Noninvasive diagnostic procedures for the preoperative localization of parathyroid tumors were performed on a 59-year-old woman with hypercalcemia. In this case, sonography and computed tomographic scanning could not pin...Noninvasive diagnostic procedures for the preoperative localization of parathyroid tumors were performed on a 59-year-old woman with hypercalcemia. In this case, sonography and computed tomographic scanning could not pinpoint the location of the tumor. Thallium-201 and technetium-99m subtraction scintigraphy was also inconclusive in the precise localization of the tumor, but it did define the location retrospectively. However, magnetic resonance imaging (MRI) clearly demonstrated the parathyroid tumor as a high signal on T2-weighted image in the left upper part of the superior mediastinum. The intrathymic parathyroid oxyphil adenoma was resected. Therefore, MRI was considered an effective tool for the localization of parathyroid adenoma, particularly mediastinal parathyroid adenoma.
We report a 69-year-old female patient with mucinous cystadenocarcinoma of the appendix and elevated serum carcinoembryonic antigen (CEA). Serum CEA levels were 27.6-37.8 ng/ml. An oval shaped cystic mass at the ileoceca...We report a 69-year-old female patient with mucinous cystadenocarcinoma of the appendix and elevated serum carcinoembryonic antigen (CEA). Serum CEA levels were 27.6-37.8 ng/ml. An oval shaped cystic mass at the ileocecal region was consistently seen by several radiologic procedures such as, barium enema, ultrasonography, computed tomography, and magnetic resonance imaging. The tumor was resected, and the histopathologic findings indicated mucinous cystadenocarcinoma of the appendix. CEA was demonstrated in the neoplastic columnar cells in immunohistochemical studies. The literature on the determination of serum CEA level in adenocarcinoma of the appendix is reviewed.
A rare case of tracheopathia osteochondroplastica complicated with malignancy is reported. Further examination of hemosputum following thyroid cancer operation revealed an abnormal finding of the trachea, suggesting the...A rare case of tracheopathia osteochondroplastica complicated with malignancy is reported. Further examination of hemosputum following thyroid cancer operation revealed an abnormal finding of the trachea, suggesting the recurrence of thyroid cancer. However, the serum level of thyroglobulin was within the normal range. In contrast, the findings of bronchofiberscopy and the histological analysis confirmed the presence of tracheopathia osteochondroplastica. Therefore, measurement of serum thyroglobulin level and the bronchofiberscopy procedure were valuable for the differential diagnosis of metastasis of thyroid cancer in this case. Additionally, case reports of tracheopathia osteochondroplastica in Japan are summarized.
A 73-year-old man developed graft-versus-host disease (GVHD) after blood transfusion; he developed hepatitis, fever, rash, and pancytopenia. Although similar cases have been previously reported, the spectra of their live...A 73-year-old man developed graft-versus-host disease (GVHD) after blood transfusion; he developed hepatitis, fever, rash, and pancytopenia. Although similar cases have been previously reported, the spectra of their liver injury was not clarified. The clinical and pathological findings of this case and a review of earlier reports suggest a possible predominance of hepatocellular injury in cases of GVHD after blood transfusion, which is in contrast to the prevalence of cholestatic liver disease in GVHD following bone marrow transplantation.
A case of primary diffuse tracheobronchial amyloidosis in a 45-year-old woman is reported. Because of tracheal stenosis immediately beneath the vocal cords, due to amyloid deposits, she was treated with Nd-YAG laser irra...A case of primary diffuse tracheobronchial amyloidosis in a 45-year-old woman is reported. Because of tracheal stenosis immediately beneath the vocal cords, due to amyloid deposits, she was treated with Nd-YAG laser irradiation. Immediately after treatment, symptoms such as cough, wheezing, and shortness of breath on exertion improved. Bronchoscopic Nd-YAG laser irradiation proved useful for the removal of amyloid deposits from the trachea in this patient.
