タイプに目視判読で分類し,その面積変化を調べた。この時2012年冬の空中写真を補足的に使用して,2005年の画像での常緑広葉樹の確認を行った。2005年の分類結果を基準とすることで,単独で常緑広葉樹と落葉広葉樹の分類が困難な1976年データを分類することができた。その結果,全ての調査区で林冠ギャップ面積が40年の間に減少していることがわかった。また,600m調査区では落葉広葉樹の樹冠面積にはほとんど変化が見られず,常緑広葉樹の樹冠面積のみが増加していること,一方,700m,800mの調査区では落葉広葉樹,常緑広葉樹の両方の樹冠面積が増加していることがわかった。従って空中写真の判読により,人為影響の非常に少ない常緑広葉樹の40年間の分布変化を抽出することが可能であるとわかった。Detection of the changes in canopy predominance of evergreen broad-leaved trees for 40 years from 1976to 2005 was examined at the boundary between warm-temperate evergreen broad-leaved forest and cool-temperate deciduous broad-leaved forest in the Kan-nami primary forest by using aerial photographs. Canopies of evergreen and deciduous broad-leaved trees and gaps were distinguished from each other for three study plots (150m × 150m in area) set on the three different altitudes; 600m, 700m, and 800m a.s.l., based on the ortho images of aerial photographs in autumn 1976 and 2005. For the discrimination of evergreen canopies in 2005, ortho images in winter 2012 were used as a supplement, because evergreen canopies could be easily distinguished from deciduous canopies in winter. We distinguished the three types of canopies in 1976 after the identification of the same canopies on the ortho images in 1976 and 2005. Total area of gaps decreased during 40 years in all the three study plots. In the study plot at 600m, total area of evergreen canopies increased, but that of deciduous canopies did not change. In the two study plots at higher altitude, 700m and 800m, both of the total areas of evergreen and deciduous canopies increased during 40 years. It may suggest that the increase in predominance of evergreen broad-leaved trees due to the global warming have already started from lower altitude at the boundary between warm-temperate evergreen broad-leaved forest and cool-temperate deciduous broad-leaved forest