研究者総覧

大城 久 (オオシロ ヒサシ)

  • 総合医学第1講座 教授
Last Updated :2021/09/23

研究者情報

学位

  • 医学博士

ホームページURL

J-Global ID

研究キーワード

  • mechanisms of cancer metastasis   pathology of the serosal membrane   pathology of the lymphatic system   

研究分野

  • ライフサイエンス / 消化器内科学
  • ライフサイエンス / 外科学一般、小児外科学
  • ライフサイエンス / 腫瘍診断、治療学
  • ライフサイエンス / 人体病理学
  • ライフサイエンス / 実験病理学

研究活動情報

論文

  • Mio Tamba-Sakaguchi, Hisashi Oshiro, Naoko Mato, Ichiro Kikkawa, Teruaki Endo, Miki Yanagita, Tomoko Suzuki, Maho Akimoto, Naota Okabe, Masahiro Hiruta, Eriko Ikeda, Noriyoshi Fukushima
    Diagnostic cytopathology 2021年09月 
    Cytological detection of chordoma cells in the serosal cavity is challenging because of its rare presentation. Herein, we report a case of chordoma showing malignant pleural effusion accompanied by pleuropulmonary metastases in a 68-year-old woman. Cytological analysis was performed using pleural fluid obtained following thoracentesis. Conventional cytological staining demonstrated few clusters of large, atypical cells characterized by epithelial cell-like connectivity and rich cytoplasm with foamy and/or multivacuolar changes. The nuclei of these atypical cells were large and either round or oval with no conspicuous irregularities in the nuclear membrane. Periodic acid-Schiff staining of these atypical cells revealed fine granules in the cytoplasm. Giemsa staining showed foamy and/or multivacuolar cytoplasm in these cells, with metachromatic mucoid stroma in the surroundings. Immunocytochemistry analysis using cellblock showed these cells to be positive for broad cytokeratins, epithelial membrane antigen, S100 protein, vimentin, and Brachyury. To the best of our knowledge, this is the first case report in which chordoma cells were cytologically detected in pleural effusions. Our findings also suggest that conventional cytology combined with cellblock immunocytochemistry can increase the accuracy of chordoma cell detection in the serosal cavity.
  • Katsutoshi Sugimoto, Dong Ho Lee, Jae Young Lee, Su Jong Yu, Fuminori Moriyasu, Kentaro Sakamaki, Hisashi Oshiro, Hiroshi Takahashi, Tatsuya Kakegawa, Yusuke Tomita, Masakazu Abe, Yu Yoshimasu, Hirohito Takeuchi, Byung Ihn Choi, Takao Itoi
    Radiology 210046 - 210046 2021年09月 
    Background Nonalcoholic fatty liver disease (NAFLD) is common in the general population but identifying patients with high-risk -nonalcoholic steatohepatitis (NASH) who are candidates for pharmacologic therapy remains a challenge. Purpose To develop a score to identify patients with high-risk NASH, defined as NASH with an NAFLD activity score (NAS) of 4 or greater and clinically significant fibrosis (stage 2 [F2] or higher). Materials and Methods This was a cross-sectional secondary analysis of data prospectively collected between April 2017 and March 2019 for a group of patients with NAFLD in Japan (Japan NAFLD, the derivation data set) with contemporaneous two-dimensional shear-wave elastography and biopsy-proven NAFLD (age range, 20-89 years). Three US markers (liver stiffness [LS, measured in kilopascals], attenuation coefficient [AC, measured in decibels per centimeter per megahertz], and dispersion slope [DS, measured in meters per second per kilohertz]) were determined, together with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and the AST-to-ALT ratio. The best-fit multivariate logistic regression model for identifying patients with high-risk NASH was determined. Diagnostic performance was assessed by using the area under the receiver operating characteristic curve (AUC). The findings were validated in an independent data set (Korea NAFLD; age range, 20-78 years). Results The Japan NAFLD data set included 111 patients (mean age, 53 years ± 18 [standard deviation]; 57 men), 84 (76%) with NASH. The Korea NAFLD data set included 102 patients (mean age, 48 years ± 18; 43 men), 55 (36%) with NASH. The most predictive model (LAD NASH score) combined LS, AC, and DS. Performance was satisfactory in both the derivation sample (AUC, 0.86; 95% CI: 0.79, 0.93) and the validation sample (AUC, 0.88; 95% CI: 0.80, 0.95). The LAD NASH score showed a positive predictive value of 86.5% and a negative predictive value of 87.5% for high-risk NASH in the derivation sample. Conclusion A score combining three US markers may be useful for noninvasive identification of patients with high-risk nonalcoholic steatohepatitis for inclusion in clinical trials and pharmacologic therapy. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Lockhart in this issue.
  • Katsutoshi Sugimoto, Masakazu Abe, Hisashi Oshiro, Hiroshi Takahashi, Tatsuya Kakegawa, Yusuke Tomita, Yu Yoshimasu, Hirohito Takeuchi, Takao Itoi
    Journal of medical ultrasonics (2001) 2021年08月 
    PURPOSE: Attenuation imaging (ATI) is a new noninvasive ultrasound technique for assessing steatosis grade (S). However, validated region-of-interest (ROI) sampling strategies are not currently available. We investigated the diagnostic performance of various ATI-ROI positions for determining histopathologic S in patients with nonalcoholic fatty liver disease (NAFLD). METHODS: This retrospective study included 105 patients with biopsy-proven NAFLD. All attenuation coefficient (AC, dB/cm/MHz) measurements were obtained by the same hepatologist using a commercially available ultrasound system on the same day as liver biopsy. Mean (± standard deviation) age and body mass index of the patients were 53 (± 18) years and 27.1 (± 4.1) kg/m2, respectively. The numbers of patients with steatosis affecting < 5%, 5-33%, 33-66%, and > 66% of hepatocytes were 8, 50, 29, and 18, respectively. The ATI-ROI was placed at three different positions for AC measurement using a dedicated workstation: the upper edge of the area ROI, twice the depth of the liver capsule, and the lower edge of the area ROI. Diagnostic performance was evaluated using the area under the receiver-operating characteristic curve (AUC). RESULTS: The AUCs of AC at the three ATI-ROI positions were 0.734 (95% confidence interval [CI]: 0.470-0.998), 0.750 (0.639-0.861), and 0.878 (0.788-0.968) for S ≥ 1; 0.503 (0.392-0.615), 0.824 (0.741-0.907), and 0.809 (0.724-0.895) for S ≥ 2; and 0.606 (0.486-0.726), 0.849 (0.767-0.932), and 0.737 (0.626-0.848) for S = 3, respectively. CONCLUSION: For accurate steatosis grade assessment, the ATI-ROI should not be placed at the upper edge of the area ROI.
  • Yoshiko Mizushina, Fumiyoshi Ohyanagi, Jun Shiihara, Motoko Nomura, Hiromitsu Ohta, Hisashi Oshiro, Hiroyoshi Tsubochi, Gen Kusaka, Yasuhiro Yamaguchi
    Thoracic cancer 2021年07月 [査読有り]
     
    A 52-year-old man underwent pneumonectomy of the left lung for previously diagnosed primary spindle cell carcinoma (pT4aN1M0, stage III B) with programmed death-ligand 1 expression (tumor proportion score ≥95%) and without epidermal growth factor receptor gene mutation and anaplastic lymphoma kinase fusion gene. However, brain metastasis and chest wall tumor relapse occurred. Considering insufficient improvement with gamma knife treatment for brain metastasis and combination chemotherapy (paclitaxel, carboplatin, and bevacizumab), pembrolizumab monotherapy and palliative irradiation therapy for chest metastases were started after brain tumor volume reduction using craniotomy. Brain edema and chest wall metastases markedly improved following a pseudoprogression of the brain edema accompanied by a performance status decline; this effect continued until 11 cycles of pembrolizumab administration.
  • Yoshihiro Furuichi, Katsutoshi Sugimoto, Hisashi Oshiro, Masakazu Abe, Hirohito Takeuchi, Yuu Yoshimasu, Takao Itoi
    Journal of medical ultrasonics (2001) 2021年06月 [査読有り]
     
    PURPOSE: Measurement of spleen stiffness (SS) using ultrasound (US) elastography is useful for predicting portal hypertension. However, the mechanism leading to increased SS remains unclear. We jointly developed a new US elastography system (Aplio i-series, Canon Medical Systems) that can easily measure organ viscosity (dispersion slope: DS). We analyzed the cause of increased SS by calculating the shear wave speed (SWs, which reflects fibrosis) and DS of the spleen in carbon tetrachloride (CCL4) rat liver cirrhosis models. METHODS: A total of 13 Sprague-Dawley rats were randomly divided into four groups (C group: 3 rats as control, 2D group: 3 rats injected with CCL4 twice in 1 week, 4D group: 4 rats injected 4 times in 1 week, 6W group: 3 rats injected twice a week for 6 weeks). The SWs and the DS of each group were calculated, and histopathological analysis was performed. RESULTS: The spleen SWs of the 6W group was significantly higher than that of the C group (p = 0.044). The spleen DS did not change after CCL4. The liver SWs of the 4D and 6W groups was significantly higher than that of the C group (p = 0.012 and 0.007, respectively) with fibrosis change on histopathology, and the DS of the 4D group was significantly higher than that of the C group (p = 0.033). Splenic fibrosis was confirmed in the 6W group, but inflammation and necrosis were not seen. CONCLUSION: SS increased due to fibrosis and can be predicted based on SWs and DS values.
  • Yusuke Amano, Mio Sakaguchi-Tamba, Yumiko Sasaki, Hisashi Oshiro, Noriyoshi Fukushima, Takashi Fujita, Shinobu Masuda, Toshiro Niki
    Medicine 99 42 e22665  2020年10月 [査読有り]
     
    INTRODUCTION: Breast adenomyoepithelioma (AME) is a rare tumor composed of myoepithelial cells and ductal or luminal cells. Most cases of AME are benign, but rare cases in which either or both cell types exhibited malignant features have been reported. Due to its rarity, no diagnostic criteria for malignancy have been established for AME. PATIENT CONCERNS: A 64-year-old woman presented with a mass in her right breast. Fine-needle aspiration cytology and biopsy examinations revealed lesions composed of spindle-shaped cells and round epithelial cells. AME was suspected, and partial mastectomy was performed. DIAGNOSIS: The tumor specimen showed AME, which mainly consisted of spindle-shaped myoepithelial cells with slight atypia, admixed with tubular luminal cells and small areas of atypical intraductal proliferative lesions. No apparent features of malignancy, such as necrosis or invasion, were seen in the myoepithelial cells or the luminal or intraductal component. However, the atypical intraductal component exhibited focal nuclear atypia, a cribriform pattern, and moderate to strong membranous human epidermal growth factor receptor 2 (HER2) immunoreactivity. HER2 amplification was detected in focal regions of the atypical intraductal component by fluorescence in situ hybridization (FISH), which resulted in a diagnosis of AME with ductal carcinoma in situ. OUTCOMES: The patient did not receive further therapy and was free from tumor recurrence at 23 months after the operation. CONCLUSION: HER2 FISH might be useful for evaluating suspected AME tumors for malignancy when an atypical ductal lesion that lacks definitive features of malignancy is encountered.
  • Koji Okudela, Tetsukan Woo, Yusuke Saigusa, Hiromasa Arai, Mai Matsumura, Hideaki Mitsui, Misaki Sugiyama, Motoki Sekiya, Yoshihiro Ishikawa, Hisashi Oshiro, Yoichi Kameda, Kenichi Ohashi
    Histopathology 2020年08月 [査読有り][通常論文]
     
    AIMS: Proliferative activity, evaluated from the Ki-67 index, is a strong prognostic factor in lung adenocarcinoma (LADC). Here, we optimized a procedure to measure the Ki-67 index and establish the best cut-off value. METHODS AND RESULTS: We examined 342 LADCs at stage I for the immunohistochemical expression of Ki-67 using different antibodies, MIB1 and SP6. The results revealed the superior specificity of SP6; therefore, SP6 was used in subsequent analyses. Slides were scanned with a virtual slide system. Using software, tumor cells were counted in a whole tumor. Thereafter, the tumor was evenly subdivided into 0.25-mm2 tiles. The frequency of positive cells was counted in each tile of an invasive area or the whole tumor. We calculated the number of tumor cells required to produce a 95% confidential interval (CI) <0.05. Additionally, we calculated coverage probabilities (CP) using two different methods, counting any number or 200 cells per tile. The results showed that we could meet our goal by counting 2000 cells from 10 random tiles (200 cells each) in invasive areas. CONCLUSIONS: We successfully developed an optimal procedure using an SP6 antibody, which provided CP >70% and CI of <0.05 in more than 90% of cases. Furthermore, we identified an optimal cut-off value of 0.12 with an alternative of 0.15, based on disease recurrence. This procedure and the cut-off values may be used in the routine pathological diagnosis of LADC.
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Hisashi Oshiro, Hirohito Takeuchi, Masakazu Abe, Yu Yoshimasu, Yoshitaka Kasai, Kentaro Sakamaki, Takeshi Hara, Takao Itoi
    Radiology 192665 - 192665 2020年06月 [査読有り][通常論文]
     
    Background Nonalcoholic steatohepatitis (NASH) is diagnosed with histopathologic testing, but noninvasive surrogate markers are desirable for screening patients who are at high risk of NASH. Purpose To investigate the diagnostic performance of dispersion slope, attenuation coefficient, and shear-wave speed measurements obtained using two-dimensional (2D) shear-wave elastography (SWE) in assessing inflammation, steatosis, and fibrosis and in the noninvasive diagnosis of NASH in patients suspected of having nonalcoholic fatty liver disease (NAFLD). Materials and Methods This prospective study collected data from 120 consecutive adults who underwent liver biopsy for suspected NAFLD and were enrolled between April 2017 and March 2019. Three US parameters (dispersion slope [(m/sec)/kHz], attenuation coefficient [dB/cm/MHz], and shear-wave speed [in meters per second]) were measured using a 2D SWE system immediately before biopsy. The biopsy specimens were scored by one expert pathologist according to the Nonalcoholic Steatohepatitis Clinical Research Network criteria (119 participants underwent a histologic examination). Diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUC) for the categories of inflammation, steatosis, and fibrosis. Results One hundred eleven adults (mean age, 53 years ± 18 [standard deviation]; 57 men) underwent a US examination. Dispersion slope enabled the identification of lobular inflammation, with an AUC of 0.95 (95% confidence interval [CI]: 0.91, 0.10) for an inflammation grade greater than or equal to A1 (mild), 0.81 (95% CI: 0.72, 0.89) for an inflammation grade greater than or equal to A2 (moderate), and 0.85 (95% CI: 0.74, 0.97) for an inflammation grade equal to A3 (marked). Attenuation coefficient enabled the identification of steatosis, with an AUC of 0.88 (95% CI: 0.80, 0.97) for steatosis grade greater than or equal to S1 (mild), 0.86 (95% CI: 0.79, 0.93) for steatosis grade greater than or equal to S2 (moderate), and 0.79 (95% CI: 0.68, 0.89) for steatosis grade equal to S3 (severe). Shear-wave speed enabled the identification of fibrosis, with an AUC of 0.79 (95% CI: 0.69, 0.88) for fibrosis stage greater than or equal to F1 (portal fibrosis), 0.88 (95% CI: 0.82, 0.94) for fibrosis stage greater than or equal to F2 (periportal fibrosis), 0.90 (95% CI: 0.84, 0.96) for fibrosis stage greater than or equal to F3 (septal fibrosis), and 0.95 (95% CI: 0.91, 0.99) for fibrosis stage equal to F4 (cirrhosis). The combination of dispersion slope, attenuation coefficient, and shear-wave speed showed an AUC of 0.81 (95% CI: 0.71, 0.91) for the diagnosis of NASH. Conclusion Dispersion slope, attenuation coefficient, and shear-wave speed were found to be useful for assessing lobular inflammation, steatosis, and fibrosis, respectively, in participants with biopsy-proven nonalcoholic fatty liver disease. © RSNA, 2020 Online supplemental material is available for this article.
  • Shinichiro Kawaguchi, Kazuya Sato, Hisashi Oshiro, Ken-Ichi Imadome, Yoshinobu Kanda
    Internal medicine (Tokyo, Japan) 2020年06月 [査読有り][通常論文]
     
    We encountered a patient with multiple myeloma treated with autologous hematopoietic stem cell transplantation (HSCT) who developed repeated episodes of enteritis but regressed spontaneously. An endoscopic examination revealed no abnormalities, but biopsy specimens showed massive infiltration of CD4+ and EBER+ abnormal lymphocytes in which a high copy number of Epstein Barr virus (EBV) genomes was detected by quantitative polymerase chain reaction (qPCR). EBV infection was exclusively detected in CD4+ T-cells, leading to a diagnosis of EBV-positive CD4+ T-cell LPD. This case suggests that an immediate biopsy and examinations, including qPCR for EBV DNA, should be considered for patients with recurrent enteritis after autologous HSCT, regardless of endoscopic findings.
  • Yuichi Aoki, Hisashi Oshiro, Akihiko Yoshida, Kazue Morishima, Atsushi Miki, Hideki Sasanuma, Yasunaru Sakuma, Alan Kawarai Lefor, Naohiro Sata
    BMC gastroenterology 20 1 105 - 105 2020年04月 [査読有り][通常論文]
     
    BACKGROUND: Capicua transcriptional repressor (CIC) -rearranged sarcoma is characterized by small round cells, histologically similar to Ewing sarcoma. However, CIC-rearranged sarcoma has different clinical, histological, and immunohistochemical features from Ewing sarcoma. It is important to differentiate between these tumors. CASE PRESENTATION: The patient is a 44-year-old man with a duodenal tumor diagnosed in another hospital who presented with a history of melena. Laboratory studies showed anemia with a serum hemoglobin of 6.0 g/dL. He was hospitalized and gastrointestinal bleeding was controlled successfully with endoscopy. However, he suffered from appetite loss and vomiting and progression of anemia a few weeks after presentation. Upper gastrointestinal endoscopy showed a circumferential soft tumor in the second portion of the duodenum and the endoscope could not pass distally. Computed tomography scan showed a greater than 10 cm tumor in the duodenum, with compression of the inferior vena cava and infiltrating the ascending colon. A definitive pathologic diagnosis could not be established despite four biopsies from the tumor edge. Due to gastrointestinal obstruction and progression of anemia, a pylorus-preserving pancreaticoduodenectomy with partial resection of the inferior vena cava and right hemicolectomy was performed as a complete tumor resection. The tumor was diagnosed as a CIC-rearranged sarcoma, but 2 months postoperatively local recurrence and distant metastases to the liver and lung were found. The patient died 3 months after surgery. CONCLUSIONS: Although the only definitive treatment for CIC-rearranged sarcoma is surgical resection, the CIC-rearranged sarcoma is highly malignant with a poor prognosis even after radical resection. More research is needed to establish optimal treatment strategies.
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Hisashi Oshiro, Hirohito Takeuchi, Yu Yoshimasu, Yoshitaka Kasai, Takao Itoi
    Ultrasonography (Seoul, Korea) 39 1 3 - 10 2020年01月 [査読有り][通常論文]
     
    Shear wave (SW) dispersion imaging is a newly developed imaging technology for assessing the dispersion slope of SWs, which is related to tissue viscosity in diffuse liver disease. Our preclinical and preliminary clinical studies have shown that SW speed is more useful than dispersion slope for predicting the degree of fibrosis and that dispersion slope is more useful than SW speed for predicting the degree of necroinflammation. Thus, dispersion slope, which reflects viscosity, may provide additional pathophysiological insight into diffuse liver disease.
  • Kentaro Tsuji, Atsushi Ito, Shinsuke Kurokawa, Takeo Nakaya, Taichiro Yoshimoto, Hirotoshi Kawata, Mio Tamba-Sakaguchi, Noriyoshi Fukushima, Hisashi Oshiro
    Medicine 98 32 e16643  2019年08月 [査読有り][通常論文]
     
    RATIONALE: Primary carcinosarcoma of the upper urinary tract is rare. Ureteral duplication is one of the most common urinary tract malformations. Additionally, the association between ureteral duplication and malignancy is unknown. To the best of our knowledge, no cases of malignant tumors diagnosed as carcinosarcoma with ureteral duplication have been reported. We herein report the case of a patient with carcinosarcoma of the ureteropelvic junction associated with incomplete ureteral duplication. PATIENT CONCERNS: A 60-year-old Japanese woman presented with painless gross hematuria. She had a history of total hysterectomy and chemotherapy for endometrioid carcinoma 5 years before. She had no history of occupational chemical exposure. DIAGNOSES: Radiographic imaging revealed right incomplete ureteral duplication, hydronephrosis, and a polypoid tumor in the ureteropelvic junction of the lower moiety of the right kidney. Urine cytology showed a small amount of degenerated atypical epithelial and nonepithelial cells. The transureteral biopsy specimen showed dysplastic urothelial cells and atypical myoid spindle cells. These findings were indefinite for malignancy. INTERVENTIONS: The patient underwent right nephroureterectomy. Pathological examination of the resected tumor showed a biphasic neoplasm composed of carcinomatous and sarcomatous components. The sarcomatous component was immunohistochemically positive for vimentin, desmin, h-caldesmon, and α-SMA and negative for pancytokeratin (AE1/AE3), low molecular weight cytokeratin (CAM 5.2), EMA, E-cadherin, GATA3, uroplakin 2, and p63. Based on these findings, we diagnosed the tumor as carcinosarcoma. OUTCOMES: The postoperative course was uneventful. No additional therapy was administered. The patient has remained alive without recurrence for 21 months since surgery. LESSONS: Carcinosarcoma can arise from ureteral duplication. Although the majority of carcinosarcomas of the upper urinary tract are diagnosed at an advanced stage and have a poor prognosis, some can have a less aggressive course. Further studies are needed to determine the association between ureteral duplication and malignancy.
  • Morita K, Fujiwara SI, Ikeda T, Kawaguchi SI, Toda Y, Ito S, Ochi SI, Nagayama T, Mashima K, Umino K, Minakata D, Nakano H, Yamasaki R, Kawasaki Y, Sugimoto M, Ashizawa M, Yamamoto C, Hatano K, Sato K, Oh I, Ohmine K, Muroi K, Ashizawa K, Yamamoto Y, Oshiro H, Kanda Y
    Acta haematologica 141 3 158 - 163 2019年02月 [査読有り][通常論文]
  • Toshihide Komatsubara, Hisashi Oshiro, Yasunaru Sakuma, Naohiro Sata, Toshiro Niki, Noriyoshi Fukushima
    Pathology international 69 2 86 - 93 2019年02月 [査読有り][通常論文]
     
    Bile duct cancer is known to contain numerous fibroblasts, and reported to recruit cancer- associated fibroblasts by secreting platelet-derived growth factor-D (PDGF-D) which needs serine proteases, such as matriptase, to behave as a ligand. However, their expression pattern, and prognostic value have not been clarified. In this study, we investigated the clinicopathological significance of PDGF-D and matriptase expression in patients with extrahepatic bile duct cancer. The samples were obtained from 256 patients who underwent the surgical resection between 1991 and 2015, and the expression levels of PDGF-D and matriptase were evaluated immunohistochemically. Staining intensities and distribution were scored, and finally classified into low and high expression groups in cancer cells and stroma respectively. High expression of matriptase in the cancer stroma was detected in 91 tumors (40%). The high stromal matriptase expression was significantly associated with shorter recurrence-free survival (RFS) and overall survival (OS) (P = 0.0027 and 0.0023, respectively). Multivariate analyses also demonstrated that the stromal matriptase expression level was an independent influential factor in RFS (P = 0.0050) and OS (P = 0.0093). Our findings suggest that the high stromal matriptase expression was strongly associated with tumor progression, recurrence and poor outcomes in patients with extrahepatic bile duct cancer.
  • Kumiko Mito, Yusuke Amano, Hisashi Oshiro, Daisuke Matsubara, Noriyoshi Fukushima, Shigeru Ono
    Medicine 98 4 e14211  2019年01月 [査読有り][通常論文]
     
