Peritoneal keratin granuloma associated with endometrioid adenocarcinoma of the uterine corpus

We present a 69-year-old woman with a chief complaint of postmenopausal bleeding. She was diagnosed as having an endometrioid adenocarcinoma by biopsy, and underwent a total abdominal hysterectomy. At the time of surgery, granulation tissue-like nodules were found on the peritoneal serosa of the uterus. In the intraoperative cytology of peritoneal washing, atypical cells were noted. The intraoperative frozen section of the peritoneal nodule revealed granulation tissue with proliferating mesothelial cells. Microscopic examination of the permanent section showed keratin granulomas without viable adenocarcinoma cells on the serosal surface of the ovaries, fallopian tubes and broad ligaments. Postoperative chemotherapy was administered. She has been alive with no evidence of recurrence for 6 months postoperatively. It should be noted that the prognosis of cases in peritoneal keratin granuloma without viable cancer cells is favorable, and that the histological examination is essential for its diagnosis

Mucosa-associated lymphoid tissue lymphoma of parotid gland with involvement of subglottis and trachea

Although it is well recognized that the salivary glands may acquire Mucosa-associated lymphoid tissue (MALT) lymphoma as a result of Sjögren syndrome (SS), involvements of subglottis and trachea are rare. A 78-year-old woman was referred to our hospital for an enlarged mass of the right parotid area with a history of SS for 7 months. Two weeks after the first visit, she presented with the complaint of stridor and difficulty in breathing. Laryngoscopy revealed the stricture of subglottic space due to the nodular submucosal mass. She was emergently admitted and underwent tracheostomy. Biopsies of the tracheal mucosa and subglottic nodular submucosal mass were pathologically diagnosed as MALT lymphoma. After 6 courses of rituximab plus CHOP (R-CHOP), all lesions disappeared and tracheal stoma were successfully closed. Although MALT lymphoma of upper respiratory tract is extremely rare, respiratory tract should be examined in the patients of parotid lymphoma associated with SS

Detection and diagnosis of rice-infecting viruses

Rice-infecting viruses have caused serious damage to rice production in Asian, American, and African countries, where about 30 rice viruses and diseases have been reported. To control these diseases, developing accurate, quick methods to detect and diagnose the viruses in the host plants and any insect vectors of the viruses is very important. Based on an antigen–antibody reaction, serological methods such as latex agglutination reaction (LAR) and enzyme-linked immunosorbent assay (ELISA) have advanced to detect viral particles or major proteins derived from viruses. They aid in forecasting disease and surveying disease spread and are widely used for virus detection at plant protection stations and research laboratories. From the early 2000s, based on sequence information for the target virus, several other methods such as reverse transcription-polymerase chain reaction (RT-PCR) and reverse transcription- loop-mediated isothermal amplification (RT-LAMP) have been developed that are sensitive, rapid, and able to differentiate closely related viruses. Recent techniques such as real-time RT-PCR can be used to quantify the pathogen in target samples and monitor population dynamics of a virus, and metagenomic analyses using next-generation sequencing and microarrays show potential for use in the diagnosis of rice diseases

