1
|
Yorita K, Miyazaki K, Urano M, Nagao T, Nakaguro M, Tahara K, Takeda T, Nakatani K. Macrocystic and non-necrotic salivary duct carcinoma of the submandibular gland: A case report. Radiol Case Rep 2024; 19:3049-3055. [PMID: 38756951 PMCID: PMC11096982 DOI: 10.1016/j.radcr.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
Salivary duct carcinoma (SDC) is a major malignant salivary gland tumor that usually forms a solid tumor. Non-necrotic macrocystic SDCs have rarely been reported among salivary gland tumors. A 78-year-old Japanese man with a submandibular gland tumor was evaluated radiologically, pathologically, and immunohistochemically. A multilocular lesion with a maximum size of 6 cm was radiologically observed in the left submandibular region. It had been noticed 20 years earlier. Malignant cytological result was obtained, and surgical resection was performed. Pathological examination revealed a non-necrotic, macrocystic submandibular gland tumor lined with glandular, cribriform, or papillary forms of atypical cuboidal cells. Frankly invasive components were observed in intercystic areas. Intraductal, mucoepidermoid, and secretory carcinomas were identified as pathological differential diagnoses because of their macrocystic morphology. We diagnosed SDC because there was no intraductal growth based on the lack of myoepithelial markers, diffuse immunoreactivity to gross cystic disease fluid protein15, androgen receptor, and mammaglobin and immunonegativity to S100 and p63. Postoperative positron emission tomography revealed the absence of lymph node and distant metastases. The patient was disease-free 9 months after surgery. Salivary duct carcinoma can be included in the differential diagnoses of cystic salivary gland tumors.
Collapse
Affiliation(s)
- Kenji Yorita
- Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Katsushi Miyazaki
- Department of Otorhinolaryngology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Fujita Health University Bantane Hospital, Nagoya-shi, 3-6-10 Otobashi, Nakagawa-ku, Nagoya-shi, Aichi 454-8509, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Kazuhiko Tahara
- Department of Otorhinolaryngology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Takashi Takeda
- Department of Otorhinolaryngology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Kimiko Nakatani
- Department of Radiology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| |
Collapse
|
2
|
Iwaki S, Kawakita D, Nagao T, Tada Y, Honma Y, Ando M, Matoba T, Minohara K, Nakano S, Murase T, Iwasaki S, Inagaki H. Comprehensive genomic profiling of salivary gland carcinoma: Analysis of the Center for Cancer Genomics and Advanced Therapeutics database in Japan. Int J Cancer 2024. [PMID: 38686510 DOI: 10.1002/ijc.34972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
Comprehensive information on genetic alterations in salivary gland cancer (SGC) is limited. This study aimed to elucidate the genetic and clinical characteristics of patients with SGC using the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database, a Japanese national genomic database. We analyzed data of 776 patients with SGC registered in the C-CAT database between June 1, 2019, and June 30, 2023. Adenoid cystic carcinoma was the most common histologic type, followed by salivary duct carcinoma (SDC) and adenocarcinoma not otherwise specified. Genetic data of 681 patients receiving FoundationOne® CDx were analyzed. We identified specific features of the combination of TP53 and CDKN2A alterations among the histological types. Specific LYN amplification was mainly detected in carcinoma ex pleomorphic adenoma and myoepithelial carcinoma. For SDC, the frequency of ERBB2 and BRAF alterations were higher in cases with metastatic lesions than in those with primary lesions. Although 28.6% patients were offered recommended treatment options, only 6.8% received the recommended treatments. This study highlights the differences in genetic alterations among the histological types of SGC, with comprehensive genomic profiling tests revealing lower drug accessibility. These findings could contribute to the development of personalized treatment for patients with SGC.
Collapse
Affiliation(s)
- Sho Iwaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Department of Pathology and Molecular Diagnosis, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, Mita Hospital, International University of Health and Welfare, Tokyo, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mizuo Ando
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takuma Matoba
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kiyoshi Minohara
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satsuki Nakano
- Department of Pathology and Molecular Diagnosis, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnosis, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinichi Iwasaki
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnosis, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| |
Collapse
|
3
|
Kudo Y, Nakamura T, Matsubayashi J, Ichinose A, Goto Y, Amemiya R, Park J, Shimada Y, Kakihana M, Nagao T, Ohira T, Masumoto J, Ikeda N. AI-driven Characterization of Solid Pulmonary Nodules on CT Imaging for Enhanced Malignancy Prediction in Small-sized Lung Adenocarcinoma. Clin Lung Cancer 2024:S1525-7304(24)00069-X. [PMID: 38760224 DOI: 10.1016/j.cllc.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/21/2024] [Accepted: 04/24/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES Distinguishing solid nodules from nodules with ground-glass lesions in lung cancer is a critical diagnostic challenge, especially for tumors ≤2 cm. Human assessment of these nodules is associated with high inter-observer variability, which is why an objective and reliable diagnostic tool is necessary. This study focuses on artificial intelligence (AI) to automatically analyze such tumors and to develop prospective AI systems that can independently differentiate highly malignant nodules. MATERIALS AND METHODS Our retrospective study analyzed 246 patients who were diagnosed with negative clinical lymph node metastases (cN0) using positron emission tomography-computed tomography (PET/CT) imaging and underwent surgical resection for lung adenocarcinoma. AI detected tumor sizes ≤2 cm in these patients. By utilizing AI to classify these nodules as solid (AI_solid) or non-solid (non-AI_solid) based on confidence scores, we aim to correlate AI determinations with pathological findings, thereby advancing the precision of preoperative assessments. RESULTS Solid nodules identified by AI with a confidence score ≥0.87 showed significantly higher solid component volumes and proportions in patients with AI_solid than in those with non-AI_solid, with no differences in overall diameter or total volume of the tumors. Among patients with AI_solid, 16% demonstrated lymph node metastasis, and a significant 94% harbored invasive adenocarcinoma. Additionally, 44% were upstaging postoperatively. These AI_solid nodules represented high-grade malignancies. CONCLUSION In small-sized lung cancer diagnosed as cN0, AI automatically identifies tumors as solid nodules ≤2 cm and evaluates their malignancy preoperatively. The AI classification can inform lymph node assessment necessity in sublobar resections, reflecting metastatic potential.
Collapse
Affiliation(s)
- Yujin Kudo
- Department of Surgery, Tokyo Medical University, Japan.
| | | | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | | | - Yushi Goto
- Department of Surgery, Tokyo Medical University, Japan
| | | | - Jinho Park
- Department of Radiology, Tokyo Medical University, Japan
| | | | | | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, Japan
| | | | | |
Collapse
|
4
|
Utsumi Y, Nakaguro M, Tada Y, Nagao T. High-grade salivary carcinomas: A current insight on diagnostic pathology and the key to clinical decision making. Semin Diagn Pathol 2024:S0740-2570(24)00031-5. [PMID: 38658249 DOI: 10.1053/j.semdp.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
High-grade carcinomas of the salivary glands are a group of several tumor entities with highly malignant histologic appearances, and have an aggressive biological behavior accompanied by poor a prognosis. In general, they require more intensive treatment than low- or intermediate-grade carcinomas. High-grade salivary carcinomas are rare and the microscopic features often overlap between different tumor types, making an appropriate diagnosis challenging in daily practice settings. However, with recent rapid advances in molecular pathology and molecular-targeted therapy in this field, there is a growing need to properly classify tumors, rather than just diagnosing the cases as "high-grade carcinomas". This leads to specific treatment strategies. In this article, we review representative high-grade salivary gland carcinomas, including salivary duct carcinoma and its histologic subtypes, high-grade mucoepidermoid carcinoma, solid-type adenoid cystic carcinoma, and high-grade transformation of low- or intermediate-grade carcinomas, and discuss their differential diagnoses and clinical implications. Other rare entities, such as neuroendocrine carcinoma, NUT carcinoma, and metastatic carcinoma, should also be considered before diagnosing high-grade carcinoma, NOS. Of these tumors, salivary duct carcinoma has received the most attention because of its strong association with androgen deprivation and anti-HER2 therapies. Other tumor-type-specific treatments include anti-TRK therapy for high-grade transformation of secretory carcinoma, but further therapeutic options are expected to be developed in the future. It should be emphasized that detailed histological evaluation with adequate sampling, in addition to the effective use of molecular ancillary tests, is of the utmost importance for a suitable diagnosis.
Collapse
Affiliation(s)
- Yoshitaka Utsumi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Masato Nakaguro
- Departments of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichiro Tada
- Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
| |
Collapse
|
5
|
Hayakawa K, Irisawa R, Umefune R, Mae K, Shimada Y, Takahashi R, Nagao T, Harada K. Marked effect of larotrectinib on primary cutaneous secretory carcinoma: A case report. J Dermatol 2024. [PMID: 38605458 DOI: 10.1111/1346-8138.17218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Kazuma Hayakawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Ryokichi Irisawa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Rika Umefune
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Kenichiro Mae
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Yoshihisa Shimada
- Department of Thoracic and Thyroid Surgery, Tokyo Medical University, Tokyo, Japan
| | | | - Toshitaka Nagao
- Department of Pathology, Tokyo Medical University, Tokyo, Japan
| | - Kazutoshi Harada
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
6
|
Kojima J, Ono M, Tasaki K, Nagai T, Nagao T, Rinno S, Kanno Y, Yoshida R, Suzuki T, Kuji N, Nishi H. Miscarriage-Related Acute Kidney Injury: A Case Report. Int Med Case Rep J 2024; 17:295-300. [PMID: 38601796 PMCID: PMC11005928 DOI: 10.2147/imcrj.s451790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/28/2024] [Indexed: 04/12/2024] Open
Abstract
Background Pregnancy-related acute kidney injury (Pr-AKI) is associated with significant maternal and fetal morbidity and mortality, with a three- to four-fold increase in perinatal mortality. Pr-AKI can arise from various obstetric complications, such as hyperemesis gravidarum, septic abortion, hypertensive disorders of pregnancy, pyelonephritis, and antiphospholipid antibody syndrome. Therefore, early diagnosis and appropriate intervention, including the identification of the underlying etiology, are important to effectively manage Pr-AKI. Therefore, we report a case of Pr-AKI after early miscarriage in a patient without hyperemesis gravidarum or septic abortion whose renal function gradually improved postoperatively for miscarriage. Case Presentation A 34-year-old primigravid woman was referred to us for perinatal management at 6 weeks of gestation. Unfortunately, she was diagnosed with miscarriage 1 week later. The patient had no history of hyperemesis gravidarum or septic abortion; however, she developed oliguria, and her serum creatinine and blood urea nitrogen levels were abnormally increased. Consequently, she underwent a renal biopsy to evaluate renal dysfunction, which indicated tubulointerstitial damage. The patient also underwent manual vacuum aspiration for a miscarriage. Postoperatively, her urine output increased, and her renal function improved. She was determined to have experienced Pr-AKI due to her miscarriage. Conclusion Our patient had Pr-AKI after a miscarriage in the absence of other causes. This case report highlights the presence of unknown causes of Pr-AKI, warranting further research for the development of preventive interventions.
Collapse
Affiliation(s)
- Junya Kojima
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Masanori Ono
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Koichiro Tasaki
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Nagai
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Sho Rinno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Yoshihiko Kanno
- Department of Nephrology, Tokyo Medical University, Tokyo, Japan
| | - Rie Yoshida
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Tomoo Suzuki
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Naoaki Kuji
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Hirotaka Nishi
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
7
|
Matsunaga K, Kikuno M, Sakamoto H, Okada H, Hashimoto T, Honda S, Matsubayashi J, Nagao T, Yamada Y, Horiuchi H, Kuroda M, Murayama S, Terashi H, Kohno M. A Cerebral Embolism Caused by a Malignant Peripheral Nerve Sheath Tumor in a Patient with Neurofibromatosis Type 1. Intern Med 2024:2996-23. [PMID: 38569908 DOI: 10.2169/internalmedicine.2996-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
A 31-year-old man with neurofibromatosis type 1 (NF-1) had undergone resection of a malignant peripheral nerve sheath tumor (MPNST) on the buttock 3 months previously. He subsequently underwent mechanical thrombectomy for a hyperacute left middle cerebral artery embolism. Histopathologically, the emboli comprised neurofilament-positive pleomorphic tumor cells with geographic necrosis and conspicuous mitosis and were identified as MPNST. The patient died of respiratory failure due to lung MPNST metastasis on day 15 of hospitalization. To our knowledge, this is the first report of a spontaneous cerebral embolism due to MPNST in a NF-1 patient.
Collapse
Affiliation(s)
- Kyosuke Matsunaga
- Department of Neurosurgery, Tokyo Medical University Hospital, Japan
| | - Muneaki Kikuno
- Department of Neurosurgery, Tokyo Medical University Hospital, Japan
- Department of Neurology, Tokyo Medical University Hospital, Japan
| | - Hiroki Sakamoto
- Department of Neurosurgery, Tokyo Medical University Hospital, Japan
| | - Hirofumi Okada
- Department of Neurosurgery, Tokyo Medical University Hospital, Japan
| | - Takao Hashimoto
- Department of Neurosurgery, Tokyo Medical University Hospital, Japan
| | - Shogo Honda
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | - Yuko Yamada
- Department of Molecular Pathology, Tokyo Medical University, Japan
| | - Hajime Horiuchi
- Department of Molecular Pathology, Tokyo Medical University, Japan
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, Japan
| | - Shigeo Murayama
- Department of Neuropathology (Brain Bank for Aging Research), Tokyo Metropolitan Institute for Geriatrics and Gerontology, Japan
| | - Hiroo Terashi
- Department of Neurology, Tokyo Medical University Hospital, Japan
| | - Michihiro Kohno
- Department of Neurosurgery, Tokyo Medical University Hospital, Japan
| |
Collapse
|
8
|
Nemoto R, Usui Y, Komatsu H, Tsubota K, Sugawara R, Nagao T, Goto H. Immunophenotypic profiles in chalazion and pyogenic granuloma associated with chalazion. Graefes Arch Clin Exp Ophthalmol 2024; 262:1329-1335. [PMID: 37934292 DOI: 10.1007/s00417-023-06304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion. METHODS Eighty-two surgical specimens from 74 consecutive patients newly diagnosed with chalazion or chalazion-associated pyogenic granuloma at Tokyo Medical University Hospital between 2016 and 2022 were studied. Sixty specimens were chalazion lesions and 22 specimens were pyogenic granuloma lesions (from 15 men and 7 women, mean age 36.6 ± 14.4 years). All patients were immunocompetent Asian Japanese adults. Specimens were analyzed by immunohistochemistry and flow cytometry. Flow cytometry was performed using the following antibodies: CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, CD20, CD23, CD25, CD34, CD44, CD56, CD69, and CD138. RESULTS In flow cytometric analysis, the proportion of cells expressing the T cell marker CD3 was significantly higher compared with other immune cells expressing specific markers (p < 0.0001), and the proportion of CD4-positive T cells was significantly higher than that of CD8-positive T cells (p < 0.0001), in both chalazion and pyogenic granuloma specimens. The chalazion and pyogenic granuloma lesions shared similar immunophenotypic profile characterized by predominant T cell infiltration, and CD4 T cells dominating over CD8 cells. The pattern of expression of CD4 and CD8 in the specimens was confirmed by immunohistochemistry. CONCLUSION The present study demonstrates immunophenotypic features of chalazion and chalazion-associated pyogenic granuloma. Although various inflammatory cells are involved in the pathology of chalazion and pyogenic granuloma, a significantly higher proportion of CD4-positive T cells may be closely related to the pathological mechanisms of both lesions.
