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神澤 真紀医学部附属病院 病理診断科講師
研究活動情報
■ 受賞- 2021年04月 第94回日本内分泌学会学術総会, KO Rounds Grand Winner, 妊娠中に高血圧と精神症状を呈した副腎皮質・髄質混合腫瘍の1例
- 2011年05月 日本病理学会近畿支部, 人体病理学学術奨励賞, 頭蓋骨腫瘍の一例
- We describe histopathological and ultrastructural evidence of osilodrostat-induced regression of a cortisol- and possibly aldosterone-producing adrenocortical adenoma. An 82-year-old woman with adrenal Cushing syndrome received preoperative osilodrostat therapy. Seventy days after starting osilodrostat, the patient developed an adrenal crisis, and the adrenal tumor obviously decreased in size. Laparoscopic adrenalectomy was performed 11 months after osilodrostat plus hydrocortisone treatment. Histological examination revealed no evident hemorrhage, necrosis, or conspicuous apoptosis. Instead, diffuse and extensive infiltration of CD163-positive histiocytes was observed, outnumbering the tumor cells. Residual neoplastic cells exhibited a global reduction in the expression of cortisol-synthesizing enzymes. Notably, focal weak CYP11B2 (aldosterone synthase) positivity was detected in the tumor, whereas adjacent nontumorous cortex showed preserved rather prominent CYP11B2 expression. Electron microscopy showed a marked loss of organelles essential for steroidogenesis. These findings suggest that osilodrostat exerts biochemical suppression of both cortisol and aldosterone secretion and modulates the morphology and function of the adrenocortical adenoma tissue.2026年06月, JCEM case reports, 4(6) (6), luag093, 英語, 国際誌研究論文（学術雑誌）
- OBJECTIVE: Rathke's cleft cysts (RCCs) are benign cystic lesions of the sellar and suprasellar regions that may cause hypopituitarism and arginine vasopressin (AVP) deficiency when symptomatic. A recent study with Isl-1 knockout mice identified six molecular markers-KRT8, TUBA1A, SOX2, SOX9, FOXA1, and FOXJ1-as potential indicators of RCC pathogenesis. This study aimed to investigate the expression patterns of these markers in human RCCs and examine their association with clinical manifestations. METHODS: A retrospective analysis was conducted on 108 histopathologically confirmed RCC cases resected between 2011 and 2023 at three medical centers. Immunofluorescence staining was performed for six markers, and expression profiles were correlated with clinical symptoms (hypopituitarism, AVP deficiency, visual disturbances, and headache), epithelial morphology, and MRI findings. Statistical analysis was conducted using chi-square or Fisher's exact tests. RESULTS: KRT8 was expressed in 100% of RCC samples, while the expression rates for TUBA1A, SOX2, SOX9, FOXA1, and FOXJ1 were 90.7%, 75.9%, 76.9%, 55.6%, and 84.3%, respectively. SOX9 expression was significantly associated with single-layered epithelial morphology (p = 0.001). The absence of TUBA1A expression was significantly associated with AVP deficiency (p = 0.042), and FOXJ1 positivity was significantly associated with hypopituitarism (p = 0.040). No other significant associations were found between marker expression and imaging findings or other clinical symptoms. CONCLUSIONS: This study confirms that the six molecular markers identified in Isl-1 knockout mice are also expressed in human RCCs, with variable expression patterns. KRT8 and FOXA1 staining may aid in distinguishing RCCs from craniopharyngiomas. Moreover, FOXJ1 and TUBA1A expression profiles provide novel insights into the mechanisms underlying hypopituitarism and AVP deficiency, respectively. These findings highlight the potential diagnostic and prognostic utility of molecular markers in RCC management and underscore the need for further studies in asymptomatic and incidental cases.2026年04月, Journal of neurosurgery, 1 - 9, 英語, 国際誌研究論文（学術雑誌）