    RATIONALE: Liver heterotopia associated with congenital diaphragmatic hernia (CDH) is a rare condition; to the best of our knowledge, only 17 cases have been reported to date. The histogenesis and clinicopathological features are largely unknown. We herein report 2 cases of liver heterotopia associated with CDH along with 17 cases described in the literature to shed light on their clinicopathological characteristics. PATIENT CONCERNS: Case 1 was a vaginally delivered male newborn who presented with respiratory distress immediately after birth. Case 2 was a female fetus who was found to have left-sided CDH during gestation. DIAGNOSIS: In case 1, a chest X-ray revealed left-sided CDH. In case 2, magnetic resonance imaging performed at 33 weeks of gestation revealed left-sided CDH. INTERVENTIONS: Case 1 underwent diaphragmatic patch repair surgery 3 days after birth. Histopathological examination following surgery in case 1 revealed the presence of ectopic liver tissue in the hernia sac. Case 2 was delivered by Cesarean section, and diaphragmatic patch surgery was performed 3 days after birth. During surgery, an isolated nodule was identified on the peritoneal side of the border of the defective foramen of the diaphragm. Histopathological examination following surgery in case 2 confirmed the presence of an epidermal cyst in the hernia sac. In addition, the isolated nodule was histopathologically found to be ectopic liver tissue. OUTCOMES: In Case 1, CDH recurred at 6 months after surgery, and a second patch repair surgery was performed. The surgically removed hernia sac was found to contain microscopic ectopic liver tissue on histopathology. Case 1 recovered well after surgery, and there was no critical change during the 10-month postoperative period. Case 2 recovered well after surgery, and there was no critical change during the 20-month postoperative period. LESSONS: There were no secondary pathological conditions associated with the presence of ectopic liver in CDH, such as torsion, infarction, rupture, intra-abdominal bleeding, or tumorization. Our observations suggest that liver heterotopia is a rare but asymptomatic condition in patients with CDH.
  • Kohei Morita, Hisashi Oshiro, Kumiko Mito, Makiko Naka Mieno, Mio Tamba-Sakaguchi, Toshiro Niki, Atsushi Miki, Masaru Koizumi, Yasunaru Sakuma, Toshihide Komatsubara, Naohiro Sata, Noriyoshi Fukushima
    Medicine 97 49 e13466  2018年12月 [査読有り][通常論文]
     
    Little is known concerning the prognostic significance of the degree of lymphatic vessel invasion in pancreatic head cancer. To address this gap in knowledge, we retrospectively examined 60 patients with locally advanced, surgically resectable pancreatic head cancer who underwent pancreaticoduodenectomy and lymph node (LN) dissection.All cases were histopathologically diagnosed as ductal adenocarcinoma, stage II (25 pT3N0 cases, 35 pT3N1 cases). The following variables were investigated: age; sex; neoadjuvant therapy; adjuvant therapy; tumor size; tumor grade; invasion into the serosa, retropancreatic tissue, duodenum, bile duct, portal venous system and perineural area; cut margins; LN metastasis; and the number of invaded lymphatic vessels (LVI-score).Univariate analysis demonstrated that LN metastasis and an LVI-score ≥5 were significantly associated with poor disease-free survival. Multivariate Cox regression analysis confirmed that LN metastasis and an LVI-score ≥7 were significantly associated with poor disease-free survival. Additionally, LVI-scores ≥9 and ≥10 were comparable to or surpassed the significance of LN metastasis based on the hazard ratio. Univariate analysis demonstrated that tumor size >30 mm, duodenal invasion, LN metastasis and an LVI-score ≥2 were significantly associated with poor overall survival. Multivariate Cox regression analysis confirmed that LN metastasis and LVI-scores ≥9 and ≥10 were significantly associated with poor overall survival, and an LVI-score ≥10 was comparable to or surpassed the significance of LN metastasis based on the hazard ratio.Our study strongly suggests that a high degree of lymphatic vessel invasion is associated with a poor prognosis in patients with locally advanced, surgically resectable pancreatic head cancer.
  • Mio Tamba-Sakaguchi, Hisashi Oshiro, Daisuke Minakata, Miki Yanagita, Toshikatsu Kohri, Takaaki Nikaido, Midori Kikuchi, Tomoko Suzuki, Taichiro Yoshimoto, Noriyoshi Fukushima
    Diagnostic cytopathology 46 12 1077 - 1080 2018年12月 [査読有り][通常論文]
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Hisashi Oshiro, Hirohito Takeuchi, Yu Yoshimasu, Yoshitaka Kasai, Yoshihiro Furuichi, Takao Itoi
    Ultrasound in medicine & biology 44 9 2018 - 2024 2018年09月 [査読有り][通常論文]
     
    To investigate the usefulness of shear-wave speed and dispersion slope measurements obtained, using an ultrasound elastography system in rat livers with various degrees of necroinflammation and fibrosis. A total of 25 male Sprague Dawley rats were randomly divided into 5 groups of 5 rats each: G0 (control), G1 (CCl4 injected twice a week for 1 wk), G2 (CCl4 injected four times a wk for 1 wk), G3 (CCl4 injected twice a wk for 6 wk) and G4 (CCl4 injected twice a wk for 10 wk). The shear-wave speed (m/s) and the dispersion slope ([m/s]/kHz) were measured. Histologic features (inflammation, necrosis and fibrosis) were used as reference standards. In multivariable analysis with histologic features as independent variables, the fibrosis grade was significantly related to shear-wave speed (p < 0.05) and the necrosis grade was significantly related to dispersion slope (p < 0.05). Dispersion slope is more useful than shear-wave speed for predicting the degree of necroinflammation.
  • 杉本 勝俊, 森安 史典, 大城 久, 吉益 悠, 竹内 啓人, 笠井 美孝, 古市 好宏, 糸井 隆夫
    肝臓 59 7 370 - 373 (一社)日本肝臓学会 2018年07月 [査読有り][通常論文]
     
    組織学的に診断した非アルコール性肝疾患(NAFLD)24症例を対象として、超音波エラストグラフィによる画像パラメータと肝生検による組織学的パラメータの相関性を評価した。その結果、粘弾性に関連するshear wave(SW)speedと粘性に関連するdispersion slope、脂肪化の程度を反映する減衰値とAlanine aminotransferase、SW speedと線維化の指標であるFIB4、dispersion slopeとFIB4との間にそれぞれ有意な相関関係を認めた。また、SW speedは線維化を反映し、dispersion slopeは小葉内炎症を反映しており、減衰値は組織学的肝脂肪化と関連する傾向を認めた。SW speedとdispersion slopeはNAFLDの病態評価において有用な指標と考えられた。
  • Hirohito Takeuchi, Katsutoshi Sugimoto, Hisashi Oshiro, Kunio Iwatsuka, Shin Kono, Yu Yoshimasu, Yoshitaka Kasai, Yoshihiro Furuichi, Kentaro Sakamaki, Takao Itoi
    Journal of medical ultrasonics (2001) 45 2 243 - 249 2018年04月 [査読有り][通常論文]
     
    PURPOSE: Shear wave elastography (SWE) has been validated in chronic hepatitis C and B; however, limited data are available in non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the accuracy of SWE and FIB4 index for the diagnosis of fibrosis in a cohort of consecutive patients with biopsy-proven NAFLD, and to evaluate the effects of other histologic parameters on SWE measurement. METHODS: Written informed consent was obtained from all patients, and this study was approved by our internal review board and ethics committee. Seventy-one patients with histologically proven NAFLD (mean age 50.8 years ± 15.7) were examined. All patients underwent SWE (Aixplorer™; SuperSonic Imagine) and FIB4 index (based on age, aspartate aminotransferase and alanine aminotransferase levels, and platelet counts) measurements. SWE measurements were compared with the histologic features based on the NAFLD activity score and FIB4 index. RESULTS: The area under the ROC curve for the diagnosis of hepatic fibrosis stage 3 or higher was 0.821 (optimal cut-off value 13.1 kPa, sensitivity 62.5%, specificity 57.4%) for SWE and 0.822 (optimal cut-off value 1.41, sensitivity 71.9%, specificity 53.9%) for FIB4 index. The median liver stiffness values measured using SWE showed a stepwise increase with increasing hepatic fibrosis stage (P < 0.001), inflammation score (P = 0.018), and ballooning score (P < 0.001), and showed a stepwise decrease with increasing hepatic steatosis stage (P = 0.046). CONCLUSIONS: SWE and FIB4 index are useful noninvasive tools for estimating the severity of fibrosis in NAFLD patients. However, the presence of severe steatosis may affect the liver stiffness measurement, resulting in underestimations of liver fibrosis.
  • Komatsubara Toshihide, Fukushima Noriyoshi, Oshiro Hisashi, Niki Toshiro, Sakuma Yasunaru, Sata Naohiro
    MODERN PATHOLOGY 31 681 - 682 2018年03月 [査読有り][通常論文]
  • Nakaya Takeo, Oshiro Hisashi, Saito Takumi, Sakuma Yasunaru, Horie Hisanaga, Sata Naohiro, Tanaka Akira
    INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 11 6 3141 - 3146 2018年 [査読有り][通常論文]
  • Takeo Nakaya, Hisashi Oshiro, Ayako Takigami, Yoshihiko Kanai, Kenji Tetsuka, Koichi Hagiwara, Hirofumi Fujii, Shunsuke Endo, Akira Tanaka
    Medicine (United States) 96 50 e8926  2017年12月 [査読有り][通常論文]
     
    Rationale: Solitary fibrous tumors are mesenchymal tumors presenting as fibroblastic neoplasms with prominent branching vascular patterns, which are often generated from the pleura. Most solitary fibrous tumors are benign however, some can turn malignant. High-grade sarcomas from solitary fibrous tumors include multidirectional histopathological components. Patient concerns: We describe our experience of a giant high-grade sarcoma with mixed components generated from a solitary fibrous tumor of the pleura in a 67-year-old female patient presenting with cough and left-sided chest pain. The patient had been diagnosed with a pleural mass in the left chest by X-ray about 30 years earlier. However, the tumor was allowed to grow, without surgical intervention, for a long time. Interventions: Thoracic surgeons performed the removal of the giant pleural tumor the tumor measured 18.0 × 14.5 × 10 cm in size, and was considered a giant tumor generated from the pleura of the left chest cavity. Diagnoses: The surgically removed tumor was solid and light brownish, and included myxoid and arabesque pattern lesions. The tumor also showed hemorrhagic and necrotic lesions. Moreover, spindle cells with less atypia, resembling fibroblasts, were noted. These spindle tumor cells were CD34- and Stat6-positive, suggesting a solitary fibrous tumor. Some of the spindle tumor cells were surrounded by thick collagenous fibers. Considering that the tumor originated from the parietal pleura, the tumor was defined as a solitary fibrous tumor in origin. The tumor also comprised high-grade sarcomatous components these included lipid-rich, rhabdomyosarcomatous, and pleomorphic components. The high-grade sarcoma component included bizarre tumor cells with severe atypia. Outcomes: Tumor recurrence occurred in the left chest about 4 months after the surgery, and the patient died 8 months postoperatively. Lessons: The present case clearly demonstrates that a solitary fibrous tumor can develop into high-grade sarcomatous overgrowth, including lipid-rich, rhabdomyosarcoma, and pleomorphic sarcoma components, if left untreated for a prolonged period. This case provides profound insights about the natural history, histogenesis, differentiation, and malignant transformation of solitary fibrous tumors.
  • 杉本 勝俊, 森安 史典, 大城 久, 吉益 悠, 竹内 啓人, 笠井 美孝, 古市 好宏, 小林 功幸, 中村 郁夫, 糸井 隆夫
    肝臓 58 9 536 - 539 (一社)日本肝臓学会 2017年09月 [査読有り][通常論文]
     
    四塩化炭素(CCL)投与にて急性肝障害モデルと肝繊維化モデルを作製し、各種病態における粘性と弾性との関係について考察した。5週齢の雄性SDラット25匹を用い、20匹にCCLを投与して急性肝障害モデルと肝繊維化モデルを作製し、残りの5匹は正常コントロール(G0)とした。CCL2回隔日投与群急性肝障害モデルG1群(n=5)、CCL4回連日投与急性肝障害モデルG2群(n=5)、CCL週2回6週間投与肝繊維化モデルG3群、CCL週2回10週間投与肝繊維化モデルG4群とした。実験の結果より、粘弾性に関連するSW伝搬速度と、粘性のみと関連するdispersion slopeとの間には弱い相関があるものの、dispersion slopeは弾性率とは独立した指標と捉えることができた。弾性は主に肝繊維化を反映し、粘性は主に肝臓の壊死・炎症を反映することが示唆された。粘性と関連する指標であるdispersion slopeは弾性率とは独立した指標であり、肝臓の病態を評価する上で有用であると考えられた。
  • Atsushi Ito, Yuto Yamazaki, Hironobu Sasano, Daisuke Matsubara, Noriyoshi Fukushima, Mio Tamba, Kenichi Tabata, Kentaro Ashizawa, Akihito Takei, Masaru Koizumi, Yasunaru Sakuma, Naohiro Sata, Hisashi Oshiro
    PATHOLOGY INTERNATIONAL 67 4 214 - 221 2017年04月 [査読有り][通常論文]
     
    Unilateral multiple adrenocortical micronodules (UMNs) constitute a rare subset of primary aldosteronism (PA) characterized by the hypersecretion of aldosterone derived from multiple small nodules in the zona glomerulosa of the unilateral adrenal grand. This case study describes a 49-year-old man with PA and UMNs who presented with muscle cramps at rest due to hypokalemia. The patient had a 6-year history of hypertension treated with antihypertensive drugs. Imaging studies revealed bilateral adrenal nodules as large as 5mm. Adrenal venous sampling confirmed unilateral PA; therefore, the patient underwent the removal of the affected adrenal gland. Macroscopically, the removed adrenal gland exhibited irregular adrenocortical thickening accompanied by ill-defined, adrenocortical macronodules as large as 6mm. The zona glomerulosa was histologically hyperplastic. However, an immunohistochemistry test of the steroidogenic enzymes revealed that these macronodules and the hyperplastic glomerular layer tested negative for CYB11B2. Moreover, we observed adrenocortical micronodules as large as 0.5mm that tested immunohistochemically positive for CYP11B2 and HSD3B2 but negative for CYP17A1 and CYP11B1. Thus, UMNs were diagnosed. This case instructively indicates that a grossly or histologically detectable nodular lesion is not necessarily a culprit lesion for PA. Therefore, functional histopathology is indispensable for the correct subclassification of PA.
  • Hirotoshi Ishiwatari, Tsuyoshi Hayashi, Hiroshi Kawakami, Hiroyuki Isayama, Hiroyuki Hisai, Takao Itoi, Michihiro Ono, Kazumichi Kawakubo, Natsuyo Yamamoto, Mariko Tanaka, Fumihide Itokawa, Hisashi Oshiro, Tomoko Sonoda, Tadashi Hasegawa
    GASTROINTESTINAL ENDOSCOPY 84 4 670 - 678 2016年10月 [査読有り][通常論文]
     
    Background and Aims: A side-port needle has been developed to improve diagnostic accuracy by obtaining more cellular material during EUS-guided FNA (EUS-FNA). We compared the accuracy rate of histology and the quality of histologic specimens from 22-gauge (G) side-port and standard needles for EUS-FNA of a solid pancreatic mass in a multicenter, prospective, randomized control trial. Methods: Between January 2013 and September 2013, 160 consecutive patients with a suspected solid pancreatic mass at 5 tertiary referral centers were enrolled. Patients were randomized to the 22G side-port needle or 22G standard needle group. The primary endpoint was the diagnostic accuracy of histology. Secondary endpoints were the quality of the histologic specimen (quantity of tissue, degree of GI contamination, and amount of blood). Results: An analysis of 154 patients (side-port, 76, vs standard, 78) was performed. Six patients were excluded because of no pancreatic mass on EUS. There was no significant difference in the rate of diagnostic accuracy of histology (side-port, 87% [66/76], vs standard, 82% [64/78]; P = .51). Samples that enabled histologic interpretation were obtained in 64% (47/73) and 43% (33/77) of patients from the side-port and standard groups, respectively (P = .009). No significant difference was seen in the degree of GI contamination and amount of blood between groups. Conclusions: There was no significant difference in the accuracy rate of histology between needle types. The side-port needle was superior to the standard needle in terms of obtaining samples that enabled histologic interpretation.
  • Hisashi Oshiro, Bogdan A Czerniak, Kentaro Sakamaki, Koji Tsuta, Jolanta Bondaruk, Afsaneh Keyhani, Colin P Dinney, Takeshi Nagai, Ashish M Kamat
    Medicine 95 31 e4500  2016年08月 [査読有り][通常論文]
     
    Recent tissue microarray (TMA)-based studies have shown that cell proliferation- and apoptosis-related biomarkers are associated with clinical outcomes in patients with bladder urothelial carcinoma. However, little is known about the differences in these biomarker measurements between whole mount tissue preparations and TMAs. This study aimed to elucidate the discrepancy in the measurements of Ki-67 indices (KIs) and apoptosis indices (AIs) between whole mount tissue preparations and TMAs of bladder urothelial carcinoma samples.Whole mount tissue preparations for Ki-67 immunohistochemistry and terminal deoxynucleotidyl transferase dUTP nick end labeling were made from 30 patients who underwent transurethral resection of bladder urothelial carcinoma. Digital microscopy-assisted virtual TMAs, consisting of 3 small round areas (1 or 0.6 mm in diameter), were generated from the same whole mount tissue preparations. The measurement results in highly reactive areas of biomarkers were compared between the whole mount tissue preparation- and the TMA-based methods. Bland-Altman plot analysis, regression analysis, and Kendall τ were performed to investigate differences in the measurement results, systematic biases, and correlations between biomarkers.Although the Bland-Altman plot analysis demonstrated that almost all the plots were within the limits of agreement, fixed biases were detected in the 1- and 0.6-mm TMAs for the KI (0.181 and 0.222, respectively) and the AI (0.055 and 0.063, respectively). Proportional biases were also detected in the 1- and 0.6-mm TMAs for the AI (P < 0.001 and P < 0.001, respectively). Furthermore, positive correlations between KIs and AIs were observed in whole mount tissue preparations (r = 0.260, P = 0.044) and in the 1 mm TMAs (r = 0.375, P = 0.004); however, no such correlation was observed in the 0.6 mm TMAs.Our study suggests that the measurement results for certain biomarkers of bladder urothelial carcinoma obtained from TMA-based samples can be susceptible to systematic bias, and the lack of correlation between biomarkers cannot be avoided as it is in whole mount tissue preparations. Virtual TMAs can help identify systematic bias and establish a better sampling strategy prior to performing high-throughput TMAs for biomarker studies.
  • Saori Ogawa, Fuminori Moriyasu, Keiko Yoshida, Hisashi Oshiro, Mayumi Kojima, Takatomo Sano, Yoshihiro Furuichi, Yoshiyuki Kobayashi, Ikuo Nakamura, Katsutoshi Sugimoto
    JOURNAL OF MEDICAL ULTRASONICS 43 3 355 - 360 2016年07月 [査読有り][通常論文]
     
    The aim of the present study was to investigate two methods of determining liver stiffness in rats with various degrees of non-alcoholic steatohepatitis induced by a methionine- and choline-deficient (MCD) diet by comparing each finding with reference to histopathological liver findings. Twenty male Wister rats were fed an MCD diet for up to 32 weeks, and four were fed a normal diet. Ultrasound-based shear wave elastography (SWE) and mechanical compression testing using an Instron Universal Testing machine were performed on each rat at designated time points. After each examination, liver histopathology was analyzed to evaluate the degrees of steatosis, inflammation, and fibrosis based on non-alcoholic fatty liver disease (NAFLD) activity score, and each finding was compared with reference to liver histopathologic findings. Median liver stiffness values measured using SWE showed a stepwise increase with increasing histological inflammation score (P = 0.002), hepatic fibrosis stage (P = 0.029), ballooning score (P = 0.012), and steatosis grade (P = 0.030). Median liver stiffness measured using an Instron machine showed a stepwise increase only with increasing histological fibrosis stage (P = 0.033). Degree of liver stiffness measured by SWE and the Instron machine differed. SWE reflected mainly inflammation, whereas Instron machine-derived values primarily reflected fibrosis. This is the main source of discrepancies between measurements made with these two modalities.
  • Itaru Sato, Masanari Umemura, Kenji Mitsudo, Hidenobu Fukumura, Jeong-Hwan Kim, Yujiro Hoshino, Hideyuki Nakashima, Mitomu Kioi, Rina Nakakaji, Motohiko Sato, Takayuki Fujita, Utako Yokoyama, Satoshi Okumura, Hisashi Oshiro, Haruki Eguchi, Iwai Tohnai, Yoshihiro Ishikawa
    SCIENTIFIC REPORTS 6 24629  2016年04月 [査読有り][通常論文]
     
    We previously investigated the utility of mu-oxo N,N'-bis(salicylidene) ethylenediamine iron (Fe(Salen)) nanoparticles as a new anti-cancer agent for magnet-guided delivery with anti-cancer activity. Fe(Salen) nanoparticles should rapidly heat up in an alternating magnetic field (AMF), and we hypothesized that these single-drug nanoparticles would be effective for combined hyperthermia-chemotherapy. Conventional hyperthermic particles are usually made of iron oxide, and thus cannot exhibit anticancer activity in the absence of an AMF. We found that Fe(Salen) nanoparticles induced apoptosis in cultured cancer cells, and that AMF exposure enhanced the apoptotic effect. Therefore, we evaluated the combined three-fold strategy, i.e., chemotherapy with Fe(Salen) nanoparticles, magnetically guided delivery of the nanoparticles to the tumor, and AMF-induced heating of the nanoparticles to induce local hyperthermia, in a rabbit model of tongue cancer. Intravenous administration of Fe(Salen) nanoparticles per se inhibited tumor growth before the other two modalities were applied. This inhibition was enhanced when a magnet was used to accumulate Fe(Salen) nanoparticles at the tongue. When an AMF was further applied (magnet-guided chemotherapy plus hyperthermia), the tumor masses were dramatically reduced. These results indicate that our strategy of combined hyperthermia-chemotherapy using Fe(Salen) nanoparticles specifically delivered with magnetic guidance represents a powerful new approach for cancer treatment.
  • Norifumi Kennoki, Shinichi Hori, Atsushi Hori, Yuki Takeo, Hisashi Oshiro
    BJR case reports 2 4 20150417 - 20150417 2016年 
    A 57-year-old female was diagnosed as having primary breast cancer (invasive carcinoma of no special type), which was immunohistochemically negative for oestrogen receptor, androgen receptor and human epidermal growth factor receptor Type 2. The main tumour was 54 × 35 mm in size and was located in the internal upper area of the left breast. The tumour had markedly invaded the skin and a daughter nodule was observed in the external upper area of the ipsilateral breast. An enlarged lymph node measuring 12mm in diameter was present in the axilla and an affected parasternal lymph node was also observed. A blood test showed no abnormalities and the patient was negative for tumour markers. We performed three sessions of transcatheter arterial chemoembolization with docetaxel-loaded HepaSphere™. The treatment procedure was successfully performed in all the three sessions. No adverse events higher than Grade 3 were observed. The sizes of the primary lesion and axillary lymph node decreased to 26 × 14 mm (37% reduction) and 10mm, respectively. The parasternal lymph node completely resolved. 2 months later, left total mastectomy and axillary lymph node dissection were performed. The histopathological post-therapy effect was considered to be a mild response (Grade 1a) in the breast lesion and a complete response (Grade 3) in the axillary lymph node. The mean±standard deviation of the minor axis of the vessels embolized with spherical particles was 183.0±96.5 μm. Our results indicate that transcatheter arterial chemoembolization used together with HepaSphere can be an alternative and effective therapy for locally advanced breast cancer.
  • Takeshi Nagai, Hisashi Oshiro, Yasukazu Sagawa, Kentaro Sakamaki, Fumitoshi Terauchi, Toshitaka Nagao
    Medicine 94 50 e2296  2015年12月 [査読有り][通常論文]
     