Collapse
Affiliation(s)
- Rey Nemoto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan.
| | - Hiroyuki Komatsu
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Kinya Tsubota
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Risa Sugawara
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| |
Collapse
|
9
|
Fushimi C, Takahashi H, Kawakita D, Kano S, Tsukahara K, Ozawa H, Okami K, Sakai A, Yamazaki K, Okada T, Hanazawa T, Sato Y, Imanishi Y, Shimizu A, Matsuki T, Nagao T, Tada Y. Brain metastases in patients with salivary duct carcinoma: A retrospective study. Cancer Med 2024; 13:e7037. [PMID: 38477487 DOI: 10.1002/cam4.7037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is a high-grade adenocarcinoma with a 5-year survival rate of 40%. Although drug therapy has improved patients' prognosis, the impact of brain metastasis (BM) remains poorly understood. We aimed to retrospectively examine the incidence of BM in patients with SDC (n = 464) and develop a tool to estimate their prognoses. METHODS We retrospectively examined 464 patients with SDC enrolled in a multicenter study. We investigated the incidence of BM, overall survival (OS) rates, and factors affecting prognosis in patients with BM. We also developed an SDC-graded prognostic assessment (GPA) score for disease prognostication. RESULTS Sixty-five (14%) patients had BM. The median OS (mOS) was 13.1 months. On univariate and multivariate analyses, factors such as Eastern Cooperative Oncology Group Performance Status >1, human epidermal growth factor receptor 2-negative status, and locoregional uncontrolled disease were associated with poor OS. SDC-GPA scores according to the prognostic factors were 0, 1, 2, and 3 points, and mOS estimates were 50.5, 16.1, 3.9, and 1.2 months, respectively (p < 0.001). CONCLUSION The SDC-GPA score emerged as a useful prognostication tool for patients with BM.
Collapse
Affiliation(s)
- Chihiro Fushimi
- Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoshi Kano
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Akihiro Sakai
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Keisuke Yamazaki
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Takuro Okada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yorihisa Imanishi
- Otorhinolaryngology, Head and Neck Surgery, International University of Health and Welfare, Narita Hospital, Chiba, Japan
| | - Akira Shimizu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takashi Matsuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yuichiro Tada
- Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| |
Collapse
|
10
|
Honda S, Yamaguchi H, Aimono E, Hara S, Minamiguchi S, Norose T, Ohike N, Yamochi T, Yasuda M, Moriya T, Shiko Y, Nishihara H, Nagao T. High-grade Solid Pseudopapillary Neoplasms of the Pancreas: Distinct Clinicopathological Malignant Features With Intriguing Gene Alterations through a Comparison With the Conventional Type. Am J Surg Pathol 2024; 48:353-363. [PMID: 38189381 DOI: 10.1097/pas.0000000000002177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Pancreatic solid pseudopapillary neoplasm (SPN) is a low-grade malignant neoplasm with a good prognosis. Clinically aggressive SPNs have rarely been reported but have not been analyzed in detail. In this study, we referred to this highly malignant type of SPN as high-grade SPN (HG-SPN) and compared its clinicopathological and genetic characteristics with conventional SPN (C-SPN) using immunohistochemistry and gene panel analyses. Five HG-SPNs and 15 C-SPNs were evaluated in this study. HG-SPNs share many pathologic characteristics: macroscopically, solid/cystic appearances, microscopically, pseudopapillary/pseudorosette pattern (100%), tumor cell loose cohesiveness (100%), thin/delicate vasculature (100%), tumor cell cytoplasmic vacuolization (100%), immunohistochemical positivity for β-catenin (nuclear expression) (100%), CD10 (80%), CD56 (80%), and vimentin (100%). Conversely, HG-SPNs showed distinct malignant features compared with C-SPNs: mean tumor size (11.7 vs. 2.9 cm, P <0.001); true necrosis (100% vs. 0%, P <0.001); high-grade nuclear atypia (100% vs. 0%, P <0.001); lymphatic and/or venous invasion (100% vs. 20%, P =0.004); mean mitotic count (4.38 vs. 0.05/high-power field, P <0.001); and mean Ki-67 labeling index (33.9% vs. 3.4%, P <0.001). All HG-SPN patients died of primary disease 3 to 36 months after surgery, while all C-SPN patients were alive without disease. Genetic studies have shown that all analyzed HG-SPNs have CTNNB1 mutations. Two HG-SPN cases showed RB1 mutations with altered immunohistochemical findings for RB1 and p16. Two HG-SPN cases had TP53 mutation and/or p53 overexpression. In conclusion, HG-SPNs show distinct malignant features and some genetic alterations that differ from C-SPNs, indicating the importance of differentiating between these 2 subtypes.
Collapse
Affiliation(s)
- Shogo Honda
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Pathology, NHO Sagamihara National Hospital
| | - Hiroshi Yamaguchi
- Department of Anatomic Pathology, Tokyo Medical University
- Department of Pathology, Saitama Medical University
| | - Eriko Aimono
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine
| | - Shigeo Hara
- Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, Kobe
| | | | - Tomoko Norose
- Department of Pathology, Showa University School of Medicine, Tokyo
- Department of Pathology, Division of Molecular Pathology, St. Marianna University School of Medicine, Kanagawa
| | - Nobuyuki Ohike
- Department of Pathology, Showa University School of Medicine, Tokyo
- Department of Pathology, Division of Molecular Pathology, St. Marianna University School of Medicine, Kanagawa
| | - Toshiko Yamochi
- Department of Pathology, Showa University School of Medicine, Tokyo
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University, International Medical Center, Saitama
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Okayama
| | - Yuki Shiko
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Nishihara
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine
| | | |
Collapse
|
11
|
Ohkubo Y, Okubo T, Asari Y, Matsuzaka Y, Kitaguchi M, Shiota S, Fujita R, Okamoto K, Obata H, Kishida Y, Nagao T. Adenoid cystic carcinoma of the orbit without lacrimal gland involvement and with intracranial extension: A case report. Radiol Case Rep 2024; 19:1068-1072. [PMID: 38229598 PMCID: PMC10789932 DOI: 10.1016/j.radcr.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/02/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024] Open
Abstract
We present a 76-year-old female with a 6-year history of decreased vision in the right eye and right-sided facial neuralgia. She had a T1 isointense and T2 isointense enhancing lesion in the right orbit and the middle cranial fossa on MRI examination. Granulomatous disease or meningioma was suspected, however, after removal, the tumor was identified by pathology as adenoid cystic carcinoma (ACC). The tumor has no radiological and clinical lacrimal grand involvement. ACC shows a slow and indolent growth pattern but is associated with poor long-term outcomes, mainly due to perineural invasion, local control failure, and distant metastasis. This case highlights the importance of a pathologic diagnosis and early intervention in similar presentations.
Collapse
Affiliation(s)
- Yu Ohkubo
- Department of Radiology, University Hospital Mizonokuchi, Teikyo University School of Medicine, Kanagawa, Japan
| | - Toshiyuki Okubo
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Yusuke Asari
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Yuki Matsuzaka
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | | | - Saori Shiota
- Department of Radiology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Richi Fujita
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichiro Okamoto
- Department of Neurosurgery, Tokyo Teishin Hospital, Tokyo, Japan
| | - Hiroto Obata
- Department of Ophthalmology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yukiko Kishida
- Department of Pathology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
12
|
Kanno C, Kudo Y, Matsubayashi J, Furumoto H, Takahashi S, Maehara S, Hagiwara M, Kakihana M, Ohira T, Nagao T, Ikeda N. Association between pathological infiltrative tumor growth pattern and prognosis in patients with resected lung squamous cell carcinoma. Eur J Surg Oncol 2024; 50:107973. [PMID: 38262301 DOI: 10.1016/j.ejso.2024.107973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/31/2023] [Accepted: 01/17/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Lung squamous cell carcinoma (LUSC) usually shows expansive growth with large tumor nests; few reports on invasive growth patterns (INF) in LUSC have been associated with poor prognosis in gastrointestinal and urothelial cancers. In this study, we examine the association between INF and the prognosis of LUSC. MATERIALS AND METHODS We analyzed INF as a potential prognostic factor in 254 consecutive patients with LUSC who underwent complete surgical resection at our hospital between 2008 and 2017. INF was classified into 3 categories based on the structure of the tumor other than the large round solid nest of tumor cells. RESULTS INF was categorized as INFa in 59 patients (23 %) with only well-demarcated large solid tumor cell nests, INFb in 89 patients (35 %) with medium to small, alongside large solid nests, and INFc in 98 patients (39 %) with cord-like/small nests or isolated cells plus large or medium solid nests. No significant lymph node metastasis differences were observed between INFc and INFa/b tumors. However, in patients with p-stage I, INFc had a poorer prognosis with regard to recurrence-free survival (RFS), with a 5-year RFS rate of 53.3 %, compared to 74.9 % for INFa/b (p = 0.010). CONCLUSION Our study highlights a novel pathological concept of INF in LUSC, and contributed to the proposal that it is a factor indicating an unfavorable prognosis in patients with early-stage LUSC. A prospective multicenter study is warranted for INFc patients, as careful follow-up and adjuvant chemotherapy might lead to the early detection and prevention of recurrence.
Collapse
Affiliation(s)
- Chiaki Kanno
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yujin Kudo
- Department of Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
| | | | | | - Sachio Maehara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | | | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
13
|
Shimodaira K, Inoue R, Hashimoto T, Satake N, Shishido T, Namiki K, Harada K, Nagao T, Ohno Y. Significance of the cribriform morphology area ratio for biochemical recurrence in Gleason score 4 + 4 prostate cancer patients following robot-assisted radical prostatectomy. Cancer Med 2024; 13:e7086. [PMID: 38477506 DOI: 10.1002/cam4.7086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/31/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND In prostate cancer, histological cribriform patterns are categorized as Gleason pattern 4, and recent studies have indicated that their size and percentage are associated with the risk of biochemical recurrence (BCR). However, these studies included a mixture of cases with various Gleason scores (GSs). We therefore examined the prognostic value of the area and percentage of cribriform patterns in patients with GS 4 + 4 prostate cancer. METHODS We investigated 108 patients with GS 4 + 4 prostate cancer who underwent robot-assisted radical prostatectomy (RARP). After digitally scanning the hematoxylin and eosin-stained slides, we measured the area of the entire cancer and cribriform patterns. Predictive factors for BCR were explored using log-rank test and Cox proportional hazard model analyses. RESULTS Sixty-seven (62.0%) patients had a cribriform pattern in RARP specimens, and 32 (29.6%) experienced BCR. The median total cancer area, cribriform pattern area, and percentage of cribriform pattern area (% cribriform) were 427.70 mm2 (interquartile range [IQR], 171.65-688.53 mm2 ), 8.85 mm2 (IQR, 0-98.83 mm2 ), and 2.44% (IQR, 0%-33.70%), respectively. Univariate analyses showed that higher preoperative serum prostate-specific antigen (PSA) levels, positive resection margins, advanced pathological T stage, extraprostatic extension, larger total cancer area, larger cribriform morphology area, and higher % cribriform values were significantly associated with BCR. A multivariate analysis demonstrated that the PSA level (hazard ratio [HR], 1.061; 95% confidence interval [CI], 1.011-1.113; p = 0.017) and % cribriform (HR, 1.018; 95% CI, 1.005-1.031; p = 0.005) were independent predictors of BCR. CONCLUSIONS An increased % cribriform value was associated with BCR in patients with GS 4 + 4 prostate cancer following RARP.
Collapse
Affiliation(s)
| | - Rie Inoue
- Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoya Satake
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Kazunori Namiki
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Kazuharu Harada
- Department of Health Data Science, Tokyo Medical University, Tokyo, Japan
| | | | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
14
|
Bishop JA, Nakaguro M, Urano M, Yamamoto Y, Utsumi Y, Li R, Weinreb I, Nagashima Y, Gangahar C, Yamashiro K, Hashimoto K, Rooper LM, Carlile B, Wang RC, Gagan J, Nagao T. Keratocystoma: A Distinctive Salivary Gland Neoplasm Characterized by RUNX2 Rearrangements. Am J Surg Pathol 2024; 48:317-328. [PMID: 38084005 DOI: 10.1097/pas.0000000000002169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Keratocystoma is a rare salivary gland lesion that has been reported primarily in children and young adults. Because of a scarcity of reported cases, very little is known about it, including its molecular underpinnings, biological potential, and histologic spectrum. Purported to be a benign neoplasm, keratocystoma bears a striking histologic resemblance to benign lesions like metaplastic Warthin tumor on one end of the spectrum and squamous cell carcinoma on the other end. This overlap can cause diagnostic confusion, and it raises questions about the boundaries and definition of keratocystoma as an entity. This study seeks to utilize molecular tools to evaluate the pathogenesis of keratocystoma as well as its relationship with its histologic mimics. On the basis of targeted RNA sequencing (RNA-seq) results on a sentinel case, RUNX2 break-apart fluorescence in situ hybridization (FISH) was successfully performed on 4 cases diagnosed as keratocystoma, as well as 13 cases originally diagnosed as tumors that morphologically resemble keratocystoma: 6 primary squamous cell carcinomas, 3 metaplastic/dysplastic Warthin tumors, 2 atypical squamous cysts, 1 proliferating trichilemmal tumor, and 1 cystadenoma. RNA-seq and/or reverse transcriptase-PCR were attempted on all FISH-positive cases. Seven cases were positive for RUNX2 rearrangement, including 3 of 4 tumors originally called keratocystoma, 2 of 2 called atypical squamous cyst, 1 of 1 called proliferating trichilemmal tumor, and 1 of 6 called squamous cell carcinoma. RNA-seq and/or reverse transcriptase-PCR identified IRF2BP2::RUNX2 in 6 of 7 cases; for the remaining case, the partner remains unknown. The cases positive for RUNX2 rearrangement arose in the parotid glands of 4 females and 3 males, ranging from 8 to 63 years old (mean, 25.4 years; median, 15 years). The RUNX2 -rearranged cases had a consistent histologic appearance: variably sized cysts lined by keratinizing squamous epithelium, plus scattered irregular squamous nests, with essentially no cellular atypia or mitotic activity. The background was fibrotic, often with patchy chronic inflammation and/or giant cell reaction. One case originally called squamous cell carcinoma was virtually identical to the other cases, except for a single focus of small nerve invasion. The FISH-negative case that was originally called keratocystoma had focal cuboidal and mucinous epithelium, which was not found in any FISH-positive cases. The tumors with RUNX2 rearrangement were all treated with surgery only, and for the 5 patients with follow-up, there were no recurrences or metastases (1 to 120 months), even for the case with perineural invasion. Our findings solidify that keratocystoma is a cystic neoplastic entity, one which appears to consistently harbor RUNX2 rearrangements, particularly IRF2BP2::RUNX2 . Having a diagnostic genetic marker now allows for a complete understanding of this rare tumor. They arise in the parotid gland and affect a wide age range. Keratocystoma has a consistent morphologic appearance, which includes large squamous-lined cysts that mimic benign processes like metaplastic Warthin tumor and also small, irregular nests that mimic squamous cell carcinoma. Indeed, RUNX2 analysis has considerable promise for resolving these differential diagnoses. Given that one RUNX2 -rearranged tumor had focal perineural invasion, it is unclear whether that finding is within the spectrum of keratocystoma or whether it could represent malignant transformation. Most important, all RUNX2 -rearranged cases behaved in a benign manner.