- Ectopic adrenocorticotropic hormone (ACTH) syndrome resulting from ectopically secreting tumors poses a significant clinical challenge. Accurately identifying the tumor source and achieving curative resection are pivotal for patient prognosis; however, achieving these objectives is often complicated by complex ACTH secretion patterns. High-molecular-weight ACTH, frequently secreted by ectopic ACTH-producing tumors, is distinct from the conventional 39-amino-acid ACTH (ACTH1-39) produced by the pituitary gland. We believe that the evaluation of ACTH characteristics using gel filtration chromatography (GFC) can be used to determine whether curative resection can be achieved. A patient with ectopic ACTH syndrome owing to a thymic neuroendocrine tumor was enrolled in this study. Despite a marked reduction in plasma ACTH levels post-surgery, the levels remained above the detection threshold, raising concerns regarding potential residual tumor activity. To investigate this further, GFC was employed to differentiate between ACTH1-39 and high-molecular-weight ACTH in postoperative plasma samples. High-molecular-weight ACTH was predominant in the postoperative samples, whereas preoperative peripheral blood was primarily composed of ACTH1-39. These findings suggest that sustained low-level ACTH post-surgery was likely owing to a delayed clearance of high-molecular-weight ACTH rather than a residual tumor activity. This interpretation is supported by the patient's favorable postoperative course and long-term follow-up, which showed no recurrence. This case study highlights the novel potential of GFC for aiding clinical decision-making.2025年10月, Endocrine journal, 72(10) (10), 1127 - 1134, 英語, 国内誌研究論文（学術雑誌）
- Sarcomatoid adrenal cortical carcinoma (SACC) is an extremely rare histological subtype accounting for only 0.2% of all adrenal cortical carcinomas. Most reported cases of SACC are nonfunctional, showing a biphasic histological pattern with both epithelial adrenocortical carcinoma and sarcomatous components, which are often associated with poor prognosis. Herein, we report a unique case of SACC with characteristics distinct from those previously documented. A 66-year-old man presented with uncontrolled hypertension, night sweats, exertional dyspnea, and palpitations. Imaging revealed an 11 cm mass in the left adrenal gland. Laboratory results indicated hypokalemia with suppressed plasma renin and aldosterone levels and the presence of mineralocorticoid intermediates, notably elevated deoxycorticosterone (DOC), detected via LC-MS/MS. The patient underwent a left adrenalectomy. Histologically, the tumor consisted solely of spindle cells without the typical adrenocortical carcinoma components. Immunohistochemical analysis demonstrated partial positivity for steroidogenic enzymes, including 3β-hydroxysteroid dehydrogenase, cytochrome P450 family 21 subfamily A member 2 (CYP21A2) and cytochrome P450 family 11 subfamily B member 1 (CYP11B1). This finding was consistent with RNA expression analysis, supporting the synthesis of mineralocorticoid intermediates within the tumor. However, the discrepancy between the measured steroid intermediate metabolites and enzyme expression patterns in the tumor, as indicated by immunostaining and mRNA levels, suggests that the steroid production pathway in this tumor remains partially unclear. Two years postoperatively, the patient has remained free from recurrence or metastasis. This case holds particular value, as it is the first report to describe hormone production in a SACC composed solely of spindle cells.2025年10月, Endocrine journal, 72(10) (10), 1151 - 1161, 英語, 国内誌研究論文（学術雑誌）
- The specific human leukocyte antigen (HLA) alleles in individuals with tumors that ectopically express adrenocorticotropic hormone (ACTH), resulting in paraneoplastic isolated ACTH deficiency (IAD), remain elusive, primarily because of the scarcity of reported cases. In this study, we endeavored to elucidate the pathogenic mechanisms underlying paraneoplastic IAD, a novel subtype of autoimmune hypophysitis. We specifically examined the histological characteristics of ACTH-expressing cells in cancer tissues of one patient and investigated the prevalence of shared HLA alleles across three patients diagnosed with paraneoplastic IAD. We analyzed the histological features of prostate-cancer tissues, including ectopic ACTH expression, in a patient with paraneoplastic IAD. In