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1.
A relatively rare case of papillary adenocarcinoma of prostate is reported. The patient was a 49-year-old male. He presented with the chief complaints of micturition frequency, a feeling of residual urine and a burning sensation in urethra. There was no palpable abnormality in the prostate. Endoscopic examination revealed papillary tumors in the prostatic urethra and the anterior urethra, but no evidence of abnormality in the utricle. Both hematological examination and blood chemistry revealed no abnormalities; ACP, PACP and PAP were normal. The tumors were resected by TUR on March 8, 1982. Histopathological findings indicated papillary proliferation of single layer of columnar epithelium, with clear cytoplasm and nuclei with atypism distributed in the base. The tumors in the anterior urethra gave the same findings, and the diagnosis made was papillary adenocarcinoma which seemed to have originated from the prostatic duct. After operation, hormone therapy and chemotherapy with peplomycin were conducted. Eleven months after the operation, the remaining prostatic tissues including surgical capsule were resected as completely as possible. Histopathological findings revealed only atrophic prostatic tissues without any remaining tumor. The hormone therapy was discontinued. Presently, 19 months has elapsed since the first TUR. His micturition condition is good without evidence of recurrence or metastasis. 相似文献
2.
A case of papillary adenocarcinoma of the prostate is reported. A 73-year-old man was referred to our hospital with macrohematuria. The serum level of the PSA ranged within normal limits. Urethroscopy revealed a papillary tumor near the verumontanum. The tumor was resected transurethrally. Histopathological examination revealed adenocarcinoma with papillary growth and the tumor displayed immunoreactivity for PSA stain. Radical prostatectomy was performed. The follow-up at 11 months revealed neither local recurrence nor distant metastases. 相似文献
3.
Kimata R Nemoto K Matsuzawa I Yamagata K Kimura G Kondo Y Horiuchi K Tsuboi N Yoshida K Akimoto M 《Hinyokika kiyo. Acta urologica Japonica》2000,46(8):565-568
A 70-year-old man complaining of painless right scrotal swelling was referred to our hospital. He had a past history of left nephrectomy for renal tuberculosis at the age of 28. Power Doppler ultrasonography revealed a hypoechoic and hypovascular tumor with septa in the scrotum. We suspected a right testicular tumor and therefore, performed a right high inguinal orchiectomy. On macroscopic findings, the fluid of the tumor was yellowish and mucinous and the ipsilateral testis was remarkably atrophic. The pathological diagnosis was tuberculous epididymitis with central necrosis. In recent years, tuberculous epididymitis is rare, and this case was considered to be the first report of power Doppler ultrasonographic findings in tuberculous epididymitis. 相似文献
4.
J Yasuda S Mashiyama R Katakura T Yoshimoto 《No shinkei geka. Neurological surgery》1991,19(10):979-983
The authors report a case of glioblastoma in which MR images with Gd-DTPA enhancement changed rapidly during the early stage. A 61 year-old male presented with sudden right facial spasm and dysarthria. However, both a plain and an enhanced CT failed to demonstrate any abnormal lesions. On the other hand, T2 weighted MR image revealed a well circumscribed high intensity lesion in the left frontal lobe without mass effect. This lesion could not be differentiated from cerebral infarction, since no contrast enhanced lesion was able to be observed in T1 weighted MR image with Gd-DTPA. His symptoms gradually became aggravated and at 3 months from the onset, MR image with Gd-DTPA disclosed a small enhanced lesion in the left frontal lobe near the cortical surface. After 6 months from the onset, he suffered from right hemiparesis and motor aphasia. The MR image with Gd-DTPA at this time showed a large enhanced lesion in the left frontal lobe with mass effect. He was admitted to our hospital, and subtotal removal of the tumor and intraoperative radiation was carried out. The patient did well postoperatively without additional neurological deficit, and then he received additional radiation therapy. It should be noted that Gd-DTPA enhanced MR image might fail to reveal the lesion of glioblastoma in its early stage, while T1 weighted image discloses only the gyral swelling. 相似文献
5.
A 57-year-old man was admitted to our hospital complaining of nausea, vomiting and fever of 38.7 degrees C. He was diagnosed as having acute cholecystitis with gallstones. Abdominal CT, however, incidentally revealed a space-occupying solid mass lesion at the upper pole of the left kidney. The feature of the lesion on ultrasonography was similar to that of renal simple cyst. The renal angiography showed that the tumor was avascular. Aspiration biopsy was done. Cytologically, small tumor cells forming cell clusters had scanty granular cytoplasms and small round or oval shaped nuclei sized 13-15 mu. The chromatin was diffusely distributed and increasing its density. Nucleoli were not so evident and if existing, usually small. Fatty stain was positive at granules in the cytoplasms. Radical nephrectomy was performed on August 28, 1984. Pathological examination revealed that almost all components of the tumor consisted of typical papillary renal adenocarcinoma, and staging was pT2, pN0, pV0, M0, INF alpha. Alpha-type interferon to a total doze of 11,700 X 10(4) units was administered intramuscularly daily for a month after the operation. By January 11, 1986, no evidence of tumor recurrence was noted. 相似文献
6.