Collapse
Affiliation(s)
| | - Masato Nakaguro
- Departments of Pathology and Laboratory Medicine, Nagoya University Hospital
| | - Makoto Urano
- Department of Diagnostic Pathology, Bantane Hospital, Fujita Health University School of Medicine, Nagoya
| | | | | | - Rong Li
- Department of Pathology and Laboratory Medicine, Children's of Alabama, Birmingham, AL
| | - Ilan Weinreb
- Department of Pathology, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University Hospital, Tokyo
| | | | | | - Kimio Hashimoto
- Department of Pathology, Nishi-Kobe Medical Center, Kobe, Japan
| | - Lisa M Rooper
- Departments of Pathology and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Brian Carlile
- Department of Pathology, Baylor Scott and White Health, All Saints Medical Center, Fort Worth, TX
| | - Richard C Wang
- Department of Dermatology, UT Southwestern Medical Center, Dallas
| | - Jeffrey Gagan
- Department of Pathology, UT Southwestern Medical Center
| | | |
Collapse
|
15
|
Shishido-Hara Y, Akimoto J, Fukami S, Kohno M, Matsubayashi J, Nagao T. Pathology for severe inflammatory PML with PD1/PD-L1 expression of favorable prognosis: What's a prognostic factor for PML-IRIS? Neuropathology 2024; 44:47-58. [PMID: 37424276 DOI: 10.1111/neup.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
A 72-year-old woman with dermatomyositis (DM) developed neurological manifestation, and magnetic resonance imaging (MRI) revealed multiple T2/fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions predominantly in the deep white matter of the cerebral hemisphere. Punctate or linear contrast enhancement was observed surrounding the T1-hypointense area. Multiple T2/FLAIR-hyperintense lesions were aligned along with the corona radiata. Malignant lymphoma was first suspected, and a brain biopsy was performed. Pathological investigation suggested the provisional diagnosis of "suspicious of malignant lymphoma." Owing to emergent clinical conditions, high-dose methotrexate (MTX) therapy was conducted, and then T2/FLAIR-hyperintense lesions were dramatically reduced. However, the diagnosis of malignant lymphoma was concerning since multiplex PCR demonstrated clonal restriction of the Ig H gene for B cells and TCR beta genes for T cells. Histopathology revealed the infiltration of both CD4+ and CD8+ T cells, and the CD4+ /CD8+ ratio was 4.0. Moreover, prominent plasma cells were observed, in addition to CD20+ B cells. Atypical cells with enlarged nuclei were present, and they were not hematopoietic but found as glial cells. JC virus (JCV) infection was verified with both immunohistochemistry and in situ hybridization; the final diagnosis was progressive multifocal leukoencephalopathy (PML). The patient was treated with mefloquine and discharged. This case is informative in understanding the host anti-viral response. Variable inflammatory cells were observed, including CD4+ and CD8+ T cells, plasma cells, and a small amount of perivascular CD20+ B cells. PD-1 and PD-L1 expression was observed in lymphoid cells and macrophages, respectively. PML with inflammatory reactions was thought fatal, and autopsy cases of PML with immune reconstitution inflammatory syndrome (IRIS) demonstrated excessive infiltration of only CD8+ T cells. However, this case revealed infiltration of variable inflammatory cells, and a favorable prognosis would be expected under PD-1/PD-L1 immune-checkpoint regulation.
Collapse
Affiliation(s)
- Yukiko Shishido-Hara
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
- Department of Pathology and Applied Neurobiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jiro Akimoto
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Shinjiro Fukami
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Michihiro Kohno
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
16
|
Kawamoto T, Ishida M, Yorozu T, Arizono E, Wakabayashi Y, Nagao T, Ohno Y, Saito K. Mucinous adenocarcinoma derived from villous adenoma of the kidney with muconephrosis. Clin Case Rep 2024; 12:e8397. [PMID: 38173885 PMCID: PMC10762481 DOI: 10.1002/ccr3.8397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/29/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
Upper respiratory tract villous adenoma (VA) with muconephrosis is rare and should be included in the differential diagnosis when pelvic dilatation with a solid component is detected. VA may transform into malignant mucinous adenocarcinoma, which should be suspected if contrast enhancement on computed tomography (CT)/magnetic resonance imaging (MRI) and restricted diffusion on MRI are observed.
Collapse
Affiliation(s)
- Tsubasa Kawamoto
- Department of RadiologyTokyo Medical University HospitalTokyoJapan
| | - Masanori Ishida
- Department of RadiologyTokyo Medical University HospitalTokyoJapan
| | - Takashi Yorozu
- Department of PathologyTokyo Medical University HospitalTokyoJapan
| | - Elly Arizono
- Department of RadiologyTokyo Medical University HospitalTokyoJapan
| | | | - Toshitaka Nagao
- Department of PathologyTokyo Medical University HospitalTokyoJapan
| | - Yoshio Ohno
- Department of UrologyTokyo Medical University HospitalTokyoJapan
| | - Kazuhiro Saito
- Department of RadiologyTokyo Medical University HospitalTokyoJapan
| |
Collapse
|
17
|
Obikane H, Shimodai-Yamada S, Koizumi N, Ogino H, Nagao T, Hao H. Histopathological Evaluation of Pulmonary Thromboendarterectomy Specimens of Chronic Thromboembolic Pulmonary Hypertension. J Atheroscler Thromb 2023; 30:1661-1673. [PMID: 37005330 PMCID: PMC10627741 DOI: 10.5551/jat.63973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/28/2023] [Indexed: 04/03/2023] Open
Abstract
AIMS Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition with a poor prognosis in which the pulmonary arteries are occluded by organized thrombi. Pulmonary thromboendarterectomy (PEA) is an effective treatment for CTEPH; however, the literature on its histopathological examination is lacking. This study aimed to investigate the histopathological findings and protein and gene expression in PEA specimens, establish an optimal histopathological evaluation method, and clarify the mechanisms of thrombus organization and disease progression in CTEPH. METHODS In total, 50 patients with CTEPH who underwent PEA were analyzed. The patients were categorized according to their clinical data into two groups: good and poor postoperative courses. The relationship between their histopathological findings and the clinical course was examined. Immunohistochemical studies confirmed the expression of oxidants, antioxidants, and smooth muscle cell (SMC) differentiation markers and their changes during the progression of thrombus organization. The mRNA expression analysis of 102 samples from 27 cases included oxidants, antioxidants, and vasoconstrictor endothelin-1. RESULTS In the PEA specimens, colander-like lesions (aggregations of recanalized blood vessels with well-differentiated SMCs) were significantly more common in the good postoperative course group than in the poor postoperative course group; analysis of proteins and genes proposed that oxidative and antioxidant mechanisms were involved. In the colander-like lesions, there was an increase in endothelin-1 mRNA and protein expression of endothelin receptor A. CONCLUSIONS Colander-like lesions in PEA specimens must be identified. Additionally, SMC differentiation in recanalized vessels and the expression of vasoconstrictors and their receptors may contribute to the progression of CTEPH.
Collapse
Affiliation(s)
- Hiyo Obikane
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Sayaka Shimodai-Yamada
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Nobusato Koizumi
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Hao
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
18
|
Kanno C, Kudo Y, Amemiya R, Matsubayashi J, Furumoto H, Takahashi S, Maehara S, Hagiwara M, Kakihana M, Nagao T, Ohira T, Ikeda N. Sublobar resection utilizing near-infrared thoracoscopy with intravenous indocyanine green for intralobar pulmonary sequestration: a case report and literature review. Surg Case Rep 2023; 9:176. [PMID: 37804436 PMCID: PMC10560170 DOI: 10.1186/s40792-023-01758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/30/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Pulmonary sequestration is a rare pulmonary malformation, with intralobar pulmonary sequestration being the most common subtype. Lobectomy has generally been performed for its treatment, owing to unclear boundaries of the lesion. However, recent reports have introduced lung resection using intravenous indocyanine green (ICG) as a treatment for pulmonary sequestrations. CASE DESCRIPTION A 34-year-old woman presented with chest pain, and enhanced chest computed tomography (CT) displayed a solid mass of 4.5 × 3.1 cm in the right S10 area. An aberrant artery was found running from the celiac artery through the diaphragm to the thoracic cavity. The patient was diagnosed as having pulmonary sequestration Pryce type III, and surgical resection was performed. Intrathoracic findings demonstrated that the precise area of the pulmonary sequestration could not be clearly identified, and a 5-mm aberrant artery was present in the pulmonary ligament. Following the separation of the aberrant artery, intravenous injection of ICG clearly delineated the border between the normal lung tissue and the pulmonary sequestration. Wedge resection was then performed without any postoperative events, and the pathological diagnosis was also pulmonary sequestration. CONCLUSIONS We herein reported a case of a patient who underwent sublobar resection for intrapulmonary sequestration using intravenous ICG injection, together with a literature review. Our case suggests that a comprehensive understanding of abnormal vessels and pulmonary vasculature in pulmonary resection for intrapulmonary sequestrations, complemented with the use of ICG, might potentially avoid unnecessary pulmonary resection and enable sublobar surgical resection.
Collapse
Affiliation(s)
- Chiaki Kanno
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Yujin Kudo
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
| | - Ryosuke Amemiya
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Hideyuki Furumoto
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Satoshi Takahashi
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Sachio Maehara
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Masatoshi Kakihana
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| |
Collapse
|
19
|
Ueda K, Murase T, Kawakita D, Nagao T, Kusafuka K, Nakaguro M, Urano M, Yamamoto H, Taguchi KI, Kano S, Tada Y, Tsukahara K, Okami K, Onitsuka T, Fujimoto Y, Sakurai K, Hanai N, Nagao T, Kawata R, Hato N, Nibu KI, Inagaki H. The Landscape of MYB/MYBL1- and Peri-MYB/MYBL1-Associated Rearrangements in Adenoid Cystic Carcinoma. Mod Pathol 2023; 36:100274. [PMID: 37423587 DOI: 10.1016/j.modpat.2023.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/03/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
Approximately 60% of adenoid cystic carcinoma (AdCC) cases are positive for MYB::NFIB or MYBL1::NFIB, whereas MYB/MYBL1 oncoprotein, a key driver of AdCC, is overexpressed in most cases. Juxtaposition of superenhancer regions in NFIB and other genes into the MYB/MYBL1 locus is an attractive oncogenic hypothesis for AdCC cases, either negative or positive for MYB/MYBL1::NFIB. However, evidence supporting this hypothesis is insufficient. We examined 160 salivary AdCC cases for rearrangements in MYB/MYBL1 loci and peri-MYB/MYBL1 areas (centromeric and telomeric areas of 10 Mb each) using formalin-fixed, paraffin-embedded tumor sections. For the detection of the rearrangements, we employed conventional fluorescence in situ hybridization split and fusion assays and a 5 Mb fluorescence in situ hybridization split assay. The latter is a novel assay that enabled us to detect any possible splits within a 5 Mb distance of a chromosome. We found MYB/MYBL1- and peri-MYB/MYBL1-associated rearrangements in 149/160 patients (93%). AdCC cases positive for rearrangements in MYB, MYBL1, the peri-MYB area, and the peri-MYBL1 area numbered 105 (66%), 20 (13%), 19 (12%), and 5 (3%), respectively. In 24 peri-MYB/MYBL1 rearrangement-positive cases, 14 (58%) were found to have a juxtaposition of the NFIB or RAD51B locus into the MYB/MYBL1 loci. On comparing with a tumor group positive for MYB::NFIB, a hallmark of AdCC, other genetically classified tumor groups had similar features of overexpression of the MYB transcript and MYB oncoprotein as detected by semiquantitative RT-qPCR and immunohistochemistry, respectively. In addition, clinicopathological and prognostic features were similar among these groups. Our study suggests that peri-MYB/MYBL1 rearrangements may be a frequent event in AdCC and may result in biological and clinicopathological consequences comparable to MYB/MYBL1 rearrangements. The landscape of MYB/MYBL1 and peri-MYB/MYBL1 rearrangements shown here strongly suggests that juxtaposition of superenhancers into MYB/MYBL1 or peri-MYB/MYBL1 loci is an alteration that acts as a key driver for AdCC oncogenesis and may unify MYB/MYBL1 rearrangement-positive and negative cases.