addition, we investigated common HLA alleles and estimated haplotypes among this patient and two others with paraneoplastic IAD on which we previously reported. Immunohistochemical analyses revealed ACTH-positive cells in only one of four tissue samples. Ectopic ACTH expression was limited to areas of relatively high-grade prostate cancer, with cellular cords and cribriform glands that exhibited nuclear hyperchromatism. HLA typing revealed shared class II alleles and haplotypes, including DRB4*01:03, among the three cases. This study provides novel histological insights and highlights the commonality of HLA class II alleles in the diagnosis and pathogenesis of paraneoplastic IAD, potentially aiding the identification of new cases and our understanding of the underlying mechanisms of the disease.2025年10月, Journal of neuroendocrinology, 37(10) (10), e70074, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: Approximately 20% of pheochromocytomas are cystic in nature. However, research on the correlation between catecholamine and metanephrine fractions in cystic fluid and peripheral blood is limited. This study investigated the relationship between catecholamine fractions and their metabolites in peripheral blood and cystic fluid. METHODS: Five patients with pathologically diagnosed cystic pheochromocytomas were included in the analysis. Catecholamine fractions and their metabolites in the cystic fluid were measured. The relationship between phenylethanolamine N-methyltransferase (PNMT) expression in tumor tissues and catecholamine fractions of cystic fluid was also assessed. RESULTS: The elevated patterns of catecholamine and metanephrine fractions in the cystic fluid were consistent with those observed in the peripheral blood of two patients. However, in two other patients. discordance was observed, with normetanephrine predominance in the peripheral blood despite adrenaline/metanephrine and noradrenaline/normetanephrine elevations in the cystic fluid. Immunohistochemical analysis revealed that PNMT expression in tumor tissues and the elevated pattern of catecholamine fractions in the peripheral blood were consistent in all patients, except for one patient with non-elevated peripheral blood catecholamines. However, in cystic fluid, the predominantly catecholamine fraction did not consistently align with PNMT expression. CONCLUSION: In cystic pheochromocytoma, the elevation patterns of catecholamine fractions in cysts may not align with those in the peripheral blood and may differ relative to PNMT expression in tumor tissues.2025年04月, Journal of endocrinological investigation, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本病理学会, 2025年03月, 日本病理学会会誌, 114(1) (1), 402 - 402, 英語DOC産生性肉腫型副腎皮質癌の一例(A case of DOC- producing sarcomatoid adrenal cortical carcinoma)
- The incidence of ulcerative colitis (UC) is on the rise also in Japan. Simultaneously, therapeutic options, including biologics and Janus kinase (JAK) inhibitors, have significantly expanded over the past decade. Although tofacitinib (TOF), one of JAK inhibitors, is a viable option for patients with moderate to severe UC, there is insufficient data to predict responsiveness of TOF treatment. The present study aimed to determine whether the infiltration of IL-17 A-positive mononuclear cells into the colonic mucosa can predict responsiveness to TOF treatment. Patients with UC who underwent TOF treatment were divided into responder and failure groups. Subsequently, we conducted a comparative analysis to identify differences in the infiltration of IL-17 A-positive cells into the colonic mucosa through immunohistochemical examination of colon biopsy samples. The proportion of IL-17 A positive mononuclear cells in colon biopsy samples was significantly higher in the failure group than among responders (38.2% vs. 21.2%). Consistent with this finding, our re-analysis of RNA sequence datasets available in the Gene Expression Omnibus (GEO) database suggested that TOF exerts a more pronounced influence on Th1 cells compared with IL-17-producing Th17 cells. In summary, an abundance of IL-17 A-positive mononuclear cells in the colonic mucosa has the potential to predict the responsiveness to TOF treatment.2025年02月, Scientific reports, 15(1) (1), 6112 - 6112, 英語, 国際誌研究論文（学術雑誌）