K Arita T Uozumi S Kuwabara K Mukada M Sumida K Sugiyama K Watanabe Y Saito 《No shinkei geka. Neurological surgery》1991,19(11):1073-1077
The authors reported a rare case of sellar germinoma which was misdiagnosed as nonfunctioning pituitary adenoma. A 32-year-old woman was admitted to our hospital because of amenorrhea and disturbance of left visual acuity. She had become amenorrhagic after her second delivery two years before. Neurological examination revealed she was normal except for diminished left visual acuity (Rt. = 1.2, Lt. = 0.5). The general condition was good. Urine volume and its specific gravity were within normal range. Endocrinological examination showed hyperprolactinemia (PRL 72 ng/ml) accompanied with impairment of GH, TSH, LH and FSH's reserve. Basal levels and reserve of the blood cortisol were normal. AFP and hCG were within normal range. CT scan revealed a homogenously enhanced intrasellar tumor which had a suprasellar portion (vertical length: 15 mm). T1 weighted MRI revealed low intensity tumor, and T2 weighted image revealed high intensity tumor. Sagittal MR image with gadolinium enhancement showed the pituitary gland anterior to the tumor. Transsphenoidal removal was performed. The histological diagnosis was pure germinoma. After the operation, the intracranial and spinal disseminations were disclosed. Complete neuraxis irradiation resulted in the complete remission of the tumor. Sellar germinoma without diabetes insipidus is considered to be very difficult to diagnose preoperatively. However, the authors proposed that anterior shift of the pituitary gland in sagittal MR image may be a clue to the diagnosis of sellar germinoma. 相似文献
7.
Fukuhara S Hara T Koichi T Mori N Yamaguchi S Adachi S Fujisue T 《Hinyokika kiyo. Acta urologica Japonica》2004,50(8):531-534
A 63-year-old man presented with dysuria. Ultrasonography revealed a cystic intravesical mass. During needle aspiration we aspirated bloody fluid. The result cytology was class II. We gave medication on an outpatient basis, but symptoms became worse. We performed transurethral resection (TUR) of prostate. Histopathological examination of the TUR specimen revealed a papillary cystadenocarcinoma of the prostate. We diagnosed the tumor as a stage B prostate cancer, and performed total prostatectomy. Histopathological examination of prostate revealed no residual cancer. Eleven cases of papillary cystadenocarcinoma of the prostate in the Japanese literature are reviewed briefly. 相似文献
8.
Takaaki Ito Masakuni Furusato Akihito Akiyama Hiroyuki Kato Shigeo Aizawa 《The Prostate》1995,26(1):23-27
Clinical and immunohistochemical studies were conducted to evaluate prostatic papillary adenocarcinoma and prostatic papillary hyperplasia. Subjects consisted of 5 cases of papillary adenocarcinoma and 2 cases of papillary hyperplasia. There is no conclusive clinical factor for preoperative diagnosis, but we attach importance to endoscopic findings. PSA, PAP, high molecular weight cytokeratin, and PCNA were evaluated immunohistochemically. PSA became positive in every instance but one—a case of papillary adenocarcinoma which became ±. PAP was + in all cases, except for 1 case of papillary adenocarcinoma. Basal cells were positive for high molecular weight cytokeratin in 2 cases of papillary hyperplasia but were missing in papillary adenocarcinoma. Although PCNA was free from positive nuclei in papillary hyperplasia, positive nuclei were found in all cases of papillary adenocarcinoma. Considering these immunohistochemical results, papillary adenocarcinoma can be said to originate in the glandular epithelium of the prostate, as does ordinary prostatic carcinoma. 相似文献
9.
Takashima S Nakano H Misao T 《Kyobu geka. The Japanese journal of thoracic surgery》2008,61(7):599-601
We report a case of 45-year-old man with true thymic hyperplasia. Three years earlier he had undergone operation for carcinoma of the floor of mouth. He had no symptoms but had been pointed out an anterior mediastinal mass on chest computed tomography (CT). Chest CT revealed a well defined solid mass in front of the ascending aorta. The mass showed sail sign. The size of this mass did not increase on a follow-up chest CT. The signal intensity of this mass was slightly inhomogeneous on chest magnetic resonance imaging (MRI). No invasion of the surround tissues was observed. Since the possibility of thymoma or other malignancy, extended thymectomy under median sternotomy was performed. His postoperative course was uneventful. Histopathological examination revealed true thymic hyperplasia. 相似文献
10.