Collapse
Affiliation(s)
- Kaori Ueda
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Bantane Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate of School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Ken-Ichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuro Onitsuka
- Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Otolaryngology-Head and Neck Surgery, Aichi Medical University, Nagakute, Japan
| | - Kazuo Sakurai
- Department of Otorhinolaryngology, Fujita Health University, Okazaki Medical Center, Okazaki, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Naohito Hato
- Department of Otolaryngology, Ehime University School of Medicine, Toon, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| |
Collapse
|
20
|
Kurebayashi Y, Tsujikawa H, Sugimoto K, Yunaiyama D, Araki Y, Saito K, Takahashi H, Kakegawa T, Wada T, Tomita Y, Abe M, Yoshimasu Y, Takeuchi H, Hirata T, Sakamaki K, Kakimi K, Nagao T, Itoi T, Sakamoto M. Tumor steatosis and glutamine synthetase expression in patients with advanced hepatocellular carcinoma receiving atezolizumab plus bevacizumab therapy. Hepatol Res 2023; 53:1008-1020. [PMID: 37300323 DOI: 10.1111/hepr.13933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/11/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
AIM The anti-programmed death-ligand 1 antibody atezolizumab and vascular endothelial growth factor-neutralizing antibody bevacizumab in combination (Atezo + Bev) have become the first-line therapy in advanced hepatocellular carcinoma (HCC). Distinct types of tumor immune microenvironment (TIME) and their associations with specific molecular subclasses and driver gene mutations have been identified in HCC; however, these insights are mainly based on surgically resected early-stage tumors. The current study aimed to reveal the biology and TIME of advanced HCC and their significance in predicting clinical outcomes of Atezo + Bev therapy. METHODS Thirty-three patients with advanced HCC who were scheduled for treatment with Atezo + Bev therapy were included in this study. Pretreatment tumor biopsy, pre- and posttreatment diffusion-weighted magnetic resonance imaging (MRI) with nine b values (0-1500 s/mm2 ), and other clinicopathologic factors were analyzed. RESULTS Compared with resectable HCC, advanced HCC was characterized by higher proliferative activity, a higher frequency of Wnt/β-catenin-activated HCC, and lower lymphocytic infiltration. Prognostically, two metabolism-related factors, histopathologically determined tumor steatosis and/or glutamine synthetase (GS) expression, and MRI-determined tumor steatosis, were the most significant prognostic indicators for progression-free survival (PFS) and overall survival after Atezo + Bev therapy. Furthermore, changes in the pre- and posttreatment true diffusion coefficients on MRI, which might reflect changes in TIME after treatment, were significantly associated with better PFS. CONCLUSIONS The biology and TIME of HCC were strikingly different in advanced HCC compared with those of surgically resected HCC. Two metabolism-related factors, pathologically determined tumor steatosis and/or GS expression, and MRI-determined tumor steatosis, were found to be the most significant prognostic indicators for Atezo + Bev therapy in advanced HCC.
Collapse
Affiliation(s)
- Yutaka Kurebayashi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Hanako Tsujikawa
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
- Department of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | | | - Yoichi Araki
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Takahashi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuya Kakegawa
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Takuya Wada
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Yusuke Tomita
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Masakazu Abe
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Yu Yoshimasu
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Hirohito Takeuchi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Taiki Hirata
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Kentaro Sakamaki
- Center for Data Science, Yokohama City University, Yokohama, Japan
| | - Kazuhiro Kakimi
- Department of Immuno-therapeutics, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomical Pathology, Tokyo Medical University, Tokyo, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
21
|
Shimoda H, Teshima M, Murase T, Nagao T, Kusafuka K, Nakaguro M, Urano M, Taguchi KI, Yamamoto H, Kano S, Tada Y, Tsukahara K, Okami K, Onitsuka T, Fujimoto Y, Kawakita D, Sakurai K, Hanai N, Nagao T, Kawata R, Hato N, Nibu KI, Inagaki H. Prognostic scores for patients with salivary adenoid cystic carcinoma without lymph node metastasis. Oral Oncol 2023; 145:106491. [PMID: 37487445 DOI: 10.1016/j.oraloncology.2023.106491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/16/2023] [Accepted: 07/02/2023] [Indexed: 07/26/2023]
Abstract
Adenoid cystic carcinoma (AdCC) of salivary gland grows relatively slowly, but occasionally develops distant metastasis. Although cervical lymph node metastasis (LNM) has been reported as a strong prognostic factor, most of AdCC do not have LNM. In this study, we investigated the prognostic factors to predict disease free survival (DFS), distant metastasis free survival (DMFS), and overall survival (OS) for 175 patients surgically treated for AdCC without LNM, and developed prognostic score (PS) determined as number of positive prognostic factors. The following emerged as significant prognostic factors: positive surgical margin in DFS, pT3/4 and positive surgical margin in DMFS, and positive surgical margin and high-histological grade in OS. 10-year DFS rates were 56.4% in PS0, and 19.1% in PS1 (p < 0.0001). 10-year DMFS rates were 86.3% in PS0, 56.4% in PS1, and 30.7% in PS2 (p < 0.0001). 10-year OS rates were 100% in PS0, 73.3% in PS1, and 38.8% in PS2 (p < 0.0001).
Collapse
Affiliation(s)
- Hikari Shimoda
- Department of Otolaryngology‑Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masanori Teshima
- Department of Otolaryngology‑Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Bantane Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Ken-Ichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate of School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Satoshi Kano
- Department of Otolaryngology‑Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology‑Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuro Onitsuka
- Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazuo Sakurai
- Department of Otorhinolaryngology, Fujita Health University, Okazaki Medical Center, Okazaki, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology‑Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Naohito Hato
- Department of Otolaryngology, Ehime University School of Medicine, Toon, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology‑Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| |
Collapse
|
22
|
Bishop JA, Weinreb I, van Vliet C, Leslie C, Utsumi Y, Aishima S, Shiraishi J, Koyama M, Nara Y, Kimura M, Palsgrove D, Kuo YJ, Gilbert R, Gagan J, Nakaguro M, Nagao T. Palisading Adenocarcinoma: A Morphologically Unique Salivary Gland Tumor With a Neuroendocrine-like Appearance and a Predilection for the Sublingual Glands of Women. Am J Surg Pathol 2023; 47:1176-1185. [PMID: 37382149 DOI: 10.1097/pas.0000000000002091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Adenocarcinoma, not otherwise specified (NOS) is a heterogenous group of salivary gland tumors that likely contains distinct tumors that have not yet been characterized. Indeed, in recent years, cases previously diagnosed as adenocarcinoma, NOS have been recategorized into novel tumor designations such as secretory carcinoma, microsecretory adenocarcinoma, and sclerosing microcystic adenocarcinoma. We sought to describe a distinctive, hitherto-undescribed salivary gland tumor encountered in the authors' practices. Cases were pulled from the surgical pathology archives of the authors' institutions. Histologic, immunohistochemical, and clinical findings were tabulated, and targeted next-generation sequencing was performed on all cases. Nine cases were identified, arising in 8 women and 1 man ranging from 45 to 74 years (mean, 56.7 y). Seven tumors (78%) arose in the sublingual gland, while 2 (22%) arose in the submandibular gland. The cases shared a distinctive morphologic appearance. They were biphasic, with ducts scattered among a predominant polygonal cell with round nuclei, prominent nucleoli, and pale eosinophilic cytoplasm. These cells were arranged as trabeculae and palisaded as pseudorosettes around hyalinized stroma and vessels, resembling a neuroendocrine tumor. Four of the cases were well-circumscribed, while the remaining 5 showed infiltrative growth including perineural invasion in 2 (22%) and lymphovascular invasion in 1 (11%). Mitotic rates were low (mean, 2.2/10 HPFs); necrosis was absent. By immunohistochemistry, the predominant cell type was strongly positive for CD56 (9 of 9) and variably positive for pan-cytokeratin (AE1/AE3) (7 of 9) with patchy S100 (4 of 9), but negative for synaptophysin (0 of 9) and chromogranin (0 of 9), while the ducts were strongly positive for pan-cytokeratin (AE1/AE3) (9 of 9) and CK5/6 (7 of 7). Next-generation sequencing did not reveal any fusions or obvious driver mutations. All cases were resected surgically, with external beam radiation also done in 1 case. Follow-up was available in 8 cases; there were no metastases or recurrences after 4 to 160 months (mean, 53.1 mo). A dual population of scattered ducts with a predominance of CD56-positive neuroendocrine-like cells characterizes a unique salivary gland tumor which is often encountered in the sublingual glands of women, for which we propose the term "palisading adenocarcinoma." Although the tumor was biphasic and had a neuroendocrine-like appearance, it lacked convincing immunohistochemical evidence of myoepithelial or neuroendocrine differentiation. Although a subset showed unequivocally invasive growth, this tumor appears to behave in an indolent manner. Moving forward, recognition of palisading adenocarcinoma and its separation from other salivary adenocarcinomas, NOS will facilitate a better understanding of the characteristics of this previously unrecognized tumor.
Collapse
Affiliation(s)
- Justin A Bishop
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX
| | | | | | - Connull Leslie
- PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia
| | | | - Shinichi Aishima
- Department of Pathology & Microbiology, Faculty of Medicine, Saga University, Saga
| | - Junichi Shiraishi
- Department of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo
| | - Masamichi Koyama
- Department of Diagnostic Pathology, Asama Nanroku Komoro Medical Center, Nagano
| | - Yoshiharu Nara
- Department of Pathology, Yokkaichi Municipal Hospital, Mie
| | - Masatomo Kimura
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama
| | - Doreen Palsgrove
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX
| | - Ying-Ju Kuo
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ralph Gilbert
- Head and Neck Surgery, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - Jeffrey Gagan
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | | |
Collapse
|
23
|
Hirai H, Nakaguro M, Tada Y, Saigusa N, Kawakita D, Honma Y, Kano S, Tsukahara K, Ozawa H, Okada T, Okami K, Yamazaki K, Sato Y, Urano M, Kajiwara M, Utsumi Y, Shimura T, Fushimi C, Shimizu A, Kondo T, Imanishi Y, Sakai A, Sato Y, Togashi T, Hanazawa T, Matsuki T, Yamazaki K, Nagao T. Prognostic value and clinicopathological roles of the tumor immune microenvironment in salivary duct carcinoma. Virchows Arch 2023; 483:367-379. [PMID: 37464232 DOI: 10.1007/s00428-023-03598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/21/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023]
Abstract
Salivary duct carcinoma (SDC) is an aggressive type of salivary gland carcinoma. Recently, immunotherapies targeting immune checkpoints, including PD1, PD-L1, CTLA4, and LAG3, have had a considerable prognostic impact on various malignant tumors. The implementation of such immune checkpoint inhibitor (ICI) therapies has also been attempted in cases of salivary gland carcinoma. The tumor immune microenvironment (TIME) is implicated in tumorigenesis and tumor progression and is closely associated with the response to ICI therapies. However, the TIME in SDC has not been fully explored. We examined the immunohistochemical expression of CD8, FOXP3, PD1, PD-L1, CTLA4, LAG3, and mismatch repair (MMR) proteins, tumor-infiltrating lymphocytes (TILs), and microsatellite instability (MSI) status in 175 cases of SDC. The associations between these TIME-related markers and the clinicopathological factors and prognosis were evaluated. An elevated expression of CD8, FOXP3, PD1, CTLA4, and LAG3 was associated with more aggressive histological features and an advanced N and/or M classification, elevated Ki-67 index, and poor prognosis. Furthermore, cases with a high PD-L1 expression exhibited more aggressive histological features and adverse clinical outcomes than those with a low expression. Alternatively, there was no significant correlation between TILs and clinicopathological factors. No SDC cases with an MSI-high status or MMR deficiency were found. The coexistence of both an immunostimulatory and immunosuppressive TIME in aggressive SDC might play a role in the presence of T-cell exhaustion. The contribution of multiple immune escape pathways, including regulatory T cells and immune checkpoints, may provide a rationale for ICI therapy, including combined PD1/CTLA4 blockade therapy.
Collapse
Affiliation(s)
- Hideaki Hirai
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Natsuki Saigusa
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
- Dental and Maxillofacial Radiology and Oral Pathology Diagnostic Services, The Nippon Dental University Hospital, Tokyo, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Kano
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takuro Okada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Kenji Okami
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Keisuke Yamazaki
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yukiko Sato
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Manami Kajiwara
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Yoshitaka Utsumi
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Tomotaka Shimura
- Department of Otolaryngology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Akira Shimizu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Yorihisa Imanishi
- Department of Otorhinolaryngology, Head and Neck Surgery, International University of Health and Welfare, Narita Hospital, Narita, Japan
| | - Akihiro Sakai
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Takafumi Togashi
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takashi Matsuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kazuto Yamazaki
- Department of Surgical Pathology, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
| |
Collapse
|
24
|
Kurata A, Harada Y, Fujita K, Ohno SI, Takanashi M, Yoshizawa S, Nagashima Y, Nagao T, Yamaguchi J, Kuroda M. Smooth muscle differentiation of coronary intima in autopsy tissues after sirolimus-eluting stent implantation. Cardiovasc Pathol 2023; 66:107554. [PMID: 37321466 DOI: 10.1016/j.carpath.2023.107554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/22/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND In coronary atherosclerotic disease, the proliferation of intimal smooth muscle cells (SMCs) is regarded as beneficial with respect to stable and unstable plaques, but is thought detrimental in discussions on coronary stent restenosis. To resolve this discrepancy, we focused on the quality, not quantity, of intimal SMCs in coronary atherosclerotic disease. METHODS Autopsied coronary artery specimens from seven patients implanted with bare metal stents (BMS), three with paclitaxel-eluting stents (PES), and 10 with sirolimus (rapamycin)-eluting stents (SES) were immunostained for SMC markers. Cultured human coronary artery SMCs were also treated with sirolimus and paclitaxel. RESULTS Intimal SMC differentiation, estimated by the ratio of h-caldesmon+ cells to α-smooth muscle actin+ (α-SMA+) cells, was significantly increased whereas dedifferentiation, estimated from the ratio of fibroblast activation protein alpha (FAPα)+ cells to α-SMA+ cells, was significantly decreased, in tissues of SES compared with BMS cases. No difference in the degree of differentiation was found between PES and BMS cases or between the three groups in nonstented arteries used as controls. Correlation analyses for each field of view revealed a significant positive correlation between h-caldesmon and calponin staining but significant negative correlations with FAPα staining in α-SMA+ cells. Cultured SMCs were shorter (dedifferentiated) and showed an increased FAPα/α-SMA protein when treated with paclitaxel, whereas they became elongated (differentiated) and showed increased calponin/α-SMA proteins with sirolimus. CONCLUSIONS The SMCs of the coronary intima may differentiate after SES implantation. SMC differentiation may explain both the plaque stabilization and reduced risk of reintervention associated with SES.
