Superficial Carcinoma of the Esophagus Coexisting with Esophageal Leiomyoma: A Case Report and Review of the Japanese Literature

A case of superficial spreading squamous cell carcinoma locatedjust over a leiomyoma is presented. The patient complained ofslight dysphagia and an esophagogram showed an elevated tumorin the middle thoracic esophagus. Esophagoscopy revealed anulcerative mucosal lesoin over the elevated lesion and biopsyshowed that the lesion was a squamous cell carcinoma. Bluntdissection of the esophagus with esophago-gastro-anastomosiswas performed. There was neither lymph vessel invasion nor lymphnode metastasis. His postoperative recovery was satisfactoryand he is doing well two years after the operation. A reviewof the Japanese and English literature revealed that a few casesof esophageal carcinoma coexisting with esophageal leiomyomahave been reported. There was no report of superficial esophagealcarcinoma coexisting with esophageal leiomyoma. This is thefirst report of the coexistence of these two lesions, and esophagoscopyis necessary to find a superficial esophageal carcinoma coexistingwith esophageal leiomyoma.     

Pathological effects of neoadjuvant hormonal therapy help predict progression of prostate cancer after radical prostatectomy

BACKGROUND: It is not clear whether pathological changes following neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy have any value as predictors of progression in prostate cancer. METHODS: We conducted a study of 100 patients with prostate cancer who underwent radical prostatectomy following NHT. We used the Japanese general rule as the criterion to assess the biochemical recurrence rate and pathological changes after NHT. RESULTS: In terms of preoperative risk factors, the probability of recurrence was significantly higher for patients with more than 20 ng/mL of pretreatment serum prostate-specific antigen (PSA) and/or a Gleason score of 7 or higher for biopsy specimens. We defined these pretreatment findings as high-risk factors. Among 65 patients with high-risk factors, patients with a post-NHT pathological effect of grade 3 according to the Japanese general rule showed no recurrence, whereas patients with a grade 0 had a poor prognosis. Patients with a PSA nadir 0.5 ng/mL or less tended to have a better prognosis. CONCLUSION: Despite preoperative high-risk factors, patients showing good pathological effects after NHT tend to have a favorable prognosis after radical prostatectomy. Therefore; assessment of the pathological effects of NHT using the Japanese general rule as the criterion proved to be useful for the prediction of biochemical recurrence.     

Emergence of basophils at sites of local allergic reactions using a skin vesicle test

Vesicular exudate, produced by the application of cantharides plaster over normal skin and sites of intradermal allergen injection, was examined for the presence of basophils and eosinophils in normal subjects and patients with bronchial asthma. In comparison with the normals, the asthmatic group demonstrated a high rate of basophil appearance in vesicular fluid derived from areas of untreated skin. Basophil appearance was even more prominent in vesicular fluid from skin injected intradermally with various allergens. Modest numbers of basophils appeared at skin sites injected with house dust, but relatively large numbers appeared in areas injected with Candida, ragweed or tuberculin extracts. Patients with severe, intractable asthma frequently demonstrated large numbers of basophils in vesicular exudates. Intradermal injections of anti-IgE caused the greatest number of basophils to appear in the vesicular fluid, The numbers of eosinophils migrating into such vesicular lesions were not statistically significant though their numbers were proportional to those of the basophils. A significant correlation was shown to exist between both basophil and eosinophil blood counts and the numbers of these cells appearing in cutaneous vesicular fluid. This study demonstrates that basophil leukocytes, together with eosinophils, migrate from blood into extravascular tissues at sites of allergic reaction—especially reaginic hypersensitivity. The skin vesicle technique described is simpler than the skin window technique and may be of use in detection of allergens and evaluation of allergic disease states.     