A case of renal cell carcinoma difficult to diagnose preoperatively because of hypovascular findings
H Nakajima Y Yui N Tsuboi K Yoshida M Akimoto 《Hinyokika kiyo. Acta urologica Japonica》1985,31(6):1021-1025
A 35-year-old man visited our out-patient clinic with the chief complaint of macroscopic hematuria. After admission to the hospital, examinations by CT scan, renal angiography, etc. revealed a hypovascular space-occupying lesion in the right kidney, but no definite diagnosis could be made; blood findings such as accentuated alpha 2-globulin and raised LDH suggested the possibility of malignancy; and right nephrectomy was performed. In view of the preoperative X-ray findings together with postoperative pathological findings, papillary renal cell carcinoma was suspected intensively. Some discussion was made on the differentiation of lesions of hypovascular to avascular tumors and the reliability of image diagnosis based on CT scan, angiography, and other methods. 相似文献
11.
Erni M.M. Cia M.D. Athanase Billis M.D. Hlio Moriyama M.D. Augusto A. Ferreira M.D. 《Urology》1981,18(6)
A rare case is presented of metastases in the epididymides from prostatic carcinoma. The microscopic features of the tumor were those of a papillary adenocarcinoma, a rare type of neoplasia of the prostate. 相似文献
12.
Naoto Fukunaga Masashi Ishikawa Takuya Minato Yoko Yamamura Hisashi Ishikura Toshihiro Ichimori Suguru Kimura Akihiro Sakata Yoshiyuki Fujii 《Surgery today》2009,39(10):901-904
A 58-year-old woman was admitted to our hospital to optimize the management of her diabetes mellitus. A computed tomography
(CT) scan showed a 30-mmdiameter, multilocular cyst in the head of the pancreas. The tumor markers, including DUPAN 2, SPAN-1,
and carbohydrate antigen 19-9, were within the normal ranges. A contrast-enhanced CT scan showed a nonenhanced, multilocular
cyst. Abdominal magnetic resonance imaging showed a multilocular cyst. Endoscopic retrograde cholangiopancreatography showed
that the main pancreatic duct was normal. Based on these findings, we suspected a branch duct type intraductal papillary mucinous
neoplasm. A distal pancreatectomy with a splenectomy was performed, since more of the mass was located on the dorsolateral
side, inconsistent with the preoperative imaging results. On the resected specimen, a 4-cm-diameter, multilocular cyst containing
serous fluid was found. Pathologically, the cyst wall was lined with squamous epithelium surrounded by abundant lymphoid tissue
with follicles, consistent with a lymphoepithelial cyst of the pancreas, which is an unusual benign cyst. 相似文献
13.
Sugi M 《Hinyokika kiyo. Acta urologica Japonica》2004,50(7):489-492
A 76-year-old male patient complained of frequent urination. Computed tomographic and magnetic resonance imaging scans revealed a heterogeneous mass involving his bladder, prostate and Sigmoid colon. He was diagnosed with an invasive urachal tumor and surgery was performed due to severe tumor adhesion to adjacent organs. Partial resection of the tumor was performed with partial cystectomy and sigmoidectomy. A post-operative pathological diagnosis revealed the tumor was a desmoid abdominal wall tumor. The desmoid abdominal wall tumor was not easily differentiated preoperatively from an urachal tumor. 相似文献
14.
We report a rare case of metastatic prostate adenocarcinoma to the pituitary gland. The patient had lung and bone metastases when he presented with bitemporal hemianopsia. He was also receiving total androgen blockade at that time. Magnetic resonance imaging showed an intrasellar mass, and biopsy confirmed metastatic prostate cancer. Radiotherapy, in the form of intensity-modulated radiotherapy, was delivered to the intrasellar mass. The patient responded well to radiotherapy. The mechanisms of spread to the pituitary gland and treatment options, including intensity-modulated radiotherapy, are discussed. 相似文献
15.
Yamashita R Yamaguchi R Yuen K Niwakawa M Tobisu K 《Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology》2006,97(4):668-671
On September 25th, 2003, a 39-year-old man complained of asymptomatic gross hematuria. He was admitted to a nearby hospital and evaluated. Cystoscopy revealed a non-papillary broad base tumor in the anterior wall of the bladder. On October 2nd, a TUR-Bt was performed. The pathological diagnosis was difficult to determine because mitosis and nuclear pleomorphism were apparent. He next came to our hospital for further evaluation. We diagnosed his condition as an inflammatory pseudotumor of the bladder because fibroblasts and inflammatory cells had increased; however, we did not see abnormal nuclear mitosis or severe pleomorphism. Although we did not perform a complete TUR-Bt, the mass regressed spontaneously and did not reoccur. The presence of mitosis and mild nuclear pleomorphisms make certain cases difficult to diagnose as inflammatory pseudotumors. Inflammatory pseudotumors are generally considered benign, and some cases regress spontaneously. It is important that we are able to identify and characterize these pseudotumors in order to avoid more invasive surgeries whenever possible. 相似文献
16.