Collapse
Affiliation(s)
- Atsushi Kurata
- Department of Pathology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
| | - Yuichiro Harada
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Koji Fujita
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Shin-Ichiro Ohno
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Masakatsu Takanashi
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Saeko Yoshizawa
- Department of Surgical Pathology, Tokyo Women's Medical University Hospital, Shinjuku, Tokyo, Japan
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University Hospital, Shinjuku, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Junichi Yamaguchi
- Department of Cardiology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| |
Collapse
|
25
|
Goto M, Oriyama T, Kawahara K, Shibata A, Nagao T. Response to the Letter to the Editor re: "Intraosseous carcinoma of the anterior maxilla identified as the occult primary tumour of carcinoma of unknown primary". Int J Oral Maxillofac Surg 2023; 52:1016. [PMID: 36764866 DOI: 10.1016/j.ijom.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Affiliation(s)
- M Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan.
| | - T Oriyama
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan
| | - K Kawahara
- Department of Oral and Maxillofacial Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - A Shibata
- Department of Oral and Maxillofacial Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - T Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan
| |
Collapse
|
26
|
Ota E, Kudo Y, Maehara S, Furumoto H, Matsubayashi J, Shimada Y, Hagiwara M, Nagao T, Ohira T, Ikeda N. Correction: Ruptured mediastinal mature teratoma causing severe mediastinitis: report of a surgically resected case and a literature review. Surg Case Rep 2023; 9:130. [PMID: 37464108 DOI: 10.1186/s40792-023-01697-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Affiliation(s)
- Eri Ota
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Yujin Kudo
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
| | - Sachio Maehara
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Hideyuki Furumoto
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Yoshihisa Shimada
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| |
Collapse
|
27
|
Matsubara S, Saito A, Tokuyama N, Muraoka R, Hashimoto T, Satake N, Nagao T, Kuroda M, Ohno Y. Recurrence prediction in clear cell renal cell carcinoma using machine learning of quantitative nuclear features. Sci Rep 2023; 13:11035. [PMID: 37419897 PMCID: PMC10328910 DOI: 10.1038/s41598-023-38097-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 07/03/2023] [Indexed: 07/09/2023] Open
Abstract
The recurrence of non-metastatic renal cell carcinoma (RCC) may occur early or late after surgery. This study aimed to develop a recurrence prediction machine learning model based on quantitative nuclear morphologic features of clear cell RCC (ccRCC). We investigated 131 ccRCC patients who underwent nephrectomy (T1-3N0M0). Forty had recurrence within 5 years and 22 between 5 and 10 years; thirty-seven were recurrence-free during 5-10 years and 32 were for more than 10 years. We extracted nuclear features from regions of interest (ROIs) using a digital pathology technique and used them to train 5- and 10-year Support Vector Machine models for recurrence prediction. The models predicted recurrence at 5/10 years after surgery with accuracies of 86.4%/74.1% for each ROI and 100%/100% for each case, respectively. By combining the two models, the accuracy of the recurrence prediction within 5 years was 100%. However, recurrence between 5 and 10 years was correctly predicted for only 5 of the 12 test cases. The machine learning models showed good accuracy for recurrence prediction within 5 years after surgery and may be useful for the design of follow-up protocols and patient selection for adjuvant therapy.
Collapse
Affiliation(s)
- Shuya Matsubara
- Department of Urology, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Akira Saito
- Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
- Department of Molecular Pathology, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Naoto Tokuyama
- Department of Urology, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Ryu Muraoka
- Department of Urology, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Takeshi Hashimoto
- Department of Urology, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Naoya Satake
- Department of Urology, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-1-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Masahiko Kuroda
- Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan.
- Department of Molecular Pathology, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan.
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University Hospital, 6-7-1, Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
| |
Collapse
|
28
|
Sato A, Saito K, Abe K, Sugimoto K, Nagao T, Sukeda A, Yunaiyama D. Indium chloride bone marrow scintigraphy for hepatic myelolipoma: A case report. World J Clin Cases 2023; 11:4377-4383. [PMID: 37449238 PMCID: PMC10337005 DOI: 10.12998/wjcc.v11.i18.4377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/02/2023] [Accepted: 05/22/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND As hepatic myelolipoma is rarely encountered, its radiological diagnosis using ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) is challenging. Hepatic myelolipoma is similar to fat-contained hepatic lesions seen in hepatocellular carcinoma and angiomyolipoma. Therefore, further development of techniques to diagnose hepatic myelolipoma is warranted.
CASE SUMMARY A 44-year-old obese man was found to have a hepatic lesion during his medical checkup. The lesion was 50 mm × 57 mm in size and was detected in segment 8 (S8) of the liver by US. The patient was diagnosed with hepatic lesion 20 years ago, but it was left unresolved. The patient had no symptoms, liver dysfunction, hepatitis virus antibody, or tumor marker elevation. Plain CT showed a well-defined lesion in S8 of the liver. The central and peripheral areas of the lesion primarily exhibited fat density and hypodensity, respectively. MRI revealed a capsule-like structure. Biopsy was performed to address the probability of hepatocellular carcinoma. The lesion was pathologically confirmed as a myelolipoma. Bone marrow scintigraphy performed using 111InCl3 revealed accumulation of the radiopharmaceutical in the soft tissue component, except in the fat-dominant part of the tumor, as well as in the surrounding liver parenchyma due to the presence of reticuloendothelial cells in the liver.
CONCLUSION This is the first report on the diagnosis of hepatic myelolipoma using 111InCl3 scintigraphy. The effectiveness of bone marrow scintigraphy for diagnosing hepatic myelolipoma might be limited. As radiopharmaceuticals accumulate in both hematopoietic and reticuloendothelial cells, the accumulation of radiopharmaceuticals in the lesion is obscure.
Collapse
Affiliation(s)
- Akio Sato
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| | - Koichiro Abe
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| | - Aoi Sukeda
- Department of Anatomic Pathology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| | - Daisuke Yunaiyama
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Tokyo, Japan
| |
Collapse
|
29
|
Suda K, Sakai K, Ohira T, Chikugo T, Satou T, Matsubayashi J, Nagao T, Ikeda N, Tsutani Y, Mitsudomi T, Nishio K. Performance of Ultra-Rapid Idylla™ EGFR Mutation Test in Non-Small-Cell Lung Cancer and Its Potential at Clinical Molecular Screening. Cancers (Basel) 2023; 15:cancers15092648. [PMID: 37174112 PMCID: PMC10177517 DOI: 10.3390/cancers15092648] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The Idylla™ EGFR Mutation Test is an ultra-rapid single-gene test that detects epidermal growth factor receptor (EGFR) mutations using formalin-fixed paraffin-embedded specimens. Here, we compared the performance of the Idylla EGFR Mutation Test with the Cobas® EGFR Mutation Test v2. METHODS Surgically resected NSCLC specimens obtained at two Japanese institutions (N = 170) were examined. The Idylla EGFR Mutation Test and the Cobas EGFR Mutation Test v2 were performed independently and the results were compared. For discordant cases, the Ion AmpliSeq Colon and Lung Cancer Research Panel V2 was performed. RESULTS After the exclusion of five inadequate/invalid samples, 165 cases were evaluated. EGFR mutation analysis revealed 52 were positive and 107 were negative for EGFR mutation in both assays (overall concordance rate: 96.4%). Analyses of the six discordant cases revealed that the Idylla EGFR Mutation Test was correct in four and the Cobas EGFR Mutation Test v2 was correct in two. In a trial calculation, the combination of the Idylla EGFR Mutation Test followed by a multi-gene panel test will reduce molecular screening expenses if applied to a cohort with EGFR mutation frequency >17.9%. CONCLUSIONS We demonstrated the accuracy and potential clinical utility of the Idylla EGFR Mutation Test as a molecular screening platform in terms of turnaround time and molecular testing cost if applied to a cohort with a high EGFR mutation incidence (>17.9%).
Collapse
Affiliation(s)
- Kenichi Suda
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan
| | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Takaaki Chikugo
- Department of Diagnostic Pathology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Takao Satou
- Department of Diagnostic Pathology, Kindai University Hospital, Osakasayama 589-8511, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Yasuhiro Tsutani
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osakasayama 589-8511, Japan
| |
Collapse
|
30
|
Yorita K, Fujii T, Nagao T, Murakami I, Hashida Y, Higuchi T, Daibata M, Toi M, Ayada Y, Igawa T. Kimura disease forming a human polyomavirus 6–negative parotid gland nodule with prominent squamous metaplasia in a young female: A case report. Radiol Case Rep 2023; 18:1933-1938. [PMID: 36970233 PMCID: PMC10030818 DOI: 10.1016/j.radcr.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 03/18/2023] Open
Abstract
A case of an asymptomatic 19-year-old woman with Kimura disease presenting with a nodule in the right parotid gland is presented. She had a medical history of atopic dermatitis and noticed a mass on her right-side neck. Cervical lymphadenopathy was clinically diagnosed. The initial management plan was to observe the lesion, which had enlarged from 1 cm to 2 cm in diameter 6 months later. An excisional biopsy was performed, and the pathology confirmed an eosinophil-containing inflammatory parotid gland lesion with many squamous nests and cysts, mimicking a parotid gland tumor. High serum immunoglobulin E levels, peripheral blood eosinophilia, and pathological and genetic diagnoses confirmed Kimura disease. The lesion tested negative for human polyomavirus 6. No recurrence was observed 15 months after the biopsy. The prognosis of Kimura disease without human polyomavirus 6 infection may be favorable; however, further validation of this hypothesis is required as only 5 or 6 cases of Kimura disease have been evaluated for this viral infection. Proliferative squamous metaplasia occurring in parotid gland lesions of Kimura disease is rare and may complicate the diagnostic imaging and pathological diagnosis.
Collapse
Affiliation(s)
- Kenji Yorita
- Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, 1-4-63-11, Hadaminami-machi, Kochi-shi, Kochi, 780-8562, Japan
- Department of Diagnostic Pathology, Kochi University Hospital, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
- Corresponding author.
| | - Tatsuya Fujii
- Department of Otorhinolaryngology, JA Kochi Hospital, 526-1, Nakano, Aza, Myouken, Nankoku-shi, Kochi, 783-8509, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Ichiro Murakami
- Department of Diagnostic Pathology, Kochi University Hospital, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
- Department of Pathology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Yumiko Hashida
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Tomonori Higuchi
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Masanori Daibata
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Makoto Toi
- Department of Diagnostic Pathology, Kochi University Hospital, Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Yoshiyuki Ayada
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takuro Igawa
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| |
Collapse
|
31
|
Samejima J, Okami J, Tanaka Y, Kobayashi S, Kimura T, Mukai M, Nagao T, Matsuoka H, Tsuboi M. 159P Optimization and validation of a circulating microRNA biomarker panel for early detection of lung cancer in a Japanese population. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
|
32
|
Takano Y, Mazaki J, Tasaki K, Udo R, Tago T, Okazaki N, Kasahara K, Kuwabara H, Enomoto M, Isizaki T, Matsubayashi J, Nagao T, Nagakawa Y, Katsumata K, Tsuchida A. A case of premortem diagnosis of cardiac tamponade due to pericardial metastasis of rectal cancer. Oxf Med Case Reports 2023; 2023:omad039. [PMID: 37091690 PMCID: PMC10120427 DOI: 10.1093/omcr/omad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/11/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Colorectal cancer rarely develops pericardial metastasis, and it is an extremely rare case that cardiac tamponade due to the metastasis of colorectal cancer during life. Our case is of a 50-year-old woman who underwent laparoscopic lower anterior resection for the rectal cancer with lung metastasis 4 years ago developed cardiac tamponade due to pericardial metastasis of rectal cancer. We performed pericardiocentesis as a temporary life-saving procedure, but pericardial fluid re-accumulated within a few days. She died 23 days after admission. When a patient with advanced colorectal cancer complains dyspnea, we should consider the pericardial metastasis, and perform the proper treatment as this case.
Collapse
Affiliation(s)
- Yuki Takano
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Junichi Mazaki
- Correspondence address. Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku, Tokyo 1600023, Japan. Tel/Fax: +81-3-3342-6111; E-mail:
| | - Koichiro Tasaki
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Ryutaro Udo
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Tomoya Tago
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Naoto Okazaki
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Kenta Kasahara
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Hiroshi Kuwabara
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Masanobu Enomoto
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Tetsuo Isizaki
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Kenji Katsumata
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Shinjuku, Tokyo 1600023, Japan
| |
Collapse
|
33
|
Shen B, Saito A, Ueda A, Fujita K, Nagamatsu Y, Hashimoto M, Kobayashi M, Mirza AH, Graf HP, Cosatto E, Hazama S, Nagano H, Sato E, Matsubayashi J, Nagao T, Cheng E, Hoda SA, Ishikawa T, Kuroda M. Development of multiple AI pipelines that predict neoadjuvant chemotherapy response of breast cancer using H&E-stained tissues. J Pathol Clin Res 2023; 9:182-194. [PMID: 36896856 PMCID: PMC10073928 DOI: 10.1002/cjp2.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/23/2023] [Accepted: 02/10/2023] [Indexed: 03/11/2023]
Abstract
In recent years, the treatment of breast cancer has advanced dramatically and neoadjuvant chemotherapy (NAC) has become a common treatment method, especially for locally advanced breast cancer. However, other than the subtype of breast cancer, no clear factor indicating sensitivity to NAC has been identified. In this study, we attempted to use artificial intelligence (AI) to predict the effect of preoperative chemotherapy from hematoxylin and eosin images of pathological tissue obtained from needle biopsies prior to chemotherapy. Application of AI to pathological images typically uses a single machine-learning model such as support vector machines (SVMs) or deep convolutional neural networks (CNNs). However, cancer tissues are extremely diverse and learning with a realistic number of cases limits the prediction accuracy of a single model. In this study, we propose a novel pipeline system that uses three independent models each focusing on different characteristics of cancer atypia. Our system uses a CNN model to learn structural atypia from image patches and SVM and random forest models to learn nuclear atypia from fine-grained nuclear features extracted by image analysis methods. It was able to predict the NAC response with 95.15% accuracy on a test set of 103 unseen cases. We believe that this AI pipeline system will contribute to the adoption of personalized medicine in NAC therapy for breast cancer.
Collapse
Affiliation(s)
- Bin Shen
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Akira Saito
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Ai Ueda
- Department of Breast Oncology and Surgery, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Koji Fujita
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yui Nagamatsu
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Mikihiro Hashimoto
- Research and Development Division, Chi Corporation, Shinjuku-ku, Tokyo, Japan
| | - Masaharu Kobayashi
- Research and Development Division, Chi Corporation, Shinjuku-ku, Tokyo, Japan
| | - Aashiq H Mirza
- Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA
| | - Hans Peter Graf
- Department of Machine Learning, NEC Labs America Inc., Princeton, NJ, USA
| | - Eric Cosatto
- Department of Machine Learning, NEC Labs America Inc., Princeton, NJ, USA
| | - Shoichi Hazama
- Department of Translational Research and Development Therapeutics against Cancer, School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan
| | - Eiichi Sato
- Department of Pathology, Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Esther Cheng
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Syed Af Hoda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
34
|
Takeuchi H, Sugimoto K, Kakegawa T, Tomita Y, Takahashi H, Wada T, Abe M, Yoshimasu Y, Matsubayashi J, Nagao T, Itoi T. The usefulness of a newly developed full-core biopsy needle in liver biopsy. Hepatol Res 2023; 53:247-257. [PMID: 36355636 DOI: 10.1111/hepr.13856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/06/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022]
Abstract
AIM To evaluate the usefulness and safety of a newly developed full-core biopsy needle. METHODS We selected 149 patients who underwent percutaneous liver biopsy at our institution from February 2019 to April 2021. We excluded 35 patients with hepatic fibrosis stage F3 or higher, which made it histopathologically difficult to measure the number of complete portal triads. The patients were divided into two groups as follows: 62 cases with the 18-G conventional automated needle (TruCore needle: T needle), and 52 cases with the 18-G full-core needle (CorVocet needle: C needle). We measured the number of complete portal triads in the liver tissue specimens, and the sum of the length and width of the collected tissues. Moreover, we compared the number of session counts, fragmentations, and complications. RESULTS The sum of the length and the width was 12.8 mm (11.2-14.3) and 15.9 mm (13.1-17.3; p < 0.001), and 0.68 mm (0.63-0.74) and 0.82 mm (0.78-0.90; p < 0.001) for the T needle and C needle, respectively. The number of complete portal triads and fragmentation was six (3-8) and 10 (6-13; p < 0.001), and one (1-10) and one (1-3; p < 0.001), for the T needle and C needle, respectively. There was one session count (1-2) in both groups; however, there were significantly higher cases of two sessions with the T needle than that with the C needle (p = 0.018). There were no serious adverse events. CONCLUSIONS Compared with the conventional needles, the newly developed full-core needles enabled the acquisition of a larger amount of tissue sample in liver biopsy.