Esophageal Cancer Associated with Gastric Cancer

Among a total of 1,137 patients with esophageal cancer, therewere 44 cases of esophageal cancer associated with gastric cancer,an incidence of 3.9%. The majority of the patients were between60 and 70 yr old. Forty-two patients were male and two werefemale. Eleven of these patients had a third cancer. Six had multiplecancers in the esophagus and/or stomach. Eighteen patients hadearly gastric cancer. Thirty-two of the cancers were synchronousand 12 were metachronous. Of these 44 patients, 21 had familyhistories of cancer, 37 were smokers, and 36 were drinkers.Twenty-five patients received surgery for all of their cancers,and two patients received resection of only esophageal cancer.Of these 27 patients. five patients lived more than 5 yr. Themost frequent cause of death in our series was esophageal cancer(52.9%). Surgical treatment of all of the cancers is desirable. Whenthis is impossible, the surgery must be emphasized for the esophagealcancer in most cases.     

The role of dermal blood vessels in the pathogenesis of malignant atrophic papulosis (Degos'' disease)

The role of dermal blood vessels in the histopathogenesis of malignant atrophic papulosis has been investigated in two patients using enzyme histochemical, tissue fibrinolysis and electron-microscopic techniques. In the earliest papules the normal enzymatic reactions of the endothelium and fibrinolytic activity of affected blood vessels were markedly impaired or absent. The endothelial cells were swollen and showed minor degenerative changes, but no cytoplasmic inclusions suggestive of virus particles could be detected. The results of intradermal skin tests and lymphocyte transformation cultures did not suggest the presence of any immunological defect. It is suggested that the skin lesions of malignant atrophic papulosis could be secondary to the slow occlusion of deeper arterioles.     

A Case of Neurogenic Sarcoma of the Stomach

A very rare case of neurogenic sarcoma of the stomach is reported.It is the only case (0.03%) among 3,643 patients with malignanttumors of the stomach operated on at the National Cancer CenterHospital during the past 18 years. The patient was a 60-year-oldhousewife complaining of a palpable mass in the upper abdomen.After X-ray and endoscopical examination, partial gastrectomywas performed on the basis of the clinical diagnosis as a submucosaltumor of the stomach. The resected tumor was well demarcatedand showed extragastric growth with a continuity to the serosaof the stomach. Histologically the tumor consisted of spindle-shapedcells with moderately hyperchromatic and irregular-shaped nucleiwithout any nuclear palisading. It was very hard to differentiatethis tumor from leiomyosarcoma, fibrosarcoma and other mesenchymalmalignant tumors by routine histological methods. However, thistumor was immunohistochemically demonstrated to contain nervoustissue-specific S100 protein, which is present in both the peripheraland central nervous systems among a wide variety of vertebrates.Our results indicate that the diagnosis of neurogenic sarcomaof the stomach was appropriate for this tumor and suggest thatS100 protein would be a useful diagnostic indicator for tumorsof Schwann cell origin.     

A Mutant Exhibiting Abnormal Habituation Behavior in Caenorhabditis elegans

The acquisition and retention of information by the nervous system are major processes of learning. Habituation is a simple learning process that occurs during repeated exposure to harmless stimuli. C. elegans is habituated when repeatedly given mechanical stimuli and recover from the habituation when the stimuli are stopped. A habituation abnormal mutant was isolated and assigned to a new gene hab-1 whose mutation causes slow habituation. The hab-1 mutant phenotype is remarkable at short time interval stimuli. However, hab-1 mutant worms show normal dishabituation. Ablations of neurons constituting the neural circuit for mechanical reflexes did not abolish abnormalities caused by the hab-1 mutation.     

Primary testicular leiomyosarcoma

We report a case of primary testicular leiomyosarcoma. A 76-year-old man, who complained of left scrotal swelling for 6 months, underwent radical orchiectomy. Microscopic examination revealed intratesticular leiomyosarcoma. The patient received no adjuvant therapy and at 12 months after surgery, there had been no recurrence. Primary leiomyosarcoma of the testis is extremely rare; this is the 9th case recorded worldwide.