- 2025年01月, Modern Rheumatology Case Reports研究論文（学術雑誌）
- 2025年, ENDOCRINE JOURNAL, 72(10) (10), 英語研究論文（学術雑誌）
- (一社)日本内分泌学会, 2024年10月, 日本内分泌学会雑誌, 100(2) (2), 590 - 590, 日本語急激な症状の顕在化と共に下垂体卒中を来したCushing病の一例
- (一社)日本内分泌学会, 2024年10月, 日本内分泌学会雑誌, 100(2) (2), 623 - 623, 日本語腫瘍別にMIBG集積性が異なった両側褐色細胞腫の1例
- (一社)日本内分泌学会, 2024年10月, 日本内分泌学会雑誌, 100(2) (2), 623 - 623, 日本語腫瘍別にMIBG集積性が異なった両側褐色細胞腫の1例
- (一社)日本内分泌学会, 2024年10月, 日本内分泌学会雑誌, 100(2) (2), 590 - 590, 日本語急激な症状の顕在化と共に下垂体卒中を来したCushing病の一例
- BACKGROUND: Focal pancreatic parenchymal atrophy (FPPA) and upstream pancreatic atrophy (UPA) may indicate the presence of early pancreatic cancer. In early pancreatic cancer, the tumor occasionally spreads laterally along the main pancreatic duct, presenting challenges in determining the extent of surgical resection. This study aimed to investigate the association of pancreatic atrophy pattern and intraductal cancer extension. METHODS: Thirty-two patients with early-stage pancreatic cancer who underwent surgery at five participating centers were enrolled. Pancreatic atrophy was defined as the narrowing of parenchyma compared to the surrounding parenchyma and was classified as either FPPA (partial atrophy surrounding the pancreatic duct stenosis) or UPA (global atrophy caudal to the site of duct stenosis). Intraductal cancer extension was defined as an extension exceeding 10 mm. RESULTS: Preoperative computed tomography revealed FPPA, UPA, and no parenchymal atrophy in 13, 13, and 6 patients. Cases with FPPA or UPA showed significantly longer cancer extensions than those without atrophy (P = 0.005 and P = 0.03, respectively). Intraductal cancer extension was present in all but one case of FPPA. 69% (9/13) of the cases with UPA showed intraductal cancer extension, whereas cases without atrophy showed no intraductal cancer extension. Importantly, two patients with FPPA or UPA showed positive resection margins during surgery and three patients with FPPA or UPA showed recurrence in the remnant pancreas. CONCLUSIONS: The presence of FPPA and UPA indicates lateral cancer extension in early-stage pancreatic cancer. Preoperative assessment of the pancreatic parenchyma may provide valuable insights for determining the extent of surgical resection.2024年09月, Journal of gastroenterology, 英語, 国内誌研究論文（学術雑誌）
- Cushing's syndrome is characterized by chronic glucocorticoid oversecretion and diverse clinical manifestations. Distinguishing between adrenocorticotropic hormone (ACTH)-independent and ACTH-dependent forms is crucial for determining treatment options. Plasma ACTH levels aid in the differential diagnosis, with undetectable or low levels suggesting ACTH-independent hypercortisolemia. ACTH is derived from pro-opiomelanocortin, and its processing involves prohormone convertase 1/3. High-molecular-weight ACTH is generally found in ACTH-producing pituitary tumors and ectopic ACTH syndrome. The mechanism of negative feedback and the process of high-molecular-weight ACTH alternation during ACTH-independent Cushing's syndrome remain unclear. A 40-year-old woman with hypertension and multiple fractures developed symptoms suggestive of Cushing's syndrome. Computed tomography revealed a left adrenocortical tumor along with atrophy of the right adrenal gland. ACTH levels were undetectable at the previous clinic, indicating ACTH-independent Cushing's syndrome. However, subsequent measurements at our hospital revealed non-suppressed ACTH (18.1 pg/mL), prompting further investigation. Gel exclusion chromatography confirmed the presence of high-molecular-weight ACTH. Metyrapone treatment decreased the cortisol levels. In this situation, in which ACTH levels should be elevated, a decrease in high-molecular-weight ACTH levels was observed. Histological findings revealed cortisol-producing adenoma without ACTH expression. This case highlights the importance of assay differences in evaluating ACTH