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1. Concomitant Use of Fine-Needle Biopsy and Large-Needle Biopsy in the Diagnosis of Thyroid Nodules
Mizukami, Yuji ; Michigishi, Takatoshi ; Hisatomi, Motoji ; Noguchi, Masakuni ; Takemura, Akihiro ; Ichikawa, Katsuhiro
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Onoguchi, Masahisa ; Takayama, Teruhiko ; Tonami, Norihisa ; Mizukami, Yuji ; Kyogoku, Shinsuke ; Naoi, Yutaka ; Irimoto, Masahiro ; Maehara, Tadayuki
概要:
We studied how precisely images reflect tracer uptake .in the myocardium, and examined what degree technetium-99m-tetrof
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osmin (c-tetrofosmin) in the liver and gastrointestine gave the effect to a myocardial image. After administering dipyridamole and 99m Tc tetrofosmin to normal rats, we compared the myocardial uptakes obtained using a gamma camera with the actual uptakes in the excised organs. Methods : Thirty-seven rats were used. Following imaging the anterior view at 5, 10, 15, 30, 60 and 90 min after admini stration of the tracer, uptakes in the heart, lung, liver and blood were estimated with a well-type scintillation counter (WC) and represented as percentage of the injected dose per gram of tissue (%ID/g). The regions of interest (ROis) were placed on planar images (PI) and the uptake in each organ was estimated as percentage of the injected dose per pixel (%ID/pixel). The ratios of PI-to-WC and heart-to-organ were also evaluated. Results : Cardiac uptake with WC was 1.688%± 0.395% at 10 min post-injection. On the other hand, that with PI was 1.855%±0.965% at 10 min post-injection. There were particularly great differences from 15 min post-injection between both measurements (PI/WC ratio : about 1.2 times). Pulmonary uptake with WC was the maximum at 15 min (0.861%± 0.387%) post-injection, and there was. hardly a variation in the activity later than 15 min. However, PI measurement showed the maximum value at 15 min (0.777%±0.163%), and decreased gradually. Hepatic uptake with WC was the maximum at 5 min (1.545%±0.563 %), and rapidly decreased. On the other hand, PI measurement showed higher value than WC as" the whole. Conclusion : Pl measurement showed higher uptakes in each organ than WC measurement. There were great differences between both measurements, at late phase particularly. As one of these causes, it was considered that the decrease of activity in blood was different from that in each organ with increasing time.
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Nomura, Akitaka ; Mizukami, Yuji ; Matsubara, Fujitsugu ; Shimizu, Junzo ; Oda, Makoto ; Watanabe, Yoh ; Kamimura, Ryoichi ; Takashima, Tsutomu
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金沢大学医薬保健研究域保健学系<br />Seven patients (mean age, 50.7 +/- 20.4 years; range 21-77) with plasma cell granuloma (PCG) of the
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lung are reported. Cough and sputum were the most common presenting symptoms, followed by fever. Elevated erythrocyte sedimentation rate and serum C-reactive protein levels were found in all patients tested. Radiologically, five cases presented as solitary, well-circumscribed masses and two as ill-defined, pneumonia-like densities. One showed focal calcification. No predilection of occurrence was observed in either lobe of the lung. Histologically, the lesions consisted of a proliferation of mature plasma cells and reticulo-endothelial cells supported by a stroma of granulation tissue, with varying degrees of myxoid change or collagenization. Angioinvasion within the lesion was observed in 4 of the 7 cases. Immunohistochemical staining revealed the IgG-predominant polyclonal nature of the plasma cells, indicating a reactive inflammatory process rather than a neoplastic one. Electron microscopy confirmed the benign nature of the plasma cells with fibroblast and myofibroblast proliferation admixed with that of other inflammatory cells.
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Nomura, Akitaka ; Mizukami, Yuji ; Shimizu, Junji ; Oda, Makoto ; Watanabe, Yoh ; Kamimura, Ryoichi ; Takashima, Tsutomu ; Kitagawa, Masanobu
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金沢大学医薬保健研究域保健学系<br />A case with primary plasmacytoma of the lung is described. The patient, a 55-year-old Japanese fema
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le, who simultaneously had a pulmonary plasmacytoma and bladder carcinoma. The bladder tumor was treated with transurethral resection. Pathologically, the bladder tumor was a non-invasive, papillary transitional cell carcinoma, grade II. The lung tumor was located in the right upper lobe and upper lobectomy was performed. The tumor measured 2.8 x 2.7 x 2.0 cm and had a white-yellowish cut surface. Histologic, electron microscopic and immunohistochemical examinations of the lung tumor revealed monoclonal proliferation of plasma cells (IgA, lambda light chain). There was no evidence of multiple myeloma.
