Cytological characteristics of pulmonary large cell neuroendocrine carcinoma.

To establish cytological features of pulmonary large cell neuroendocrine carcinoma (LCNEC), we evaluated the cytological characteristics of LCNEC. Samples from 25 histologically confirmed LCNECs (14 touch imprint (TI) and 11 curettage) were analyzed. The findings were compared with those for seven small cell lung carcinomas. Cytological findings of TIs were as follows: Tumor cells were medium- to large-sized, round or polygonal, and nuclear polymorphism was observed. Some of the tumor cells had clearly identified cytoplasms, but naked nuclei were frequently observed. Nuclei were round, oval, or polygonal, and possessed thin and smooth nuclear membranes. The nuclear chromatin pattern was finely or coarsely granular. One or two nucleoli were observed in the nuclei, but were inconspicuous in some cases. Tumor cells appeared in clusters, and rosette formation was observed, but single cells were frequently observed also. Necrotic background and nuclear streaking were frequently observed. In brush or curettage specimens, the number of cells observed on a glass was small, but the findings were almost the same as those for the TI samples. TI samples have characteristic features, such as a neuroendocrine morphologic pattern, large cell size, abundant cytoplasm, finely or coarsely granular chromatin of the nucleus, and prominent nucleoli, and the diagnosis of LCNEC is possible. In brush or curettage specimen, the LCNEC diagnosis may be possible if a sufficient number of tumor cells are obtained.

Specific cardiomyopathy caused by multisystemic lipid storage in Jordans' anomaly.

Multisystemic lipid storage disease is a rare disorder of lipid metabolism. We report one case of a Japanese man with systemic lipid storage in skeletal muscle and heart as well as in leukocytes (Jordans' anomaly). Positron emission tomography (PET) using 18F-fluoro-2-deoxyglucose (FDG) clearly revealed an abnormal increase of uptake during fasting in the left ventricle, suggesting changes in the energy metabolism in the heart.

Poor prognosis after lung resection for patients with adenosquamous carcinoma of the lung.

BACKGROUND: We evaluated the prognosis of adenosquamous carcinoma of the lung after lung resection in comparison with other types of carcinoma. METHODS: We retrospectively reviewed charts of patients who underwent lung resection for lung cancer. RESULTS: Surgical outcomes for 30 patients with adenosquamous carcinoma of the lung, who were treated between 1976 and 1998, were compared with the surgical results for 1,219 patients similarly treated for adenocarcinoma or squamous cell carcinoma during the same period. Adenosquamous carcinoma comprised only 2.1% of 1,408 lung cancer cases treated by resection. The overall cumulative 5-year survival rate was only 6.2% for the patients with adenosquamous carcinoma, indicating a significantly poorer prognosis than for adenocarcinoma or squamous cell carcinoma. CONCLUSIONS: The cumulative survival rate for patients with adenosquamous carcinoma in pathologic stages IA to IIB was similar to that of patients with stage IIIA adenocarcinoma or squamous cell carcinoma.

[A study of INH 0.1 microgram/ml resistant M. tuberculosis strains assessed by BrothMIC MTB-1 method].

In the antimycobacterial susceptibility test for INH using the egg-based Ogawa media, 3 concentrations (0.1, 1, or 5 micrograms/ml) of INH were used, and 1 microgram/ml was used as a critical concentration for INH resistance. However, it was controversial whether INH 0.1 microgram/ml resistant M. tuberculosis was clinically significant or not. We investigated the MIC values of INH 0.1 microgram/ml resistant strains by using BrothMIC MTB-1 method, and 115 strains of M. tuberculosis confirmed by DNA-prove test were used. The distribution of MIC values of 115 strains determined by Ogawa INH susceptibility test was shown in figure. By BrothMIC MTB-1 method, they were classified into 3 groups; susceptible, low resistant and high resistant groups. The mean MIC value of INH 0.1 microgram/ml resistant M. tuberculosis was estimated to be 4.53 micrograms/ml with its 95% confidence interval 3.21-5.85 micrograms/ml, and they were determined as "resistant" in BrothMIC MTB-1 method. These results supported the idea that patients with INH 0.1 microgram/ml resistant M. tuberculosis strains should be regarded as clinically "resistant".

[Molecular epidemiologic study of tuberculosis--a study on isolates of M. tuberculosis in southern half of Osaka Prefecture].

Restriction fragment length polymorphism, RFLP or DNA fingerprinting technique provides a very useful tool for the study of epidemiology of tuberculosis transmission in human. We performed RFLP analysis with the IS6110 insertion sequence of the organisms isolated from culture-positive patients who visited our Hospital during the period from January to December 2001. Our Hospital covers patients living in southern half of Osaka Prefecture including a part of Osaka City, which is the highest TB prevalence area in Japan. The number of copies of IS6110 per isolate ranged from 1 to 21. Most isolates (67%) carried 10 to 15 copies. Of 410 available isolates during the year of 2001, 131 (32%) belonged to a cluster and 279 (68%) did not. The clusters comprised one matching isolate in minimum to 13 isolates in maximum and had a total of 49 distinct RFLP patterns. The average age of the clustered cases was 52.1 years and 64% cases belonged to patients with ages younger than 60 years. Above findings suggest that many cases of tuberculosis in southern part of Osaka Prefecture result from recent transmission. It remains to be elucidated, however, how and where these recent infections occurred in these clustered cases.