Diabetic mastopathy in an elderly woman: a case report.

We report a case of diabetic mastopathy in an elderly woman with type II diabetes. The patient, a 66-year-old woman with a 6-year history of diabetes mellitus, has been received an oral diabetic agent. She noticed a lump in her right breast two months previously. Mammography of the breast showed a low density mass, but there was no microcalcification or architectural distortion. Ultrasonography of the lesion revealed a hypoechoic mass with a distinct margin. Fine needle aspiration cytology was performed but sufficient tissue was not obtained. However, a cluster of small epithelial cells with nucleus swelling and increased chromatin was demonstrated. Excisional biopsy was performed and diabetic mastopathy was demonstrated histologically.

Adenoendocrine cell carcinoma of the gallbladder: report of a case.

Adenoendocrine cell carcinoma of the gallbladder is an uncommon form of cancer. We treated a 36-year-old woman who came to us with a chief complaint of abdominal pain. The abnormality was diagnosed to be a tumor-like mass in the gallbladder, and adenomyomatosis of the gallbladder was strongly suspected. A laparoscopic cholecystectomy was successfully performed, and the histopathological finding was adenoendocrine cell carcinoma of the gallbladder. The tumor cells of the small round cell carcinoma partly stained positively for synaptophysin, neuron-specific enolase, and CD 56, while adenocarcinoma cells showed positive reactions to keratin, which was thus suggestive of adenoendocrine cell carcinoma. The patient is alive and doing well at 12 months after the treatment.

Primary squamous cell carcinoma of the breast: a case report.

Primary squamous cell carcinoma of the breast is a rare entity. We treated a 55-year old woman who came to us with bleeding from the left breast tumor. The tumor was 7 x 8 x 10 cm in size with ulceration and surgical biopsy results showed it to be squamous cell carcinoma of the breast, while metastatic work-up findings ruled out other sources of primary tumor. She also complained of nausea and vomiting, and brain CT disclosed cerebellar metastasis. The metastatic brain tumor was surgically removed, however, the symptoms became gradually exacerbated. The patient died 67 days after admission.

Telomeric repeat-length alterations in colorectal carcinoma are associated with loss of heterozygosity and point mutation in p53 gene.

The telomere, the terminal region of eukaryotic chromosomes, plays an important role in the stability of DNA replication and in the protection of chromosomal ends. To investigate whether the two-stage mechanism of cellular aging and immortalization in vitro is involved in the carcinogenesis and immortalization of human colorectal carcinomas, we examined for genetic alterations in the telomeres and in the p53, Rb, and K-ras genes. Based on our results, we discuss the effects that these genetic changes might have on mechanisms, such as the mortality stage 1 (M1), that normally prevent immortalization in carcinoma cells. Telomeric repeat-lengths (TRL) were measured by Southern blot analysis, and p53 Rb and K-ras gene variants were detected by PCR based assays. Thirty-six primary colorectal carcinomas were examined. Telomere alterations were found in 19 of 36 (52.8%) cases, while mutations of the p53 gene were observed in 15 of 36 (41.7%) cases and LOH involving p53 observed in 14 of 36 (38.9%) cases. Twelve of 15 (80%) cases with p53 mutations also showed altered TRL, so that p53 mutations were positively associated with TRL alterations (p=0.008). Ten of 14 (71.4%) cases with LOH of p53 also showed alteration in TRL, also revealing a positive association with TRL (p=0.09). The six cases with both p53 mutation and LOH all showed altered TRL. K-ras gene mutations and LOH involving the Rb gene were not associated with alterations in TRL. These results suggest that inactivation of p53 is one of the factors that promotes immortalization and overcomes M1 in colorectal carcinoma.

Immunohistochemical detection of lymph node microinvolvement in node-negative gastric cancer.

BACKGROUND: Despite curative resection of the primary tumor with extensive dissection of lymph nodes, some patients with node-negative gastric cancer die of local relapse or metastatic disease. Microinvolvement of regional lymph nodes may play an important role in the prognosis.METHODS: To evaluate the incidence and prognostic implications of regional lymph node microinvolvement in node-negative gastric cancer, we retrospectively analyzed tissue samples from 51 patients operated on for primary gastric cancer. They had tumors that invaded beyond the muscularis propria, but without metastasis to the lymph nodes, shown by the conventional H&E staining method. The regional lymph nodes were examined immunohistochemically, using monoclonal antibodies against cytokeratin.RESULTS: Microinvolvement was found in 4.8% of lymph nodes (67/1390) and in 43.2% of the patients (22/51). The clinical outcome of the patients with microinvolvement was not significantly different from those without it. However, no patient died in the no-microinvolvement group, while three patients in the microinvolvement group died of recurrence.CONCLUSION: The incidence of microinvolvement in conventionally negative lymph nodes cannot be ignored, and detecting microinvolvement may be important for predicting recurrence of gastric cancer.