Phyllodes tumor of the breast: correlation between MR findings and histologic grade

PURPOSE: To retrospectively evaluate the magnetic resonance (MR) imaging findings of phyllodes tumor of the breast and to compare these findings with the histologic grade. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. The authors reviewed the MR findings in 30 female patients aged 16-73 years (mean, 40.2 years) with surgically confirmed phyllodes tumors. Analyzed MR findings included tumor shape, margin, internal enhancement, and size; signal intensity (SI) of tumor higher than that of normal breast tissue on T1-weighted images; SI of tumor lower than or equal to that of normal tissue on T2-weighted images; cyst wall appearance; kinetic curve assessment; and apparent diffusion coefficient (ADC). The MR findings and histologic grade were statistically analyzed to determine whether any correlations existed. Significant MR findings were compared with histopathologic findings. RESULTS: Nineteen benign, six intermediate (characterized by five to nine cell reproductions at 10 high-power fields, pushing or infiltrative margins, moderate stromal cellularity, and atypia and overgrowth), and five malignant phyllodes tumors were assessed. Irregular cyst wall (P = .003), tumor SI lower than or equal to normal tissue SI on T2-weighted images (P = .005), and low ADC (P = .001) correlated significantly with histologic grade. Tumor SI higher than normal tissue SI on T1-weighted images was more frequent in the malignant (in three of five tumors) and intermediate (in three of six tumors) groups than in the benign group (in two of 19 tumors); however, it was not a significant finding (P = .024). Tumor SI higher than normal tissue SI on T1-weighted images and irregular cyst wall corresponded histopathologically to hemorrhagic infarction and necrosis, respectively. Tumor SI lower than or equal to normal tissue SI on T2-weighted images and low ADC corresponded histopathologically to stromal hypercellularity. Other findings were not significant. CONCLUSION: Several MR findings can be used to help determine the histologic grade of phyllodes breast tumors.     

Granulomatous mastitis diagnosed and followed up by fine-needle aspiration cytology,and successfully treated by corticosteroid therapy: Report of a case

A 36-year-old woman presented to our hospital with a rapidly growing lump in her left breast. Fine-needle aspiration (FNA) cytology of the mass revealed many epithelioid cells admixed with multinucleated Langhans-type giant cells, neutrophils, lymphocytes, and stromal cells, leading to a diagnosis of granulomatous mastitis. This report describes the clinical course of this patient in whom granulomatous mastitis was successfully treated with corticosteroid therapy. Special reference is made to the usefulness of FNA cytology in the diagnosis and follow-up of this disease.     

Clinicostatistical study of lower lip mucoceles

We reviewed 70 patients with lower lip mucoceles for patient characteristics, clinical features, and histopathologic findings. These cases represented approximately 75% of oral mucoceles seen in the Department of Otolaryngology, Takeda General Hospital, between February 1985 and July 1988. Patients were divided almost equally between males and females, with ages ranging from 2 to 63 years, with the highest incidence of lesions occurring in the second decade. Duration of the lesions varied greatly from a few days to 3 years, with no correlation to size. The most commonly affected site was opposite the upper lateral incisor, with the incidence divided almost equally between right and left side. Of 70 biopsies, 68 were mucous extravasation cysts and 2 were mucous retention cysts. Surgical excision was the treatment of choice, with recurrence of the lesion in only 2 cases.     

Deficiency of PAR-2 gene increases acute focal ischemic brain injury.

The expression profile of the protease-activated receptor-2 (PAR-2) and effects of PAR-2 gene knockout (PAR-2 KO) on the infarct size were investigated after 60 minutes of transient middle cerebral artery occlusion (tMCAO) in mice in relation to phosphorylated extracellular signal-regulated kinase (p-ERK) and astrocyte activation. PAR-2 was normally distributed mainly in neurons of the central nervous system (CNS), and strongly upregulated at 8-24 hours after tMCAO. Deficiency of PAR-2 gene significantly increased the infarct volume and the number of TUNEL-positive cells at 24 hours of reperfusion. The strong neuronal expression of p-ERK was induced at 5 minutes as a peak after reperfusion in wild-type mice, but the signal change was significantly reduced in PAR-2 KO mice. Astroglial activation was also greatly inhibited at 24 hours after tMCAO in PAR-2 KO mice. These results show that the deficiency of PAR-2 gene increases the acute ischemic cerebral injury associating with suppression of neuronal ERK activation and reactive astroglial activation.     

