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Kojima M.,Dokkyo Medical University | Tsukamoto N.,Gunma University | Igarashi T.,Gunma Cancer Center Hospital | Matsumoto M.,National Nishigunma Hospital | And 8 more authors.
Cancer Therapy

The large majority of the retroperitoneal malignant lymphoma is follicular center cell lymphomas (FCCL) revise throughout. Frequently, FCCL is associated with extensive sclerosis (sclerosing variant of FCCL). However, little is known about the histological diversity of these types of FCCL. To further clarify histopathological findings of these types of FCCL, 13 such cases have been studied. All 13 cases showed marked sclerosis. Histologically, 9 cases demonstrated a follicular growth pattern at least in a part of the lesion, whereas the specimens of remaining 4 lesions showed a diffuse growth pattern. Based on the WHO classification system, 10 cases were grade 1, 2 were grade 2 and 1 was grade 3. Two histological subtypes have been delineated. Seven cases were easily recognized lymphomatous infiltration based on the histological findings alone because in occasional lymph node areas, tumor cells showed monotonous proliferation without significant sclerosis (monomorphic type). In 2 of the 7 cases, the tumor cells had round or slightly indented medium sized nuclei and moderate amounts of clear cytoplasm somewhat resembling marginal zone B-cell lymphoma. Six cases resembled inflammatory pseudotumor (IPT) of the lymph node (IPT type). However, immunohistochemical study demonstrated the germinal center cell phenotype in all 13 cases. Moreover, fluorescence in situ hybridization analysis demonstrated t(14;18) translocation in 1 case examined. There were only a few IgG4+ cells in 9 lesions examined. There were no Epstein-Barr virus -encoded small RNA (EBER) + spindle cells in any of the 8 lesions studied by the in situ hybridization.The present study demonstrated histological varieties of retroperitoneal FCCL. Only 7/13 cases were easily recognized as malignant lymphoma. Six cases of the IPT-type required differentiation from various fibrohistiocytic proliferations including IPT, retroperitoneal fibrosis, IgG-4 related disorders and inflammatory myofibroblastic tumor. Two of the 13 cases showed histopathological findings similar to those of marginal zone lymphoma. Although, sclerosing variant FCCL does not seem to have clinical significance, it may present diagnostic problems. Source

Mochiki E.,Gunma University | Ogata K.,Gunma University | Ohno T.,Gunma University | Toyomasu Y.,Gunma University | And 7 more authors.
British Journal of Cancer

Background: A combination of S-1 and cisplatin has been shown to be effective with acceptable safety for the first-line treatment of far-advanced gastric cancer in Japan. This is the first randomised phase II trial to compare S-1paclitaxel with S-1cisplatin in this setting. Methods: Patients with unresectable and/or recurrent advanced gastric cancer were randomly assigned to receive one of the two regimens: S-1 (40 mg m -2 twice daily) on days 1-14 plus paclitaxel (60 mg m -2) on days 1, 8, and 15 of a 4-week cycle (S-1paclitaxel) or S-1 (40 mg m -2 twice daily) on days 1-21 plus cisplatin (60 mg m -2) on day 8 of a 5-week cycle (S-1cisplatin). The primary end point was the response rate (RR). Secondary end points included progression-free survival (PFS), overall survival (OS), and safety. Results: A total of 83 patients were eligible for safety and efficacy analyses. In the S-1paclitaxel and S-1cisplatin groups, RRs (52.3% vs 48.7%; P=0.74) and median PFS (9 vs 6 months; P=0.50) were similar. The median OS was similar in the S-1paclitaxel and S-1cisplatin groups (16 vs 17 months; P=0.84). The incidence of grade 3 or higher haematological toxicity was 19.0% with S-1paclitaxel and 19.5% with S-1cisplatin. The incidence of grade 3 or higher non-haematological toxicity was 14.2% with S-1paclitaxel and 17.1% with S-1cisplatin. Conclusion: S-1paclitaxel was suggested to be a feasible and effective non-platinum-based regimen for chemotherapy in patients with advanced gastric cancer. Our results should be confirmed in multicenter, phase III-controlled clinical trials. © 2012 Cancer Research UK All rights reserved. Source

Kojima M.,Dokkyo University | Nakamura N.,Tokai University | Itoh H.,Clinical Pathology Laboratories | Shimizu K.,Saitama Social Insurance Hospital | And 5 more authors.