concentrations and introduces a novel finding of circulating high-molecular-weight ACTH. The observed decline in high-molecular-weight ACTH levels suggests a potential time lag in the negative feedback within the hypothalamic-pituitary-adrenal axis exhibited by glucocorticoids. This temporal aspect of the regulation of ACTH-related molecules warrants further exploration to enhance our understanding of the hypothalamic-pituitary-adrenal axis feedback mechanism.2024年08月, Journal of neuroendocrinology, e13438, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2024年05月, 日本内分泌学会雑誌, 100(1) (1), 426 - 426, 日本語DOC産生肉腫型副腎皮質癌の1例
- Anti-pituitary-specific transcription factor-1 (PIT-1) hypophysitis, a paraneoplastic syndrome resulting from an autoimmune response against PIT-1, typically manifests with undetectable levels of growth hormone (GH) and prolactin (PRL), and significantly low levels of serum thyroid-stimulating hormone (TSH) at diagnosis. These hormonal levels are highly specific to this disease and serve as key diagnostic indicators. Herein, we present a detailed clinical course of a 69-year-old male with a history of gastric cancer and lymph node metastases who developed anti-PIT-1 hypophysitis after the initiation of immune checkpoint inhibitor (ICI) therapy, specifically nivolumab, oxaliplatin, and capecitabine. The patient was referred to our department owing to decreased TSH, free triiodothyronine (T3), and free thyroxine (T4) levels after two doses of nivolumab. Initially suspected as central hypothyroidism due to ICI-related hypophysitis, further assessment confirmed the diagnosis of anti-PIT-1 hypophysitis. Notably, GH, PRL, and TSH levels markedly declined, leading to complete deficiencies 2 months after the first nivolumab dose-a pattern consistent with that of previous cases of anti-PIT-1 hypophysitis. Therefore, this report not only presents an atypical subset of ICI-related hypophysitis but also delineates the process of hormone impairment leading to complete deficiencies in anti-PIT-1 hypophysitis. This case highlights the importance of vigilant monitoring for endocrine issues in patients undergoing ICI therapy, given the escalating incidence of immune-related adverse events associated with the extensive use of ICI therapy for various cancers.2024年04月, Journal of neuroendocrinology, e13395, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2024年04月, 日本内分泌学会雑誌, 99(5) (5), 1681 - 1681, 日本語
- (一社)日本内分泌学会, 2024年04月, 日本内分泌学会雑誌, 99(5) (5), 1676 - 1676, 日本語
- (一社)日本内分泌学会, 2024年04月, 日本内分泌学会雑誌, 99(5) (5), 1681 - 1681, 日本語BMHAにおけるアルドステロン自律性分泌とその病理学的検討
- Adrenal cysts lined by thyroid follicular epithelium are rare, with only 14 reported cases of "ectopic thyroid tissue" to date. While the primary consideration for differential diagnosis is thyroid carcinoma metastasis, exclusion of metastases is determined based on the absence of a primary thyroid lesion, serological euthyroidism, lack of thyroglobulin elevation, and absence of epithelial atypia. Herein, we report 2 cases of adrenal cysts lined by thyroid follicular epithelium. Case 1 was a 60-year-old woman with a right adrenal cyst. Case 2 was a 51-year-old man with a left adrenal cyst. Over time, both cysts became larger, necessitating an adrenalectomy. Cystic epithelia were lined with thyroid follicular epithelium, exhibiting moderate atypia. Human bone marrow endothelial cell marker-1 and galectin-3 were focally positive; CK19 was positive in Case 1, and all 3 markers were positive in Case 2, previously reported as an immunophenotype of thyroid carcinoma. CD56 expression was positive in both cases. Targeted next-generation sequencing revealed several low-frequency mutations; however, no major driver alterations for thyroid cancer were detected. Adrenal cysts can be lined by thyroid follicular epithelium. Challenges arise in determining the malignant or benign nature of adrenal cysts.2024年04月, JCEM case reports, 2(4) (4), luae058, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Recent evidence suggests that the presence of microbiome within human pancreatic