Collapse
Affiliation(s)
- Hirohito Takeuchi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Katsutoshi Sugimoto
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuya Kakegawa
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Yusuke Tomita
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Takahashi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Takuya Wada
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Masakazu Abe
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Yu Yoshimasu
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | | | - Toshitaka Nagao
- Department of Pathology, Tokyo Medical University, Tokyo, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
35
|
Sujino H, Kasahara K, Tanigawa M, Enomoto M, Udo R, Tago T, Okazaki N, Mazaki J, Ishizaki T, Nagao T, Katsumata K, Tsuchida A, Nagakawa Y. Retroperitoneal hibernoma resected via laparoscopic surgery. Asian J Endosc Surg 2023. [PMID: 36592950 DOI: 10.1111/ases.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023]
Abstract
Hibernomas are extremely rare, benign tumors of brown fat origin with no specific symptoms. Surgery is the only treatment option, and because a definitive preoperative diagnosis is often not obtained, open surgery is usually chosen. In this case, we performed laparoscopic surgery on a 33-year-old woman with retroperitoneal hibernoma. As in most cases, a definitive diagnosis had not been preoperatively made; therefore, we laparoscopically removed the retroperitoneal tumor of unknown pathology as a diagnostic treatment. We chose laparoscopic surgery because of the magnifying effect of the laparoscope and to minimize scarring. The surgery was uneventful, with a procedure time of 280 minutes and a blood loss of 20 mL. The postoperative course was uneventful with no complications or recurrence. We conclude that laparoscopic surgery may be a viable option for hibernomas.
Collapse
Affiliation(s)
- Hiroki Sujino
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenta Kasahara
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Maki Tanigawa
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Masanobu Enomoto
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Ryutaro Udo
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Tomoya Tago
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Naoto Okazaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Junichi Mazaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Tetsuo Ishizaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Kenji Katsumata
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yuichi Nagakawa
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
36
|
Hongo H, Miyawaki S, Teranishi Y, Mitsui J, Katoh H, Komura D, Tsubota K, Matsukawa T, Watanabe M, Kurita M, Yoshimura J, Dofuku S, Ohara K, Ishigami D, Okano A, Kato M, Hakuno F, Takahashi A, Kunita A, Ishiura H, Shin M, Nakatomi H, Nagao T, Goto H, Takahashi SI, Ushiku T, Ishikawa S, Okazaki M, Morishita S, Tsuji S, Saito N. Somatic GJA4 gain-of-function mutation in orbital cavernous venous malformations. Angiogenesis 2023; 26:37-52. [PMID: 35902510 PMCID: PMC9908695 DOI: 10.1007/s10456-022-09846-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/23/2022] [Indexed: 12/25/2022]
Abstract
Orbital cavernous venous malformation (OCVM) is a sporadic vascular anomaly of uncertain etiology characterized by abnormally dilated vascular channels. Here, we identify a somatic missense mutation, c.121G > T (p.Gly41Cys) in GJA4, which encodes a transmembrane protein that is a component of gap junctions and hemichannels in the vascular system, in OCVM tissues from 25/26 (96.2%) individuals with OCVM. GJA4 expression was detected in OCVM tissue including endothelial cells and the stroma, through immunohistochemistry. Within OCVM tissue, the mutation allele frequency was higher in endothelial cell-enriched fractions obtained using magnetic-activated cell sorting. Whole-cell voltage clamp analysis in Xenopus oocytes revealed that GJA4 c.121G > T (p.Gly41Cys) is a gain-of-function mutation that leads to the formation of a hyperactive hemichannel. Overexpression of the mutant protein in human umbilical vein endothelial cells led to a loss of cellular integrity, which was rescued by carbenoxolone, a non-specific gap junction/hemichannel inhibitor. Our data suggest that GJA4 c.121G > T (p.Gly41Cys) is a potential driver gene mutation for OCVM. We propose that hyperactive hemichannel plays a role in the development of this vascular phenotype.
Collapse
Affiliation(s)
- Hiroki Hongo
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Yu Teranishi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jun Mitsui
- Department of Molecular Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroto Katoh
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Komura
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kinya Tsubota
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Takashi Matsukawa
- Department of Molecular Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masakatsu Watanabe
- Laboratory of Pattern Formation, Graduate School of Frontier Biosciences, Osaka University, Suita, Osaka, Japan
| | - Masakazu Kurita
- Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Jun Yoshimura
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Shogo Dofuku
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kenta Ohara
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daiichiro Ishigami
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Atsushi Okano
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Motoi Kato
- Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Fumihiko Hakuno
- Department of Animal Resource Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Ayaka Takahashi
- Department of Animal Resource Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Akiko Kunita
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Ishiura
- Department of Neurology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Shin
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hirofumi Nakatomi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Shin-Ichiro Takahashi
- Department of Animal Resource Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shumpei Ishikawa
- Department of Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mutsumi Okazaki
- Department of Plastic, Reconstructive and Aesthetic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Shinichi Morishita
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Chiba, Japan
| | - Shoji Tsuji
- Department of Molecular Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute of Medical Genomics, International University of Health and Welfare, Narita, Chiba, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| |
Collapse
|
37
|
Komatsu H, Usui Y, Sukeda A, Yamamoto Y, Ohno SI, Goto K, Kuroda M, Nagao T, Goto H. Prevalence of Merkel Cell Polyomavirus in Primary Eyelid Merkel Cell Carcinomas and Association With Clinicopathological Features. Am J Ophthalmol 2022; 249:49-56. [PMID: 36493850 DOI: 10.1016/j.ajo.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 11/10/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Merkel cell polyomavirus (MCPyV) infection is a known to be a critical risk factor for the development of Merkel cell carcinoma (MCC). Various reports on cutaneous MCC have shown that the differences in clinicohistopathological characteristics depend on the presence of MCPyV, but the situation in eyelid MCC is unknown. This study aimed to assess the prevalence of MCPyV in patients with eyelid MCC and examine the clinicohistopathological characteristics of MCPyV-associated eyelid MCC. DESIGN Retrospective observational case series with laboratory investigations. METHODS Ten patients treated for eyelid MCC were included. Histopathological characteristics were examined by immunohistochemical staining using 12 antibodies. MCPyV infection was evaluated by PCR using primer sets targeting large T antigens of the MCPyV genome and by immunohistochemical staining using CM2B4 and Ab3 monoclonal antibodies. The MCPyV viral load was also quantified by PCR using 3 primer sets. RESULTS All patients (4 males and 6 females) were Japanese with mean age of 79 (range: 63 to 87) years. One patient died due to distant metastasis 8 months after surgery for MCC. Immunohistochemical studies showed typical MCC findings in all cases, including CK20 and neuroendocrine marker positivity. PCR and immunohistochemistry with CM2B4 and Ab3 detected MCPyV antigen in all tumors. Quantitative PCR using sT, LT4, and TAg primers yielded 0.94, 1.72, and 1.05 copies per cell, respectively. CONCLUSION Clinical and histopathological characteristics of 10 patients with eyelid MCC were elucidated. MCPyV infection was detected in all eyelids. These results provide insight for understanding the tumorigenesis of eyelid MCC.
Collapse
Affiliation(s)
- Hiroyuki Komatsu
- From the Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan (H.K., Y.U., H.G.)
| | - Yoshihiko Usui
- From the Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan (H.K., Y.U., H.G.).
| | - Aoi Sukeda
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan (A.S., Y.Y., K.G., T.N.)
| | - Yoshinari Yamamoto
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan (A.S., Y.Y., K.G., T.N.)
| | - Shin-Ichiro Ohno
- Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan (S I. O., M.K.)
| | - Keisuke Goto
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan (A.S., Y.Y., K.G., T.N.)
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan (S I. O., M.K.)
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan (A.S., Y.Y., K.G., T.N.)
| | - Hiroshi Goto
- From the Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan (H.K., Y.U., H.G.)
| |
Collapse
|
38
|
Oriyama T, Goto M, Kawahara K, Shibata A, Nagao T. Intraosseous carcinoma of the anterior maxilla identified as the occult primary tumour of carcinoma of unknown primary. Int J Oral Maxillofac Surg 2022; 51:1510-1515. [PMID: 35346543 DOI: 10.1016/j.ijom.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
Carcinoma of unknown primary (CUP) is defined as lymph node metastasis without a detectable origin until after the initial treatment has been performed. The most common occult primary site in the head and neck, as revealed by a review of the published literature, is the oropharynx. An occult primary site in the oral region is extremely rare. We report a rare case of head and neck CUP (HNCUP) in a 69-year-old female patient, wherein the occult primary lesion was a primary intraosseous carcinoma (PIOC) invading the anterior maxilla. During the course of the initial diagnostic workup, no primary lesion could be identified; however, cervical lymph node metastasis to left levels IB and IIA were observed in the patient. A neck dissection followed by adjuvant radiotherapy was performed. However, the PIOC of the anterior maxilla was identified 6 months after neck treatment and was confirmed as the occult primary tumour of the HNCUP. This case is quite rare and required a comprehensive workup to guide optimal treatment. Careful follow-up or active biopsy should be considered if osteolytic changes are observed in the jaw.
Collapse
Affiliation(s)
- T Oriyama
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan
| | - M Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan.
| | - K Kawahara
- Department of Oral and Maxillofacial Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - A Shibata
- Department of Oral and Maxillofacial Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan
| | - T Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Chikusa-ku, Nagoya, Japan
| |
Collapse
|
39
|
Matsuyama H, Ueki Y, Okamoto I, Nagao T, Honda K, Yamazaki K, Okabe R, Togashi T, Shodo R, Ota H, Takahashi T, Omata J, Yokoyama Y, Saijo K, Tanaka R, Tsukahara K, Kitahara T, Uemura H, Yoshimoto S, Matsumoto F, Okami K, Sakai A, Takano K, Kondo A, Inohara H, Eguchi H, Oridate N, Tanabe T, Nakamizo M, Yokoshima K, Miura K, Kitani Y, Horii A. Head and neck small-cell carcinoma: A multicenter study of 39 cases from 10 institutions. Front Surg 2022; 9:1049116. [DOI: 10.3389/fsurg.2022.1049116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/05/2022] [Indexed: 11/15/2022] Open
Abstract
ObjectiveBasal information of head and neck small-cell carcinoma (HNSmCC) including epidemiology, primary site, treatment, and prognosis remains sparse due to its rarity. We report here a multicenter retrospective study on the diagnosis, treatment, and outcomes of patients with HNSmCC.Materials and methodsThis study involved 47 patients with HNSmCC from 10 participating institutions. Eight patients were excluded for whom no pathological specimens were available (n = 2) and for discrepant central pathological judgements (n = 6). The remaining 39 patients were processed for data analysis.ResultsAs pretreatment examinations, computed tomography (CT) was performed for the brain (n = 8), neck (n = 39), and chest (n = 32), magnetic resonance imaging (MRI) for the brain (n = 4) and neck (n = 23), positron emission tomography-CT (PET-CT) in 23 patients, bone scintigraphy in 4, neck ultrasonography in 9, and tumor markers in 25. Primary sites were oral cavity (n = 1), nasal cavity/paranasal sinuses (n = 16), nasopharynx (n = 2), oropharynx (n = 4), hypopharynx (n = 2), larynx (n = 6), salivary gland (n = 3), thyroid (n = 2), and others (n = 3). Stages were II/III/IV-A/IV-B/IV-C/Not determined = 3/5/16/6/5/4; stage IV comprised 69%. No patient had brain metastases. First-line treatments were divided into 3 groups: the chemoradiotherapy (CRT) group (n = 27), non-CRT group (n = 8), and best supportive care group (n = 4). The CRT group included concurrent CRT (CCRT) (n = 17), chemotherapy (Chemo) followed by radiotherapy (RT) (n = 5), and surgery (Surg) followed by CCRT (n = 5). The non-CRT group included Surg followed by RT (n = 2), Surg followed by Chemo (n = 1), RT alone (n = 2), and Chemo alone (n = 3). The 1-year/2-year overall survival (OS) of all 39 patients was 65.3/53.3%. The 1-year OS of the CRT group (77.6%) was significantly better compared with the non-CRT group (31.3%). There were no significant differences in adverse events between the CCRT group (n = 22) and the Chemo without concurrent RT group (n = 9).ConclusionNeck and chest CT, neck MRI, and PET-CT would be necessary and sufficient examinations in the diagnostic set up for HNSmCC. CCRT may be recommended as the first-line treatment. The 1-year/2-year OS was 65.3%/53.3%. This study would provide basal data for a proposing the diagnostic and treatment algorithms for HNSmCC.