    Despite exhaustive efforts to detect early-stage ovarian cancers, greater than two-thirds of patients are diagnosed at an advanced stage. Although diaphragmatic metastasis is not rare in advanced ovarian cancer patients and often precludes optimal cytoreductive surgery, little is known about the mechanisms and predictive factors of metastasis to the diaphragm. Thus, as an initial step toward investigating such factors, the present study was conducted to characterize the pathological status of ovarian cancer patients who underwent debulking surgery in combination with diaphragmatic surgery. This is a retrospective and cross-sectional study of patients who underwent debulking surgery in combination with diaphragmatic surgery at our institution between January 2005 and July 2015. Clinicopathological data were reviewed by board-certified gynecologists, pathologists, and cytopathologists. The rates of various pathological findings were investigated and compared by Fisher exact test between 2 groups: 1 group that was pathologically positive for diaphragmatic metastasis (group A) and another group that was pathologically negative for diaphragmatic metastasis (group B). Forty-six patients were included: 41 patients pathologically positive and 5 pathologically negative for diaphragmatic metastasis. The rates of metastasis to the lymph node (95.8% vs 20%, P = 0.001) and metastasis to the peritoneum except for the diaphragm (97.6% vs 60.0%, P = 0.028) were significantly increased in group A compared with group B. However, no significant differences between the 2 groups were found for rates of histological subtypes (high-grade serous or non-high-grade serous), the presence of ascites, the presence of malignant ascites, exposure of cancer cells on the ovarian surface, blood vascular invasion in the primary lesion, and lymphovascular invasion in the primary lesion. Our study demonstrated that metastasis to the lymph node and nondiaphragmatic metastasis to the peritoneum are significantly associated with metastasis to the diaphragmatic peritoneum, indicating that these factors may be pathological predictors of diaphragmatic metastasis in patients with ovarian cancer. However, as the data available are not sufficient to demonstrate the predictive power of these factors, a further comprehensive, large-scale study should be performed.
  • Kunihito Suzuki, Kazuhiro Saito, Nobutaka Yoshimura, Yoshio Ohno, Jun Nakashima, Hisashi Oshiro, Soichi Akata, Masaaki Tachibana, Koichi Tokuuye
    CLINICAL IMAGING 39 5 901 - 903 2015年09月 [査読有り][通常論文]
     
    We present a case of a 67-year-old man with intussusception of the right ureter associated with a fibroepithelial polyp. The concentric sign and line sign are characteristic radiological findings in intussusception, and these findings could be seen in the present case. Although this entity is rare, its radiological findings are specific. Multidetector row computed tomography and its multiplanar reconstruction make the diagnosis feasible, although the qualitative diagnosis of the tumor was difficult. (C) 2015 Elsevier Inc. All rights reserved.
  • Hisashi Oshiro, Yoshiaki Osaka, Shingo Tachibana, Takaya Aoki, Takayoshi Tsuchiya, Toshitaka Nagao
    MEDICINE 94 27 e1139  2015年07月 [査読有り][通常論文]
     
    The concept of the retrograde lymphatic spread of cancer cells appears to account for a subset of the essential mechanisms of cancer metastasis in various organs. However, no adequate data currently exist to illustrate the pathology of the retrograde lymphatic metastasis of cancer cells in human bodies. To shed light on this phenomenon, we report a case of a 63-year-old Japanese man who underwent an esophagectomy and lymph node dissection for early-stage esophageal cancer.The patient's clinical information was evaluated by board-certified surgeons and internists. Surgically excised materials were histopathologically evaluated by attending pathologists.Postoperative pathological examination revealed that the patient's tumor was a well-differentiated squamous cell carcinoma with negative surgical margins (T1N0M0, stage I). Apart from the primary lesion, a single lymphatic vessel invasion was found between the lamina propria and lamina muscularis of the esophagus where intralymphatic cancer cells had spread against the direction of backflow prevention valves and skipped beyond these valves without destroying them.The present case demonstrated that the retrograde lymphatic spread of cancer cells can occur in valve-equipped lymphatic vessels. Our study may not only provide a scientific basis for the concept of retrograde lymphatic metastasis but also explain a portion of the complexities associated with the lymphogenous metastasis of esophageal cancer.
  • Hisashi Oshiro, Masahiro Miura, Hiroaki Iobe, Tomoo Kudo, Yoshihito Shimazu, Takaaki Aoba, Koji Okudela, Kiyotaka Nagahama, Kentaro Sakamaki, Maki Yoshida, Toshitaka Nagao, Takeo Nakaya, Atsushi Kurata, Osamu Ohtani
    Lymphatic research and biology 13 2 137 - 45 2015年06月 [査読有り][通常論文]
     
    BACKGROUND: Lymphatic stomata are small lymphatic openings in the serosal membrane that communicate with the serosal cavity. Although these stomata have primarily been studied in experimental mammals, little is known concerning the presence and properties of lymphatic stomata in the adult human pleura. Thus, adult human pleurae were examined for the presence or absence of lymphatic stomata. METHODS AND RESULTS: A total of 26 pulmonary ligaments (13 left and 13 right) were obtained from 15 adult human autopsy cases and examined using electron and light microscopy. The microscopic studies revealed the presence of apertures fringed with D2-40-positive, CD31-positive, and cytokeratin-negative endothelial cells directly communicating with submesothelial lymphatics in all of the pulmonary ligaments. The apertures' sizes and densities varied from case to case according to the serial tissue section. The medians of these aperture sizes ranged from 2.25 to 8.75 μm in the left pulmonary ligaments and from 2.50 to 12.50 μm in the right pulmonary ligaments. The densities of the apertures ranged from 2 to 9 per mm(2) in the left pulmonary ligaments and from 2 to 18 per mm(2) in the right pulmonary ligaments. However, no significant differences were found regarding the aperture size (p=0.359) and density (p=0.438) between the left and the right pulmonary ligaments. CONCLUSIONS: Our study revealed that apertures exhibit structural adequacy as lymphatic stomata on the surface of the pulmonary ligament, thereby providing evidence that lymphatic stomata are present in the adult human pleura.
  • Hisashi Oshiro, Hidenobu Fukumura, Kiyotaka Nagahama, Itaru Sato, Kei Sugiura, Hiroaki Iobe, Emi Okiyama, Toshitaka Nagao, Yoji Nagashima, Ichiro Aoki, Shoji Yamanaka, Ayumi Murakami, Jiro Maegawa, Takashi Chishima, Yasushi Ichikawa, Yoshihiro Ishikawa, Takeshi Nagai, Masaharu Nomura, Kenichi Ohashi, Koji Okudela
    MEDICAL MOLECULAR MORPHOLOGY 48 1 13 - 23 2015年03月 [査読有り][通常論文]
     
    Morphological detection of cancer cells in the rabbit VX2 allograft transplantation model is often difficult in a certain region such as serosal cavity where reactive mesothelial cells mimic cancer cells and both cells share common markers such as cytokeratins. Therefore, tagging VX2 cells with a specific and sensitive marker that easily distinguishes them from other cells would be advantageous. Thus, we tried to establish a successively transplantable, enhanced green fluorescent protein (EGFP)-expressing VX2 model. Cancer cells obtained from a conventional VX2-bearing rabbit were cultured in vitro and transfected with an EGFP-encoding vector, and then successively transplanted in Healthy Japanese White rabbits (HJWRs) (n = 8). Besides, conventional VX2 cells were transplanted in other HJWRs (n = 8). Clinicopathological comparison analyses were performed between the two groups. The success rate of transplantation was 100 % for both groups. The sensitivity and specificity of EGFP for immunohistochemical detection of VX2 cells were 84.3 and 100 %, respectively. No significant differences in cancer cell morphology, tumor size (P = 0.742), Ki-67 labeling index (P = 0.878), or survival rate (P = 0.592) were observed between the two. VX2 cells can be genetically altered, visualized by EGFP, and successively transplanted without significant alteration of morphological and biological properties compared to those of the conventional model.
  • Nobutaka Yoshimura, Kazuhiro Saito, Natsuhiko Shirota, Kunihito Suzuki, Soichi Akata, Hisashi Oshiro, Toshitaka Nagao, Katsutoshi Sugimoto, Akihiro Tsuchida, Koichi Tokuuye
    CLINICAL IMAGING 39 2 315 - 317 2015年03月 [査読有り][通常論文]
     
    Sclerosing angiomatoid nodular transformation (SANT) is a recently recognized and rare, nonneoplastic lesion of the spleen. Some papers have reported an increased SANT diameter during the follow-up period. We present two cases of SANT whose size increased during the follow-up period. Diffusion-weighted magnetic resonance imaging (DWI) findings correlated well with the pathological findings of SANT, the multinodular high-intensity area as the angiomatoid nodules and the peripheral low-intensity area as fibrous tissues. Therefore, DWI may be a useful imaging tool. (C) 2015 Elsevier Inc. All rights reserved.
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Yoshiyuki Kobayashi, Kazuhiko Kasuya, Yuichi Nagakawa, Akihiko Tsuchida, Takeshi Hara, Hiroaki Iobe, Hisashi Oshiro
    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 26 2 279 - 287 2015年02月 [査読有り][通常論文]
     
    Purpose: To assess various ultrasound (US) findings, including B-mode, shear-wave elastography (SWE), and contrastenhanced US, in accurately assessing ablation Inargins after irreversible electroporation (IRE) based on radiologic pathologic correlation, and to compare these findings between IRE and radiofrequency (RF) ablation. Materials and Methods: IRE (n = 9) and RF ablation (n = 3) were performed in-vivo in three pig livers. Each ablation zone was imaged by each method immediately after the procedure and 90 minutes later. Ablation zones were evaluated based on gross pathologic and histopathologic findings in samples from animals euthanized 2 hours after the last ablation. The characteristics and dimensions of the histologic ablation zones were qualitatively and quantitatively compared against each US finding. Results: In B-mode US at 90 minutes after IRE, the ablation zones appeared as hyperechoic areas with a peripheral hyperechoic rim, showing excellent correlation (12 = 0.905, P < .0001) with gross pathologic findings: SWE showed that tissue stiffness in the IRE ablation zones increased over time. Contrast-enhanced US depicted the IRE ablation zones as hypovascular areas in the portal phase, and showed the highest correlation (r2 = 0.923, P < .0001) with gross pathologic findings. The RF ablation zones were clearly visualized by B-mode US. SWE showed that tissue stiffness after RF ablation was higher than after IRE. Contrast-enhanced US depicted the RF ablation zones as avascular areas. Conclusions: IRE and RF ablation zones can be most accurately predicted by portal-phase contrast-enhanced US measurements obtained imMediately after ablation.
  • Katsutoshi Sugimoto, Fukuo Kondo, Yoshihiro Furuichi, Hisashi Oshiro, Toshitaka Nagao, Kazuhiro Saito, Hiroshi Yoshida, Yasuharu Imai, Toshio Fukusato, Fuminori Moriyasu
    HEPATOLOGY RESEARCH 44 10 E309 - E315 2014年10月 [査読有り][通常論文]
     
    Great progress has been made in the diagnosis of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) in the last few years due to the use of molecular criteria. This has allowed us to identify a new type of hepatic nodule. In this case report, we present a male patient with a hepatic nodule associated with idiopathic portal hypertension (IPH) pathologically exhibiting not only the morphological features of FNH, such as ductular reactions, dilated sinusoids, major vascular abnormalities and an immunohistochemical "map-like" pattern of glutamine synthetase (GS), but also the immuno-histological features of focal HCA, such as strong expression of serum amyloid A and C-reactive protein and weak expression of GS. As the final diagnosis, the nodule was identified as an FNH-like lesion with focal inflammatory hepatocellular adenoma.
  • Kayoko Higuchi, Makoto Urano, Reisuke H. Takahashi, Hisashi Oshiro, Jun Matsubayashi, Takeshi Nagai, Hiyo Obikane, Hisashi Shimojo, Toshitaka Nagao
    DIAGNOSTIC CYTOPATHOLOGY 42 10 846 - 855 2014年10月 [査読有り][通常論文]
     
    Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland neoplasm that is defined by ETV6-NTRK3 gene fusion. There have been few case reports on the cytopathologic features of MASC to date. We examined the clinicopathological and cytological features of seven cases of MASC defined by RT-PCR analysis of the ETV6-NTRK3 fusion gene. The cases occurred in three men and four women aged between 39 and 68 years, with a mean of 51.6 years. In five of these seven cases, the tumor involved the parotid gland. Histologically, all cases displayed predominantly microcystic patterns, often a mixture of follicular and papillary-cystic structures. All tumors were immunoreactive for mammaglobin, S-100 protein, and vimentin. Available fine-needle aspiration cytology smears were cellular and exhibited many loosely cohesive syncytial clusters or isolated cells. Many histiocytes, some of which contained hemosiderin pigments, and variously shaped mucinous material were evident in the background or within the epithelial clusters. The majority of cases showed small to medium-sized follicular structures with secreted materials. Papillary clusters were occasionally found. Tumor cells exhibited small to medium-sized round to oval nuclei, with a smooth contour and indistinct or small nucleoli, and vacuolated cytoplasm. No tumor cells had obvious intracytoplasmic zymogen granules. It appeared that clusters of small to medium-sized follicular and papillary configurations consisting of bland tumor cells with vacuolated cytoplasm, but lack of intracytoplasmic zymogen granules, in a mucinous or hemosiderin-laden histiocyte-rich background, were a characteristic cytological feature highly suggestive of MASC. Diagn. Cytopathol. 2014;42:846-855. (c) 2014 Wiley Periodicals, Inc.
  • 肝臓に対する不可逆電気穿孔法(Irreversible electroporation、IRE)による病理組織学的変化
    小林 功幸, 森安 史典, 杉本 勝俊, 安藤 真弓, 佐野 隆友, 宮田 祐樹, 平良 淳一, 今井 康晴, 中村 郁夫, 大城 久
    肝臓 55 Suppl.2 A630 - A630 (一社)日本肝臓学会 2014年09月 [査読有り][通常論文]
  • Katsutoshi Sugimoto, Hisashi Oshiro, Saori Ogawa, Mitsuyoshi Honjo, Takeshi Hara, Fuminori Moriyasu
    WORLD JOURNAL OF GASTROENTEROLOGY 20 33 11850 - 11855 2014年09月 [査読有り][通常論文]
     
    AIM: To evaluate the usefulness of three-dimensional (3D) shear-wave elastography (SWE) in assessing the liver ablation volume after radiofrequency (RF) ablation. METHODS: RF ablation was performed in vivo in 10 rat livers using a 15-gauge expandable RF needle. 3D SWE as well as B-mode ultrasound (US) were performed 15 min after ablation. The acquired 3D volume data were rendered as multislice images (interslice distance: 1.10 mm), and the estimated ablation volumes were calculated. The 3D SWE findings were compared against digitized photographs of gross pathological and histopathological specimens of the livers obtained in the same sectional planes as the 3D SWE multislice images. The ablation volumes were also estimated by gross pathological examination of the livers, and the results were then compared with those obtained by 3D SWE. RESULTS: In B-mode US images, the ablation zone appeared as a hypoechoic area with a peripheral hyperechoic rim; however, the findings were too indistinct to be useful for estimating the ablation area. 3D SWE depicted the ablation area and volume more clearly. In the images showing the largest ablation area, the mean kPa values of the peripheral rim, central zone, and non-ablated zone were 13.1 +/- 1.5 kPa, 59.1 +/- 21.9 kPa, and 4.3 +/- 0.8 kPa, respectively. The ablation volumes depicted by 3D SWE correlated well with those estimated from gross pathological examination (r(2) = 0.9305, P = 0.00001). The congestion and diapedesis of red blood cells observed in histopathological examination were greater in the peripheral rim of the ablation zone than in the central zone. CONCLUSION: 3D SWE outperforms B-mode US in delineating ablated areas in the liver and is therefore more reliable for spatially delineating thermal lesions created by RF ablation. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
  • Hisashi Oshiro
    Okajimas Folia Anatomica Japonica 91 2 25 - 28 2014年08月 [査読有り][通常論文]
     
    The elucidation of the pathogenesis of human diseases requires increasingly relevant and rigorous animal models. Therefore, investigators must select an appropriate mammalian model. Mice and rats are indispensable in the understanding of the mechanisms of human diseases, but other non-rodent mammals are required in certain situations. The rabbit is one such species. The rabbit exhibits greater biological similarities to humans than the mouse or rat, and the rabbit VX2 allograft cancer model has been used in a broad range of oncological studies, such as stromal responses, metastatic behaviors and therapeutic effects. Cancer cells in this model proliferate in a host rabbit that maintains a natural immunity, which makes this model attractive and unique. However, these examples constitute only a small number of advantages of a rabbit model. Numerous reports suggest that the rabbit is an attractive cancer-bearing animal model for the study of cancer metastasis and the lymphatic system. I briefly review the relevant medical literature and compare the rabbit lymphatic system with mice, rats and humans.
  • 肝Elastographyに影響を与える因子 Shear waveの伝搬速度に影響する肝臓の病理学的要因は?
    杉本 勝俊, 本定 三季, 大城 久, 森安 史典
    超音波医学 41 Suppl. S315 - S315 (公社)日本超音波医学会 2014年04月 [査読有り][通常論文]
  • 島田 ゆうか, 三宅 真司, 五百部 浩昭, 長嶋 洋治, 松林 純, 大城 久, 池田 徳彦, 長尾 俊孝
    日本臨床細胞学会雑誌 53 1 28 - 34 (公社)日本臨床細胞学会 2014年01月 
    背景:胞巣状軟部肉腫(alveolar soft part sarcoma、ASPS)は若年成人の四肢に好発するまれな悪性腫瘍である。今回、肺転移を契機に発見された大腿部原発ASPSの1例を経験したので報告する。症例:35歳、女性。両肺に多発腫瘤を認め、胸腔鏡下肺部分切除術が施行された。肺腫瘤割面の捺印細胞診標本では、類円形核と大型の核小体を有する異型細胞が結合性の緩い細胞集団として、あるいは孤立性に多数出現していた。これらの異型細胞は豊富な細胞質を伴い、細胞質内には針状の結晶構造物を含んでいた。また、免疫細胞化学的にはtranscription factor for immunoglobulin heavy-chain enhancer3(TFE3)が異型細胞の核に陽性であった。これらの細胞学的所見より、ASPSの肺転移が示唆された。病理組織学的検索でもASPSに合致する所見が得られた。電子顕微鏡的には細胞質内に格子状配列を示す結晶が認められた。さらに、RT-PCR法にてASPL-TFE3融合遺伝子I型転写産物が検出された。その後の精査で、右大腿軟部組織に原発巣が発見された。結論:ASPSでは転移巣が原発巣に先行してみつかることがしばしばあるが、転移巣の細胞診材料でも診断を推定することが可能と考えられた。(著者抄録)
  • Mitsuyoshi Honjo, Fuminori Moriyasu, Katsutoshi Sugimoto, Hisashi Oshiro, Kentaro Sakamaki, Kazuhiko Kasuya, Takeshi Nagai, Akihiko Tsuchida, Yasuharu Imai
    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 33 1 61 - 71 2014年01月 [査読有り][通常論文]
     
    OBJECTIVES: Shear wave elastography is a novel noninvasive method for assessing liver fibrosis by measuring liver stiffness. This study was conducted to evaluate how pathologic changes could have an impact on measured elasticity values in both resected hepatocellular carcinomas and adjacent liver tissue. METHODS: Intraoperative shear wave elastography was performed in 7 patients who underwent liver resection at our institution; 7 hepatocellular carcinomas and adjacent liver tissue were subjected to elastographic measurements. A total of 48 circular regions of interest (ROIs; 3-8 mm in diameter) were located in the hepatocellular carcinomas (n = 37) and adjacent liver tissue (n = 11), and mean stiffness values were obtained from each ROI. All of the histologic images corresponding to the 48 ROIs after surgery were transformed into digital microscopic images by a scanning system, and histologic parameters, such as the proportions of nuclear areas, fatty areas, fibrous areas, and vessel areas, were quantitatively assessed. Relationships between the mean stiffness and the histologic parameters were investigated by the mixed effects model. RESULTS: By univariate analysis, the proportions of collagen fiber areas (P = .039), fibrous areas (P = .045), hepatocellular nuclear areas (P = .045), and nuclear areas other than hepatocellular and lymphoplasmacytic areas (P = .039) showed statistically positive associations with mean stiffness values. Multivariate analysis indicated that the proportion of collagen fiber areas was the strongest pathologic determinant of mean stiffness (P = .008), with hepatocellular nuclear areas also having a significant effect (P = .010). CONCLUSIONS: Fibrosis predictably affects elastographic estimation, but hepatocellular density (ie, hepatocellular nuclear areas) also alters elastographic assessment.
  • Mikiko Asai-Sato, Hisashi Oshiro, Shoji Yamanaka, Yoshiaki Inayama, Fumiki Hirahara, Etsuko Miyagi
    Acta Cytologica 58 3 255 - 261 2014年 [査読有り][通常論文]
     
    Objective: This study aimed to evaluate the usability of peritoneal swabbing cytology (PSC) with cotton swabs as an effective method for the detection of peritoneal metastasis during the staging laparotomy of epithelial ovarian carcinomas and borderline tumours (EOC/BT). Study Design: One hundred and ninety-two patients with EOC/BT who underwent laparotomy at the Yokohama City University Hospital from 2004 to 2010 were analysed retrospectively. The positive rates of the PSC and ascites/peritoneal-wash cytology (A/PWC) were compared. Results and Conclusion: Both A/PWC and PSC were performed during laparotomy (n = 140). The rate of metastasis detection with A/PWC was significantly higher than with PSC (50.0 vs. 20.7%, p < 0.001 by χ2 test). The superior detection ability of A/PWC was observed regardless of the presence of macroscopic peritoneal metastasis in 56 cases with macroscopic peritoneal metastasis, with A/PWC detecting 80.3% of cases versus PSC detecting 37.5% (p = 0.013). In 84 cases without macroscopic peritoneal metastasis, A/PWC detected 29.8% of cases versus 9.5% with PSC (p = 0.003). Our results suggest that PSC is insufficient to evaluate the peritoneal metastasis for the surgical staging of EOC/BT. Other procedures such as subdiaphragmatic A/PWC should be included when possible to maximize the accuracy of diagnosis. © 2014 S. Karger AG, Basel.
  • Hiromasa Arai, Koji Okudela, Hisashi Oshiro, Noriko Komitsu, Hideaki Mitsui, Teppei Nishii, Masahiro Tsuboi, Akinori Nozawa, Yasuharu Noishiki, Kenichi Ohashi, Kenji Inui, Munetaka Masuda
    INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 6 3 395 - 410 2013年 [査読有り][通常論文]
     