EVALUATION OF AXILLARY LYMPH NODE STATUS IN BREAST CANCER WITH MRI

Objective:We performed a retrospective study to establish the optimalradiological criteria for axillary lymph node metastases from breast cancer by measuringall dissected nodes,and to determine whether magnetic resonance imaging(MRI)couldreliably reveal axillary involvement.Methods:Pathological findings and MRI scans of 202patients with invasive breast cancer were reviewed.The long-and short-axis dimensions ofall level Ⅰ and Ⅱ lymph nodes were measured microscopically,and then the long-to-shortaxis(L/S)ratio of each node was calculated.These parameters were compared withpathological nodal status to define radiological criteria for axillary involvement.MRI wascarried iut using T1-weighted spin-eho sequences in the coronal and sagittal planes.OnMRI,every detected lymph node was measured and the shape of the nodal cortex was alsoexamined.Then the diagnostic ability of MRI was assessed using these morphologic criteri-a.Results:On histopathological examinations of 4043 dissected lymph nodes,a long-axisdime     

A trial for peripheral blood stem cell harvest by combination of G-CSF with ABVD regimen in the management of Hodgkin's disease

We studied the possibility of performing peripheral blood stem cell (PBSC) harvests during the course of ABVD therapy by adding G-CSF to the treatment regimen. Six patients with high-risk Hodgkin's disease (HD) (5 untreated cases with bulky mass and 1 relapsed case) received G-CSF (5 micrograms/kg) subcutaneously from day 8 to day 13 of their first course of ABVD treatment; the numbers of CD34+ cells and CFU-GM were monitored. PBSC harvests were performed on day 12 and day 13 of subsequent ABVD plus G-CSF treatment courses. For all patients tested, we were able to harvest CFU-GM (3.78 +/- 1.19 x 10(5) colonies/kg) for peripheral blood stem cell transplants (PBSCT) by performing 2 to 4 cycles. of apheresis, without any modification to the original ABVD protocol. These findings suggest that ABVD plus G-CSF therapy is a strong candidate for the treatment of patients with high-risk HD who may undergo autologous PBSCT.     

A case of rapidly progressive interstitial pneumonia with anti-pL-12-antibodies successfully treated by pulse methylprednisolone and cyclophosphamide

A 51-year old man with severe acute respiratory failure was referred to our hospital. He presented with cyanotic digits, high fever and dyspnea. The chest radiograph and chest CT scan showed diffuse ground-glass-opacities and reticular shadows in both lung fields. We diagnosed acute interstitial pneumonia. The pulmonary infiltration seen on chest radiograph diminished gradually after pulse methylprednisolone and cyclophosphamide therapy. Later, we screened his sera for antibodies to anti-aminoacyl tRNA synthetase to diagnose anti-aminoacyl tRNA synthetase syndrome because anti-PL-12 antibodies were positive. This case has been followed but no myositis or recurrence of interstitial pneumonia has been recognized.     

Role of plasma protein and low-molecular weight substances in the change of hydroxyl radical scavenging activity in hemodialysis patients

While it is well known that hemodialysis (HD) patients with end stage renal failure are exposed to high oxidative stress, there is not a general opinion regarding whether antioxidant activity is high or low in these patients. We evaluated the variation of plasma hydroxyl radical scavenging activity (p-HRSA) by a single-session of HD in 69 patients by using a new system, reactive flow-injection electron spin resonance. And then comparing p-HRSA with their biochemical parameters, we tried to elucidate what components affected p-HRSA in the HD patients. The average of p-HRSA significantly increased after HD and the variation of p-HRSA by HD was correlated with that of plasma total protein (TP). In 5 patients however, their p-HRSA decreased after HD, in spite of increasing TP. In pre-HD, the p-HRSA values and hydroxyl radical scavenging activity of low-molecular weight fraction of plasma were significantly higher in these 5 patients than in patients whose p-HRSA increased after HD. These 5 patients were in an inflammatory state. These findings suggest that p-HRSA is mainly affected by TP, but caution should be exercised in patients who have high p-HRSA before HD and whose p-HRSA does not increase after HD.     

Immunological equivalence between mouse brain-derived and Vero cell-derived Japanese encephalitis vaccines

The persistent spread via animal reservoirs urges expanding vaccination programs against pathogens like the Japanese encephalitis virus, JEV. The JEV is spreads to new areas by domestic as well as by wild animals. Although there is a safe and efficient vaccine on the market, this is derived from infected mouse brains, why today's situation requires overcoming the potential risk caused by using animal tissues. To meet this demand we have developed a Vero cell-derived JEV vaccine, using the same virus strain as in the established one. A phase III clinical study of the new vaccine has recently been completed with positive outcome. Like the established mouse brain-derived vaccine, the Vero cell-derived one is a formalin inactivated whole virus vaccine. We here demonstrate the very good agreement in immunological tests between the two antigens. The study includes analyses with two neutralizing monoclonal antibodies that blocks cell entry at a late stage in infection, assumedly interfering with fusion-related refolding in the virus fusion protein. It is obvious that the formalin inactivation treatment, with both virus preparations, retains these essential vaccine epitopes.