An Autopsy Case of Multiple Jejunal Diverticula Showing Severe Malabsorption

A rare autopsy case of multiple jejunal diverticula showing severe malabsorption is reported. A 56-year-old man was admitted due to vomiting and leg edema. On admission, his height was 160cm, his body weight was 39kg, and laboratory data revealed severe hypoproteinemia (TP: 4.0g/dl, ALB: 2.1g/dl). On the 14th day of admission, agonal breathing and disturbance of consciousness occurred after massive vomiting of gastric juice, and the patient died of respiratory failure. At autopsy, on abdominal sectioning, multiple diverticula situated on the mesenterium side of the enteron extending 70cm in length from the proximal jejunum were identified. However there were no findings suggesting perforation or diverticulitis. Histologically, the diverticula were lined by ordinal jejunum mucosa associated with muscularis mucosa, but the muscularis propria was not involved in the diverticular walls. The diverticula were identified as false diverticula. In both lower lungs, aspiration pneumonia was widely seen. The cause of death was considered to be aspiration pneumonia due to the vomiting caused by multiple jejunal diverticula.Only 16 case reports of multiple jejunal diverticulosis in Japan could be found in the literature however most of the reported complications were perforation and diverticulitis, and there were no reports of malabsorption. Therefore, the present case is significant concerning the cause of malabsorption in routine explorations

Positive Relationship between L-type Amino Acid Transporter 1 Expression and Liver Metastasis in T3 Colorectal Cancer

The aim of this retrospective study was to evaluate L-type amino acid transporter 1 (LAT1) expression in colorectal cancer with invasion to the subserosal layer (T3), its relationship with clinicopathological characteristics, and its potential metastatic significance. LAT1 expression was measured by immunohistochemistry in tumors from 65 patients with primary colorectal carcinomas. LAT1 expression was deemed positive when more than 10% of the tumor cells showed distinct membranous immunoreactivity. Positive LAT1 expression was demonstrated in 29.2% (19 of 65) of primary tumors. LAT1 expression showed no significant relationship with clinicopathological characteristics, such as age, gender, tumor location, tumor size, macroscopic/microscopic classification, or lymph node metastasis. However, LAT1 expression showed a positive relationship with liver metastasis (P < 0.05). LAT1 expression in cancer cells may be a good marker for predicting potential metastasis to the liver in colorectal cancer

A Rare Case of Peripheral Primitive Neuroectodermal Tumor Arising from the Minor Salivary Gland in a Young Woman

We report here a case of peripheral primitive neuroectodermal tumor (PNET) arising from the minor salivary gland. A 22-year-old woman was admitted to our hospital for surgical excision of a small painless cheek tumor with a 7-month history. Macroscopically, the tumor measured 10 × 5 × 6mm and was located in the minor salivary gland. Microscopically, the tumor comprised proliferating, small, round cells with scant cytoplasm and high nuclear cytoplasmic ratios. The tumor cells showed some mitotic figures and Homer-Wright-type rosettes. Immunohistochemically, the tumor cells were immunopositive for CD99, synaptophysin, CD56, S-100 protein, and vimentin. Based on these findings, the patient was diagnosed as having PNET arising from the minor salivary gland. There are very few case reports of PNET in the head and neck region, and to the best of our knowledge, this is the first case report of PNET arising from the minor salivary gland

A Case of Unusual Polypoid Mixed Hemangioma of the Sigmoid Colon: Possibly an Angioadenomatous Polyp

Herein, we report on an unusual case of polypoid mixed hemangioma of the sigmoid colon. An 85-year-old woman who underwent colonoscopic examination was found to have a smooth, red polypoid tumor, 6mm in diameter, in the sigmoid colon. The polyp was resected endoscopically. Microscopically, the polyp contained two pathologic components: (i) adenomatous proliferative glands as the epithelial component; and (ii) mixed hemangioma as the mesenchymal component. On the basis of these findings, a pathological diagnosis of angioadenomatous polyp was made. Although seven previous cases of polypoid hemangioma located in the submucosa have been reported in the literature, the present case is the first in which the hemangioma is localized only in the mucosa. The mixed hemangioma may be the pathogen stimulating the adenomatous proliferation of the glands

Neutrophil-rich Pulmonary Carcinoma: Clinicopathological Characteristics and Cytokine Expression and Their Relationship with Lymph Node Metastasis

A small subset of carcinomas of various origins are associated with high numbers of tumor-infiltrating neutrophils (TINs). Here, we examined the characteristics of non-small-cell pulmonary carcinomas with high numbers of TINs, and their relationship with lymph node (LN) metastasis. The study included 100 patients diagnosed and treated for primary pulmonary carcinoma at Showa University Northern Yokohama Hospital from 2011 to 2012. We histopathologically defined tumors with > 10 neutrophils per high-power field as neutrophilrich. Among the 100 patients, 40 were classed as having neutrophilrich pulmonary cancer (NRPC), and tissue samples from these patients were prepared for further examination. Comparison of the clinicopathological factors (age, gender, tumor size, histological type, and grade) in NRPC cases with or without LN metastasis showed that none of the above factors was significantly correlated with LN metastasis. Immunohistochemical analysis of two cytokines that play a major role in granulopoiesis, granulocyte-colony stimulating factor (G-CSF) and macrophage-CSF (M-CSF), revealed that the expression of M-CSF, but not G-CSF, was significantly correlated with LN metastasis. Furthermore, coexpression of M-CSF and the M-CSF receptor was significantly correlated with LN metastasis, but coexpression of G-CSF and the G-CSF receptor did not show such a correlation. These findings indicate that M-CSF-producing NRPCs show a significantly high lymph node metastasis potential