    The present study evaluated the potential clinicopathologic significance of elevated microsatellite alteration at selected tetra-nucleotide (EMAST) in non-small cell lung cancer (NSCLC). Sixty-five NSCLCs (19 squamous cell carcinomas, 39 adenocarcinomas, one adenosquamous cell carcinoma, and 6 large cell carcinomas) were examined for EMAST in the ten selected tetra-nucleotide markers. Traditional microsatellite instability (MSI) in the five mono-or di-nucleotide markers of the Bethesda panel was also examined, and compared with EMAST. The incidence of EMAST was higher than that of traditional MSI, as 64.6% (42/65) and 12.3% (8/65) tumors respectively exhibited EMAST and traditional MSI in at least one marker. EMAST and traditional MSI appear to occur independently, as no significant association in their incidence was found (Fisher's exact test, P = 0.146). Subjects who exhibited EMAST in two or more markers had a significantly higher incidence of history of other malignant neoplasms (42.9% [9/21]), compared to those with less than two markers (16.3% [7/43] (Chi-square test, P = 0.021)). Taken together, impairment of molecular machinery for maintaining stable replication of the tetra-nucleotide-repeating regions, which would differ from machinery for mono-or di-nucleotide-repeating regions, may elevate susceptibility to NSCLCs and certain neoplastic diseases. Elucidation of the potential molecular mechanism of EMAST is expected to lead to a discovery of a novel genetic background determining susceptibility to NSCLC and other multiple neoplasms. This is the first report describing a clinicopathologic significance of EMAST in NSCLC.
  • Hisashi Oshiro, Yu Odagaki, Hiroaki Iobe, Chouichirou Ozu, Issei Takizawa, Takeshi Nagai, Jun Matsubayashi, Atsushi Inagaki, Shinji Miyake, Toshitaka Nagao
    International Journal of Clinical and Experimental Pathology 6 4 729 - 736 2013年 [査読有り][通常論文]
     
    Large cell neuroendocrine carcinoma (LCNEC) is the rarest type of urinary tract malignancy. Herein, we report a case of LCNEC that arose in the ureter of a 78-year-old Japanese man with a history of ascending colon cancer that had been excised by a right hemicolectomy. Left-sided hydronephrosis associated with the ureteral tumor was discovered during follow-up. A left nephroureterectomy combined with a partial resection of the urinary bladder was performed because atypical cells were detected using voided urine cytology. A histopathological examination revealed that the ureteral tumor contained large atypical epithelial cells of neuroendocrine morphology without a urothelial carcinomatous component. The neoplastic cells were immunohistochemically positive for synaptophysin, chromogranin A, CD56, and cytokeratins, but they were negative for uroplakin III and thyroid transcription factor-1. The Ki-67 labeling index of the neoplastic cells was 50%. Transmission electron microscopy demonstrated the presence of numerous dense granules in the cytoplasm of the neoplastic cells. The ureteral lesion was finally classified as stage III, pT3 cN0 cM0. The patient's postoperative course was uneventful without chemoradiotherapy, and LCNEC did not recur in the subsequent nine months. This case demonstrates that LCNEC can occur in the ureter, which normally does not contain neuroendocrine cells in the urothelium.
  • Junko Umeda, Takao Itoi, Atsushi Sofuni, Fumihide Itokawa, Toshio Kurihara, Takayoshi Tsuchiya, Kentaro Ishii, Shujiro Tsuji, Nobuhito Ikeuchi, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Toshitaka Nagao, Hisashi Oshiro, Fuminori Moriyasu
    Journal of Oncology 2013 170625  2013年 [査読有り][通常論文]
     
    Background. Recent diagnostic imaging tests contribute to improving the diagnosis of pancreatobiliary cancers. However, it is not practical to perform these tests for all patients as screening. Thus, less-invasive and simple screening tests are still required. A method to detect the IgG antibody induced in serum against the p53 protein accumulating due to p53 gene mutation, as a biomarker, was developed around 1990. Method. 35 patients with pancreatic cancer, 12 patients with biliary tract cancer, and 31 patients with benign pancreatobiliary diseases were entered into this study. Measurement of serum anti-p53 antibody was conducted in all patients. In addition, the rate of p53 protein overexpression was examined in those cases that could be examined pathologically. Result. Among all patients in the pancreatic cancer and biliary tract cancer groups, there was no patient with serum anti-p53 antibody positive value that exceeded the standard value. The rate of p53 protein overexpression was 48.0% in the patients with pancreatobiliary cancers and 0% in the benign pancreatobiliary diseases group. Conclusion. Serum anti-p53 antibody measurement does not contribute to the diagnosis of pancreatobiliary cancers. Instead, traditional p53 immunostaining still appears to be valuable in combination with standard procedures. © 2013 Junko Umeda et al.
  • 井上 英美, 千島 隆司, 木村 万里子, 市川 靖史, 大城 久, 遠藤 格
    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 73 12 3052 - 3056 日本臨床外科学会 2012年12月 
    症例は41歳の女性,検診で右乳房腫瘤を指摘され当院を受診した.29歳と36歳時に右乳房E領域の乳腺多形腺腫に対して,他院で腫瘍摘出術を施行されている.身体所見では,右乳房EAB領域に境界不明瞭な2.3cmの腫瘤を触知し,針生検では,乳腺多形腺腫の再発が疑われた.病理学的に明らかな悪性所見は認めなかったため,整容性を考慮して乳頭温存乳房部分切除術を施行した.術後2年,明らかな局所再発は認めていない.多形腺腫は唾液腺に多く認める良性腫瘍であるが,乳腺原発の報告は少ない.不十分な切除に起因する局所再発や悪性転化が報告されているため,術前に乳腺多形腺腫と診断された場合は,十分な切除断端距離を確保し,腫瘍被膜を損傷しないように切除する必要がある.
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Yoichi Negishi, Nobuhito Hamano, Hisashi Oshiro, Nicolas G. Rognin, Tetsuya Yoshida, Naohisa Kamiyama, Yukihiko Aramaki, Yasuharu Imai
    JOURNAL OF ULTRASOUND IN MEDICINE 31 12 1909 - 1916 2012年12月 [査読有り][通常論文]
     
    Objectives The purpose of this study was to quantitatively assess the contrast kinetics of vascular endothelial growth factor receptor 2 (VEGFR2)-targeted microbubbles (BR55; Bracco Suisse, Geneva, Switzerland) compared to clinically used microbubbles (SonoVue; Bracco SpA, Milan, Italy) in both normal liver and human hepatocellular carcinoma xenograft tumors in mice. Methods-Microbubbles were injected intravenously into healthy mice (n = 5) and mice bearing hepatocellular carcinoma xenograft tumors (n = 10). Cine loops of contrast enhancement in normal liver and the tumors were acquired for 10 minutes. Quantitative perfusion parameters were derived by fitting time-intensity curves using a dedicated mathematical model combining a bolus function and a ramp function. Immunohistochemical examinations were also performed for normal liver and tumor specimens to determine the level of VEGFR2 expression. Results-The peak contrast enhancement observed in normal liver with BR55 was comparable to that with SonoVue, whereas a significant difference was observed in late-phase enhancement at 10 minutes (ramp slope: P < .01). In the tumor model, SonoVue was rapidly cleared from the circulation, without any noticeable binding in the tumor, whereas BR55 showed a gradual decline, resulting in a longer wash-out period (mean transit time: P < .01). Immunohistochemical examinations showed that intratumoral vascular endothelial cells had sparse and weak VEGFR2 expression, whereas the sinusoidal capillaries in normal liver had much more diffuse and much stronger expression. Conclusions-Our results suggest that BR55 accurately reflects the VEGFR2 status in human hepatocellular carcinoma xenograft tumors. We showed that quantification applied to molecular ultrasound imaging may provide an objective method for measuring the degree of microbubble binding.
  • Miyashita R, Chen L, Oshiro H, Uchino H, Shibasaki F
    Neuroscience letters 528 1 83 - 88 2012年10月 [査読有り][通常論文]
     
    We have previously shown that when siRNA against Int6 (siRNA-Int6) was used, hypoxia-inducible factor 2 alpha (HIF2 alpha) activity was stabilized even under normoxic conditions, and the expression of several angiogenic factors was increased. In neuronal tissues, the mechanism underlying angiogenesis remains largely unknown. In the current study, we investigate the role of the tumor suppressor Int6/eIF3e in the regulation of the expression of angiogenic factors in neuronal cells. In addition, we test whether siRNA-Int6 reduces cold-induced brain damage in rats. We used human neuroblastoma SHSY5Y cells transfected with either siRNA-Int6, or a negative control siRNA. Real-time PCR and supersensitive multiplex assay were used to detect gene and protein expression of several angiogenic factors after transfection. For the animal studies, Wistar rats were subjected to brain damage by cold injury, and 50 mu g siRNA-Int6, 100 mu g siRNA-Int6, or negative control was administrated. At day 7 post-treatment, brain sections were stained and image analysis system was used to determine the damaged area. Our experiments using SHSY5Y cells revealed a significant effect of siRNA-Int6 on the expression of HIF2 alpha but not HIF1 alpha, both at 8 and 24h after transfection. The siRNA-Int6 led to significant up-regulation of angiogenic factors, including vascular endothelial growth factor and platelet-derived growth factor-B, both at the mRNA and protein levels. Furthermore, our animal studies revealed significantly reduced area of cold-induced damage in rats receiving siRNA-Int6, compared to negative controls. Our findings indicate that Int6 act as a hypoxia-independent master switch of angiogenesis in neuronal cells, and that inhibition of Int6 by siRNA may be an effective therapeutic strategy in treating ischemic diseases such as brain ischemia and injury. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
  • 糸川 文英, 糸井 隆夫, 祖父尼 淳, 栗原 俊夫, 土屋 貴愛, 石井 健太郎, 辻 修二郎, 池内 信人, 田中 麗奈, 梅田 純子, 殿塚 亮祐, 本庄 三季, 森安 史典, 土田 明彦, 粕谷 和彦, 大城 久, 長尾 俊孝
    胆と膵 33 7 571 - 578 医学図書出版(株) 2012年07月 
    膵疾患における超音波内視鏡(EUS)elastographyについて解説した。EUSの利点とその役割にふれ、elastographyにおける膵疾患の評価、strain ratio(SR)を用いた客観的評価による膵癌と腫瘤形成性膵炎との鑑別について述べた。EUS elastographyは対象物の組織硬度を正確に反映しており、膵癌に対する感度は高かった(98.6% 71/72)。ただし進行慢性膵炎例と膵癌との鑑別は困難であった。膵癌と腫瘤形成性膵炎とのSRは膵癌vs腫瘤形成膵炎=39.08±20.54vs23.66±12.65(p<0.05)であり膵癌で高い傾向を示した。EUS elastographyは今後膵疾患の鑑別における新たな精査法の一つとして期待される。(著者抄録)
  • Kazuhiko Kasuya, Hisashi Oshiro, Kazuhiro Saito, Yoshiaki Suzuki, Satoru Kikuchi, Bunso Kyo, Takaaki Matsudo, Yuichi Nagakawa, Takao Itoi, Akihiko Tsuchida
    HEPATO-GASTROENTEROLOGY 59 116 981 - 985 2012年06月 [査読有り][通常論文]
     
    Background/Aims: Since there is a difference in the slice thickness between preoperative images of liver metastases (1-3mm slices) and surgical liver pathology specimens (5mm slices), micrometastases may not be detected in these specimens. In addition, the accuracy of preoperative imaging for the detection of metastases degenerated by chemotherapy is unclear. Methodology: Five patients with liver metastases from colorectal cancer who had received adjuvant chemotherapy and undergone hepatectomy were included. The whole resected liver was sliced at approximately 1mm intervals and the slices were examined carefully for gross lesions. The preoperative CT and EOB-MRI findings of each lesion were compared with gross and histopathological findings. Results: The accuracy of EOB-MRI was higher than that of CT for the detection of liver metastases. The number of lesions detected on EOB-MRI was in agreement with that of histopathologically proven liver metastases in 4 of the 5 patients. All lesions that were grossly identified but turned out to be non-neoplastic were regenerative nodules associated with drug-induced liver injury or lobular nodules associated with marked fatty change, measuring about 1mm in diameter. Conclusions: EOB-MRI was the most accurate method for the preoperative detection of liver metastases, enabling the visualization of almost all liver metastases.
  • Katsutoshi Sugimoto, Fuminori Moriyasu, Kazuhiro Saito, Junichi Taira, Toru Saguchi, Nobutaka Yoshimura, Hisashi Oshiro, Yasuharu Imai, Junji Shiraishi
    JOURNAL OF ULTRASOUND IN MEDICINE 31 4 529 - 538 2012年04月 [査読有り][通常論文]
     
    Objectives-To determine the relative wash-out of hepatocellular carcinomas and dysplastic nodules using Kupffer-phase sonography with Sonazoid (Daiichi-Sankyo, Tokyo, Japan) enhancement and hepatobiliary-phase gadoxetic acid-enhanced magnetic resonance imaging (MM) in the evaluation of the histopathologic grades of individual nodules. Methods-This retrospective study included 66 consecutive patients with 78 histologically confirmed hepatocellular carcinomas and dysplastic nodules. In patients with carcinomas, 33 were well differentiated; 29 were moderately differentiated; and 11 were poorly differentiated; and there were 5 dysplastic nodules. All patients underwent both gadoxetic acid-enhanced Mill and Sonazoid-enhanced sonography. The interval between the two imaging examinations was less than 30 days. Six radiologists independently reviewed both images and rated the degree of relative wash-out between the tumorous and nontumorous areas on Kupffer- and hepatobiliary-phase images using a continuous rating scale. We compared these results with the histopathologic grade of each nodule, and the results were then analyzed with multireader multicase receiver operating characteristic analysis. Results-The average Kupffer-phase (P < .001) and hepatobiliary-phase (P = .004) rating scores increased as the carcinomas became less differentiated (Kruskal-Wallis test). The diagnostic accuracies of the average area under the receiver operating characteristic curve, which were estimated using the confidence levels of the relative wash-out of the Kupffer- and hepatobiliary-phase images, were 0.705 and 0.785 for dysplastic nodules versus well-, moderately, and poorly differentiated carcinomas (P = .517), 0.791 and 0.687 for dysplastic nodules and well-differentiated carcinomas versus moderately and poorly differentiated carcinomas (P = .093), and 0.871 and 0.716 for dysplastic nodules and well- and moderately differentiated carcinomas versus poorly differentiated carcinomas (P = .005), respectively. Conclusions-Kupffer-phase Sonazoid-enhanced sonography and hepatobiliary-phase gadoxetic acid-enhanced MRI may be useful in estimating the histologic grade, although Kupffer-phase Sonazoid-enhanced sonography may be more accurate in distinguishing hepatocellular carcinomas, especially moderately and poorly differentiated types.
  • Toshitaka Nagao, Eiichi Sato, Rie Inoue, Hisashi Oshiro, Reisuke H. Takahashi, Takeshi Nagai, Maki Yoshida, Fumie Suzuki, Hiyo Obikane, Mitsumasa Yamashina, Jun Matsubayashi
    ACTA HISTOCHEMICA ET CYTOCHEMICA 45 5 269 - 282 2012年 [査読有り][通常論文]
     
    Salivary gland tumors are relatively uncommon and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants, in addition to overlapping histological patterns similar to those observed in different tumor entities. The classification is complex, but is closely relevant to the prognostic and therapeutic aspects. Although hematoxylin-eosin staining is still the gold standard method used for the diagnosis, immunohistochemistry (IHC) can enhance the accuracy and be a helpful tool when in cases to investigate the subjects that cannot be assessed by histological examination, such as the cell nature and differentiation status, cell proliferation, and tumor protein expression. This review depicts on the practical diagnostic utility of IHC in salivary gland tumor pathology under the following issues: assessment of cell differentiation, focusing on neoplastic myoepithelial cells; discrimination of histologically mimic tumor groups; diagnosis of specific tumor types, e.g., pleomorphic adenoma, adenoid cystic carcinoma, and salivary duct carcinoma; and evaluation of malignancy and prognostic factors. IHC plays a limited, even though important, role in the diagnosis of salivary gland tumors, but is often useful to support the histological assessment. However, unfortunately few tumor type-specific markers are still currently available. For these reasons, IHC should be considered a method that can be used to assist the final diagnosis, and its results themselves do not directly indicate a definitive diagnosis.
  • 表皮と連続性を示すclear cell hidradenoma
    泉 美貴, 大城 久, 入澤 亮吉
    日本皮膚病理組織学会会誌 27 1 17 - 20 日本皮膚病理組織学会 2011年12月 
    45歳男。約3年前から右側頭部皮膚に腫瘤が出現し徐々に増大したため受診となった。腫瘤は直径約2.5cm大の桑実状で表面にびらんを来たしており、PET-CTで結節は不規則な集積を示しているが骨の破壊は認めない所見で、腫瘤から1.5〜2.0cm離して全摘術を施行した。腫瘤は皮膚全層におよび不規則隆起性で充実性であり、表皮は反応性に増殖して淡明な腫瘍細胞に移行している所見で、免疫組織化学的には腫瘍細胞はサイトケラチン7や34βE12で陽性で、P53は約80%以上の腫瘍細胞の核で過剰発現しているのを認める所見でありclear cell hidradenomaと診断した。術後7ヵ月で再発や転移はない。
  • Takashi Kawahara, Hisashi Oshiro, Zenkichi Sekiguchi, Hiroki Ito, Kazuhide Makiyama, Hiroji Uemura, Yoshinobu Kubota
    INTERNATIONAL JOURNAL OF UROLOGY 18 12 851 - 853 2011年12月 [査読有り][通常論文]
     
    We report a case of high-grade invasive urothelial carcinoma with plasmacytoid differentiation of the urinary bladder. A 75-year-old woman was referred to our hospital because of macroscopic hematuria. Cystoscopy detected a solid pedunculated bladder tumor, and a transurethral resection of the bladder tumor (TUR-Bt) and the image findings showed pT1N0M0 bladder cancer. The histopathological examination revealed the coexistence of a large component of high-grade invasive urothelial carcinoma and a small component of plasmacytoid carcinoma. Following the TUR-Bt, external beam radiotherapy and chemotherapy with gemcitabine and nedaplatin were carried out. The bladder tumor has not recurred for 2 years after the TUR-Bt.
  • 沼崎 令子, 大城 久, 宮城 悦子, 稲山 嘉明, 北村 和久, 平原 史樹
    日本臨床細胞学会雑誌 50 6 341 - 345 2011年11月
  • Chikako Tokoro, Masahiko Inamori, Yusuke Sekino, Eiji Sakai, Takashi Uchiyama, Hiroshi Iida, Kunihiro Hosono, Hiroki Endo, Yasunari Sakamoto, Hirokazu Takahashi, Tomoko Koide, Hiroaki Yasuzaki, Ayumu Goto, Yasunobu Abe, Ichiro Kawana, Atsushi Nakajima, Shin Maeda, Hisashi Oshiro, Yoshiaki Inayama
    GASTROINTESTINAL ENDOSCOPY 74 4 925 - 927 2011年10月 [査読有り][通常論文]
  • 小岩 克至, 和田 秀文, 前田 修子, 繁平 有希, 安嶋 桂, 井上 雄介, 池澤 善郎, 大城 久
    Skin cancer : official organ of the Japanese Society for Skin Cancer = 皮膚悪性腫瘍研究会機関誌 26 2 143 - 147 日本皮膚悪性腫瘍学会 2011年09月 
    44歳,男性。平成19年1月より誘因なく頭頂部に腫瘤が出現。同時期に右頸部にも腫瘤を自覚。近医でMRI施行し右耳下腺腫瘍を指摘され当科紹介受診。初診時,頭頂部にドーム状隆起した2.2×1.7 cmの暗紅色腫瘤と右耳下腺に直径1.5 cm大の硬結を認めた。頭部皮膚腫瘤に対して皮膚生検術を施行し,血管肉腫と診断。右耳下腺腫瘍に関し耳鼻科へ併診したが経過観察となった。皮膚悪性腫瘍摘出術,全層植皮術を施行。病理組織学的所見で切除断端陽性であり,放射線治療を追加。右耳下腺腫瘍も針生検術で血管肉腫の転移と診断,放射線を追加照射した。術後2ヵ月で多発肺転移が出現し,術後3ヵ月で肺胞出血による呼吸不全にて永眠される。家族歴で両親に血族婚あり,長兄が30歳で白血病にて他界。既往に両眼の白内障あり。また外見上は鳥様顔貌を認め,頭髪や眉毛に白髪あり。血液検査でヒアルロン酸が高値であり,Werner症候群と診断。
  • Masaharu Nomura, Tetsuya Fukuda, Kiyonaga Fujii, Takeshi Kawamura, Hiromasa Tojo, Makoto Kihara, Yasuhiko Bando, Adi F. Gazdar, Masahiro Tsuboi, Hisashi Oshiro, Toshitaka Nagao, Tatsuo Ohira, Norihiko Ikeda, Noriko Gotoh, Harubumi Kato, Gyorgy Marko-Varga, Toshihide Nishimura
    Journal of Clinical Bioinformatics 1 1 23  2011年09月 [査読有り][通常論文]
     
    Background: Large cell neuroendocrine carcinoma (LCNEC) of the lung, a subtype of large cell carcinoma (LCC), is characterized by neuroendocrine differentiation that small cell lung carcinoma (SCLC) shares. Pre-therapeutic histological distinction between LCNEC and SCLC has so far been problematic, leading to adverse clinical outcome. We started a project establishing protein targets characteristic of LCNEC with a proteomic method using formalin fixed paraffin-embedded (FFPE) tissues, which will help make diagnosis convincing.Methods: Cancer cells were collected by laser microdissection from cancer foci in FFPE tissues of LCNEC (n = 4), SCLC (n = 5), and LCC (n = 5) with definite histological diagnosis. Proteins were extracted from the harvested sections, trypsin-digested, and subjected to HPLC/mass spectrometry. Proteins identified by database search were semi-quantified by spectral counting and statistically sorted by pair-wise G-statistics. The results were immunohistochemically verified using a total of 10 cases for each group to confirm proteomic results.Results: A total of 1981 proteins identified from the three cancer groups were subjected to pair-wise G-test under p < 0.05 and specificity of a protein's expression to LCNEC was checked using a 3D plot with the coordinates comprising G-statistic values for every two group comparisons. We identified four protein candidates preferentially expressed in LCNEC compared with SCLC with convincingly low p-values: aldehyde dehydrogenase 1 family member A1 (AL1A1) (p = 6.1 × 10-4), aldo-keto reductase family 1 members C1 (AK1C1) (p = 9.6x10-10) and C3 (AK1C3) (p = 3.9x10-10) and CD44 antigen (p = 0.021). These p-values were confirmed by non-parametric exact inference tests. Interestingly, all these candidates would belong to cancer stem cell markers. Immunohistochmistry supported proteomic results.Conclusions: These results suggest that candidate biomarkers of LCNEC were related to cancer stem cells and this proteomic approach via FFPE samples was effective to detect them. © 2011 Nomura et al licensee BioMed Central Ltd.
  • 湯川 寛夫, 利野 靖, 荒井 宏雅, 菅野 伸洋, 山田 六平, 佐藤 勉, 松浦 仁, 大中臣 康子, 大城 久, 井上 聡, 益田 宗孝
    日本外科系連合学会誌 36 4 605 - 611 2011年08月
  • Noritoshi Kobayashi, Ryu Kobayashi, Shingo Kato, Seitaro Watanabe, Takashi Uchiyama, Takeshi Shimamura, Kensuke Kubota, Shin Maeda, Atsushi Nakajima, Yasushi Ichikawa, Hisashi Oshiro, Itaru Endo
    Clinical Journal of Gastroenterology 4 4 278 - 282 2011年08月 [査読有り][通常論文]
     
