A case of sclerosing hemangioma forming a pedunculated mass

We report our experience with an unusual case of sclerosing hemangioma (SH) that formed a pedunculated mass protruding into the thoracic cavity. A pulmonary tumor was found in a 60-year-old female during the medical examination. Computed tomography showed a 19 × 17-mm nodule with a clear border and smooth margin contiguous with the diaphragm in the right S8 segment. Uneven enhancement following contrast medium administration was observed. We performed a 3-port thoracoscopic wedge resection of the right lower lobe. We observed a yellow pedunculated tumor protruding from the diaphragmatic surface of the right lower lobe. The surface of the tumor was smooth and encapsulated. Microscopically, we diagnosed it as a SH. SHs usually exist adjacent to the visceral pleura, but rarely form pedunculated tumors protruding into the cavity as seen in this case. By thoracoscopic surgery, we successfully diagnosed and treated the patient in a minimally invasive manner. Since there have been reported cases of recurrence, we anticipate that periodic follow-up observations will be required.     

Effect of the antiplatelet agent cilostazol on endovascular inflammatory biochemical parameters and the clinical symptoms of peripheral artery disease and restless legs syndrome in hemodialysis patients

Background  

Peripheral artery disease (PAD) is a common complication in patients receiving hemodialysis (HD). Cilostazol is used for the treatment of ischemic symptoms in patients with PAD, based on its antiplatelet and vasodilating effects. In addition to these beneficial effects on clinical symptoms in PAD patients, cilostazol has been proposed to have additional effects on clinical symptoms in patients with restless legs syndrome (RLS) via the upregulation of dopamine. We performed an observational, prospective study to evaluate the effect of cilostazol on several clinical and biochemical parameters in HD patients with PAD and RLS.     

Uncommon cases of immature-type CD56+ natural killer (NK)-cell neoplasms, characterized by expression of myeloid antigen of blastic NK-cell lymphoma

Immature-type CD56⁺ natural killer (NK)-cell neoplasms are classified as either myeloid/NK-cell precursor acute leukemia or blastic NK-cell lymphoma. We identified two cases of immature-type CD56⁺ NK-cell neoplasms that were not categorizable as either of these entities. The first case involved a 74-year-old woman presenting with skin eruptions and pancytopenia due to bone marrow necrosis. Skin biopsy specimen revealed CD4⁺, CD7⁻, CD34⁻, CD43⁺, CD56⁺, CD68⁺, muramidase (lysozyme)⁺, and myeloperoxidase (MPO)⁻, and immunophenotyping of peripheral blood showed CD4⁺, CD7⁻, CD13⁺, CD33⁺, CD34⁻, CD43⁺, CD56⁺, cytoplasmic (cy)CD68⁺, CD123⁺, and HLA-DR⁺. The second case involved a 62-year-old man who had bilateral optic nerve tumor and presented with malignant cells in peripheral blood. Cell surface markers of malignant cells showed CD4⁺, CD7⁻, CD13⁺, CD33⁺, CD34⁻, CD43⁺, CD56⁺, cyCD68⁺, and HLA-DR⁺. The phenotypes of tumor cells in both cases were compatible with blastic NK-cell lymphoma, except for the expression of myeloid antigen. Clinical presentations of these cases showed characteristics of both blastic NK-cell lymphoma and myeloid/NK-cell precursor acute leukemia.     

Antigen-specific free immunoglobulin light-chain antibodies: could it be a new diagnostic marker for patients with allergy?

OBJECTIVES: Human free immunoglobulin light chains (FLCs) have long been considered as nonmeaningful spillover remnants from the process of immunoglobulin production; however, recent findings suggest that the antibody activity of FLCs may be involved in the pathology of allergic responses. We therefore assessed the antigen-binding ability of FLCs to evaluate their usefulness as diagnostic markers for patients with allergy. DESIGN AND METHODS: FLCs were separated from the serum samples of patients seropositive against cedar pollen and mice immunized with bovine serum albumin and 1-fluoro-2,4-dinitrobenzene by ultrafiltration and protein G absorption. A sensitive immunoassay confirmed the absence of any IgG in the separated FLC fractions from the human serum samples. RESULTS: Solid-phase immunoassay for cedar pollen showed that none of the human serum samples possessed any antibody activity against the antigen after the removal of whole immunoglobulins. Furthermore, while the immunized mice also showed high antibody titers against the antigens, but the serum specimens showed no residual antibody activity against the antigens after the FLCs were separated from the whole immunoglobulins. CONCLUSIONS: The results of the present study suggested that the FLC fractions may possess little or no antigen-binding activity, and that therefore, they may not serve as useful diagnostic markers in patients with allergy.     

Adult T-cell leukemia/lymphoma in a 21-year-old man

Adult T-cell leukemia/lymphoma (ATL) is malignancy of mature T cells that caused by infection with human T-cell leukemia virus type I (HTLV-I). Leukemogenesis of ATL cells considered to involve a multistep oncogenic process, resulting in a very long latency period. But, we report here the case of a 21-year-old man having suffered from recurrent stomatititis who has already developed acute-type ATL. ATL generally occurs after a long latency period, and the present case in a young man is thus very rare.