化学療法が有効であった乳房外Paget癌の1例

乳房外Paget病は長期間表皮内にとどまっていることが多く,外科的切除により比較的予後良好な疾患である.しかし自覚症状に乏しく,かつ発症部位の特殊性により早期発見が困難なこともある.さらに一旦Paget癌へ進行すると有効な治療法がなく,一転して予後不良とされている.今回われわれは,化学療法により病巣の縮小と明らかな生存期間の延長を認めた乳房外Paget癌の1例を経験したので報告する.症例は72歳,女性.1984年頃より陰部に掻痒感を伴う紅色皮疹を自覚し,近医で処方された外用薬で軽決と増悪を繰り返していた.その後1994年に他院でPaget病と診断され,当院皮膚科で広範囲皮膚切除術を施行された.病理組織学的所見では真皮へ浸潤するPaget癌と診断された.補助化学療法として5-FUの経口投与を受けていたが,1996年4月にCEAの上昇を認め,局所およびリンパ節再発と診断された.手術目的で当科に転科となったが,その際左鼠径部から総腸骨動脈周囲のリンパ節に転移を認め,鼠径リンパ節の生検で低分化腺癌と診断された.そのため予後不良と判断し,患者のQOLを考慮してCDDP・Leucovorin・5-FUによる多剤併用療法を開始した.3クール施行後CEA値は低下し,局所再発巣およびリンパ節転移も著明に縮小し,PRと判定した(PR継続期間53ヵ月).1999年3月,再び左鼠径リンパ節が著明に腫大し皮膚潰瘍を伴うため,Virchowに転移を認めたが左鼠径リンパ節摘除術を施行した.このリンパ節摘除によりCEA値は著明に低下した.その後再発巣は徐々に増悪し,化学療法開始から4年3ヵ月後の2000年10月に死亡した.しかしその間他臓器への浸潤・転移はなく,本人の希望通り最後まで外来での加療が施行され,高度なQOLが得られた.We herein report a patient who presented with extramammary Paget' s carcinoma (EPC) with local and lymph-node recurrences and demonstrated a good response to biochemical modulation chemotherapy. Biochemical modulation chemotherapy seems to be beneficial for patients with EPC with lymph-node metastasis. In August 1994, under a diagnosis of EPC, the patient underwent an extensive skin resection including subcutaneous fatty tissue along a line 3 cm outside the border of the dermatitis. In January 1996, she was diagnosed to have local recurrence and lymph-node metastasis of EPC. As a result, cisplatin (CDDP) + leucovorin (LV) + 5-fluorouracil (5FU) chemotherapy was started according to the patient' s wishes and from the standpoint of the patient' s age and quality of life. After three courses of this therapy, the patient was judged to show a partial response (PR). After six courses, the regimen was changed due to grade 3 leucopenia. Thereafter, the disease progressed. However, she continued the chemotherapy. On October 13, 2000, four years and three months after bigining the chemotherapy, she died. In this case, the chemotherapy was judged to be effective based on: the degree of reduction of tumor size, the long survival period of 4 years 3 months from the start of chemotherapy, the absence of any severe side effects, and the high quality of life, which was defined as a normal daily life without admission to the hospital. It is concluded that low-dose CDDP/LV/5-FU therapy may therefore be a useful chemotherapeutic regimen for advanced EPC

化学療法が有効であった乳房外Paget癌の1例

乳房外Paget病は長期間表皮内にとどまっていることが多く,外科的切除により比較的予後良好な疾患である.しかし自覚症状に乏しく,かつ発症部位の特殊性により早期発見が困難なこともある.さらに一旦Paget癌へ進行すると有効な治療法がなく,一転して予後不良とされている.今回われわれは,化学療法により病巣の縮小と明らかな生存期間の延長を認めた乳房外Paget癌の1例を経験したので報告する.症例は72歳,女性.1984年頃より陰部に掻痒感を伴う紅色皮疹を自覚し,近医で処方された外用薬で軽決と増悪を繰り返していた.その後1994年に他院でPaget病と診断され,当院皮膚科で広範囲皮膚切除術を施行された.病理組織学的所見では真皮へ浸潤するPaget癌と診断された.補助化学療法として5-FUの経口投与を受けていたが,1996年4月にCEAの上昇を認め,局所およびリンパ節再発と診断された.手術目的で当科に転科となったが,その際左鼠径部から総腸骨動脈周囲のリンパ節に転移を認め,鼠径リンパ節の生検で低分化腺癌と診断された.そのため予後不良と判断し,患者のQOLを考慮してCDDP・Leucovorin・5-FUによる多剤併用療法を開始した.3クール施行後CEA値は低下し,局所再発巣およびリンパ節転移も著明に縮小し,PRと判定した(PR継続期間53ヵ月).1999年3月,再び左鼠径リンパ節が著明に腫大し皮膚潰瘍を伴うため,Virchowに転移を認めたが左鼠径リンパ節摘除術を施行した.このリンパ節摘除によりCEA値は著明に低下した.その後再発巣は徐々に増悪し,化学療法開始から4年3ヵ月後の2000年10月に死亡した.しかしその間他臓器への浸潤・転移はなく,本人の希望通り最後まで外来での加療が施行され,高度なQOLが得られた.We herein report a patient who presented with extramammary Paget\u27 s carcinoma (EPC) with local and lymph-node recurrences and demonstrated a good response to biochemical modulation chemotherapy. Biochemical modulation chemotherapy seems to be beneficial for patients with EPC with lymph-node metastasis. In August 1994, under a diagnosis of EPC, the patient underwent an extensive skin resection including subcutaneous fatty tissue along a line 3 cm outside the border of the dermatitis. In January 1996, she was diagnosed to have local recurrence and lymph-node metastasis of EPC. As a result, cisplatin (CDDP) + leucovorin (LV) + 5-fluorouracil (5FU) chemotherapy was started according to the patient\u27 s wishes and from the standpoint of the patient\u27 s age and quality of life. After three courses of this therapy, the patient was judged to show a partial response (PR). After six courses, the regimen was changed due to grade 3 leucopenia. Thereafter, the disease progressed. However, she continued the chemotherapy. On October 13, 2000, four years and three months after bigining the chemotherapy, she died. In this case, the chemotherapy was judged to be effective based on: the degree of reduction of tumor size, the long survival period of 4 years 3 months from the start of chemotherapy, the absence of any severe side effects, and the high quality of life, which was defined as a normal daily life without admission to the hospital. It is concluded that low-dose CDDP/LV/5-FU therapy may therefore be a useful chemotherapeutic regimen for advanced EPC