    In July 2003, a 63-year-old man received a low anterior resection for rectal cancer. In February 2006, he underwent a right hepatectomy for a solitary metastatic liver tumor the liver tumor had not invaded the bile duct, and a curative resection was performed. In August 2008, an enhanced computed tomography examination revealed a massive focal lesion at the point of the common bile duct. Endoscopic ultrasonography clearly revealed a hyperechoic polypoid lesion that had spread laterally on the surface of the slightly dilated bile duct and had a smooth outer hyperechoic layer. No lymph nodes were present in this region. Endoscopic retrograde cholangiopancreatography revealed an irregular stricture, and a biopsy was performed through the scope. Microscopic examination revealed a tumor characterized as a moderately differentiated adenocarcinoma resembling the liver tumor. We diagnosed the intrabiliary tumor as a metachronous metastatic bile duct tumor from rectal cancer without involvement of the liver parenchyma. This is a very rare case, with recurrence only in an extrahepatic bile duct after the complete resection of a metastatic liver tumor. This is the first clinical, pathological, and radiological description of this rare condition. © Springer 2011.
  • Eiji Sakai, Hiroki Endo, Chikako Tokoro, Nobuhiro Sugano, Yasushi Rino, Hisashi Oshiro, Atsushi Nakajima
    GASTROINTESTINAL ENDOSCOPY 73 5 1058 - 1060 2011年05月 [査読有り][通常論文]
  • 荒井 宏雅, 乾 健二, 西井 鉄平, 千葉 佐和子, 大城 久, 益田 宗孝
    肺癌 51 7 793 - 797 特定非営利活動法人 日本肺癌学会 2011年 [査読有り][通常論文]
     
    背景.稀ではあるが,臓側胸膜浸潤のない肺癌症例でも,術中に存在する胸水中に癌細胞が証明されることがある.臨床病理学的にも病期診断に極めて重要な所見であり,癌進展の自然史としても興味深い病態であるが,その機序は明らかでない.症例.血痰を契機に発見された左上葉原発,肺腺癌の68歳・男性.臨床病期はstage IAであった.術中所見では,少量の漿液性胸水を認めた他は,臓側胸膜面の変化や播種巣などはなく,sT1bN0M0D0E1(+)少量・漿液性PL0PM0:stage IAと診断した.術後病理診断では葉気管支間リンパ節に転移を認めた.癌組織の臓側胸膜浸潤は認めなかったが,胸水細胞診にて癌性胸水と診断され,最終的にpT1bN1(#11)M1a(E+):stage IVの診断となった.結論.癌性胸水の存在は,病期診断,術後の治療戦略上,極めて重要な所見である.術中に臓側胸膜表面に変化のない症例であっても洗浄細胞診を,また少量でも胸水が存在すれば胸水細胞診を積極的に施行すべきである.
  • Kazuho Miyashita, Naoto Tomita, Hisashi Oshiro, Chihiro Matsumoto, Yuki Nakajima, Satomi Ito, Kenji Matsumoto, Hiroyuki Fujita, Yoshiaki Ishigatsubo
    INTERNAL MEDICINE 50 6 617 - 620 2011年 [査読有り][通常論文]
     
    Primary hepatic lymphoma is a very rare condition, and the majority of the cases reported are of B-cell origin. We report a case of a 65-year-old man with primary hepatic peripheral T-cell lymphoma, not otherwise specified (PTCL-nos) who presented with 15% weight loss and general fatigue over the previous 9 months. Imaging studies and bone marrow examination could not confirm a diagnosis of lymphoma. Liver biopsy was performed because of an elevated soluble interleukin-2 receptor (sIL-2R) level (17,000 U/I) and hepatomegaly. After the diagnosis of primary hepatic PTCL-nos, treatment with low-dose corticosteroid was initiated, and the sIL-2R level decreased. Discontinuation of corticosteroid treatment resulted in the re-elevation of the sIL-2R level, and subsequently, treatment with low-dose corticosteroid was reinitiated. The sIL-2R level decreased rapidly, and the patient is alive with no evidence of lymphoma for 50 months after diagnosis. Thus, we found that a low-dose corticosteroid was effective in the long-term control of the disease, whereas many previous studies reported that primary hepatic PTCL-nos has a poor prognosis.
  • H. Oshiro, Y. Nagashima, M. Kanazawa, H. Sagawa, S. Yamanaka, Y. Inayama
    CYTOPATHOLOGY 21 6 420 - 423 2010年12月 [査読有り][通常論文]
  • Ayumi Murakami, Hisashi Oshiro, Seiichi Kanzaki, Akira Yamaguchi, Shoji Yamanaka, Mitsuko Furuya, Satoshi Miura, Hiroshi Kanno, Yoji Nagashima, Ichiro Aoki, Kiyotaka Nagahama
    NEPHROLOGY DIALYSIS TRANSPLANTATION 25 12 3884 - 3890 2010年12月 [査読有り][通常論文]
     
    Background. A large body of accumulated data has now revealed that podocytes play a major role in the development of proteinuria. However, the mechanisms of podocyte injury, leading to foot process effacement and proteinuria, are still unclear partly due to the current lack of an appropriate strategy for preparing podocytes. In this study, we have developed a novel method of rapid isolation of podocytes from mice using magnetic activated cell sorting with an anti-nephrin antibody. Methods. After endothelial cell depletion using anti-CD31 antibody, nephrin-positive cells were prepared from mouse kidneys using magnetic activated cell sorting with polyclonal rabbit anti-nephrin antibody. Purity of the positively sorted cells was determined by confocal microscopy and fluorescence-activated cell sorting (FACS) analysis. Expression profiles of podocyte-specific molecules in the sorted fractions were characterized by qualitative PCR and immunoblot analysis. Results. Nephrin-positive cells, isolated from mouse kidneys within 6 h, showed dual positivity for synaptopodin and rabbit IgG on confocal microscopy. FACS analysis revealed that the purity of the positively sorted fractions was similar to 75%. The nephrin-positive cells sorted by this approach showed a significantly higher expression of podocyte-specific molecules compared with nephrin-negative fractions. Conclusions. These data strongly suggest that our novel method for isolating podocytes has great utility for various downstream applications such as genomic analysis, proteomics and transcriptomics to elucidate molecular profiling of podocyte biology in vivo compared with conventional methods as our approach requires only several hours to complete and no tissue culture.
  • Hisashi Oshiro, Toshinori Iwai, Makoto Hirota, Kenji Mitsudo, Iwai Tohnai, Ryogo Minamimoto, Motoko Omura-Minamisawa, Yoji Nagashima, Shoji Yamanaka, Takafumi Fukui, Michiyo Kanazawa, Hiromi Sagawa, Kazuhiro Mita, Takashi Nakayama, Yoshiaki Inayama
    MEDICAL MOLECULAR MORPHOLOGY 43 4 246 - 252 2010年12月 [査読有り][通常論文]
     
    Sebaceous carcinoma is the rarest type of oral malignancies. We report a case of primary sebaceous carcinoma of the tongue. Systemic imaging studies revealed that the patient had a T2N2cM0 (International Union Against Cancer guidelines) primary lingual tumor. Histopathological examination revealed neoplastic sebocytic and basaloid cells, and Sudan III staining and electron microscopy revealed intracytoplasmic lipid droplets. The neoplastic cells stained positive for adipophilin; epithelial membrane antigen; epithelial antigen; and cytokeratins 7, 8, and 15, but negative for cytokeratins 5/6, 18, 19, and 20; the androgen receptor; and carcinoembryonic antigen. Superselective intraarterial chemotherapy was administered via the superficial temporal artery concurrent with daily radiotherapy. Multiple biopsies confirmed a complete response of the primary lesion. The patient then underwent neck dissection followed by pathological examination, which revealed lymph nodes metastases. After postoperative radiotherapy to the neck, distant metastases were identified in the mediastinal lymph nodes and the lung. The patient died 17 months after completing the initial course of chemoradiotherapy. Our case demonstrates that superselective intraarterial chemotherapy combined with concurrent radiotherapy can be effective in treating the primary lesion of patients with a sebaceous carcinoma of the tongue. However, an effective strategy to eradicate metastases has yet to be established.
  • Yuichi Nozaki, Hisashi Oshiro, Atsushi Nakajima
    CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 8 9 XVIII - XVIII 2010年09月 [査読有り][通常論文]
  • Hiroyuki Machida, Shuichi Ito, Tomonori Hirose, Fumihiko Takeshita, Hisashi Oshiro, Tomoko Nakamura, Masaaki Mori, Yoshiaki Inayama, Kunimasa Yan, Naoto Kobayashi, Shumpei Yokota
    NEPHROLOGY DIALYSIS TRANSPLANTATION 25 8 2530 - 2537 2010年08月 [査読有り][通常論文]
     
    Background. Childhood-onset systemic lupus erythematosus (SLE) is frequently complicated with lupus nephritis (LN), which is characterized by the deposition of DNA-containing immune complex to the glomerulus. Toll-like receptor 9 (TLR9), capable of recognizing the microbially derived CpG oligonucleotide, plays a crucial role in the innate immunity. TLR9 is also assumed to be related to the aetiology of SLE in the recognition of anti-DNA antibody-containing immune complex, but this remains controversial. We conducted a study to elucidate the association between TLR9 and LN in childhood-onset SLE. Methods. We compared the expression and localization of TLR9 and the slit membrane-related protein in the biopsied kidney sample by immunostaining in four children with active or inactive LN. We also evaluated their laboratory findings, such as anti-DNA antibody, complement and proteinuria at biopsy, to assess the correlation to the findings of the immunostaining. Results. TLR9 is not expressed in a normal control kidney. However, TLR9 develops in podocytes only in active LN but disappears in remission. Meanwhile, the slit membrane-related proteins such as nephrin, podocin and synaptopodin in podocytes express clearly and uniformly in remission, but their expression is markedly diminished in active LN, which results in podocyte injury. When TLR9 is expressed in podocytes, all the patients simultaneously showed hypocomplementaemia, high titre of anti-double-stranded DNA (dsDNA) antibody and proteinuria. Conclusion. Injured podocytes in active LN express TLR9. This expression could be associated with proteinuria and increased anti-dsDNA antibody. This is the first report indicating that TLR9 is involved in the aetiology of LN and that it may play some role in podocyte injury.
  • Hiroaki Shimoyamada, Takuya Yazawa, Hanako Sato, Koji Okudela, Jun Ishii, Masashi Sakaeda, Korehito Kashiwagi, Takehisa Suzuki, Hideaki Mitsui, Tetsukan Woo, Michihiko Tajiri, Takahiro Ohmori, Takashi Ogura, Munetaka Masuda, Hisashi Oshiro, Hitoshi Kitamura
    AMERICAN JOURNAL OF PATHOLOGY 177 1 70 - 83 2010年07月 [査読有り][通常論文]
     
    Vascular endothelial growth factor-A (VEGF-A) is crucial for angiogenesis, vascular permeability, and metastasis during tumor development. We demonstrate here that early growth response-1 (EGR-1), which is induced by the extracellular signal-regulated kinase (ERK) pathway activation, activates VEGF-A in lung cancer cells. Increased EGR-1 expression was found in adenocarcinoma cells carrying mutant K-RAS or EGFR genes. Hypoxic culture, siRNA experiment, luciferase assays, chromatin immunoprecipitation, electrophoretic mobility shift assays, and quantitative RT-PCR using EGR-1-inducible lung cancer cells demonstrated that EGR-1 binds to the proximal region of the VEGF-A promoter, activates VEGF-A expression, and enhances hypoxia inducible factor 1 alpha (HIE-1 alpha)-mediated VEGF-A expression. The EGR-1 modulator,.NAB-2, was rapidly induced by increased levels of EGR-1. Pathology samples of human lung adenocarcinomas revealed correlations between EGR-1/HIF-1 alpha and VEGF-A expressions and relative elevation of EGR-1 and VEGF-A expression in mutant K-RAS- or EGFR-carrying adenocarcinomas. Both EGR-1 and VEGF-A expression increased as tumors dedifferentiated, whereas HIF-1 alpha expression did not. Although weak correlation was found between EGR-1 and NAB-2 expressions on the whole, NAB-2 expression decreased as tumors dedifferentiated, and inhibition of DNA methyltransferase/histone deacetylase increased NAB-2 expression in lung cancer cells despite no epigenetic alteration in the NAB-2 promoter. These findings suggest that EGR-1 plays important roles on VEGF-A expression in lung cancer cells, and epigenetic silencing of transactivator(s) associated with NAB-2 expression might also contribute to upregulate VEGF-A expression. (Am J Pathol 2010, 177:70-83; DOI: 10.2353/ajpath.2010.091164)
  • Hitomi Tanaka, Takuma Fujii, Takashi Kusaura, Akiko Kobayashi, Hisashi Oshiro, Takeshi Sasaki, Yutaka Yamaguchi, Kiyotaka Nagahama
    AMERICAN JOURNAL OF KIDNEY DISEASES 56 1 XXXV - XL 2010年07月 [査読有り][通常論文]
  • Hisashi Oshiro, Kiyoshi Gomi, Kiyotaka Nagahama, Yoji Nagashima, Michiyo Kanazawa, Junji Kato, Takashi Hatano, Yoshiaki Inayama
    ACTA CYTOLOGICA 54 3 303 - 310 2010年05月 [査読有り][通常論文]
     
    Background Little is known about urine cytology of large cell neuroendocrine carcinoma (LCNEC) of the bladder. We report a case of primary LCNEC of the bladder, focusing on urinary cytology. Case A 76-year-old woman who had a history of transurethral resection for urothelial carcinoma of the bladder visited our hospital because of intermittent gross hematuria. Urinary cytology on this visit identified atypical cells, interpreted initially as urothelial carcinoma. Cystoscopy detected a tumor apart from the previous bladder urothelial carcinoma. The diagnosis of LCNEC was pathologically confirmed after the transurethral resection; subsequently radical cystectomy and bilateral pelvic lymphadenectomy were performed. Based on the review of urine cytology for this tumor, neoplastic cells possessed rosette and nuclear molding arrangements with finely or coarsely granular, hyperchromatic nuclei. The average nuclear size of the neoplastic cells was 10.3 mu m, whereas the average cell size was 14.9 mu m. These cells were immunocytochemically positive for synaptophysin, consistent with LCNEC. The postoperative course for this patient was uneventful, and LCNEC had not recurred in the 48 months since cystectomy. Conclusion Our observations suggest that urinary cytology in combination with morphometry and immunocytochemistry may be a potentially useful method for the detection of LCNEC of the bladder. (Acta Cytol 2010;54:303-310)
  • Takashi Kawahara, Hisashi Ohshiro, Zenkichi Sekiguchi, Mitsuko Furuya, Kazuhiro Namura, Hiroki Itoh, Futoshi Sano, Kaoru Kawaji, Narihiko Hayashi, Kazuhide Makiyama, Noboru Nakaigawa, Takehiko Ogawa, Hiroji Uemura, Masahiro Yao, Yoshinobu Kubota
    Case Reports in Oncology 3 1 30 - 34 2010年 [査読有り][通常論文]
     
    A 73-year-old female was operated with radical nephrectomy and cholecystectomy for renal cell carcinoma and suspected gallstones after 9 courses of sunitinib treatment. Gallbladder specimen showed gallbladder metastasis originating from the renal cell carcinoma. Gallbladder metastasis from renal cell carcinoma is rare. Here, we discuss a case of gallbladder metastasis from renal cell carcinoma. Copyright © 2010 S. Karger AG.
  • Takashi Kawahara, Shoji Yamanaka, Hisashi Ohshiro, Zenkichi Sekiguchi, Kazuhiro Namura, Hiroki Itou, Futoshi Sano, Kaoru Kita, Narihiko Hayashi, Kazuhide Makiyama, Noboru Nakaigawa, Takehiko Ogawa, Hiroji Uemura, Masahiro Yao, Yoshinobu Kubota
    Case Reports in Oncology 3 1 54 - 58 2010年 [査読有り][通常論文]
     
    The case was a 67-year-old male who visited our hospital with a major complaint of macroscopic hematuria. A bladder tumor was found. When a transurethral resection of the bladder tumor was performed, the histopathological diagnosis was neuroendocrine bladder cancer. After chemotherapy with cisplatin and etoposide a partial shrinkage of the tumor was observed however, the patient expired 7 months after the first visit. Copyright © 2010 S. Karger AG.
  • Hiromasa Arai, Yasushi Rino, Teppei Nishii, Norio Yukawa, Nobuyuki Wada, Hisashi Oshiro, Tsuyoshi Ishida, Noboru Nakaigawa, Munetaka Masuda
    Case Reports in Medicine 2010 327591  2010年 [査読有り][通常論文]
     
    Extraskeletal osteosarcoma is an uncommon high-grade malignant soft tissue sarcoma. Well-differentiated extraskeletal osteosarcoma is thought to have a better prognosis than classical extraskeletal osteosarcoma, but dedi fferentiation after recurrence has also been reported. We present a case of a primary retroperitoneal extraskeletal osteosarcoma in a 62-year-old Japanese woman. Abdominal CT revealed a large mass with diffuse calcification in the right retroperitoneal space and tumor resection was performed. The histopathological diagnosis was well-di fferentiated retroperitoneal extraskeletal osteosarcoma. She was followed up by CT every 6 months without adjuvant radiotherapy and chemotherapy for 31 months until anaplastic highgrade spindle cell sarcoma recurred in the retroperitoneum. Our case is the seventh reported description of well-differentiated extraskeletal sarcoma, and the first to arise in the retroperitoneum and recur as an entirely dedifferentiated spindle cell sarcoma. Copyright © 2010 Hiromasa Arai et al.
  • Yuichi Nozaki, Masahiko Inamori, Koji Fujita, Masato Yoneda, Shingo Kato, Takashi Uchiyama, Kaori Suzuki, Seitaro Watanabe, Hironori Mawatari, Hiroshi Iida, Kunihiro Hosono, Hiroki Endo, Yasunari Sakamoto, Kyoko Yoneda, Hirokazu Takahashi, Tomoko Koide, Chikako Tokoro, Noritoshi Kobayashi, Hiroyuki Kirikoshi, Takeshi Shimamura, Yasunobu Abe, Kensuke Kubota, Satoru Saito, Hisashi Oshiro, Yoshiaki Inayama, Atsushi Nakajima
    INTERNAL MEDICINE 49 7 709 - 709 2010年 [査読有り][通常論文]
  • 湯川 寛夫, 利野 靖, 菅野 伸洋, 村上 仁志, 松浦 仁, 高田 賢, 大城 久, 影山 裕, 益田 宗孝
    日本外科系連合学会誌 34 5 871 - 877 2009年10月
  • 古目谷 暢, 佐野 太, 籠田 雅予, 村上 貴之, 槙山 和秀, 三好 康秀, 中井川 昇, 小川 毅彦, 上村 博司, 矢尾 正祐, 大城 久, 長嶋 洋治, 窪田 吉信
    泌尿器科紀要 55 5 253 - 257 泌尿器科紀要刊行会 2009年05月 
    A 66-year-old woman, who developed pulmonary tuberculosis at 17 years old, had a high fever in December, 2006. Computed tomographic (CT) scan showed a tumor in the left chalked kidney, which measured 7 cm in diameter with very low enhancement. Laboratory data showed the rise of acute phase reactants (erythrocyte sedimentation rate and c-reactive protein) and severe anemia. The cultures of sputum and urine revealed no Mycobacterium tuberculosis. With the diagnosis of left renal cell carcinoma in the chalked kidney, we performed left radical nephrectomy. Histopathological diagnosis was sarcomatoid renal cell carcinoma. Although sarcomatoid renal cell carcinoma is highly malignant and its prognosis is poor, her post-operative condition has been good without any adjuvant treatments and there have been no recurrent or metastatic lesions for 9 months. The supervention of renal cell carcinoma on renal tuberculosis is rare. The possible effects of tuberculous lesions on the development and progression of renal cell carcinoma are discussed.
  • Hisashi Oshiro, Junichi Nagao, Yoji Nagashima, Takahide Taguchi, Shoji Yamanaka, Yoshiaki Inayama
    ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY 135 5 511 - 514 2009年05月 [査読有り][通常論文]
     
    Sinonasal malignant tumors constitute less than 1% of all neoplasms and approximately 3% of those of the upper aerodigestive tract.(1) Sinonasal malignant neoplasms most commonly affect the maxillary sinuses (approximately 60%), followed by the nasal cavity (approximately 22%), ethmoidal sinus (approximately 15%), and frontal and sphenoid sinuses (<3%). 1 Sinonasal neoplasms are diverse, with most being squamous cell carcinoma or variants (55%), followed by nonepithelial neoplasms (20%), glandular tumors (15%), undifferentiated carcinoma (7%), and miscellaneous tumors (3%).(1) We describe an exceedingly unusual case of ethmoidal lipid-rich carcinoma with focal glandular structures. To our knowledge, such a case has not been documented in the literature to date.
  • Arai H, Oshiro H, Yamanaka S, Yukawa N, Wada N, Rino Y, Watanuki Y, Yamanaka S, Inayama Y, Lee J, Nakayama H, Masuda M
    Journal of clinical and experimental hematopathology : JCEH 49 1 39 - 44 2009年05月 [査読有り][通常論文]
  • Ikuma Kato, Yoshiaki Inayama, Shoji Yamanaka, Hisashi Ohshiro, Kiyoshi Gomi, Sumiko Shirai, Ichiro Aoki, Hiroji Uemura, Yasuhide Miyoshi, Yoshinobu Kubota, Masahiro Yao, Yoji Nagashima
    PATHOLOGY INTERNATIONAL 59 1 38 - 43 2009年01月 [査読有り][通常論文]
     
