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1.
Cytopathology ; 28(4): 268-272, 2017 Aug.
Article in English | MEDLINE | ID: mdl-27862483

ABSTRACT

OBJECTIVE: Solid variants of papillary thyroid carcinoma (SV-PTC) are rare, and there have been few reports describing the cytological findings of such variants. METHODS: The cytological features of cellular specimens aspirated from 18 histologically confirmed SV-PTC cases were evaluated, retrospectively. RESULTS: Solid and small papillary clusters were observed in 14 (77.8%) and 13 (72.2%) cases, respectively. The incidences of large papillary clusters (11.1%) and sheet-like arrangements (11.1%) were low. Nuclear features were consistent with conventional PTC. The background was clean, and there were no colloid materials, foamy histiocytes, multinucleated giant cells, psammoma bodies, or necrotic materials. CONCLUSIONS: Solid clusters and small papillary clusters in conjunction with a clean background are diagnostic clues that indicate SV-PTC cytologically. It is thought that small papillary clusters reflect the micropapillary growth pattern seen within the lumen of middle-sized follicular structures. The presence of nuclear findings typical of conventional PTC and the absence of mitotic figures and necrotic materials are important for distinguishing SV-PTC from poorly differentiated carcinoma.


Subject(s)
Carcinoma, Papillary/pathology , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Adolescent , Adult , Aged , Biopsy, Fine-Needle , Child , Female , Humans , Male , Middle Aged , Thyroid Cancer, Papillary , Young Adult
2.
No Shinkei Geka ; 15(12): 1313-8, 1987 Dec.
Article in Japanese | MEDLINE | ID: mdl-3448501

ABSTRACT

A surgical case of prolactinoma associated with craniopharyngioma is reported. A 47-year-old man was admitted to some neurosurgical clinic on October 12, 1982, because of visual disturbance, general fatigue and impotence. Laboratory study revealed hyperprolactinemia (360 ng/ml) and slight enlargement of sella turcica indicated the pituitary adenoma. Transsphenoidal surgery was performed to remove the tumor on November 20, 1982. Histopathological examination revealed chromophobe adenoma, and prolactin was stained in the tumor cells by means of immunoperoxidase staining. Though the clinical symptoms had been improved after surgery, visual disturbance became worse about one month later. At that time empty sella syndrome was suspected and the second operation (interhemispheric approach) was performed on January 21, 1983. No pathological changes were observed at all. On July 13, 1983, he was transferred to our clinic, because his visual acuity was deteriorating. At this time we reviewed the previous CT scan and noticed a suprasellar mass. It was supposed that the lesion had been overlooked and was the cause of the visual disturbance. On August 1, 1983, a bifrontal craniotomy was performed and the suprasellar tumor was removed. Pathological examination of the tumor revealed craniopharyngioma. So it was supposed that pituitary adenoma and craniopharyngioma had been coexisting since onset. Except for cases with von Recklinghausen's disease, multiple primary intracranial tumors of different cell types are relatively rare. A review of literature revealed 94 cases until 1986. The most frequent combination of multiple tumors was meningioma and glioma. But we could not find any case of pituitary adenoma associated with craniopharyngioma in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Craniopharyngioma/surgery , Neoplasms, Multiple Primary , Pituitary Neoplasms/surgery , Prolactin/metabolism , Craniopharyngioma/pathology , Humans , Male , Middle Aged , Pituitary Neoplasms/metabolism , Pituitary Neoplasms/pathology
3.
No Shinkei Geka ; 14(3 Suppl): 465-9, 1986 Mar.
Article in Japanese | MEDLINE | ID: mdl-3703152

ABSTRACT

Successful surgical treatment of acoustic neurinoma in a case of hemodialyzed patient is reported. A 42-year-old female patient, who had been treated by hemodialysis, was diagnosed as having a C-P angle tumor by CT scan. She was refered to our clinic on June 24, 1983. Laboratory examinations on admission showed severe anemia and renal dysfunction. Every possible treatment was done in order to improve the laboratory data preoperatively. Another big problem in this case of hemodialyzed patient was brain edema and bleeding tendency. In order to cope with brain edema, intravenous administration of glycerol and slow hemodialysis for three days were performed preoperatively. These treatments were thought to be effective to reduce bleeding tendency also. During operation, however, heavy swelling of the cerebellum forced us to resect one third of the hemisphere to remove the tumor totally. In addition to this, postoperative mild bleeding in the cavity after tumor resection, subcortical hemorrhage around the shunt tube and oozing from the wound were observed. The patient was discharged from the hospital four months after surgery without any neurological deficit. The way of recovery, however, was not uneventful, because the patient developed various kinds of postoperative complications as mentioned above. In the postoperative managements, we felt almost as if we were treading on thin ice. Neurosurgical management in hemodialyzed patients is not yet very common. We should improve the postoperative management by adding new experience with similar cases.


Subject(s)
Kidney Failure, Chronic/complications , Neuroma, Acoustic/surgery , Renal Dialysis , Adult , Brain Edema/prevention & control , Female , Humans , Kidney Failure, Chronic/therapy , Preoperative Care
4.
No Shinkei Geka ; 13(2): 167-72, 1985 Feb.
Article in Japanese | MEDLINE | ID: mdl-3990900

ABSTRACT

A case of chondromyxoid fibroma of the skull is reported. A 20-year-old boy visited our clinic on December, 1982 because of a recurrent forehead tumor. He had a 4 X 4 X 1.5 cm tumor on the right side of forehead and a 3 X 3 X 0.5 cm tumor on the left. Neurological examination showed no abnormalities. Skull X-ray film showed a large round radiolucent area with clear sclerotic margin in the frontal bone and right orbit. Right carotid angiogram showed marked posterior displacement of the anterior cerebral artery, but no tumor stain. Plain CT scan showed a mass with iso to low density area in the frontal region. It was markedly and irregularly enhanced with contrast media. Surgery was performed entirely in the epidural space, and the tumor was completely removed. The post-operative clinical course was uneventful. Histologically, the three components of chondroid, myxomatous and fibrous tissues in this tumor led to the diagnosis of "chondromyxoid fibroma."