Increased expression of SPRR1A is associated with a poor prognosis in pancreatic ductal adenocarcinoma.

ObjectivesSmall proline-rich protein 1A (SPRR1A) is recognized as a squamous differentiation marker but is also upregulated in some non-squamous cancers. However, its expression in pancreatic ductal adenocarcinoma (PDAC) has not been investigated. This study elucidated the expression of SPRR1A in PDAC and its effect on the prognosis and malignant behavior of PDAC.MethodsWe examined the SPRR1A expression by immunohistochemistry in 86 surgical PDAC cases and revealed the relationship between its expression and the prognosis of the PDAC patients. Furthermore, we overexpressed SPRR1A in pancreatic cancer cell lines (PK-1 and Panc-1) and assessed the phenotype and gene expression changes in vitro.ResultsAmong the 84 cases, excluding 2 with squamous differentiation, 31 (36.9%) had a high SPRR1A expression. The overall survival (median 22.1 months vs. 33.6 months, p = 0.0357) and recurrence-free survival (median 10.7 months vs. 15.5 months, p = 0.0298) were significantly lower in the high-SPRR1A-expression group than in the low-SPRR1A-expression group. A multivariate analysis indicated that a high SPRR1A expression (HR 1.706, 95% CI 1.018 to 2.862, p = 0.0427) and residual tumor status (HR 2.687, 95% CI 1.487 to 4.855, p = 0.00106) were independent prognostic factors. The analysis of TCGA transcriptome data demonstrated that the high-SPRR1A-expression group had a significantly worse prognosis than the low-SPRR1A-expression group, which supported our data. SPRR1A overexpression in PK-1 and Panc-1 did not result in remarkable changes to in vitro phenotypes, such as the cell proliferation, chemo-resistance, EMT, migration or global gene expression.ConclusionIncreased expression of SPRR1A is associated with a poor prognosis in PDAC and may serve as a novel prognostic marker. However, our in vitro study suggests that the SPRR1A expression may be a consequence, not a cause, of the aggressive behavior of PDAC

Peritoneal keratin granuloma associated with endometrioid adenocarcinoma of the uterine corpus

Abstract We present a 69-year-old woman with a chief complaint of postmenopausal bleeding. She was diagnosed as having an endometrioid adenocarcinoma by biopsy, and underwent a total abdominal hysterectomy. At the time of surgery, granulation tissue-like nodules were found on the peritoneal serosa of the uterus. In the intraoperative cytology of peritoneal washing, atypical cells were noted. The intraoperative frozen section of the peritoneal nodule revealed granulation tissue with proliferating mesothelial cells. Microscopic examination of the permanent section showed keratin granulomas without viable adenocarcinoma cells on the serosal surface of the ovaries, fallopian tubes and broad ligaments. Postoperative chemotherapy was administered. She has been alive with no evidence of recurrence for 6 months postoperatively. It should be noted that the prognosis of cases in peritoneal keratin granuloma without viable cancer cells is favorable, and that the histological examination is essential for its diagnosis.</p