Collapse
|
40
|
Yamana K, Kawahara K, Kawakami F, Honda Y, Ishikawa K, Shinohara K, Sakata J, Hirosue A, Yoshida R, Kimoto N, Nagao T, Mikami Y, Nakayama H. Hyalinizing clear cell carcinoma with EWSR1 rearrangement in an 11-year-old girl. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2022. [DOI: 10.1016/j.ajoms.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
41
|
Kawakita D, Nagao T, Takahashi H, Kano S, Honma Y, Hirai H, Saigusa N, Akazawa K, Tani K, Ojiri H, Tsukahara K, Ozawa H, Okami K, Kondo T, Togashi T, Fushimi C, Shimura T, Shimizu A, Okamoto I, Okada T, Imanishi Y, Watanabe Y, Otsuka K, Sakai A, Ebisumoto K, Sato Y, Yamazaki K, Ueki Y, Hanazawa T, Saito Y, Ando M, Matsuki T, Nakaguro M, Sato Y, Urano M, Utsumi Y, Kohsaka S, Saotome T, Tada Y. Survival benefit of HER2-targeted or androgen deprivation therapy in salivary duct carcinoma. Ther Adv Med Oncol 2022; 14:17588359221119538. [PMID: 36090801 PMCID: PMC9459484 DOI: 10.1177/17588359221119538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022] Open
Abstract
Background The efficacy and safety of human epidermal growth factor receptor 2 (HER2)-targeted therapy and androgen deprivation therapy (ADT) for locally advanced or recurrent or metastatic (LA/RM) salivary duct carcinoma (SDC) have been reported in prospective studies. However, the survival benefit of these therapies to conventional therapy remains controversial, and whether HER2-targeted therapy or ADT should be chosen in HER2- and androgen receptor (AR)-positive SDC patients remains unknown. Methods Overall, 323 LA/RM SDC patients treated at seven institutions between August 1992 and June 2020 were retrospectively enrolled. The primary aim was to analyze the effect of HER2-targeted therapy and ADT on overall survival from the diagnosis of LA/RM disease to death from any cause (OS1). The secondary indicators included the overall response rate (ORR), clinical benefit rate (CBR), overall survival from therapy initiation for LA/RM disease (OS2), progression-free survival (PFS), time to second progression (PFS2), duration of response (DoR), and duration of clinical benefit (DoCB) of HER2-targeted therapy or ADT as first-line therapy for HER2-positive/AR-positive SDC. Results Patients treated with HER2-targeted therapy or ADT had longer OS1 than those treated without these therapies (Median OS1: historical control, 21.6 months; HER2-targeted therapy, 50.6 months; ADT, 32.8 months; HER2-targeted therapy followed by ADT, 42.4 months; and ADT followed by HER2-targeted therapy, 45.2 months, p < 0.001). Among HER2-positive/AR-positive SDC patients, although HER2-targeted therapy had better ORR, CBR, and PFS than those of ADT as first-line therapy, we found no significant differences between HER2-targeted therapy and ADT regarding OS2, PFS2, DoR, and DoCB. Conclusion Patients treated with HER2-targeted therapy and ADT showed longer survival in LA/RM SDC. HER2-targeted therapy can be recommended prior to ADT for HER2-positive/AR-positive SDC. It is warranted to establish a biomarker that could predict the efficacy of clinical benefit or better response in ADT.
Collapse
Affiliation(s)
- Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Satoshi Kano
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hideaki Hirai
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Natsuki Saigusa
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kohei Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Kaori Tani
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Chuo-ku, Niigata, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Takafumi Togashi
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Minato-ku, Tokyo, Japan
| | - Tomotaka Shimura
- Department of Otolaryngology, Showa University Fujigaoka Hospital, Aoba-ku, Yokohama, Japan
| | - Akira Shimizu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Isaku Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Takuro Okada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yorihisa Imanishi
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshihiro Watanabe
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kuninori Otsuka
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Akihiro Sakai
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Koji Ebisumoto
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Tokai University, Isehara, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Yushi Ueki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan
| | - Toyoyuki Hanazawa
- Department of Otorhinolaryngology/Head & Neck Surgery, Chiba University Graduate School of Medicine, Chuo-ku, Chiba, Japan
| | - Yuki Saito
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Mizuo Ando
- Department of Otorhinolaryngology/Head & Neck Surgery, Okayama University Graduate School of Medicine, Kita-ku, Okayama, Japan
| | - Takashi Matsuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Minami-ku, Sagamihara, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yukiko Sato
- Division of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Bantane Hospital, Fujita Health University, School of Medicine, Nakagawa-ku, Nagoya, Japan
| | - Yoshitaka Utsumi
- Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Shinji Kohsaka
- Division of Cellular Signaling, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Takashi Saotome
- Division of Medical Oncology, Matsudo City Hospital, Matsudo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan
| |
Collapse
|
42
|
Kasahara K, Katsumata K, Saito A, Ishizaki T, Enomoto M, Mazaki J, Tago T, Nagakawa Y, Matsubayashi J, Nagao T, Hirano H, Kuroda M, Tsuchida A. Artificial intelligence predicts lymph node metastasis or risk of lymph node metastasis in T1 colorectal cancer. Int J Clin Oncol 2022; 27:1570-1579. [PMID: 35908272 DOI: 10.1007/s10147-022-02209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 06/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The treatment strategies for colorectal cancer (CRC) must ensure a radical cure of cancer and prevent over/under treatment. Biopsy specimens used for the definitive diagnosis of T1 CRC were analyzed using artificial intelligence (AI) to construct a risk index for lymph node metastasis. METHODS A total of 146 T1 CRC cases were analyzed. The specimens for analysis were mainly biopsy specimens, and in the absence of biopsy specimens, the mucosal layer of the surgical specimens was analyzed. The pathology slides for each case were digitally imaged, and the morphological features of cancer cell nuclei were extracted from the tissue images. First, statistical methods were used to analyze how well these features could predict lymph node metastasis risk. A lymph node metastasis risk model using AI was created based on these morphological features, and accuracy in test cases was verified. RESULTS Each developed model could predict lymph node metastasis risk with a > 90% accuracy in each region of interest of the training cases. Lymph node metastasis risk was predicted with 81.8-86.3% accuracy for randomly validated cases, using a learning model with biopsy data. Moreover, no case with lymph node metastasis or lymph node risk was judged to have no risk using the same model. CONCLUSIONS AI models suggest an association between biopsy specimens and lymph node metastases in T1 CRC and may contribute to increased accuracy of preoperative diagnosis.
Collapse
Affiliation(s)
- Kenta Kasahara
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Kenji Katsumata
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Akira Saito
- Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tetsuo Ishizaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masanobu Enomoto
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Junichi Mazaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tomoya Tago
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yuichi Nagakawa
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroshi Hirano
- Diagnostic Pathology Division, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, 193-0998, Tokyo, Japan
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Akihiko Tsuchida
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| |
Collapse
|
43
|
Fukumura M, Ishibashi K, Nakaguro M, Nagao T, Saida K, Urano M, Tanigawa M, Hirai H, Yagyuu T, Kikuchi K, Yada N, Sugita Y, Miyabe M, Hasegawa S, Goto M, Yamamoto H, Ohuchi T, Kusafuka K, Ogawa I, Suzuki H, Notohara K, Shimoda M, Tada Y, Kirita T, Takata T, Morinaga S, Maeda H, Warnakulasuriya S, Miyabe S, Nagao T. Salivary Gland Polymorphous Adenocarcinoma: Clinicopathological Features and Gene Alterations in 36 Japanese Patients. J Oral Pathol Med 2022; 51:710-720. [PMID: 35880805 DOI: 10.1111/jop.13336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Polymorphous adenocarcinoma (PAC) is a common intraoral minor salivary gland carcinoma in Western countries but is extremely rare in Japan. The current study aimed to characterize the clinicopathological features and status of molecular alterations of PAC-associated genes, such as (e.g., PRKD1/2/3, ARID1A, and DDX3X) in a large cohort of Japanese patients with PAC. MATERIALS AND METHODS We examined the cases of 36 Japanese patients with salivary gland PAC and 26 cases involving histopathological mimics. To detect gene splits, fluorescence in situ hybridization was carried out for PAC-associated genes. Additionally, we applied a SNaPshot multiplex assay to identify PRKD1 hotspot mutations. RESULTS This study revealed the indolent clinical course of PAC with a high 10-year overall survival rate (92.9%), accompanied by occasional local recurrences and cervical lymph node metastasis (both 23.3%). Twenty cases (55.6%) of PAC (but none of the mimics) exhibited alterations in at least one PAC-associated gene. Rearrangement of PAC-associated genes and PRKD1 E710D were identified in 17 (47.2%) and 4 (11.1%) cases, respectively; one case showed coexisting PRKD3 split and PRKD1 E710D. In the multivariate analysis, high clinical stage (P=0.0005), the presence of prominent nucleoli (P=0.0003), and ARID1A split positivity (P=0.004) were independent risk factors for disease-free survival. CONCLUSION Japanese patients with PAC showed clinicopathological features similar to those reported in Western countries. This study disclosed that PAC-associated genetic alterations were common and specific findings in PACs. The diagnostic role and possible prognostic significance of PAC-associated genetic alterations in PACs were suggested.
Collapse
Affiliation(s)
- Masahiro Fukumura
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Kenichiro Ishibashi
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Kosuke Saida
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.,Department of Oral and Maxillofacial Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Bantane Hospital, Fujita Health University School of Medicine, Nagoya, Japan
| | - Maki Tanigawa
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Hideaki Hirai
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Takahiro Yagyuu
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara, Japan
| | - Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University, School of Dentistry, Saitama, Japan
| | - Naomi Yada
- Division of Oral Pathology, Kyushu Dental University, Fukuoka, Japan
| | - Yoshihiko Sugita
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Megumi Miyabe
- Department of Internal Medicine, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Shogo Hasegawa
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Mitsuo Goto
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohuchi
- Department of Diagnostic Pathology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | | | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroaki Suzuki
- Division of Diagnostic Pathology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan
| | - Kenji Notohara
- Department of Anatomic Pathology, Kurashiki Central Hospital, Okayama, Japan
| | - Masayuki Shimoda
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara, Japan
| | | | - Shojiroh Morinaga
- Department of Diagnostic Pathology, Hino Municipal Hospital, Hino, Japan
| | - Hatsuhiko Maeda
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London and The WHO Collaborating Centre for Oral Cancer, London, UK
| | - Satoru Miyabe
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Toru Nagao
- Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| |
Collapse
|
44
|
Nakaguro M, Sadow PM, Hu R, Hattori H, Kuwabara K, Tsuzuki T, Urano M, Nagao T, Faquin WC. NKX3.1 Expression in Salivary Gland "Intraductal" Papillary Mucinous Neoplasm: A Low-Grade Subtype of Salivary Gland Mucinous Adenocarcinoma. Head Neck Pathol 2022; 16:1114-1123. [PMID: 35834096 PMCID: PMC9729659 DOI: 10.1007/s12105-022-01471-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/20/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Salivary gland intraductal papillary mucinous neoplasm (SG IPMN) is a recently proposed entity characterized by a papillary-cystic proliferation of mucin-producing cells. Because of overlapping histologic features and a clonal AKT1 p.E17K variant, SG IPMN has been presumed to be a precursor or a low-grade subtype of mucinous adenocarcinoma. NKX3.1 is a tumor suppressor gene located on chromosome 8p and is a known immunohistochemical marker of prostate epithelium and mucinous acinar cells of the intraoral salivary glands. METHODS We retrieved 12 SG IPMN cases, and performed histologic and genetic analysis. Given the association of SG IPMN with mucinous acinar cells, we also investigated the performance of NKX3.1 as a marker of this tumor entity. RESULTS Diffuse and strong NKX3.1 expression was observed in all SG IPMN cases (12/12, 100%) as well as in normal mucinous acinar cells. In contrast, mucoepidermoid carcinoma and pancreatic IPMN cases as well as normal serous acinar cells were negative for NKX3.1. Genetically, 11 of 12 cases (92%) harbored an AKT1 p.E17K variant. A novel PTEN frameshift deletion (p.G36Dfs*18) was detected in the other single case. At least one of the histologic features implying malignant tumors, such as severe cellular atypia, brisk mitotic activity, high Ki-67 proliferating index, lymphovascular invasion, and lymph node metastasis, was detected in 6 SG IPMN cases (50%). CONCLUSION The findings suggest that SG IPMN is a low-grade subtype of mucinous adenocarcinoma which may be derived from mucinous acinar cells of the minor salivary gland.
Collapse
Affiliation(s)
- Masato Nakaguro
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, MA USA ,grid.437848.40000 0004 0569 8970Department of Pathology and Laboratory Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560 Japan
| | - Peter M. Sadow
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, MA USA
| | - Rong Hu
- grid.14003.360000 0001 2167 3675Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Hikaru Hattori
- grid.437848.40000 0004 0569 8970Department of Medical Genomics Center, Nagoya University Hospital, Nagoya, Japan
| | - Kyoko Kuwabara
- grid.415442.20000 0004 1763 8254Department of Pathology and Clinical Laboratories, Komaki City Hospital, Komaki, Japan
| | - Toyonori Tsuzuki
- grid.411234.10000 0001 0727 1557Department of Surgical Pathology, Aichi Medical University, Nagakute, Japan
| | - Makoto Urano
- grid.256115.40000 0004 1761 798XDepartment of Diagnostic Pathology, Bantane Hospital, Fujita Health University, Nagoya, Japan
| | - Toshitaka Nagao
- grid.410793.80000 0001 0663 3325Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - William C. Faquin
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, MA USA
| |
Collapse
|
45
|
Honma Y, Monden N, Yamazaki K, Kano S, Satake H, Kadowaki S, Nagao T, Nakatogawa T, Fujii K, Koroki Y, Aoyama J, Ouchi S, Ogawa T, McCarthy S, Brookman-May SD, Mundle S, Li J, Tada Y. Yatagarasu: A single-arm, open-label, phase 2 study of apalutamide (APA) plus goserelin (GOS) for patients (pts) with far locally advanced or recurrent/metastatic (fLA/RM) and androgen receptor (AR)-expressing salivary gland carcinoma (SGC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.6079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6079 Background: Overexpression of AR is identified as a potential molecular target of SGC treatment. Combined androgen blockade (CAB) with bicalutamide has been evaluated previously, but the clinical usefulness of CAB with a next generation AR inhibitor has been unclear in SGC. We prospectively assessed the efficacy and safety of APA+GOS for pts with AR-expressing SGC. Methods: Eligible pts had fLA/RM SGC, and AR expression with at least 1% of cell nuclei immunohistochemistry staining positive. Pts were treated with APA 240 mg orally once daily and GOS 3.6 mg subcutaneously once 28 days. Primary endpoint was overall response rate (ORR) by central review according to RECIST v1.1, and a response (complete response [CR] or partial response [PR]) was confirmed by repeat assessments at least 4 weeks after the initial evaluation showing a response. Primary analysis was performed based on first 24 response evaluable (RE) pts who had been observed at least 24 weeks (Primary RE pts). The ORR was tested using exact test based on the binominal distribution, the null hypothesis for ORR of 14% was rejected when at least 8 of the 24 Primary RE pts were responders, and the efficacy was to be declared. Key secondary endpoints included clinical benefit rate (CBR), disease control rate (DCR), duration of response (DOR), and time to response (TTR) in the Primary RE pts, and overall survival (OS), progression free survival (PFS), and safety in the treated pts. Results: Twenty-six of the 31 pts treated with APA+GOS were regarded as RE by central review. For the 24 Primary RE pts, ORR was 25.0% (6/24), while 37.5% (9/24) including unconfirmed PR. Clinical benefit rate and DCR in the Primary RE pts were 50.0% and 70.8%, respectively. At the data cut-off (Apr 28, 2021), 5 of 6 pts with confirmed response were still on protocol treatment. Median PFS and OS in the treated pts were 7.43 months (mos) and not reached, respectively, with the median follow-up period of 8.57 mos. Grade 3 or higher treatment-related adverse events were reported in 4/31 (12.9%) pts, and the events were rash maculo-papular (n=2), anemia (n=1), and leukopenia (n=1). Conclusions: This is the first prospective trial evaluating CAB with APA for AR-expressing SGC. Although this study did not meet the predefined criteria of efficacy, clinically meaningful activity with well-tolerated safety profile of APA+GOS was shown. Clinical trial information: NCT04325828. [Table: see text]
Collapse
Affiliation(s)
- Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuya Monden
- Department of Head and Neck Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hironaga Satake
- Cancer Treatment Center, Kansai Medical University Hospital, Hirakata, Japan
| | - Shigenori Kadowaki
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Koji Fujii
- Janssen Pharmaceutical K.K., Tokyo, Japan
| | - Yosuke Koroki
- Department of Medical Affairs, Janssen Pharmaceutical K.K., Tokyo, Japan
| | | | | | | | | | | | | | - Jinhui Li
- Janssen Research & Development, San Diego, CA
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| |
Collapse
|
46
|
Sakamoto S, Miyauchi M, Ando T, Fujihara M, Nakaguro M, Nagao T, Ogawa I. Non-sebaceous lymphadenoma-like mucoepidermoid carcinoma: A case report. Pathol Int 2022; 72:371-375. [PMID: 35596702 DOI: 10.1111/pin.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 11/26/2022]
Abstract
Non-sebaceous lymphadenoma is a rare benign salivary gland tumor comprised of non-sebaceous epithelial cells and lymphoid tissue. Although its clinicopathological features have been described, its histogenesis and genetic background have not yet been elucidated. MAML2 rearrangement and the resultant CRTC1/3-MAML2 fusion gene are well-known specific genetic changes in mucoepidermoid carcinoma. Here, we present a case of lymphoepithelial tumor characterized by histomorphology of the non-sebaceous lymphadenoma and CRTC1-MAML2 fusion gene. The patient was an 83-year-old woman with an 8-year history of a solid, well-circumscribed tumor in the parotid gland. Histologically, the tumor was surrounded by thin fibrous connective tissue and was composed of tubular-cystic and solid nests of epithelial cells equally distributed in the lymphoid tissue. The histological features were suggestive of non-sebaceous lymphadenoma. Although the histomorphology was not consistent with mucoepidermoid carcinoma, a diagnosis of non-sebaceous lymphadenoma-like mucoepidermoid carcinoma was made based on the presence of the CRTC1-MAML2 fusion gene. The histological features alone could not establish the diagnosis, and ancillary molecular analysis was required.