Subject(s)
Chondroma/pathology , Frontal Bone , Skull Neoplasms/pathology , Adult , Chondroma/diagnostic imaging , Chondroma/surgery , Humans , Male , Radiography , Skull Neoplasms/diagnostic imaging , Skull Neoplasms/surgery
5.
No Shinkei Geka ; 12(8): 995-9, 1984 Jul.
Article in Japanese | MEDLINE | ID: mdl-6435004

ABSTRACT

An autopsy case of intracranial multiple meningiomas associated with extracranial multiple neurinomas was presented. A 55-year-old woman, who had received surgical treatment for right parasagittal meningioma 20 years ago, gradually showed the sign of increased intracranial pressure and disturbance of the lower cranial nerves. Brain CT scan demonstrated numerous intracranial tumors. At autopsy 124 intracranial meningiomas, and neurinomas in her left cervical and right axillar portion were found. Meningiomas showed the transitional and fibroblastic type, histopathologically, and axillary and cervical tumors were the Antoni A type neurinomas. It is suggested that this case had a tendency of heterogenous and multiple origination of tumors.


Subject(s)
Brain Neoplasms/pathology , Meningeal Neoplasms/pathology , Meningioma/pathology , Neoplasms, Multiple Primary/pathology , Neurilemmoma/pathology , Peripheral Nervous System Neoplasms/pathology , Female , Humans , Middle Aged , Neurofibromatosis 1/pathology
6.
No Shinkei Geka ; 12(7): 841-6, 1984 Jun.
Article in Japanese | MEDLINE | ID: mdl-6483093

ABSTRACT

In this paper, a case with subdural tension pneumocephalus secondary to bifrontal craniotomy and VP shunt for ruptured Acom aneurysm is reported. In this patient, the mechanisms for entry of air into the subdural space and producing mass effect (Tension pneumocephalus) seem to be one way valve mechanism and negative pressure due to excess of CSF drainage owing to shunting system. Only 29 reported cases of tension pneumocephalus following surgery were found in an extensive review of the literature. We discussed about the clinical symptoms and signs, therapy, and especially about the mechanisms leading to this condition, and prevention for it.


Subject(s)
Intracranial Aneurysm/surgery , Pneumocephalus/etiology , Cerebrospinal Fluid Shunts/adverse effects , Humans , Male , Middle Aged , Peritoneal Cavity/surgery , Pneumocephalus/surgery , Postoperative Complications , Subdural Space
7.
No Shinkei Geka ; 12(3 Suppl): 325-9, 1984 Mar.
Article in Japanese | MEDLINE | ID: mdl-6462340

ABSTRACT

A successful case of ruptured aneurysm of the persistent trigeminal artery (PTA) treated with direct operation is reported. Only 14 cases out of ever-reported 400 cases with persistent trigeminal artery have aneurysms developing from PTA itself or its junction. These aneurysms originate most frequently from the trunk portion of the PTA. In our case, aneurysms are found at the rt. internal carotid-PTA junction and the rt. IC-PC junction. Six out of 14 are associated with another intracranial aneurysms, indicating high multiplicity. Of 14 cases, only 2 including our case are treated by direct surgery. Since the internal carotid-PTA junction aneurysm is located in the cavernous sinus, special consideration is needed during the operation. Surgical keypoints in opening the cavernous sinus under normothermia and getting the landmark for orientation are described.


Subject(s)
Carotid Artery Diseases/complications , Cerebral Arteries/abnormalities , Intracranial Aneurysm/complications , Carotid Artery, Internal , Female , Humans , Intracranial Aneurysm/pathology , Intracranial Aneurysm/surgery , Middle Aged , Rupture, Spontaneous
8.
No Shinkei Geka ; 9(7): 843-8, 1981 Jun.
Article in Japanese | MEDLINE | ID: mdl-7266768

ABSTRACT

Intracranial mesenchymal chondrosarcoma is very rare, only 14 cases being reported in Europe and in the United States of America. Recently we experienced a case in which the follow-up indicating computed tomograms (CT) demonstrated interesting data on the radiosensitivity of this tumor. The patient, a 14-year-old female was admitted to out hospital with the complaint of left hemiplegia which had gradually progressed. CT revealed an area spreading upward from the right median base of the skull and consisted of two components showing (A) a density as high as that of calcium and (B) a density higher than that of surrounding brain tissue, but much lower than that of calcium. Temporoparietal craniotomy was performed to react approximately one-half of the tumor. Histological finding revealed mesenchymal chondrosarcoma. The component-A was though to be a cartilaginous tissue, and-B to be an undifferentiated mesenchymal tissue. Postoperative irradiation of 7,000 rad was initiated. The effect of radiotherapy as seen on computed tomograms is as follows, (1) decrease in the volume of the tumor by 26%, (2) decrease in density and enhancement of the area which is considered to be the undifferentiated mesenchymal cells, (3) mild reduction of the area which is considered to be the cartilaginous tissue, and (4) a very high density of the entire tumor similar in degree to that of the bone one year later. These results suggested that radiotherapy is effective for this tumor.


Subject(s)
Brain Neoplasms/diagnostic imaging , Chondrosarcoma/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Brain Neoplasms/radiotherapy , Brain Neoplasms/surgery , Chondrosarcoma/radiotherapy , Chondrosarcoma/surgery , Female , Humans
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