    Epithelioid angiomyolipoma (eAMLoma) is an uncommon renal mesenchymal tumor with malignant potential and is frequently associated with tuberous sclerosis (TSC). It is composed of polygonal large-sized tumor cells arranged in an epithelioid manner. Differential diagnosis from renal cell carcinoma (RCC) is often challenging because of its epithelioid morphology. Herein is reported three cases of eAMLoma, involving one in a 28-year-old man with TSC and two in women without TSC (34 and 62 years of age, respectively). The male TSC patient had microscopic conventional AMLomas in the same kidney. All patients were positive for melanoma (reactive with HMB45 antibody, and positive for melan A, tyrosinase and microphthalmia transcription factor) and smooth muscle markers (positive for alpha-smooth muscle-specific actin), but not for epithelial markers (cytokeratin, epithelial membrane antigen). In particular, the translocation RCC is an important differential diagnostic candidate, in terms of the positive reaction with HMB45 and morphological similarity. The present tumor samples did not show any reactivity for transcription factor binding to IGHM enhancer 3 or transcription factor EB, which excluded the possibility of translocation RCC. The possibility of eAMLoma should be evaluated as a diagnostic candidate, especially in cases of renal tumors (i) in young patients; (ii) associated with TSC; or (iii) with an epithelioid morphology and a high nuclear grade.
  • Kensuke Kubota, Shingo Kato, Tomoyuki Akiyama, Masato Yoneda, Koji Fujita, Masami Ogawa, Masahiko Inamori, Noritoshi Kobayashi, Satoru Saito, Yukio Kakuta, Hisashi Ohshiro, Atsushi Nakajima
    GASTROINTESTINAL ENDOSCOPY 68 6 1204 - 1208 2008年12月 [査読有り][通常論文]
     
    Background: Differentiating primary sclerosing cholangitis (PSC) and sclerosing cholangids caused by autoimmune pancreatitis (SC-AIP) is often challenging. Recently, endoscopic findings of the duodenal papilla in cases with AIP or PSC were reported by Unno and Parlak, although the endoscopic differentiation of these 2 conditions has not yet been fully clarified. Objective: Our purpose was to clarify, the endoscopic findings of the duodenal papilla in patients with SC-AIP and those with PSC and to determine criteria for the differentiation of these conditions. Design: Case series. Setting: Restrospective. Patients: Twenty-seven,en patients With SC-AIP and 12 patients with PSC who had undergone ERCP were identified from out database. We reviewed these records to determine whether the duodenal papillary findings (swollen papilla/normal papilla/small papilla) might be potentially useful for differentiating SC-AIP and PSC. Immunohistopathological findings for the duodenal papilla were also examined by using immunoglobulin G4 (IgG4) among the infiltrating plasma cells. Interventions: ERCP, biopsy specimen taken from duodenal papilla. Main Outcome Measurements: The presence of a swollen duodenal papilla with IgG4-positive plasma cells was useful for discriminating SC-AIP from with PSC. Results: A swollen duodenal papilla was observed in 63% (17/27) of the patients with SC-AIP, whereas there was no swelling of the duodenal papilla of the patients with PSC. A small papilla was recognized in 50% (6/12) of the patients with PSC. IgG4-positive plasma cells in the duodenal papilla were significantly detected in the patients with SC-AIP but not in the patients with PSC. Limitation: Single-center study. Conclusions: Characteristic duodenal endoscopic papillary features in patients with SC-AIP, such as a swollen duodenal papilla and positive immunostaining for IgG4, might be helpful for discriminating this condition from PSC.
  • Hisashi Oshiro, Kenichi Matsuo, Hironori Mawatari, Yoshiaki Inayama, Shoji Yamanaka, Kiyotaka Nagahama, Itaru Endo, Hiroshi Shimada, Atsushi Nakajima, Kensuke Kubota
    PATHOLOGY INTERNATIONAL 58 12 780 - 786 2008年12月 [査読有り][通常論文]
     
    Herein is reported a case of mucin-producing carcinoma of the gallbladder in a 55-year-old Japanese woman. Although the patient's status and laboratory data initially suggested biliary pancreatitis due to gallstone, radiography and endoscopy confirmed the presence of pancreaticobiliary maljunction and a gallbladder tumor with excessive mucin, in which the duodenal papilla and the common bile duct were impacted. Following surgery, the gallbladder tumor was histopathologically diagnosed as a mixed endocrine-exocrine carcinoma. The carcinoma predominantly consisted of papillary, but also contained some tubular adenocarcinomatous components. Additionally, small foci of small cell and large cell neuroendocrine carcinomatous components were observed. There was no evidence of lymph node metastasis, distant metastasis, or direct invasion outside the gallbladder. Thus, the final classification of pT2N0M0 stage II was given to this lesion, according to the Union Internationale Contre le Cancer guidelines. The postoperative course was uneventful, and the carcinoma had not recurred in the absence of chemoradiotherapy for a period of 20 months. Mucin-producing gallbladder carcinoma is a rare clinical condition that can occur in patients with pancreaticobiliary maljunction. Detailed investigation of this condition is important to develop and refine effective therapeutic strategies.
  • Hiroshi Iida, Masahiko Inamori, Yusuke Sekino, Hiroki Endo, Tomoyuki Akiyama, Koji Fujita, Hirokazu Takahashi, Masato Yoneda, Noritoshi Kobayashi, Yasunobu Abe, Hiroyuki Kirikoshi, Kensuke Kubota, Satoru Saito, Hisashi Oshiro, Yasushi Rino, Atsushi Nakajma
    DIGESTIVE DISEASES AND SCIENCES 53 10 2832 - 2833 2008年10月 [査読有り][通常論文]
  • Hiromasa Arai, Yasushi Rino, Sumitaka Yamanaka, Norio Yukawa, Nobuyuki Wada, Hiromi Kato, Masakatsu Yanagimachi, Hiroaki Goto, Hisashi Oshiro, Shoji Yamanaka, Yoshiaki Inayama, Jin Lee, Munetaka Masuda
    SURGERY TODAY 38 10 965 - 969 2008年10月 [査読有り][通常論文]
     
    Adrenocortical carcinoma (ACC) in childhood is rare: in 2002, only three new cases were reported in Japan. Although there is no established therapeutic management system, margin-free complete surgical excision of the tumor is very important to a satisfactory outcome. We report a case of ACC with bilateral pulmonary metastasis in a 10-year-old boy. Preoperative chest computed tomography (CT) showed pulmonary metastasis with near-water density. The patient was treated successfully with complete surgical resection of the primary tumor and adjuvant chemotherapy, including mitotane. After bilateral lung surgery for the metastatic lesions, the plasma dehydroepiandrosterone sulfate level became negative.
  • Hisashi Oshiro, Yohei Miyagi, Yoshiaki Kawaguchi, Yasushi Rino, Hiromasa Arai, Mikiko Asai-Sato, Hiroki Nakayama, Shoji Yamanaka, Yoshiaki Inayama, Noriyoshi Fukushima
    PATHOLOGY INTERNATIONAL 58 7 456 - 461 2008年07月 [査読有り][通常論文]
     
    Reported herein is a case of endometrial adenocarcinoma without myometrial invasion that metastasized to the pancreas in a 69-year-old Japanese woman who had a history of hysterectomy. Although systemic radiography could not detect any metastasis in the whole body before hysterectomy, imaging performed 2 months after the hysterectomy consisting of CT, magnetic resonance imaging, gallium scintigraphy and positron emission tomography identified a solitary pancreatic tumor. Imaging demonstrated an intracystic papillary growth in the pancreas, suggesting intraductal papillary mucinous neoplasm or mucinous cystic neoplasm. Excised in distal pancreatectomy, the tumor was diagnosed as a pancreatic primary, an invasive papillary adenocarcinoma at first, but both the endometrial tumor and the pancreatic tumor demonstrated similar morphology and immunohistochemistry. Furthermore, the identical nucleotide mutation of TP53 gene was observed from both the endometrial and pancreatic tumors. The pancreatic tumor was therefore confirmed to be a metastasis from the primary endometrial adenocarcinoma. Metastasis to the pancreas from endometrial carcinoma is extremely rare but must be considered even if the previous cancer was treated at an early stage. Histopathological comparison study and genetic analysis are important for the correct diagnosis of metastasis.
  • Hiromasa Arai, Yasushi Rino, Sumitaka Yamanaka, Nobuyasu Suganuma, Norio Yukawa, Nobuyuki Wada, Sayaka Hara, Michiko Hirokado, Hisashi Oshiro, Munetaka Masuda
    SURGERY TODAY 38 7 639 - 643 2008年07月 [査読有り][通常論文]
     
    Lung cancer associated with Sweet's syndrome is extremely rare. There are only seven reports of such cases. As far as could be determined from a comprehensive search, there is no reported operative case of lung cancer with this syndrome in the world literature. A 75-year-old Japanese man was diagnosed as having Sweet's syndrome. A chest computed tomography (CT) scan to screen for malignant lesions associated with this syndrome revealed an abnormal shadow in the lung. Although [F-18]2-fluoro-2-deoxy-D-glucose positron emission tomography showed no abnormal uptake, lung cancer was most strongly suspected by chest CT. His erythema improved rapidly with steroid therapy and he underwent a segmentectomy (S-6) of the right lower lobe. A pathological examination revealed lung adenocarcinoma (pT1N0M0: Stage Ia). The patient was discharged from the hospital without any worsening of Sweet's syndrome. We herein report a first operative case of an early stage lung adenocarcinoma with this syndrome.
  • Arai H, Rino Y, Yamanaka S, Yukawa N, Wada N, Kudo M, Watanuki Y, Fukumura H, Nakajima K, Oshiro H, Yamanaka S, Masuda M
    Gan to kagaku ryoho. Cancer & chemotherapy 35 5 813 - 816 2008年05月 [査読有り][通常論文]
  • Masanori Hisaoka, Tsuyoshi Ishida, Tseng-Tong Kuo, Atsuji Matsuyama, Tetsuo Imamura, Kazunori Nishida, Hiroshi Kuroda, Yoshiaki Inayama, Hisashi Oshiro, Hiroshi Kobayashi, Takashi Nakajima, Toshio Fukuda, Keisuke Ae, Hiroshi Hashimoto
    AMERICAN JOURNAL OF SURGICAL PATHOLOGY 32 3 452 - 460 2008年03月 [査読有り][通常論文]
     
    Clear cell sarcoma (CCS) of soft tissue is a rare sarcoma with morphologic similarities to malignant melanoma but a distinct genetic background including a chromosomal translocation, t(12;22)(q13;q12), or a resultant EWSR1-ATF1 fusion gene. In addition, the tumors occurring in the gastrointestinal tract may have a variant fusion gene EWSR1-CREB1. This study analyzed the clinicopathologic and molecular genetic features of 33 CCSs of soft tissue. The patients' ages ranged from 13 to 73 years (median, 30 y), and there was a male predominance (20 males, 13 females). The tumors were located in the deep soft tissues of the extremities (N = 25) or in the trunk or limb girdles (N = 8). The median tumor size was 4cm (range, 1 to 15cm). The tumor cells were either spindle or epithelioid, and they were arranged predominantly in a short fascicular (N = 19) or a solid sheetlike growth pattern (N = 14). Minor histologic variations included the existence of rhabdoid cells (N = 8), bizarre pleomorphic cells (N = 6), alveolar structures due to loss of cellular cohesion (N = 3), and a seminomalike pattern (N 2). Tumor necrosis was evident in 14 tumors, and the mitotic activity ranged from 0 to 43 mitotic figures (MF)/10 high-power fields (HPF) (mean: 4MF/10 HPF). Immunohistochemically, the tumors were consistently positive for S-100 protein (33/33) and variably or focally for HMB45 (32/33), microphthalmia transcription factor (26/32), Melan A (23/32), CD57 (25/33), bcl-2 (30/32), synaptophysin (14/32), CD56 (7/32), epithelial membrane antigen (12/33), cytokeratin (AE1/AE3) (1/32), CD34 (3/32), c-erbB-2 (10/32), c-kit (5/32), and c-met (5/32). a-Smooth muscle actin, desmin, and cytokeratin (CAM5.2) were negative. Reverse transcription-polymerase chain reaction using RNA extracted from formalin-fixed, paraffin-embedded tissues demonstrated transcripts of the EWSR1-ATF1 (31/33) or EWSR1-CREB1 fusion gene (2/33). In 26 cases with available clinical information, local recurrences and metastases developed in 2 and 15 patients, respectively. Ten patients were dead of the disease, and the overall survival rate was 63% at 5 years. However, no clinicopathologic or molecular variables associated with the patients' prognosis were identified. This study confirms that CCS is an aggressive soft tissue tumor with a melanocytic phenotype and wider morphologic variations than had been generally considered. In cases with unusual histologic findings, molecular detection of the EWSR1-ATF1/CREB1 fusion genes provides critical information regarding the diagnosis of the tumor.
  • Michiyo Kanazawa, Midori Ishii, Yoshimi Sato, Kazuhisa Kitamura, Hisashi Oshiro, Yoshiaki Inayama
    ACTA CYTOLOGICA 52 2 266 - 268 2008年03月 [査読有り][通常論文]
  • Yamada T, Rino Y, Wada N, Yukawa N, Saeki H, Arai H, Kanari M, Nakayama T, Masuda M, Oshiro H, Imada T
    Gan to kagaku ryoho. Cancer & chemotherapy 35 1 117 - 119 2008年01月 [査読有り][通常論文]
  • Keiko Suzuki, Taiichi Kawabe, Hirokazu Takahashi, Satoshi Nakao, Akihiro Suzuki, Masahiko Inamori, Hiroshi Iida, Hiroki Endo, Tomoyuki Akiyama, Koji Fujita, Masato Yoneda, Yasunobu Abe, Noritoshi Kobayashi, Kensuke Kubota, Hisashi Oshiro, Atsushi Nakajima
    DIGESTION 77 3-4 155 - 156 2008年 [査読有り][通常論文]
  • Kensuke Kubota, Hiroshi Iida, Toshio Fujisawa, Masato Yoneda, Masahiko Inamori, Yasunobu Abe, Hiroyuki Kirikoshi, Satoru Saito, Hisashi Ohshiro, Yukio Kakuta, Atushi Nakajima
    GASTROINTESTINAL ENDOSCOPY 66 6 1142 - 1151 2007年12月 [査読有り][通常論文]
     
    Background: The rates of spontaneous remission and relapse of autoimmune pancreatitis (AIP) are not known. Objective: To study the clinicopathologic factors predictive of remission and relapse in cases of AIP. Design: Retrospective study. Patients: Of the 20 patients with AIP, complete response to steroid therapy was recognized in 12 patients, and the remaining 8 patients improved without steroid therapy. Seven patients experienced a relapse. Results: Patients who were seronegative for immunoglobulin (Ig) G4, had no obstructive jaundice, no diabetes mellitus, no swelling of the duodenal papilla, negative staining of the duodenal papilla for IgG4, and focal pancreatic swelling showed a greater tendency toward spontaneous remission (P <.05). The results of multivariate analysis revealed that negative staining of the duodenal papilla for IgG4 was the only independent predictor of spontaneous remission of AIP (odds ratio [OR] 1.395, P =.0304). Seropositivity for IgG4, diffuse swelling of the pancreas, and the presence of stricture in the lower part of the bile duct were significantly associated with a relapse of AIP (P <.05) according to the results of univariate analysis, whereas the results of multivariate analysis revealed only diffuse pancreatic swelling as an independent predictor of a relapse of AIP (OR 26.197, P =.0331). Conclusions: Endoscopic findings are of useful prognostic value, because patients with AIP and with negative staining of the duodenal papilla for IgG4 appeared to have a higher frequency of remission without steroid therapy. Patients with AIP and with diffuse pancreatic swelling were found to be at an increased risk of relapse after the initial steroid administration.
  • 湯川 寛夫, 利野 靖, 佐伯 博行, 荒井 宏雅, 大城 久, 益田 宗孝
    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 68 11 2804 - 2810 日本臨床外科学会 2007年11月 
    虫垂粘液嚢胞腺腫は稀な疾患である. 今回, われわれは高CEA血症を呈し術後正常化した虫垂粘液嚢胞腺腫の2例を経験したので報告する.
    症例1 : 58歳, 女性. 2005年3月近医にて右卵巣腫大を指摘され, 婦人科を受診しCTにて右卵巣腫瘍が疑われ12月当院婦人科を受診し入院. CEA=9.3と高値を示し, CT, MRI, USで右下腹部に嚢胞状腫瘤を認めた. 2006年2月当科で回盲部切除術施行. 術後CEA=1.8と正常化した.
    症例2 : 50歳, 女性. 2005年4月悪性リンパ腫の経過観察中のCTで回盲部に腫瘤を指摘された. 11月のCTで増大が認められ2006年3月入院となった. CEA=5.9と高値を示した. CT, USで右下腹部に嚢胞状腫瘤を認めた. 2006年3月盲腸部分切除術施行. 術後CEA=1.6と正常化した.
    いずれも病理検査で虫垂粘液嚢胞腺腫と診断され, 免疫染色ではCEA陽性であった.
    88年以降本邦で原著として報告されCEA高値を示す虫垂粘液嚢胞腺腫は自験例を含め40例であった.
  • Oshiro H, Nomura M, Yamanaka S, Watanabe S, Inayama Y
    Journal of clinical and experimental hematopathology : JCEH 47 2 83 - 88 2007年11月 [査読有り][通常論文]
  • Satoshi Inoue, Hisashi Oshiro, Yuji Watanuki, Naoki Miyazawa, Makoto Kudo, Hideto Goto, Jun Tsukiji, Takeshi Kaneko, Yoshiaki Ishigatsubo
    CLINICAL LUNG CANCER 8 7 436 - 438 2007年07月 [査読有り][通常論文]
     
    Brain metastasis Is a critical complication of small-cell lung cancer (SCLC), resulting In rare long-time survival. We report a case of a 72-year-old man who displayed a very unique clinical appearance, with a large metastatic brain tumor that grew much faster than primary SCLC. The brain tumor expressed high levels of vascular endothellal growth factor (VEGF) that was negative In primary lung tumor. The patient, who underwent brain surgery and chemotherapy against SCLC, has survived for > 2 years with a good performance status since Initial brain symptoms occurred. Weak expression of VEGF In primary tumor might be associated with good prognosis. However, VEGF upregulation could occur after metastasis, resulting In aggressive tumor growth.
  • Shimpei Sugiura, Kazuhide Makiyama, Noboru Nakaigawa, Masahiro Yao, Yoshinobu Kubota, Hisashi Oshiro
    INTERNATIONAL JOURNAL OF UROLOGY 14 6 555 - 557 2007年06月 [査読有り][通常論文]
     
    We present a 67-year-old male with a rare case of collecting duct carcinoma producing granulocyte colony-stimulating factor. He was referred to us with lumbago and fever. Laboratory testing showed leukocytosis and computed tomography revealed a left renal mass. After chemotherapy with gemcitabine and nedaplatin, computed tomography showed a partial response. A left nephroureterectomy was performed. The histopathological diagnosis was collecting duct carcinoma producing granulocyte-colony-stimulating factor. White blood cell levels were reduced to 9900/mm(3). No recurrence was detected after completion of adjuvant chemotherapy and the patient was discharged from the hospital. However, 3 months later, computed tomography revealed multiple lung metastasis. Nedaplatin- based chemotherapy was administered but computed tomography after chemotherapy identified a progressive disease. The patient died 9 months after the operation.
  • 西井 鉄平, 利野 靖, 荒井 宏雅, 千葉 明彦, 大城 久, 高梨 吉則
    日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery 21 2 165 - 169 特定非営利活動法人日本呼吸器外科学会 2007年03月 
    検診を契機に発見された淡明細胞腺癌の1例を経験したので報告する.症例は76歳,男性で,胸部CT上,左肺S3末梢に単発性の腫瘤性病変を認めた.経気管支肺生検等で確定診断に至らず,左肺部分切除術を施行した.術中迅速凍結組織診断で腺癌が疑われたため,左肺上葉切除術及び縦隔リンパ節郭清に術式を変更した.術前術後の全身の画像診断にて他臓器に腫瘍性病変を認めなかったため,臨床的に原発性肺腫瘍を考えた.術後の病理学的検索で,病変の90%以上を淡明細胞が占め,ごくわずかに乳頭状構造を呈することが分かった.免疫組織化学的にはケラチン陽性,EMA陽性,Thyroid transcription factor-1陽性,Surfactant apoprotein A陽性,HMB45陰性を示し,肺原発の淡明細胞腺癌の診断を得た.術後22ヵ月間経過しているが,再発はなく,健康である.
  • 和田 博雄, 野沢 昭典, 大城 久, 利野 靖, 今田 敏夫, 稲山 嘉明
    日本消化器外科学会雑誌 = The Japanese Journal of Gastroenterological Surgery 40 3 247 - 252 一般社団法人日本消化器外科学会 2007年03月 [査読有り][通常論文]
     
    はじめに:内視鏡的切除された大腸粘膜下組織浸潤癌(以下,大腸sm癌と略記)につき,HE染色とD2-40免疫染色標本によるリンパ管侵襲検出の程度を比較し,リンパ管侵襲検出に関する同免疫染色の有用性を検討した.対象と方法:内視鏡的切除された大腸sm癌30例につき連続切片を作成し,HE染色,D2-40免疫染色を行った.結果:HE標本でリンパ管侵襲は2例2病変,D2-40免疫染色では5例6病変であった.両者で一致したのは1例1病変,乖離がみられたのは5例6病変で,4例5病変がHE標本で過小評価され,1例1病変がHE標本で過大評価された.前者4例は,組織との空隙が乏しい,腫瘍胞巣やリンパ管が小型である,などのため,HE標本ではリンパ管侵襲と認識困難であったが,D2-40免疫染色では認識容易であった.後者1例は,HE標本でリンパ管とみなしたが,D2-40免疫染色陰性であった.一方,同免疫染色では,腫瘍胞巣を一見取り囲むように非特異的に染まることがあり,リンパ管侵襲と誤認しないよう注意が必要であった.考察:D2-40免疫染色は,内視鏡的切除術を受けた大腸sm癌におけるリンパ管侵襲の正確な評価に有用であると考えられた.
  • Yasuyo Kashiwagi, Hisashi Kawashima, Satoshi Sato, Hiroaki Ioi, Masahiro Amaha, Kouji Takekuma, Akinori Hoshika, Hisashi Oshiro, Jun Matsubayashi, Kiyoshi Mukai
    MICROBIOLOGY AND IMMUNOLOGY 51 1 53 - 62 2007年 [査読有り][通常論文]
     
    We report three infants and one teenager with fatal virus-associated haemophagocytic syndrome (VAHS). Two infants were admitted to our hospital because of cardio-pulmonary arrest (CPA). The third infant was admitted to our department because of fever and liver dysfunction, and he was diagnosed as combined immunodeficiency with predominant T cell defect. The teenager was diagnosed as systemic lupus erythema (SLE) when she was 10 years old and admitted to our department because of fever and thrombocytopenia. The histological findings for the four patients' organs revealed many haemophagocytic cells. The patients were infected by Parainfluenza virus type 2 (PIV2), Enterovirus (EV), Cytomegalovirus (CMV), and Epstein-Barr virus (EBV), respectively. Their laboratory data revealed elevated levels of ferritin and IL-6, which also suggested virus-associated haemophagocytic syndrome (VAHS). Although aggressive therapies were performed in all cases, the outcome was fatal. Further investigation would be needed to clarify the mechanism of VAHS and an effective therapeutic regimen is needed.
  • Kensuke Kubota, Hiroshi Iida, Toshio Fujisawa, Masami Ogawa, Masahiko Inamori, Satoru Saito, Yukio Kakuta, Hisashi Oshiro, Atsushi Nakajima
    Pancreas 35 4 e51 - e60 2007年 [査読有り][通常論文]
     
