Fujieda Municipal General Hospital Fujieda

Fujieda, Japan

Fujieda Municipal General Hospital Fujieda

Fujieda, Japan
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PubMed | Hamamatsu University School of Medicine, Fujieda Municipal General Hospital Fujieda and University of Tokyo
Type: Journal Article | Journal: Respirology case reports | Year: 2015

An extremely rare case of anterior mediastinal mature teratoma with almost complete gastrointestinal and bronchial walls is described. A 65-year-old woman presented with left precordial pain. Chest computed tomography showed a huge anterior mediastinal tumor, 15cm 21cm, occupying the left thoracic cavity. Post-resection histopathological examination confirmed the diagnosis of mature teratoma and demonstrated almost complete gastrointestinal and bronchial walls. Although mature teratomas of the ovary and sacrococcygeal area are known to rarely contain organoid structures with various degrees of differentiation, this is the first case of an anterior mediastinal mature teratoma that contained well-developed organoid structures.


PubMed | Fujieda Municipal General Hospital Fujieda and University of Tokyo
Type: Journal Article | Journal: Respirology case reports | Year: 2015

The fusion gene echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) is identified in approximately 5% of non-small-cell lung cancer patients. A rare case of ALK-positive squamous cell carcinoma of the lung is reported. A 60-year-old man, an ex-smoker with a 720-packs-per-year tobacco smoking history, presented with a mass lesion in the upper lobe of the left lung on chest computed tomography. Transbronchial biopsy of the mass confirmed a diagnosis of lung squamous cell carcinoma, and it was proven to have ALK rearrangement by fluorescent in situ hybridization. The patient underwent left upper lobectomy. Hematoxylin and eosin staining of the surgical specimen demonstrated the typical morphology of pure squamous cell carcinoma. The patient has been advised to attend regular check-ups for postoperative recurrence. ALK testing and subsequent ALK-targeted treatment can be a possible option in cases of postoperative recurrence.


PubMed | Shizuoka Saiseikai General Hospital Shizuoka and Fujieda Municipal General Hospital Fujieda
Type: Case Reports | Journal: International journal of clinical and experimental pathology | Year: 2015

The morphology of thymoma is diverse, although 5 basic subtypes are recognized in the World Health Organization classification system. Sclerosing thymoma was first documented in 1994 and to date only 13 cases have been reported. Sclerosis itself is considered to be an ancient change and can occur in various histological subtypes. Herein, we present a case of a 62-year-old woman incidentally found to have an anterior mediastinal mass, 31 24 17 mm in size, without an associated autoimmune disease such as myasthenia gravis. The mass was finally diagnosed as sclerosing thymoma derived from type A thymoma. Intraoperative pathological examination using a limited amount of sample did not allow a definitive diagnosis of thymoma in this case. When dealing with fibrous lesions observed in limited samples such as biopsy and intraoperative frozen specimens, recognizing sclerosing thymoma is important since there are several disease entities accompanying fibrosis in the anterior mediastinum.


PubMed | Fujieda Municipal General Hospital Fujieda and University of Tokyo
Type: Case Reports | Journal: International journal of clinical and experimental pathology | Year: 2015

The mesenchymal lesion nodular fasciitis (NF) can affect various sites of the body but usually arises in subcutaneous tissue or occasionally skeletal muscle. NF is not commonly known to arise in joints, and articular NF is extremely rare. Herein, we present a case of a 54-year-old woman with articular NF. No sign of recurrence was observed after surgical piecemeal removal with a suspected positive surgical margin. In our case, a differential diagnosis of NF, desmoid-type fibromatosis, and low-grade myofibroblastic sarcoma was considered. Stromal hyalinization, a characteristic of articular NF, made the diagnosis somewhat difficult, although typical NF morphology was present. Immunohistochemical analysis of -smooth muscle actin, desmin, -catenin, and protein gene product 9.5 expression along with close morphological examination provided a reliable distinction.


PubMed | Hamamatsu University School of Medicine, Fujieda Municipal General Hospital Fujieda and University of Tokyo
Type: Case Reports | Journal: International journal of clinical and experimental pathology | Year: 2016

Bronchial surface epithelium (BSE)-type lung adenocarcinoma is a subtype of non-terminal respiratory unit (TRU)-type lung adenocarcinoma originating in the bronchial surface epithelium. However, there are few known cases of BSE-type adenocarcinoma with marked expression of thyroid transcription factor-1 (TTF-1). This paper describes a very rare case of KRAS mutation-positive BSE-type adenocarcinoma that exhibited strong expression of TTF-1 that was putatively involved in oncogenesis. An 84-year-old woman, a never smoker, was referred to our hospital because of an abnormal chest radiograph. Chest computed tomography (CT) showed a solid mass lesion, 15 mm 10 mm, with a relatively smooth margin in the left upper lobe. The patient underwent partial resection of the left upper lobe for strongly suspected lung cancer with a clinical stage of cT1aN0M0. Histopathological findings showed continuous migration of papillary, hyperplastic, atypical columnar tumor cells originating from normal bronchial surface epithelium, leading to a diagnosis of BSE-type adenocarcinoma. TTF-1 was strongly expressed in almost 100% of the tumor cells, which tested positive for the KRAS mutation. TTF-1 has recently attracted attention as an oncogene, and it is purportedly involved in the carcinogenesis and survival of lung adenocarcinoma cells. There is typically an inverse correlation between the respective expressions of KRAS and TTF-1, but in the present study, they appeared simultaneously and were both putatively involved as oncogenic driver alterations. This case is important in that it sheds some light on the largely unknown pathogenic mechanism of BSE-type adenocarcinoma.

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