ductal adenocarcinoma (PDAC) tissue potentially influences cancer progression and prognosis. However, the significance of tumor-resident microbiome remains unclear. We aimed to elucidate the impact of intratumoral bacteria on the pathophysiology and prognosis of human PDAC. METHODS: The presence of intratumoral bacteria was assessed in 162 surgically resected PDACs using quantitative polymerase chain reaction (qPCR) and in situ hybridization (ISH) targeting 16S rRNA. The intratumoral microbiome was explored by 16S metagenome sequencing using DNA extracted from formalin-fixed paraffin-embedded tissues. The profile of intratumoral bacteria was compared with clinical information, pathological findings including tumor-infiltrating T cells, tumor-associated macrophage, fibrosis, and alterations in four main driver genes (KRAS, TP53, CDKN2A/p16, SMAD4) in tumor genomes. RESULTS: The presence of intratumoral bacteria was confirmed in 52 tumors (32%) using both qPCR and ISH. The 16S metagenome sequencing revealed characteristic bacterial profiles within these tumors, including phyla such as Proteobacteria and Firmicutes. Comparison of bacterial profiles between cases with good and poor prognosis revealed a significant positive correlation between a shorter survival time and the presence of anaerobic bacteria such as Bacteroides, Lactobacillus, and Peptoniphilus. The abundance of these bacteria was correlated with a decrease in the number of tumor-infiltrating T cells positive for CD4, CD8, and CD45RO. CONCLUSIONS: Intratumoral infection of anaerobic bacteria such as Bacteroides, Lactobacillus, and Peptoniphilus is correlated with the suppressed anti-PDAC immunity and poor prognosis.2024年03月, Journal of gastroenterology, 59(3) (3), 250 - 262, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Corticotrophs are susceptible to lymphocyte cytotoxicity, as seen in hypophysitis, suggesting that an immunological approach may be a potential strategy for corticotroph-derived tumors. OBJECTIVES: We aimed clarify whether corticotroph tumors that induce hypercortisolemia (ACTHomas) could be targets for immunotherapy. METHODS: Tumor-infiltrating immune cells were immunohistochemically analyzed. ACTHomas (Naïve: ACTHomas without preoperative treatment) were compared with other pituitary tumors, and further divided into three different cortisol-exposed milieus: Naïve, Met (ACTHomas with preoperative metyrapone), and SCA (silent corticotroph adenomas). A three-dimensional cell culture of resected tumors was used to analyze the effects of immune checkpoint inhibitors. RESULTS: The number of tumor-infiltrating lymphocytes (TILs) was low in ACTHomas. Among these, the number of CD8+ cells was lower in ACTHomas than in both somatotroph) and gonadotroph tumors (P < 0.01 and P < 0.01, respectively). Then we compared the differences in TILs among Naïve, Met, and SCA. The number of CD4+ cells, but not CD8+ cells, was higher in both Met and SCA than in Naïve. Next, we investigated tumor-associated macrophages, which could negatively affect T cell infiltration. The numbers of CD163+ and CD204+ cells were positively associated with cortisol levels. Moreover, tumor size was positively correlated with the number of CD204+ cells. CONCLUSIONS: We found the possibility that ACTHomas were immunologically cold in a cortisol-independent manner. In contrast, the tumor infiltration of CD4+ cells and M2-macrophages were associated with the cortisol milieu. Future studies are needed to validate these results and develop effective immunotherapy while considering the cortisol milieu.2024年02月, Endocrinology, 英語, 国際誌研究論文（学術雑誌）
- (公社)日本医学放射線学会, 2024年02月, Japanese Journal of Radiology, 42(Suppl.) (Suppl.), 40 - 40, 日本語術前診断が困難であった後腹膜肺分画症の1例