Collapse
Affiliation(s)
- Shinnichi Sakamoto
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Mutsumi Miyauchi
- Department of Oral & Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshinori Ando
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Megumu Fujihara
- Department of Pathology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| |
Collapse
|
47
|
Saigusa N, Hirai H, Tada Y, Kawakita D, Nakaguro M, Tsukahara K, Kano S, Ozawa H, Kondo T, Okami K, Togashi T, Sato Y, Urano M, Kajiwara M, Shimura T, Fushimi C, Shimizu A, Okamoto I, Okada T, Suzuki T, Imanishi Y, Watanabe Y, Sakai A, Ebisumoto K, Sato Y, Honma Y, Yamazaki K, Ueki Y, Hanazawa T, Saito Y, Takahashi H, Ando M, Kohsaka S, Matsuki T, Nagao T. The Role of the EZH2 and H3K27me3 Expression as a Predictor of Clinical Outcomes in Salivary Duct Carcinoma Patients: A Large-Series Study With Emphasis on the Relevance to the Combined Androgen Blockade and HER2-Targeted Therapy. Front Oncol 2022; 11:779882. [PMID: 35186711 PMCID: PMC8850643 DOI: 10.3389/fonc.2021.779882] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/27/2021] [Indexed: 12/15/2022] Open
Abstract
ObjectiveSalivary duct carcinoma (SDC) is a highly aggressive and uncommon tumor arising not only de novo but also in pleomorphic adenoma. Androgen receptor (AR)- and HER2-targeted therapy have recently been introduced for SDC as promising treatment options; however, no predictive biomarkers have yet been established. EZH2 and H3K27me3 are closely linked to the development and progression of various cancers, and EZH2 is also expected to be a desirable therapeutic target. We therefore explored the clinicopathological and prognostic implications of EZH2 and H3K27me3 in a large cohort of SDC patients, focusing on their impact on the therapeutic efficacy of AR- or HER2-targeted therapy.Materials and MethodsThe EZH2 and H3K27me3 immunohistochemical expression and EZH2 Y646 gain-of-function mutation status were examined in 226 SDCs, and the relationship with the clinicopathological factors as well as clinical outcomes were evaluated within the three groups depending on the treatment: AR-targeted (combined androgen blockade with leuprorelin acetate and bicalutamide; 89 cases), HER2-targeted (trastuzumab and docetaxel; 42 cases), and conventional therapy (112 cases).ResultsEZH2 and H3K27me3 were variably immunoreactive in most SDCs. A positive correlation was found between the expression of EZH2 and H3K27me3. The EZH2 expression in the SDC component was significantly higher than that in the pre-existing pleomorphic adenoma component. EZH2 Y646 was not identified in any cases. EZH2-high cases more frequently had an advanced clinical stage and aggressive histological features than EZH2-low cases. An EZH2-high status in patients treated with AR-targeted therapy was associated with a significantly shorter progression-free and overall survival as well as a lower objective response rate and clinical benefit rate. In addition, a H3K27me3-high status in patients treated with AR-targeted therapy was related to a shorter overall survival. Conversely, there was no association between the EZH2 and H3K27me3 expression and the clinical outcomes in the conventional or HER2-targeted therapy groups.ConclusionsA high expression of EZH2 and H3K27me3 in SDC might be a predictor of a poor efficacy of AR-targeted therapy. Our data provide new insights into the role of EZH2 and H3K27me3 in therapeutic strategies for SDC.
Collapse
Affiliation(s)
- Natsuki Saigusa
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Hideaki Hirai
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Satoshi Kano
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Takafumi Togashi
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yukiko Sato
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology Bantane Hospital Fujita Health University, School of Medicine, Nagoya, Japan
| | - Manami Kajiwara
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Tomotaka Shimura
- Department of Otolaryngology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Akira Shimizu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Isaku Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takuro Okada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yorihisa Imanishi
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Watanabe
- Department of Otorhinolaryngology Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Akihiro Sakai
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Koji Ebisumoto
- Department of Otolaryngology Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yushi Ueki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yuki Saito
- Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, Yokohama, Japan
| | - Mizuo Ando
- Department of Otolaryngology-Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shinji Kohsaka
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Takashi Matsuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
- *Correspondence: Toshitaka Nagao,
| |
Collapse
|
48
|
Hara N, Suwanai H, Abe H, Yakou F, Ishikawa T, Urayama M, Nagai T, Nagao T, Shikuma J, Miwa T, Suzuki R, Odawara M. Hypercalcemia associated with dysgerminoma and elevation of calcitriol: A case report and review of the literature. SAGE Open Med Case Rep 2022; 10:2050313X211068562. [PMID: 35070316 PMCID: PMC8771755 DOI: 10.1177/2050313x211068562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
We report on the case of a patient with dysgerminoma, a rare germ cell tumor, which showed hypercalcemia with an elevation of 1α,25-dihydroxycholecalciferol (calcitriol). A 27-year-old nulliparous woman presented with hypercalcemia during the examination of a right ovarian tumor with an elevation of calcitriol, lactate dehydrogenase, and alkaline phosphatase. Fractional excretion of calcium was elevated, and intact parathyroid hormone was suppressed. After undergoing right salpingo-oophorectomy, the patient’s serum calcium and calcitriol returned to the normal range within a week. A literature search was conducted on the topic by reviewing databases for dysgerminoma showing hypercalcemia. We identified 14 patients from the literature and performed a pooled analysis, including the results of our case. However, most cases lack data that can help investigate the potential association between parathyroid hormone, parathyroid hormone-related protein, calcitriol, and phosphorus in hypercalcemia. Thus, more case reports that include additional information are required to fully elucidate the mechanism of hypercalcemia associated with dysgerminoma.
Collapse
Affiliation(s)
- Natsuko Hara
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Hirotsugu Suwanai
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Hironori Abe
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Fumiyoshi Yakou
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Takuya Ishikawa
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Munehiro Urayama
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Takeshi Nagai
- Department of Pathology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Pathology, Tokyo Medical University, Tokyo, Japan
| | - Jumpei Shikuma
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Takashi Miwa
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Ryo Suzuki
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| | - Masato Odawara
- Department of Diabetes, Metabolism, Endocrinology, Rheumatology and Collagen Diseases, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
49
|
Tokuyama N, Saito A, Muraoka R, Matsubara S, Hashimoto T, Satake N, Matsubayashi J, Nagao T, Mirza AH, Graf HP, Cosatto E, Wu CL, Kuroda M, Ohno Y. Prediction of non-muscle invasive bladder cancer recurrence using machine learning of quantitative nuclear features. Mod Pathol 2022; 35:533-538. [PMID: 34716417 PMCID: PMC8964412 DOI: 10.1038/s41379-021-00955-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022]
Abstract
Non-muscle invasive bladder cancer (NMIBC) generally has a good prognosis; however, recurrence after transurethral resection (TUR), the standard primary treatment, is a major problem. Clinical management after TUR has been based on risk classification using clinicopathological factors, but these classifications are not complete. In this study, we attempted to predict early recurrence of NMIBC based on machine learning of quantitative morphological features. In general, structural, cellular, and nuclear atypia are evaluated to determine cancer atypia. However, since it is difficult to accurately quantify structural atypia from TUR specimens, in this study, we used only nuclear atypia and analyzed it using feature extraction followed by classification using Support Vector Machine and Random Forest machine learning algorithms. For the analysis, 125 patients diagnosed with NMIBC were used; data from 95 patients were randomly selected for the training set, and data from 30 patients were randomly selected for the test set. The results showed that the support vector machine-based model predicted recurrence within 2 years after TUR with a probability of 90% and the random forest-based model with probability of 86.7%. In the future, the system can be used to objectively predict NMIBC recurrence after TUR.
Collapse
Affiliation(s)
- Naoto Tokuyama
- grid.410793.80000 0001 0663 3325Department of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Akira Saito
- grid.410793.80000 0001 0663 3325Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, Shinjuku-ku, Tokyo 160-8402 Japan ,grid.410793.80000 0001 0663 3325Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-8402 Japan
| | - Ryu Muraoka
- grid.410793.80000 0001 0663 3325Department of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Shuya Matsubara
- grid.410793.80000 0001 0663 3325Department of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Takeshi Hashimoto
- grid.410793.80000 0001 0663 3325Department of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Naoya Satake
- grid.410793.80000 0001 0663 3325Department of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Jun Matsubayashi
- grid.410793.80000 0001 0663 3325Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Toshitaka Nagao
- grid.410793.80000 0001 0663 3325Department of Anatomic Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| | - Aashiq H. Mirza
- grid.410793.80000 0001 0663 3325Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-8402 Japan ,grid.5386.8000000041936877XDepartment of Pharmacology, Weill Cornell Medicine, New York, NY 10065 USA
| | - Hans-Peter Graf
- Department of Machine Learning, NEC Labs America Inc., Princeton, NJ 08540 USA
| | - Eric Cosatto
- Department of Machine Learning, NEC Labs America Inc., Princeton, NJ 08540 USA
| | - Chin-Lee Wu
- grid.32224.350000 0004 0386 9924Department of Pathology, Massachusetts General Hospital, Boston, MA 02114 USA
| | - Masahiko Kuroda
- Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-8402, Japan. .,Department of Molecular Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-8402, Japan.
| | - Yoshio Ohno
- grid.410793.80000 0001 0663 3325Department of Urology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023 Japan
| |
Collapse
|
50
|
Kudo Y, Shimada Y, Matsubayashi J, Kitamura Y, Makino Y, Maehara S, Hagiwara M, Park J, Yamada T, Takeuchi S, Kakihana M, Nagao T, Ohira T, Masumoto J, Ikeda N. Artificial intelligence analysis of three-dimensional imaging data derives factors associated with postoperative recurrence in patients with radiologically solid-predominant small-sized lung cancers. Eur J Cardiothorac Surg 2021; 61:751-760. [DOI: 10.1093/ejcts/ezab541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/09/2021] [Accepted: 11/23/2021] [Indexed: 02/07/2023] Open
Abstract
Abstract
OBJECTIVES
Indications of limited resection, such as segmentectomy, have recently been reported for patients with solid-predominant lung cancers ≤2 cm. This study aims to identify unfavourable prognostic factors using three-dimensional imaging analysis with artificial intelligence (AI) technology.
METHODS
A total of 157 patients who had clinical N0 non-small cell lung cancer with a radiological size ≤2 cm, and a consolidation tumour ratio > 0.5, who underwent anatomical lung resection between 2011 and 2017 were enrolled. To evaluate the three-dimensional structure, the ground-glass nodule/Solid Automatic Identification AI software Beta Version (AI software; Fujifilm Corporation, Japan) was used.
RESULTS
Maximum standardized uptake value (SUVmax) and solid-part volume measured by AI software (AI-SV) showed significant differences between the 139 patients with adenocarcinoma and the 18 patients with non-adenocarcinoma. Among the adenocarcinoma patients, 42 patients (30.2%) were found to be pathological upstaging. Multivariable analysis demonstrated that high SUVmax, high carcinoembryonic antigen level and high AI-SV were significant prognostic factors for recurrence-free survival (RFS; P < 0.05). The 5-year RFS was compared between patients with tumours showing high SUVmax and those showing low SUVmax (67.7% vs 95.4%, respectively, P < 0.001). The 5-year RFS was 91.0% in patients with small AI-SV and 68.1% in those with high AI-SV (P = 0.001).
CONCLUSIONS
High AI-SV, high SUVmax and abnormal carcinoembryonic antigen level were unfavourable prognostic factors of patients with solid-predominant lung adenocarcinoma with a radiological size ≤2 cm. Our results suggest that lobectomy should be preferred to segmentectomy for patients with these prognostic factors.
Collapse
Affiliation(s)
- Yujin Kudo
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | | | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Yojiro Makino
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Sachio Maehara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Jinho Park
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Takafumi Yamada
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Susumu Takeuchi
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | | | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Jun Masumoto
- Medical System Research & Development Center, FUJIFILM Corporation, Tokyo, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|