    Objectives: To evaluate the clinical significance of a swollen main duodenal papilla and the associated immunohistopathologic findings in patients with autoimmune pancreatitis (AIP). Methods: Seventeen consecutive patients with AIP registered between April 2001 and October 2005 who underwent both endoscopic retrograde cholangiopancreatography and endoscopic biopsy were enrolled in this study. The endoscopic features, stromal inflammatory cell infiltrate (SICI), and results of immunohistochemical examination of the duodenal papilla using IgG4, CD3, and CD79a antibodies were retrospectively reviewed. These findings in the AIP patients were compared with those in 12 patients with chronic alcoholic tumor-forming pancreatitis (CAP). The numbers of cells in the SICI and of IgG4-positive plasma cells per high-power field were counted in all the histopathologic specimens. Results: A swollen main duodenal papilla was observed in 11 (11 [64.7%]/17) patients with AIP and 4 (4 [33.3%]/12) patients with CAP (P < 0.05). Resolution of the swollen main duodenal papilla was observed in all of these 11 patients with AIP (11 [100%]/11) in response to treatment with corticosteroids. On the other hand, the 6 patients without elevated serum IgG4 or a swollen duodenal papilla, but with a swollen pancreas, improved even without corticosteroid treatment. The number of cells in the SICI in the AIP patients was significantly higher than that in the CAP patients. Although in 13 of 17 AIP patients, infiltration by IgG4-positive plasma cells was detected in the duodenal papilla, no such significant infiltration of the duodenal papilla by IgG4-positive plasma cells was observed in the patients with CAP (P < 0.05). More predominant T-cell infiltration of the duodenal papilla was recognized in the AIP patients than in the CAP patients (P < 0.05). Conclusions: These results suggest that a swollen main duodenal papilla with IgG4-positive plasma cell and T-cell-dominant infiltration and an abundant stromal cell infiltrate are characteristic findings in AIP. We suggest that these findings may be valuable adjuncts to the diagnosis of AIP as well as for selecting suitable candidates for corticosteroid therapy. © 2007 Lippincott Williams and Wilkins, Inc.
  • 湯川 寛夫, 利野 靖, 井野 裕代, 金成 正浩, 佐伯 博行, 和田 修幸, 大城 久, 益田 宗孝, 今田 敏夫
    日本外科系連合学会誌 31 6 961 - 965 Japanese College of Surgeons 2006年12月 
    大腸は他臓器に比べ多重癌を合併する頻度が高く, また診断治療技術の向上に伴い他臓器癌との重複例も増加している。今回, われわれは喉頭癌, 肺癌, S状結腸癌 (異時性2病変) の四重重複癌症例を経験したので報告する。症例は75歳の男性。2000年2月喉頭癌に対して化学放射線療法が著効し消失した。2004年8月肺腺癌に対し左上葉切除施行。2004年11月大腸内視鏡 (CF) 施行し肛門縁 (AV) より30cmのS状結腸ポリープにポリペクトミー施行。腺腫内高分化腺癌であった。2005年7月CF施行しAVより45cmのS状結腸にIp型ポリープを認め, ポリペクトミー施行。病理検査にて中分化腺癌, sm2 ly1 v0で断端 (+) が疑われたため, 2005年9月腹腔鏡下S状結腸切除術D2郭清を行い病理検査ではn0で腫瘍の残存はなかった。術後経過は順調で現在外来通院中である。
  • H Oshiro, Y Ebihara, H Serizawa, T Shimizu, S Teshima, M Kuroda, M Kudo
    AMERICAN JOURNAL OF MEDICINE 118 7 782 - 786 2005年07月 [査読有り][通常論文]
     
    Idiopathic retroperitoneal fibrosis is characterized by the deposition of dense fibrous connective tissue and varying degrees of lymphoid cell infiltration.(1) Some descriptions of this disease also refer to the presence of distorted plasma cells and to nuclear irregularities and clonal gene rearrangement in the lymphoid cells.(2,3) Reports of the incidence of malignant lymphoma, following an initial diagnosis of idiopathic retroperitoneal fibrosis and associated condition,(4-8) suggest that these sclerosing entities should perhaps be classified as lymphoid dyscrasia, which may be predisposed to forming low grade malignant lymphomas.(3) The aim of this study was to further investigate immunohematological abnormalities in cases of idiopathic retroperitoneal fibrosis.
  • S Sato, H Kawashima, H Oshiro, D Hasegawa, Y Kashiwagi, K Takekuma, A Hoshika
    JOURNAL OF CLINICAL VIROLOGY 31 3 235 - 238 2004年11月 [査読有り][通常論文]
     
    Hemophagocytic syndrome (HPS) is caused by the hyperactivation of T-cells and macrophages. The clinical characteristics associated with this disease result from overproduction of cytokines including interferon-gamma (INF-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6). HPS presents with fever, liver dysfunction, coagulation abnormalities, pancytopenia, and a benign histiocytic proliferation with prominent hemophagocytosis in bone marrow, lymph node, spleen, and liver. We describe a 19-year-old female with fatal HPS. She had been given corticosteroid every other day for systemic lupus erythematosus (SLE) without flare Lip. The causative underlying disease was acute primary Epstein-Barr virus (EBV) infection. EBV genomes were detected by the polymerase chain reaction (PCR). To measure the virus load we use a real-time PCR assay to quantify the amount of EBV DNA in peripheral blood lymphocytes, lung, kidney, brain and liver at autopsy. Further in situ hybridisation (ISH) and immunohistochemical studies demonstrated that Epstein-Barr virus encoded small RNA (EBER) was detected in CD8(+) T-cells in bone marrow, lung, kidney, brain, liver and spleen. In each organ, mRNA levels of inflammatory cytokines (INF-gamma, TNF-alpha, IL-6) were highly detected compared with beta-Actin mRNA levels. These results Suggest that EBV-infected CD8(+) T-cells in each organ (peripheral blood lymphocytes, lung, kidney, brain and liver) may have an integral role in the pathophysiology of the HPS. (C) 2004 Elsevier B.V. All rights reserved.
  • Yoshinori Sasaki, Toshihumi Wada, Masato Moritani, Keiichiro Yamamoto, Akihiko Tsuchida, Tatsuya Aoki, Yasuhisa Koyanagi, Hiromi Serizawa, Keiichi Iwaya, Hisashi Oshiro
    Japanese Journal of Gastroenterological Surgery 37 8 1469 - 1474 2004年 [査読有り][通常論文]
     
    A 72-year-old woman admitted for lower abdominal pain. She had a hard, mobile abdominal mass located from the subumbilical region to the pelvic cavity. Abdominal X-ray findings showed ileus of the small intestine. Computed tomography showed an abdominal mass containing air, necessitating surgery under a diagnosis of severe ileus due to the abdominal mass. We found in surgery that the mass originated from the mesentery of the small intestine near the promontrium, which involved part of the small intestine and sigmoid colon, i.e., 2 sites of the small intestine and part of the sigmoid colon. We excised 2 sites of the small intestine and part of the sigmoid colon with the tumor. The abdominal mass was pathologically diagnosed as CD56+ T-cell lymphoma of the small intestine. She refused chemotherapy and alimentary examination, and left hospital. But she caused perforated panperitonitis of the duodenum T-cell lymphoma considered to be simultaneity and multiple. She was died after the operation on the 83rd. The T-cell lymphoma of the small intestine are only 30 cases including our case. Especially, CD56+ T-cell Lymphoma has a high rate of perforation, the prognosis is so poor, and it was considered the disease which should be careful of.
  • Kubota N, Miyazawa K, Shoji N, Sumi M, Nakajima A, Kimura Y, Oshiro H, Ebihara Y, Ohyashiki K
    Haematologica 88 11 EIM13  2003年11月 [査読有り][通常論文]
  • Kubota N, Miyazawa K, Shoji N, Sumi M, Nakajima A, Kimura Y, Oshiro H, Ebihara Y, Ohyashiki K
    Haematologica 88 9 EIM11  2003年09月 [査読有り][通常論文]
  • 髄膜癌症の発症機序に関する一考察 脈絡叢ならびに脳室周囲器官の血管経路について
    工藤 玄恵, 大城 久, 米山 寿一, 岡田 真也, 石井 英昭, 海老原 善郎, 北沢 吉昭
    リンパ学 24 2 51 - 56 日本リンパ学会 2001年11月 
    髄膜癌症をきたした6例の剖検例を用いて,脳を病理組織学的に詳細に検索した.各々の症例から側脳室,第三脳室,そして第四脳室内の脈絡叢組織とその周囲の脳実質を切り出し,組織学的に検索した.6例とも顕微鏡的に脳実質内浸潤巣を伴っており,純粋な髄膜癌症ではなかった.血管周囲腔やクモ膜下腔における血液と腫瘍細胞の混在像はある特定の一部に限定する,選択的な分布であった.更に,脈絡叢基部における毛細血管の一部の壁は開放性となり,血液細胞成分と共に腫傷細胞のクモ膜下腔内への播種像が認められた.なお,脳表と異なり,脈絡までは腫瘍に対する組織反応は殆どなかった
  • S. Liu, H. Oshiro, Y. Kato, M. Kudo, Y. Ebihara
    Japanese Journal of Lung Cancer 41 6 643 - 648 2001年 [査読有り][通常論文]
     
    Objective: This study was designed to understand the pathogenetic mechanism of pleural carcinomatosis. Patients and Methods: We collected 207 surgical cases of primary lung cancer and identified 43 cases with positive intraoperative pleural lavage cytology (PLC). We then histologically examined the pulmonary ligament (PL), visceral pleura (VP) and parietal pleura (PP) in these cases and found that 24 cases belonged to either the p0 or p1 categories of the Classification of Lung Cancer of the Japan Lung Cancer Society. Unfortunately the surgical cases were unsuitable for investigation of PL, because of severe operative manipulation involving the ligament. However, 15 autopsy cases of primary lung cancer and 63 of extrapulmonary primary origin were similarly investigated. Results: Surgical cases: Positive PLC cases showed a statistically significantly higher involvement in lymphatics and blood vessels of the lung parenchyma and hilar lymph nodes, than cases with negative PLC (p < 0.001). Autopsy cases: Varying degrees of pleural carcinomatosis were found in 8 cases (53.3%) of primary lung tumors, which were all adenocarcinoma in 2 out of the 8 cases, however, tumor cells were found, only in the PL. In addition, varying degrees of pleural carcinomatosis were observed in 21 cases (33.3%) of extrapulmonary origin, in which combined PL involvement was only observed in 5 cases. Furthermore, cancer cell clusters were found in the lymphatic cisterns of the PL in 29 autopsy cases (37.2%). Conclusion: There was also evidence of permeation of tumor cells in the cisterns into the pleural cavity via adjacent stomas in the PL. The PL was found to be a site with numerous lymphatic cisterns with stomas in the thoracic cavity. As a result, we consider that tumor invasion into the subpleural lymphatics might be a prerequisite for the development of pleural carcinomatosis.
  • 岡田 真也, 工藤 玄恵, 海老原 善郎, Payzulla Dilinur, 大城 久, 垣花 昌俊
    肺癌 40 3 223 - 229 特定非営利活動法人 日本肺癌学会 2000年 
    気管支原発の顆粒細胞腫1例と本邦33例の文献報告について臨床細胞組織学的に検討した. 症例; 39歳, 男性. 健診時の胸部X線写真上, 左上肺野に異常陰影が指摘された. 気管支鏡検査で粘膜下腫瘍による左B1+2cの閉塞所見が認められた. 擦過及び擦過後気管支洗浄細胞診検査においてシート状配列を示し, 豊富な顆粒状細胞質と小型類円形核からなる腫瘍細胞と, その細胞質内に封入体を認めたため, 顆粒細胞腫と診断した. 左上区区域切除術が施行された. 病巣部は長軸方向12mmにわたり, 白色乳頭状腫瘍であった. 組織学的には特徴的な大型好酸性顆粒状細胞質内にジアスターゼ耐性のPAS強陽性のangulate bodyが認められた. 免疫組織学的にS-100蛋白陽性で, 電顕的にはschwann cellの特徴を示していた. 術後4年間, 再発転移は認められていない. 結語; 本例は顆粒細胞腫の末梢神経細胞の起源説を支持する所見を有している.

MISC

  • 中村 香織, 天野 雄介, 織田 智博, 鈴木 智子, 柳田 美樹, 郡 勝俊, 池田 恵理子, 大城 久, 仁木 利郎, 福嶋 敬宜 日本臨床細胞学会雑誌 58 (Suppl.1) 295 -295 2019年05月 [査読有り][通常論文]
  • 坂口 美織, 大城 久, 笹島 ゆう子, 吉本 多一郎, 小柳 貴裕, 竹井 裕二, 藤原 寛行, 松原 大祐, 仁木 利郎, 福嶋 敬宜 日本臨床細胞学会雑誌 58 (Suppl.1) 277 -277 2019年05月 [査読無し][通常論文]
  • 肝胆道系疾患における細胞診の役割 胆汁細胞診における免疫細胞化学的染色の有用性について
    織田 智博, 渡邊 温子, 中村 香織, 二階堂 貴章, 柳田 美樹, 郡 俊勝, 鈴木 智子, 芳賀 美子, 池田 恵理子, 小松原 利英, 大城 久, 福嶋 敬宜 日本臨床細胞学会雑誌 57 (Suppl.2) 568 -568 2018年10月 [査読無し][通常論文]
  • 重複尿管の腎盂尿管移行部に発生した癌肉腫の尿細胞診所見
    辻 賢太郎, 大城 久, 伊藤 淳史, 田畑 憲一, 丹波 美織, 吉本 多一郎, 天野 雄介, 木原 淳, 河田 浩敏, 二階堂 貴章, 柳田 美樹, 郡 俊勝, 鈴木 智子, 仁木 利郎, 福嶋 敬宜 日本臨床細胞学会雑誌 57 (Suppl.2) 622 -622 2018年10月 [査読無し][通常論文]
  • 中枢神経系原発と考えられ、その後他臓器浸潤がみられた悪性リンパ腫の一例
    柳田 美樹, 二階堂 貴章, 郡 俊勝, 鈴木 智子, 渡邊 温子, 天野 雄介, 大城 久, 福嶋 敬宜 日本臨床細胞学会雑誌 57 (Suppl.1) 264 -264 2018年04月 [査読無し][通常論文]
  • 肝細胞癌の上顎歯肉転移の1例
    田畑 憲一, 大城 久, 柳田 美樹, 郡 俊勝, 鈴木 智子, 天野 雄介, 木原 淳, 松原 大祐, 仁木 利郎, 福嶋 敬宜 日本臨床細胞学会雑誌 57 (Suppl.1) 327 -327 2018年04月 [査読無し][通常論文]
  • 胸水中への脊索腫細胞の出現を証明しえた1例
    丹波 美織, 大城 久, 柳田 美樹, 郡 俊勝, 鈴木 智子, 芳賀 美子, 織田 智博, 二階堂 貴章, 仁木 利郎, 福嶋 敬宜 日本臨床細胞学会雑誌 57 (Suppl.1) 248 -248 2018年04月 [査読無し][通常論文]
  • 乳腺腺筋上皮腫の一例
    郡 俊勝, 天野 雄介, 鈴木 智子, 柳田 美樹, 伊藤 聡史, 田中 裕美子, 藤田 崇史, 大城 久, 福嶋 敬宜 自治医科大学臨床検査技師年報 (40) 54 -56 2018年01月 [査読無し][通常論文]
     
    症例は64歳女性で、10年前に右乳腺腫瘍を指摘され、経過観察していた。マンモグラフィーでFADカテゴリー3、超音波で右乳腺D領域に20mmの範囲で低エコー領域を認め、MRIで右CD領域に20mmの範囲で小結節性病変の集簇を認めた。乳腺腫瘤の疑いで、穿刺吸引細胞診、針生検および右乳腺部分切除術を施行した。細胞所見により推定診断として紡錘形細胞腫瘍を疑った。針生検で採取した組織には紡錘形細胞が主体に増殖し、一部では腺管構造を認めた。組織像と免疫染色の結果において腺筋上皮腫と診断した。摘出検体は、肉眼像で腫瘍は境界明瞭で白色多結節性に認めた。組織学的に病変は多結節性で充実性に認め、一部では腺管構造を観察した。組織像は紡錘形細胞が主体に増殖し、一部において腺管構造を観察した。組織像と免疫染色の結果において、腺筋上皮腫と診断した。
  • ブラシを用いた横隔腹膜擦過・液状化細胞診断法の細胞採取量の検討 綿棒法との比較
    蘆澤 健太郎, 大城 久, 丹波 美織, 田畑 憲一, 伊藤 淳史, 鈴木 智子, 渡邊 温子, 柳田 美樹, 郡 俊勝, 二階堂 貴章, 藤原 寛行, 芳賀 美子, 福嶋 敬宜 日本臨床細胞学会雑誌 56 (Suppl.2) 800 -800 2017年10月 [査読無し][通常論文]
  • 不正子宮出血を契機に再発が確認された急性骨髄性白血病の一例
    丹波 美織, 大城 久, 柳田 美樹, 郡 俊勝, 鈴木 智子, 芳賀 美子, 蘆澤 健太郎, 田畑 憲一, 伊藤 淳史, 松原 大祐, 吉本 多一郎, 木原 淳, 天野 雄介, 仁木 利郎, 福嶋 敬宜 日本臨床細胞学会雑誌 56 (Suppl.2) 715 -715 2017年10月 [査読無し][通常論文]
  • 部分血栓化巨大右椎骨動脈瘤に対するコイル塞栓術後に右側Wallenberg症候群を呈して死亡した一剖検例
    田畑 憲一, 大城 久, 檜垣 鮎帆, 難波 克成, 河合 謙介, 蘆澤 健太郎, 丹波 美織, 伊藤 淳史, 福嶋 敬宜 日本病理学会会誌 106 (2) 75 -75 2017年09月 [査読無し][通常論文]
  • 異所性胃粘膜を伴うブルンナー腺の増殖性病変からなる十二指腸ポリポーシスの一例
    蘆澤 健太郎, 大城 久, 三登 久美子, 丹波 美織, 田畑 憲一, 伊藤 淳史, 福嶋 敬宜 日本病理学会会誌 106 (1) 436 -436 2017年03月 [査読無し][通常論文]
  • 膵頭部膵癌における、D2-40染色を用いたリンパ管侵襲数の測定の意義
    森田 剛平, 三登 久美子, 大城 久, 仁木 利郎, 福嶋 敬宜 日本病理学会会誌 106 (1) 317 -317 2017年03月 [査読無し][通常論文]
  • 広範な胸膜進展を伴う肺胞上皮置換性優位型肺腺癌の1例
    田畑 憲一, 森田 剛平, 大城 久, 吉本 多一郎, 松原 大祐, 仁木 利郎, 福嶋 敬宜 日本病理学会会誌 106 (1) 371 -371 2017年03月 [査読無し][通常論文]
  • 伊藤淳史, 山崎有人, 笹野公伸, 松原大祐, 福嶋敬宜, 丹波美織, 田畑憲一, 武井暁一, 小泉大, 大城久 日本病理学会会誌 105 (2) 112 -112 2016年09月 [査読無し][通常論文]
  • 片側性多発副腎皮質微小結節による原発性アルドステロン症の一例
    伊藤 淳史, 山崎 有人, 笹野 公伸, 松原 大祐, 福嶋 敬宜, 丹波 美織, 田畑 憲一, 武井 暁一, 小泉 大, 大城 久 日本病理学会会誌 105 (2) 112 -112 2016年09月 [査読無し][通常論文]
  • Hisashi Oshiro, Bogdan Czerniak, Kentaro Sakamaki, Koji Tsuta, Jolanta Bondaruk, Afsaneh Keyhani, Colin Dinney, Takeshi Nagai, Ashish Kamat JOURNAL OF UROLOGY 193 (4) E537 -E537 2015年04月 [査読無し][通常論文]
  • Hiromasa Arai, Koji Okudela, Hisashi Oshiro, Noriko Komitsu, Keita Fujii, Masahiro Tsuboi, Munetaka Masuda JOURNAL OF THORACIC ONCOLOGY 8 S753 -S754 2013年11月 [査読無し][通常論文]
  • 胸腺原発リンパ上皮腫様癌の1例
    稲垣 敦史, 松林 純, 桑原 淳, 三宅 真司, 渡部 顕章, 鈴木 恵美子, 石原 里佳子, 五百部 浩昭, 大城 久, 大平 達夫, 池田 徳彦, 長尾 俊孝 日本臨床細胞学会雑誌 52 (Suppl.2) 645 -645 2013年10月 [査読無し][通常論文]
  • Masaharu Nomura, Tetsuya Fukuda, Kiyonaga Fujii, Takeshi Kawamura, Hiromasa Tojo, Yasuhiko Bando, Adi F. Gazdar, Masahiro Tsuboi, Hisashi Ohshiro, Toshitaka Nagao, Tatsuo Ohira, Norihiko Ikeda, Noriko Gotoh, Harubumi Kato, Gyorgy M. Varga, Toshihide Nishimura JOURNAL OF THORACIC ONCOLOGY 6 (6) S1053 -S1054 2011年06月 [査読無し][通常論文]
  • 菅野 伸洋, 湯川 寛夫, 嶋田 裕子, 大城 久, 利野 靖, 益田 宗孝 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 72 (2) 379 -383 2011年02月 
    症例は6歳,男児.Henoch-Schönlein紫斑病(HSP)に対し,前医にてステロイドや第XIII因子,ウリナスタチンの投与,ステロイドパルス療法などの対処療法を行ったが,紫斑,腹痛,下血は徐々に増悪した.腎機能障害も出現し,第16病日当院小児科紹介入院となった.再度ステロイドパルス療法,ステロイド投与を行い,症状・検査データーともに一時改善に向かったが,第24病日腹痛再燃,翌日腹部筋性防御が出現,消化管穿孔の診断で同日緊急手術を施行した.回腸に約50cmにわたる壊死腸管を認め,穿孔が多発しており,同部を切除し吻合した.病理組織学検査にて,HSPに特有な血栓や血管炎の所見は乏しく,またHE染色で巨細胞封入体,免疫組織化学染色でCMV陽性像を認めた.血液検査にてCMVアンチゲネミア陽性,以上よりCMV腸炎の合併が証明され,穿孔の原因であると考えられた.早期のステロイド減量を心掛け,術後33日目退院となった.
  • カプセル内視鏡を契機に発見されたサイトメガロウイルス起因性出血性小腸潰瘍の1例
    酒井 英嗣, 遠藤 宏樹, 内山 崇, 細野 邦広, 古出 智子, 高橋 宏和, 所 知加子, 阿部 泰伸, 稲森 正彦, 中島 淳, 菅野 伸洋, 利野 靖, 大城 久, 稲山 嘉明 栄養-評価と治療 28 (1) 90 -90 2011年02月 [査読無し][通常論文]
  • 早期大腸癌に対する内視鏡治療成績からみた追加切除の適応
    諏訪 宏和, 大田 貢由, 高橋 宏和, 所 知加子, 内山 崇, 辰巳 健志, 秋山 浩利, 大城 久, 中島 淳, 遠藤 格, 稲山 嘉明 日本大腸肛門病学会雑誌 63 (7) 455 -455 2010年07月 [査読無し][通常論文]
  • 横浜市立大学におけるバイオバンク室の運営と課題
    稲山 嘉明, 山中 正二, 村上 あゆみ, 中山 崇, 大城 久, 海野 俊徳, 小野 響子, 平 沙代子, 矢澤 卓也, 下山田 博明, 奥寺 康司, 長嶋 洋治, 古屋 充子, 長濱 清隆, 北村 均, 青木 一郎 日本病理学会会誌 99 (1) 286 -286 2010年03月 [査読無し][通常論文]
  • Magnet activated cell sorting(MACS)を用いた糸球体上皮細胞の単離
    村上 あゆみ, 潘 勤雅, 大城 久, 山中 正二, 古屋 充子, 長嶋 洋治, 青木 一郎, 長濱 清隆 日本病理学会会誌 99 (1) 342 -342 2010年03月 [査読無し][通常論文]
  • 石田 修一, 窪田 賢輔, 馬渡 弘典, 阿部 泰伸, 稲森 正彦, 小林 規俊, 斉藤 聡, 大城 久, 山中 正二, 中島 淳 Progress of Digestive Endoscopy 75 (2) 126,10 -127,10 2009年12月 [査読無し][通常論文]
     