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Nomura, Akitaka ; Mizukami, Yuji ; Matsubara, Fujitsugu ; Nakanuma, Yasuni ; Kobayashi, Kenichi
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金沢大学医薬保健研究域保健学系<br />Intrahepatic infiltrate from 18 patients who died of fulminant hepatitis, was analyzed by an immuno
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histochemical method using formalin-fixed, paraffin-embedded liver sections and monoclonal antibodies. Inflammatory cells were characteristically located in the portal and periportal areas adjoining resting hepatocytes, but were infrequently found in the perivenular areas where hemorrhagic hepatocyte necrosis predominated. In the inflammatory infiltrate, T cells were the most predominant cell type, composing about two-thirds of the total hepatic infiltrate, followed by lysozyme-positive macrophages which composed about one-third of the total hepatic infiltrate, irrespective of the etiology of the fulminant hepatitis. On the other hand, B cells made up less than 2% in all cases, and plasma cells were also few, less than 2% in 12 of 18 cases. Furthermore, an enhanced display of beta 2-microglobulin on hepatocyte membranes was demonstrated in all cases with remaining hepatocytes, indicating an increased expression of class I MHC antigens on these cells. These results suggest that T cells may play an important role in the pathogenesis of the portal and periportal lesions of fulminant hepatitis, probably with a help of MHC class I antigens on hepatocytes, while hemorrhagic necrosis of hepatocytes around the central veins may be caused by a different mechanism, most likely a circulatory disturbance secondary to cell-mediated immune reactions in the periportal areas.
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Nomura, Akitaka ; Mizukami, Yuji ; Murakami, Shinya ; Shimizu, Junzo ; Watanabe, Yoh ; Kamimura, Ryoichi ; Takashima, Tsutomu ; Kitagawa, Masanobu
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金沢大学医薬保健研究域保健学系<br />A 79-year-old male was admitted to the hospital with the complaint of bloody sputum. Chest X-ray re
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vealed an abnormal shadow in the right upper lobe. Macroscopically, the lesion measured about 3.5 x 2.5 x 2.0 cm with a central cavity containing pus. Histologically, the lesion was composed of interlacing fibroblastic proliferation with abundant plasma cell infiltration and central cavitation. The inner surface of the cavity wall was partially covered by bronchial epithelial cells; there was no cartilage found, suggesting that the lesion had developed from chronic inflammatory processes in relation to ectatic bronchioles. Since the pathogenesis of plasma cell granuloma (PCG) has not been well established, it is probable that this case represents one stage in the development of classic PCG.
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Nomura, Akitaka ; Mizukami, Yuji ; Hirone, Takae ; Ohtake, Shigeki ; Yoshida, Takashi ; Nakamura, Shinobu ; Matsuda, Tamotsu ; Naito, Katsusuke ; Tachibana, Osamu ; Muramoto, Hiroaki
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金沢大学医薬保健研究域保健学系<br />We report a case of unusual B-cell malignant lymphoma of the kidney and mediastinum. Renal biopsy s
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howed prominent myxoid changes and sarcomatous features, leading to considerable difficulty in histologic diagnosis on routinely stained histologic sections. However, immunohistochemical staining for lymphocyte markers led to the final histologic diagnosis of B-cell malignant lymphoma. Although myxoid change is not generally found in malignant lymphoma, malignant lymphoma should not be excluded from consideration when one encounters a small round cell sarcoma with myxoid stroma, especially in extranodal soft tissue tumors.
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Takayama, Teruhiko ; Kinuya, Seigo ; Kobayashi, Kazunori ; Onoguchi, Masahisa ; Mizukami, Yuji ; Koshida, Kichiro ; Tsuji, Shiro ; Tonami, Norihisa
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金沢大学大学院医学系研究科
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