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論文
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Yoshida, Takashi ; Kimura, Morihiko ; Goto, Yoshinari ; Horiguchi, Jun ; Takeyoshi, Izumi ; 吉田, 崇 ; 木村, 盛彦 ; 後藤, 與四成 ; 堀口, 淳 ; 竹吉, 泉
概要:
Journal Article<br />症例は52歳の女性で, 3年前に左乳癌で乳腺部分切除,腋窩リンパ節郭清を受けた.病理組織診断は乳頭腺管癌で, リンパ節転移はなかった. 最近, 倦怠感, 食欲低下, 腰痛が出現し, 他院で高カルシウ
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ム血症と大動脈周囲リンパ節の腫大を指摘され, 当科に紹介となった. CT で大動脈周囲のリンパ節は著明に腫大し, 血清の可溶性インターロイキン-2レセプターは8980U/mlと高値を示したことから悪性リンパ腫を強く疑った. ゾレドロン酸とエルカトニンを投与し,高カルシウム血症が改善した後,他院血液内科に転院となった.転院後,頚部のリンパ節生検で, CD5陽性びまん性大細胞型B細胞性リンパ腫と診断された. 化学療法が行われたが,7か月後に永眠された.（Kitakanto Med J 2014；64：159～163）<br />A 52-year-old woman underwent partial mastectomy and axillary lymph-node dissection three years ago. The pathological diagnosis was papillotubular carcinoma and no metastases were found in axillary lymph nodes. Recently, the patient complained of general fatigue, appetite loss and lumbago, and consulted another hospital. Laboratory tests revealed hypercalcemia. CT showed para-aortic lymphadenopathy. The patient was transferred to our hospital. Because of para-aortic lymphadenopathy and the high level of soluble interleukin-2 receptor in serum,we suspected malignant lymphoma. After hypercalcemia was improved following administration of zoledronic acid hydrate and elcatonin, the patient was transferred to the department of hematology in another hospital. By cervical lymph node biopsy, the diagnosis was a CD5-positive diffuse large B-cell lymphoma. The patient was treated with chemotherapy, but died seven months later.（Kitakanto Med J 2014；64：159～163）
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論文
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Horiguchi, Jun ; Koibushi, Yukio ; Rokutanda, Nana ; Nagaoka, Rin ; Ishikawa, Yuko ; Odawata, Hiroki ; Iino, Yuichi ; Sakurai, Hideyuki ; Oyama, Tetsunari ; Izumi, Takeyoshi
概要:
application/pdf<br />Journal Article<br />Background& Aims: True local recurrences(TR)and new primary tumors(NP)in the c
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onserved breast\nafter breast-conserving surgery with radiation therapy are determined by the initial surgical margin, the\nlocation of recurrent tumors and the histological consistency between initial tumors and recurrent tumors.\nMethods: A total of 15 patients with breast recurrence out of a group of 389 women with breast cancer\nwho underwent breast-conserving therapy between 1991 and 2003 were included in this study. The\nbiological differences between TR and NP were examined. Results: Eight patients had TR, and seven\nhad NP. The disease-free interval was 34.6 months in the TR group and 94.1 in the NP group.\nBreast-free survival was significantly better in the NP group than the TR group. The accumulated\n10-year overall survival after salvage surgery in patients with TR or NP tumors was 85.1％. The\naccumulated overall survival after salvage surgery was better in the NP group than the TR group.\nConclusions: Patients with NP tumors have a favorable prognosis compared to those with TR tumors.\nIt is important to determine the type of breast recurrence in order to accurately predict the prognosis of\npatients with breast recurrence.
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論文
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Yoshida, Takashi ; Koibuchi, Yukio ; Horiguchi, Jun ; Iijima, Kotaro ; Kikuchi, Mami ; Takata, Daisuke ; Rokutanda, Nana ; Nagaoka, Rin ; Sato, Ayako ; Oyama, Tetsunari ; Iino, Yuichi ; Morishita, Yasuo
概要:
application/pdf<br />Journal Article<br />We present a rare case of a 26-year old woman with diffuse sclerosing variant of papillary thyroid\ncarcinoma. The patient was referred to our hospital with diffuse enlargement of the thyroid
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accompanied\nwith palpable bilateral cervical lymph nodes. Ultrasonography showed a heterogeneous\npattern with ill-defined hypoechoic areas in both thyroid lobes. There were multiple small punctate\nechogenic foci. Fine-needle aspiration cytology revealed typical signs of papillary carcinoma. The\npatient underwent a total thyroidectomy using a bilateral modified neck dissection. Pathological\nfindings demonstrated diffuse involvement and continuous infiltration of the tumors to both thyroid\nlobes, lymph nodes and cervical soft tissue. Postoperatively, 100 mCi of 131I was administrated to the\nsmall amount of residual thyroid tissue. The patient is free from recurrence one year after the operation.
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論文
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Iijima, Kotaro ; Yoshimoto, Masataka ; Horiguchi, Jun ; Oyama, Tetsunari ; Morishita, Yasuo ; Kasumi, Fujio ; Sakamoto, Goi
概要:
application/pdf<br />Journal Article<br />Background & Aims: The purpose of this study was to investigate the influence
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of pregnancy on breast\ncancer prognosis by analyzing clinical and pathological features of young patients with breast cancer in\nrelation to last birth. Method: A total of 622 young breast cancer patients under 35 years of age\nundergoing surgical treatment between 1960 and 1990 at Cancer Institute Hospital were included in this\nstudy. The patients were classified into four groups; group A patients who were diagnosed during\npregnancy or within one year after delivery, group B patients who were diagnosed from one to three years\nafter delivery, group C patients who were diagnosed three years or more after delivery, and group D\npatients who were nulliparous. All four groups were examined from the viewpoint of clinical and\npathological findings with regard to age, disease duration, first childbirth, clinical stage, histopathological\ntype, lymph node metastasis, and survival. Furthermore, nuclear grade and immunohistochemical\nstaining of both estrogen receptor (ER) and factor-VIII were examined in early-stage breast\ncancer patients. Result: The incidence of early-stage(0, I and II) breast cancer was significantly(p＜\n0.05) lower in group A (69％) than in groups C (88％) and D (85％). The incidence of nodal involvement\ndecreased from group A (61％), B (59％), C (51％) to D (43％) in that order. The incidence of\nnodal involvement in group D was significantly (p＜0.05) lower than that in groups A and B. The\npositive rate of estrogen receptor increased from group A (50％), B (56％) to C (72％) in that order. \nDisease-free survival was significantly (p＜0.05) more favorable in group D than in groups A and C. \nThe similar result was obtained in patients with clinically early-stage breast cancer. Conclusion:\nPatients who developed breast cancer during pregnancy or within less than one year postpartum have a\npoor prognosis among patients under 35 years old. Patients having no childbirth history generally have\na high risk factor of developing breast cancer, however, breast cancer patients without childbirth history\nunder 35 years old result in a favourable prognosis.
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