    症例は63歳、男性。膵腫大、膵管狭細像に加え、Vater乳頭部腫大と同部位でのIgG4陽性形質細胞浸潤を認め、自己免疫性膵炎と診断された。これらの所見は、いずれもステロイド治療開始後より改善を認めた。自己免疫性膵炎における診断、治療効果の判定の補助にVater乳頭部所見と、同部位へのIgG4陽性形質細胞浸潤の程度が有用であることが示唆された。(著者抄録)
  • 子宮頸部細胞診が有用であった卵管癌と子宮頸部腺癌の重複癌の1例
    杉浦 賢, 宮城 悦子, 井畑 穣, 平原 史樹, 小林 友紀, 稲山 嘉明, 北村 和久, 大城 久, 山中 正二, 古屋 充子 日本臨床細胞学会雑誌 48 (Suppl.2) 580 -580 2009年09月 [査読無し][通常論文]
  • 湯川 寛夫, 利野 靖, 和田 修幸, 村上 仁志, 松浦 仁, 菅野 伸洋, 大城 久, 益田 宗孝 日本消化器外科学会雑誌 42 (7) 1164 -1164 2009年07月
  • 胃過形成ポリープの癌化、1切除例
    飯田 洋, 阿部 泰伸, 稲森 正彦, 内山 崇, 馬渡 弘典, 秋本 恵子, 遠藤 宏樹, 秋山 智之, 米田 恭子, 藤田 浩司, 高橋 宏和, 米田 正人, 小林 規俊, 桐越 博之, 窪田 賢輔, 斉藤 聡, 上野 規男, 利野 靖, 大城 久, 中島 淳 日本消化器病学会雑誌 105 (臨増大会) A775 -A775 2008年09月 [査読無し][通常論文]
  • 千葉 秀幸, 窪田 賢輔, 米田 正人, 阿部 泰伸, 稲森 正彦, 斎藤 聡, 中島 淳, 野村 直人, 嶋田 紘, 大城 久, 稲山 嘉昭 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 50 (8) 1736 -1742 2008年08月 [査読無し][通常論文]
     
    75歳男性。患者は腹痛を主訴に、肝胆道系酵素の上昇、IgG 4高値を認め、著者らの施設へ精査入院となった。腹部超音波・CTでは膵頭部の腫大と総胆管拡張が認められ、ERCPでは主乳頭が腫大し、主膵管の狭細像、尾側膵管の拡張を認めた。一方、膵生検ではlymphoplasmacytic screlosing pancreatitisが認められ、また上部消化管内視鏡では早期胃癌が確認された。以上より、本症例は早期胃癌を合併した自己免疫性膵炎(AIP)と診断され、胃癌に対する外科的切除後にステロイド治療を開始した。その結果、画像所見および血液検査所見の改善が確認され、更に十二指腸乳頭部生検では膵と同様にIgG 4陽性形質細胞を認め、AIPの補助診断となる可能性が示唆された。
  • アレルギー機序を背景に発症した自己免疫性膵炎の一例
    阿部 真也, 窪田 賢輔, 石川 公, 馬渡 弘典, 阿部 泰伸, 稲森 正彦, 小林 規俊, 斎藤 聡, 大城 久, 中島 淳 Progress of Digestive Endoscopy 73 (1) 97 -97 2008年06月 [査読無し][通常論文]
  • 佐川 弘美, 北村 和久, 石井 みどり, 三田 和博, 本野 紀夫, 西尾 由紀子, 金澤 美千代, 大城 久, 山中 正二, 稲山 嘉明 日本臨床細胞学会雑誌 47 (1) 198 -198 2008年03月
  • 超音波内視鏡下膵嚢胞ドレナージが有効であった自己免疫性膵炎の一例
    馬渡 弘典, 窪田 賢輔, 関野 雄典, 飯田 洋, 藤田 浩司, 高橋 宏和, 米田 正人, 稲森 正彦, 阿部 泰伸, 桐越 博之, 小林 規俊, 斉藤 聡, 中島 淳, 大城 久 日本消化器病学会雑誌 105 (臨増総会) A318 -A318 2008年03月 [査読無し][通常論文]
  • 星野 耕二, 蓮見 壽史, 村上 貴之, 槇山 和秀, 吉田 実, 三好 康秀, 中井川 昇, 小川 毅彦, 上村 博司, 矢尾 正祐, 窪田 吉信, 大城 久, 長嶋 洋治 泌尿器外科 20 (11) 1482 -1482 2007年11月 [査読無し][通常論文]
  • 金澤 美千代, 大城 久, 西尾 由紀子, 佐川 弘美, 三田 和博, 本野 紀夫, 石井 みどり, 北村 和夫, 山中 正二, 稲山 嘉明 日本臨床細胞学会雑誌 46 (2) 418 -418 2007年09月
  • 長嶋 洋治, 北村 和久, 河野 尚美, 山中 正二, 大城 久, 稲山 嘉明 日本臨床細胞学会雑誌 46 (2) 476 -476 2007年09月
  • 湯川 寛夫, 利野 靖, 山口 惠子, 長 知樹, 菅沼 伸康, 佐伯 博行, 佐々木 一嘉, 大城 久, 益田 宗孝, 今田 敏夫 日本消化器外科学会雑誌 40 (7) 1416 -1416 2007年07月
  • 三田 和博, 北村 和久, 石井 みどり, 佐川 弘美, 本野 紀夫, 西尾 由紀子, 金澤 美千代, 大城 久, 山中 正二, 稲山 嘉明 日本臨床細胞学会雑誌 46 (1) 182 -182 2007年03月
  • Hisashi Oshiro, Yoshiaki Inayama, Shoji Yamanaka, Isao Yoshihama, Motoshige Kudo, Yoshiro Ebihara CLINICAL & EXPERIMENTAL METASTASIS 24 (4) 291 -292 2007年 [査読無し][通常論文]
  • 五味 淳, 長嶋 洋治, 梁 明秀, 北村 和久, 金澤 美千代, 山中 正二, 大城 久, 堀 武生, 高橋 晃, 稲山 嘉明 日本臨床細胞学会雑誌 45 (2) 524 -524 2006年09月
  • 本野 紀夫, 金澤 美千代, 佐川 弘美, 三田 和博, 北村 和久, 大城 久, 山中 正二, 稲山 嘉明 日本臨床細胞学会雑誌 45 (2) 525 -525 2006年09月
  • Vater乳頭部生検が補助診断に有用であった硬化性胆管炎の1例
    田野島 玲太, 窪田 賢輔, 千葉 秀幸, 藤澤 聡郎, 斉藤 聡, 中島 淳, 武田 和永, 遠藤 格, 島田 紘, 大城 久, 稲山 嘉明 日本消化器病学会雑誌 103 (臨増大会) A921 -A921 2006年09月 [査読無し][通常論文]
  • 膵癌術後の予防的全肝照射により著明な肝細胞脂肪変性を来した1例
    内山 崇, 酒井 英嗣, 渡辺 誠太郎, 米田 正人, 高橋 宏和, 阿部 泰伸, 稲森 正彦, 桐越 博之, 窪田 賢輔, 斉藤 聡, 上野 規男, 大城 久, 山中 正二, 稲山 嘉明, 中島 淳 日本消化器病学会雑誌 103 (臨増大会) A937 -A937 2006年09月 [査読無し][通常論文]
  • 湯川 寛夫, 利野 靖, 井野 裕代, 金成 正浩, 佐伯 博行, 大城 久, 和田 博雄, 今田 敏夫 日本消化器外科学会雑誌 39 (7) 1282 -1282 2006年07月
  • Kensuke Kubota, Tosio Fujisawa, Masahiko Inamori, Yasunobu Abe, Hiroyuki Kirikoshi, Satoru Saito, Atushi Nakajima, Hisashi Ohshiro GASTROINTESTINAL ENDOSCOPY 63 (5) AB309 -AB309 2006年04月 [査読無し][通常論文]
  • EUS-FNAが診断に有用であった原発不明癌の一例
    窪田 賢輔, 谷田 恵美子, 藤澤 聡郎, 稲森 正彦, 阿部 泰伸, 桐越 博之, 齋藤 聡, 中島 淳, 市川 靖史, 大城 久 Gastroenterological Endoscopy 48 (Suppl.1) 880 -880 2006年04月 [査読無し][通常論文]
  • 大城 久, 稲山 嘉明, 山中 正二, 北村 和久, 三田 和博, 五味 淳, 長嶋 洋治, 下山田 博明, 石川 章夫, 工藤 玄恵 日本臨床細胞学会雑誌 45 (1) 210 -210 2006年03月
  • 佐川 弘美, 金澤 美千代, 三田 和博, 石井 みどり, 北村 和久, 大城 久, 山中 正二, 稲山 嘉明 日本臨床細胞学会雑誌 44 (2) 352 -352 2005年09月
  • 杉浦 賢, 宮城 悦子, 横田 奈朋, 佐治 晴哉, 佐藤 美紀子, 井畑 穰, 北村 和久, 大城 久, 稲山 嘉明, 平原 史樹 日本臨床細胞学会雑誌 44 (2) 458 -458 2005年09月
  • 西尾 由紀子, 石井 みどり, 三田 和博, 本野 紀之, 佐川 弘美, 北村 和久, 大城 久, 稲山 嘉明 日本臨床細胞学会雑誌 44 (1) 227 -227 2005年03月
  • 三田 和博, 北村 和久, 石井 みどり, 本野 紀夫, 佐川 弘美, 西尾 由紀子, 大城 久, 稲山 嘉明 日本臨床細胞学会雑誌 43 (2) 412 -412 2004年09月
  • 大城 久, 長濱 清隆, 加藤 順治, 坂元 肇, 三田 和博, 北村 和久, 梁 明秀, 山中 正二, 長嶋 洋治, 稲山 嘉明 日本臨床細胞学会雑誌 43 (2) 521 -521 2004年09月

共同研究・競争的資金等の研究課題

  • 膵癌リンパ管侵襲の病態解明とそれを抑制する新規治療法の開発
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2020年04月 -2024年03月 
    代表者 : 大城 久
  • 肝病態評価における超音波 弾性・粘性イメージングの基礎的検討
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2017年04月 -2020年03月 
    代表者 : 杉本 勝俊, 大城 久
     
    2018年度は実験動物を用い、急性肝障害モデル、肝線維化モデルを作製し、超音波エラストグラフィの画像パラメータ:SW speed, Dispersin slopeと病理所見との比較を行った。結果、Dispersion slopeは肝臓の炎症の程度と有意に関連し、SW speedは肝線維化の程度と有意に関連していることを見出した。この知見をもとに、本手法がヒトにおける病理所見の推定にも有用であるかを検討した。肝線維化の肝生検にて診断された非アルコール性脂肪性肝疾患(NAFLD)患者を対象に、超音波エラストグラフィの画像パラメータ:SW speed, Dispersion slope, Attenuation valueと病理学的パラメータ:Steatosis grade, Lobular Inflammation grade, Fibrosis stageとの比較を行った。結果、SW speedはFibrosis stage、Dispersion slopeはLobular Inflammation grade、Steatosis gradeはAttenuation valueが有意に相関していることを見出した。しかしまだ症例数が少ないため(n=24)、今後は100症例を目標に症例を集積していく予定である。最終的には、これらの超音波パラメータを用い、NASH診断を目的としたコンピュータ支援診断システムのアルゴリズムを構築していきたい。
  • 新開発超音波エラストグラフィーによる画期的「非侵襲的食道胃静脈瘤診断法」の開発
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2017年04月 -2020年03月 
    代表者 : 古市 好宏, 杉本 勝俊, 中村 郁夫, 糸井 隆夫, 大城 久, 大藤 さとこ
     
    平成30年度の目的・実施計画は、1.「新開発超音波エラストグラフィーを用い危険な食道胃静脈瘤を高精度に診断するための肝臓・脾臓粘弾性最適カットオフ値をRetrospective に割り出す」ことと、2.「 門脈圧亢進症ラットモデルで肝臓・脾臓の粘弾性値の変化を免疫病理学的に解析する」こと、3.難病特定疾患(特発性門脈圧亢進症、バッドキアリ症候群)の肝・脾臓粘弾性値をRetrospective に解析することである。1.については食道静脈瘤治療を行った54症例のうち21症例について肝臓・脾臓の粘性値・弾性値を測定した。いずれの数値も高値を示しており、肝臓・脾臓の粘性値・弾性値が高い場合は高率に危険な食道静脈瘤が存在している可能性が示唆された。2.については、5週齢のSDラット・雄性25匹を用い、急性肝障害モデルと肝線維化モデルを作成し実験を行った。急性肝障害モデルでは正常コントロールに比べ、肝臓と脾臓の粘性値が上昇することが判明した。肝線維化モデルでは急性肝障害モデルに比べると肝脾の粘性値がやや低下し、代わりに肝脾の弾性値が上昇することが判明した。3.については特発性門脈圧亢進症10例とバッドキアリ症候群10例に対して検討を行い、特発性門脈圧亢進症は肝弾性(線維化)低値・脾弾性(線維化)異常高値を示していた。また、バッドキアリ症候群は肝粘性(うっ血)異常高値・脾粘性(うっ血)高値を示すことが判明した。
  • 卵巣癌の横隔腹膜転移の病態とその予測因子,臨床的意義の解明
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2016年04月 -2020年03月 
    代表者 : 大城 久, 黒田 雅彦
     
    本年度は卵巣癌の横隔腹膜転移の病態とその予測因子を明らかにするため、当施設で卵巣癌の腫瘍減量術を受けた成人女性患者を対象に研究を行った。 卵巣癌の手術中に腹水を採取して細胞診検査を行い、また、ブラシを用いて横隔腹膜擦過・液状化細胞診検査を行い、これらの検体中の癌細胞の有無を調べた。また、摘出された臓器の病理組織標本を作製し、卵巣癌の組織型や卵巣被膜破綻、卵巣被膜浸潤、原発巣における脈管侵襲、大網転移、大網以外の腹膜転移、リンパ節転移の有無を調べた。 本年度の対象患者は50人で、年齢の平均値は58.9、年齢の中央値は57.0、年齢の幅は33-84であった。術前化学療法を施行された患者は12人で、リンパ節郭清を施行された患者は28人であった。癌の組織型は高異型度漿液性癌19例、明細胞癌15例、類内膜癌5例、粘液癌3例、類内膜癌と明細胞癌の混合型上皮性腫瘍2例、扁平上皮癌1例、癌肉腫1例、低異型度漿液性癌1例、その他の組織亜型3例であった。横隔腹膜転移陽性例は10例認められた。横隔腹膜転移陽性例では悪性腹水やリンパ節非郭清、癌の卵巣被膜浸潤、癌の大網転移、癌の大網以外の腹膜転移、原発巣での癌の脈管侵襲、術前化学療法施行例の頻度が統計学的に有意に高かった(P < 0.05、Fisherの正確検定)。年齢や組織型(高異型度漿液性癌か否か)、被膜破綻、リンパ節転移に関しては頻度に差があるとは言えなかった。 本年度の研究対象ではリンパ節非郭清症例が予想よりも多く、病理学的に証明可能なリンパ節転移が癌の横隔腹膜膜転移に与える影響を詳細に検討することが困難であった。今後、術前の放射線画像情報を用いてリンパ節転移の有無を評価し、解析に加える必要があると考えられた。
  • 肝細胞癌に対する不可逆電気穿孔法(IRE)における細胞死の分子機構と有効性の検討
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2015年04月 -2017年03月 
    代表者 : 小林 功幸, 杉本 勝俊, 大城 久
     
    不可逆電気穿孔法(IRE)はラジオ波焼灼療法とは異なり、高圧電流により細胞膜に不可逆的なナノサイズの小孔を開け、細胞のアポトーシスを惹起する非熱的アブレーション治療として期待されている。その特徴は既存の組織構築を温存しながら,細胞を死滅させ,血管,胆管への影響が少ない点とheat-sink effectがない点にあり、太い脈管に近接する肝癌に対する有効性も報告されつつある。我々は,肝に対するIREおよびRFA後の組織学的変化を検討するとともに、肝癌に対するIREの有効性と安全性を評価する臨床試験を行った 【結果】基礎的検討:ブタ肝臓におけるIREの組織学的所見は肝細胞のアポトーシス、うっ血所見を認める一方、類洞の細網線維、膠原線維は保たれていた。IREのパルス数の増加とともに門脈炎、胆管炎の増強を認めたが、門脈・胆管の蛋白の抗原性は保たれていた。一方、RFAでは線維組織及び門脈・胆管の染色性は消失していた。MIB-1染色では治療翌日よりIRE部の胆管上皮のMIB-1 indexは非IRE部に比し、著明に上昇し(80% vs 9%)、門脈内皮のindexは治療3日後にピークに達した(50% vs 10%)。 臨床的検討:肝癌患者19症例,27結節に対しIRE治療(2,000-3,000V, 90-360 pulses)を全身麻酔下、心電図同期下にエコーガイド下で行った. IRE治療は全症例に対し完遂され,1例で局所再発を認めた,grade 3以上の有害事象は3例(血小板減少、心房細動、腹腔内出血)に認めた. 【結論】IREの局所制御率は良好で,太い脈管に近接する腫瘍に対しても安全な治療法であった.IREは組織学的に脈管や線維組織の構造が保たれ、焼灼後早期より胆管等の脈管が再生する特徴を有していたことより,RFAではリスクの高い太い脈管に近接する肝癌に対する適応が期待される。
  • 日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2012年04月 -2015年03月 
    代表者 : 大城 久, 長尾 俊孝, 奥寺 康司, 大谷 修, 三浦 真弘, 芹澤 博美
     
    胸腹膜のリンパ管小孔の特徴と癌性胸腹水貯留の病態を解明するため,人体材料を病理学的に解析した結果,癌性胸腹水の有無にかかわらず,胸腔では肺靭帯に,腹腔では横隔腹膜にリンパ管小孔が多数観察され,癌細胞の両方向性の通過を可能にする小孔の構造的特徴が確かめられた.また,リンパ管小孔への癌転移は癌性胸腹水貯留の独立した予測因子であることが明らかにされた.さらに,癌性胸腹水陽性群では陰性群と比較してリンパ管小孔径や漿膜リンパ管密度が増大しており,リンパ管小孔より下流に位置する集合リンパ管やリンパ節への癌の転移頻度が高く,両方向性,逆行性,経路再選択性のリンパ行性癌進展を起こしている可能性が示唆された.
  • 日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2011年 -2013年 
    代表者 : 長尾 俊孝, 大城 久
     
    唾液腺腫瘍の悪性化機構の解明を目的に、多形腺腫由来癌症例の病理学的解析を行った。多形腺腫由来癌の癌成分で最も多いのは唾液腺導管癌であり、癌発生の早期では既存の多形腺腫の導管を癌細胞が置換しながら増殖していた。また、癌成分は多形腺腫成分に比べて細胞増殖能が高く、癌成分のみにp53とHER2が約半数の症例に陽性であった。H-, K-, N-ras遺伝子の変異はなかったが、癌成分にのみp53遺伝子のLOHと点突然変異が認められた。さらに、唾液腺導管癌32例中、AR、HER2、およびEGFRの陽性例が各々75%、44%、および81%に認められ、ARとHER2陰性例は2年無病生存率が有意に低かった。
  • 日本学術振興会:科学研究費助成事業 若手研究(B)
    研究期間 : 2008年 -2009年 
    代表者 : 大城 久, 大谷 修, 三浦 真弘, 青葉 孝昭, 島津 徳人, 工藤 朝雄, 海老原 善郎, 工藤 玄恵, 芹澤 博美, 吉濱 勲, 千島 隆司, 前川 二郎, 長濱 清隆, 奥寺 康司, 深澤 由里
     
    ヒト癌性胸水の発症機序を明らかにするため,担癌患者の剖検例を解析した.単変量解析では,癌性胸水陽性例では陰性例に比べて,癌の胸膜播種/胸膜侵襲,肺門リンパ節転移,肺靱帯リンパ管小孔転移,静脈角リンパ節転移の頻度が有意に高かったが,多変量解析では,肺靱帯リンパ管小孔転移のみが癌性胸水を予測する独立した因子であった.未治療の癌性胸水陽性例では,癌のKi-67とアポトーシスのインデックスに関してリンパ管小孔転移巣と原発巣との間に有意差はなく,VEGF-C発現率は原発巣よりもリンパ管小孔転移巣のほうが高く,E-カドヘリン発現率は原発巣よりもリンパ管小孔転移巣の方が低い傾向がみられた.リンパ管小孔への癌の転移は癌性胸水の発症に寄与している可能性が示唆された.
  • 特発性線維硬化性疾患における線維化の分子病態の解析と病理組織学的検討
    日本学術振興会:科学研究費助成事業 若手研究(B)
    研究期間 : 2005年 -2006年 
    代表者 : 大城 久
     
    特発性線維硬化性疾患に続発したリンパ腫の発症の病因を解明するために,特発性後腹膜線維症(IRF)の1症例が検索対象に選ばれた.IRF発症時の後腹膜病変,その約4年後に発症したリンパ腫の顎下腺病変,さらにその後4年の経過で再発したリンパ腫の胃病変の計3つを解析した. 後腹膜病変はリンパ腫を示唆する組織学的所見はみられなかったが,病巣内にはリンパ球集団の約17%にbcl-10の核内発現(+)かつCD79a(+)のB細胞を見出した.顎下腺病変は濾胞性リンパ腫であり,この顎下腺病変の染色体分析の結果は,97,XY+X,+del(1)(p22),+del(1)(p10),+der(1)t(1;14)(p22;q10),+der(1)t(1;14)(p22;q10),+der(1)t(1;14)(p22;q10),+der(1)(q24),+2,+2,+3,+del(3)(p21),+5,+5,+5,+6,+6,+7,+7,+7,+add(7)(q33),+8,+add(8)(q24),+9,+10,+10,+del(10)(q24),+11,+11,+11,+11,t(11;14)(q11;q32),+12,+12,+12,+12,+13,+14,+15,+16,+16,+17,+17,+19,+20,+20,+21,+21,+22,+22,+mであった.胃病変はび漫性大細胞性B細胞リンパ腫であった.これら3つの病変で免疫グロブリン重鎖遺伝子再構成のモノクローナリティを認めたが,各病変のクローンの塩基配列はそれぞれ別のものであった. IRFの宿主には発症と同時に免疫血液学的異常性があり,遺伝子レベルではB細胞集団に単一のクローンの拡大が,分子レベルではbcl-10を介するシグナルの活性化が起こっていると考えられ,不安定な分子病態がリンパ腫の発症に重要な意義を与えていると考えられた.


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