Background and Study Aim: Because of the small biopsy specimens in the Waldeyer's ring (WR) the differential diagnosis between Epstein-Barr virus (EBV)-associated lymphoproliferative disorder (LPD) and malignant lymphoma is occasionally difficult. We report here clinicopathological, immunohistochemical and genotypic findings of 9 cases of EBV-associated LPDs in WR. Patients and Methods: Using formalin-fixed paraffin-embedded sections, histological analyses, immunohistochemistry, in situ hybridization and polymerase chain reaction were performed. Results: Clinically, all 9 cases showed more than one atypical clinical finding of infectious mononucleosis including absence of systemic symptoms, absence of atypical lymphocytosis and age over 30 years. Histologically, 3 types were delineated: (1) Hodgkin lymphoma-like (n = 1), (2) T cell/histiocyte-rich large B cell lymphoma-like (n = 4), and (3) marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT)-like (n = 4). The in situ hybridization study demonstrated EBV-encoded small RNA (EBER)+ cells in all 9 lesions. The immunohistochemical and flow cytometry study demonstrated the reactive nature of the B cells in all 9 lesions. However, 3 of our 7 cases examined demonstrated immunoglobulin heavy chain gene rearrangement on PCR study. There was no development of B cell lymphoma in any of the 3 lesions demonstrating IgH rearrangement. Conclusion: EBV-associated LPDs of the WR showed marked histological diversity. Among these, a MALT-like pattern was frequently seen. Marginal zone B cell lymphoma frequently affects WR. We emphasized that EBV-associated LPD should be added to the differential diagnosis of primary tonsillar MALT-type lymphoma. Copyright © 2010 S. Karger AG. Source

Takahashi M.,Chiyoda Corporation | Fukuda T.,Gunma Cancer Center Hospital
International Journal of Surgery Case Reports

A 51-year-old man was seen at our hospital because of diarrhea. Barium enema and colonoscopy revealed a cancer in the lower rectum and fistula formation from the site to ileum. Resection of the rectal cancer and ileorectal fistula was performed. Histologically, the resected lesion was mucinous adenocarcinoma with contiguous invasion from the rectum to the ileum. The patient is alive with no sign of recurrence 120 months after operation. Fistula formation between the colon and other gastrointestinal tract organs is very rare, especially for rectal cancer. Fistula-forming colorectal cancers are rarely found to have metastatic lesions in the liver, peritoneum and lymph nodes despite their invasive behavior; accordingly, curative resection involving partial resection of the intestine with fistula is expected. © 2010 Surgical Associates Ltd. Source

Tsukada H.,Niigata Cancer Center Hospital | Yokoyama A.,Niigata Cancer Center Hospital | Goto K.,National Cancer Center Hospital East | Shinkai T.,National Hospital Organization Shikoku Cancer Center | And 40 more authors.
Japanese Journal of Clinical Oncology

Objective: Prospective trials specifically designed for elderly patients with advanced non-small-cell lung cancer demonstrating the benefit of platinum-based therapies are still lacking. This trial was designed to clarify whether the addition of cisplatin to monotherapy could improve survival for elderly patients. Methods: Elderly patients (age ≥70 years, ECOG performance Status 0-1) with advanced non-small-cell lung cancer were randomized to receive docetaxel 20 mg/m2 plus cisplatin 25 mg/m2 on Day 1, 8 and 15 (docetaxel plus cisplatin) or docetaxel 25 mg/m2 on the same schedule (docetaxel). Both regimens were repeated every 4 weeks until disease progression. Results: One hundred and twenty-six patients were enrolled. Sixty-three were randomly assigned docetaxel plus cisplatin and 63 docetaxel monotherapy. Median age was 76 years (range 70-88). The second planned interim analysis was performed on 112 assessable patients (docetaxel/docetaxel plus cisplatin: 56/56). Although the formal criterion for stopping the trial was not met, the Data and Safety Monitoring Committee recommended study termination on ethical grounds based on the interaction (two-sided P = 0.077, hazard ratios for ≤74/≥75: 0.23/0.72) between age and subgroup and treatment arm, which suggested that docetaxel may not represent an adequate control arm regimen for the age subgroup of 70-74 years. Conclusions: The interpretation of study results is limited due to early stopping. Further study is needed to confirm survival benefit of platinum-based chemotherapy for elderly non-small-cell lung cancer [UMIN-CTR (www.umin.ac.jp/ctr/) ID: C000000146]. © The Author 2014. Published by Oxford University Press. All rights reserved. Source

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