Sioka E Symeonidis D Chatzinikolaou I Koukoulis G Pavlakis D Zacharoulis D 《International journal of surgery case reports》2011,2(7):232-234
Introduction
Adrenal cysts represent rare clinical entities. Although surgical indications are well defined, pitfalls arise from the failure to establish an accurate preoperative diagnosis. Cystic lesions of other abdominal organs especially the pancreas complicate the diagnostic field.Presentation of case
We present the case of a giant adrenal cyst in a young female causing diagnostic dilemma. Imaging studies revealed a large cystic lesion of uncertain origin located between the spleen and the tail of the pancreas. It was decided to perform a laparotomy which confirmed the presence of an adrenal cyst and enucleation of the cyst was performed. Examination at one year confirmed no complications.Discussion
Adrenal cysts should always be included in the differential diagnosis of cystic abdominal lesions.Conclusion
When the preoperative diagnosis is uncertain, surgical intervention can be both diagnostic and therapeutic. 相似文献17.
We report a case of papillary cystadenoma of the left epididymis in a 37-year-old single man. He visited our clinic complaining of painless tumor in the left scrotum. The physical and radiological examinations showed no signs of von Hippel-Lindau syndrome. Surgical exploration revealed a 15 x 15 x 10 mm tumor on the head of the left epididymis. Histopathological examination suggested efferent duct ectasia with papillary formation, with cuboidal epithelium, which was finally diagnosed as papillary cystadenoma of the epididymis. This is the 16th case of papillary cystadenoma of epididymis in Japan. 相似文献
18.
Taniguchi D Sawada T Ryu C Nagayasu T 《Kyobu geka. The Japanese journal of thoracic surgery》2012,65(9):804-807
A 61-year-old man, with a history of renal transplant for immunoglobulin A (IgA) nephropathy and surgery for advanced gastric carcinoma, was noted to have a nodular shadow of 1.3 cm in diameter in the left lung( S8) based on chest computed tomography( CT), and was suspected to have primary pulmonary carcinoma or a metastatic pulmonary tumor, for which surgical resection was performed. A rapid pathological diagnosis of inflammatory granuloma was made, and the patient was finally diagnosed as having pulmonary cryptococcosis based on the histopathology, and received fluconazole postoperatively. Patients with organ transplant history showing a nodular shadow in the lung should undergo a careful workup in consideration of both malignant tumor and infection. 相似文献
19.
Hyuga T Nakamura S Ishino T Kawakami K 《Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology》2011,102(3):591-594
A 66 years old man visited our hospital with a chief complaint of right flank pain and abdominal palpable mass. Abdominal enhanced computed tomography scan showed a large cystic mass with infiltrating surrounding tissue in the right kidney. We diagnosed it infected cystic renal cell carcinoma because of high grade fever and acute inflammatory response. It was surgically unresectable tumor. Therefore, percutaneous puncture and drainage was performed under ultrasound guidance. In the culture of drainage fluid, Escherichia coli (E. coli) was isolated. Then, we confirmed reduction in the size of the tumor, right radical nephrectomy was performed. Because of tumor invasion to ascending colon, we performed the excision of right kidney together with ascending colon. Histological study confirmed target-shaped Michaelis-Gutmann body, and the definitive diagnosis was malacoplakia of the kidney. We reported a case of renal malacoplakia that was difficult to distinguish from cystic renal cell carcinoma. Our case is 12th case of renal malacoplakia in the Japanese literature. 相似文献
20.
K Ishizu S Yoshihiro K Joko H Takihara J Sakatoku K Tanaka 《Hinyokika kiyo. Acta urologica Japonica》1991,37(9):1057-1060
A 79-year-old man complained of pollakisuria and sense of retention. The prostate was stony hard and heterogeneously enhanced on computed tomographic (CT) scan. The serum levels of prostatic specific antigen, prostatic acid phosphatase and gamma-Seminoprotein were abnormally high. Prostatic biopsy showed mucinous adenocarcinoma which was stained by prostatic specific antigen. Bone scintigraphy revealed multiple metastases. Hormonal therapy was performed. Each prostatic tumor marker decreased to the normal range within 2 months. After 3 months, the prostate was almost normalized on digital examination and CT scan. There were no new metastases, prostatic biopsy revealed that most cancer cells had degenerated to nonviable cells and bone metastases had decreased. 相似文献