A case of primary chondrosarcoma of the lung is presented. The tumor, located in the medial segment of the right lower lobe, was successfully resected surgically. Clinical survey did not reveal any primary lesion elsewhe...A case of primary chondrosarcoma of the lung is presented. The tumor, located in the medial segment of the right lower lobe, was successfully resected surgically. Clinical survey did not reveal any primary lesion elsewhere. The tumor consisted of myxomatous, chondromatous, and fibrous lesions. Immunohistochemical study revealed that tumor cells were positive for S-100 protein and vimentin, and negative for other antisera which characterize epithelial tumors. With these clinical, histological, and immunohistochemical studies we diagnosed the tumor as a primary chondrosarcoma of the lung.
A 53-year-old previously healthy woman suddenly developed adult respiratory distress syndrome (ARDS) of unknown etiology. High-dose corticosteroid pulse therapy and artificial ventilation were started immediately and she...A 53-year-old previously healthy woman suddenly developed adult respiratory distress syndrome (ARDS) of unknown etiology. High-dose corticosteroid pulse therapy and artificial ventilation were started immediately and she dramatically responded to the treatment. However, soon after recovery from ARDS, she developed typical rheumatoid arthritis (RA). Although no apparent relationship between RA and ARDS was clear, this case is quite suggestive in the consideration of the etiology of ARDS.
A 77-year-old man, who had been a subway construction worker, was admitted to our hospital for surgical treatment of left cheek carcinoma and an examination for pancytopenia on November 17, 1986. Bone marrow aspiration r...A 77-year-old man, who had been a subway construction worker, was admitted to our hospital for surgical treatment of left cheek carcinoma and an examination for pancytopenia on November 17, 1986. Bone marrow aspiration revealed that 10% of the nucleated cells were blasts with morphological atypism. Bone marrow biopsy showed hypocellular marrow and a diffuse increase of argyrophil fibers with the presence of asbestos fibers was observed by microscope. A chest X-ray showed the findings of old tuberculosis and pulmonary asbestosis, and asbestos fibers were demonstrated in the broncho-pulmonary lavage fluid. He was diagnosed to have pulmonary asbestosis complicated with hypoplastic low percentage leukemia.
Skin involvement of Hodgkin's disease, which typically occurs in the advanced stage, is rare and is associated with a poor prognosis. We report a case of Hodgkin's disease which recurred solely in the skin and followed a...Skin involvement of Hodgkin's disease, which typically occurs in the advanced stage, is rare and is associated with a poor prognosis. We report a case of Hodgkin's disease which recurred solely in the skin and followed a favorable clinical course. A 44-year-old Japanese man was diagnosed as having a mediastinal Hodgkin's disease in January 1983. After a complete remission, recurrent skin tumors appeared in the left supraclavicular and anterior chest regions in March 1988. No evidence of lymph nodes or visceral organ involvement was detected. The tumors regressed after chemotherapy. There is no evidence of the disease 7 months after discharge.
A new variant of apolipoprotein E (apo E), named apo E-Kochi, was identified in the sera of a 29-year-old male with hyperlipoproteinemia as characterized by a broad-beta band. The characteristic double bands of apo E wer...A new variant of apolipoprotein E (apo E), named apo E-Kochi, was identified in the sera of a 29-year-old male with hyperlipoproteinemia as characterized by a broad-beta band. The characteristic double bands of apo E were seen in the isoelectric focusing gel of very low density lipoprotein from the proband and three members of his family. Of the double bands from the probands, the more cationic component was identical to ordinary apo E3 and the other anionic band was located at approximately a distance of one-half charge to the anode side. This anionic band is a new electrophoretical isoform of apo E (apo E-Kochi), and the molecular weight by sodium dodecyl sulfate electrophoresis and its antigenicity against anti apo E serum are the same as apo E3. Sequence analysis of lysyl endopeptidase fragments showed that apo E-Kochi differs from normal apo E3 at residue 145, where an arginine residue is substituted for histidine.