- PURPOSE: Preoperative medical management is critical to prevent intraoperative cardiovascular complications in patients with pheochromocytomas and paragangliomas (PPGLs). Initial treatment involves α-adrenergic receptor blockers. However, while the routine use of metyrosine alongside these blockers is not strongly recommended due to a lack of evidence supporting its efficacy and associated safety concerns, there are previous studies on combination therapy with phenoxybenzamine and metyrosine. There are few reports on combination therapy with the selective α1-adrenergic receptor blocker doxazosin. Therefore, we investigated this combination treatment, which theoretically can affect perioperative outcomes in patients with PPGLs. To our knowledge, this is the first such study. METHODS: This retrospective single-center observational study involved 51 patients who underwent surgical resection of PPGLs at Kobe University Hospital between 2014 and 2022. All patients received doxazosin at maximum doses. Fourteen patients received concomitant metyrosine, while 37 received doxazosin alone. Their perioperative outcomes were compared. RESULTS: No severe event, such as acute coronary syndrome, was observed in either group. Intraoperatively, the doxazosin + metyrosine group exhibited a lower median minimum systolic blood pressure (56 [54-60] vs. 68 [59-74] mmHg, P = 0.03) and required lower median remifentanil (P = 0.04) and diltiazem (P = 0.02) doses than the doxazosin-alone group. CONCLUSION: The combination of metyrosine and doxazosin as a preoperative treatment for PPGLs affects intraoperative circulatory hemodynamics, such as a reduced occurrence of blood pressure elevation during surgery. Further research is necessary to identify patients who will benefit most from this combination treatment.2024年01月, Endocrine, 英語, 国際誌研究論文（学術雑誌）
- 2024年01月, Journal of medical ultrasonics (2001), 51(1) (1), 143 - 144, 英語, 国内誌研究論文（学術雑誌）
- The pathogenesis of anti-pituitary-specific transcription factor 1 (PIT-1) hypophysitis was gradually revealed as cases emerged. Our comprehensive analysis, including all reported cases, identified a new instance of anti-PIT-1 hypophysitis post-immune checkpoint inhibitor therapy. All nine patients exhibited extremely low GH, PRL, and TSH levels; two had a slightly atrophic pituitary gland; four had thymoma, and five had malignant neoplasms of diffuse large B-cell lymphoma (DLBCL) and other origins. Patients with thymoma showed multiple autoimmune diseases. HLA-A*24:02 and/or A*02:06 were present in six and DR53 in five cases analyzed. High anti-PIT-1 antibody titers and ectopic PIT-1 expression in the cytosol and nucleus of the tumor tissues were observed in patients with thymoma or DLBCL, whereas it was exclusively observed in the nuclei of a bladder cancer patient. These findings provide new insights into the pathophysiology of paraneoplastic autoimmune hypophysitis.2023年12月, European journal of endocrinology, 英語, 国際誌研究論文（学術雑誌）
- Herein, we report a rare case of a carcinoma with primitive phenotype (enteroblastic and/or hepatoid differentiation) occurring at a colostomy site. The patient was an elderly male who underwent neoadjuvant chemoradiotherapy for rectal cancer, followed by abdominoperineal resection. A biopsy specimen for the rectal carcinoma before neoadjuvant chemoradiotherapy was conventional tubular adenocarcinoma. Moreover, a pathological complete response was confirmed in the proctectomy specimen. However, a colostomy-site tumor appeared 6 months after the proctectomy, and it was resected 1 year after the initial proctectomy. The colostomy-site tumor comprised solid to focal glandular growth of atypical polygonal cells with clear to pale eosinophilic cytoplasm and was immunohistochemically positive for cytokeratin, spalt-like transcription factor 4, glypican-3, caudal type homeobox 2, and special AT-rich sequence-binding protein 2. Thus, the tumor was diagnosed as poorly differentiated adenocarcinoma with primitive phenotype, with suggested origin from the colorectal epithelium. Additionally, a multilocular cystic lesion comprising various types of epithelia was found adjacent to the tumor, suggestive of metaplasia or heterotopia. Changes in the histology and immunophenotype, and the findings of an adjacent cystic lesion suggest a metachronous tumor rather than a recurrence of the primary tumor.2023年12月, Pathology international, 英語, 国際誌
- (一社)日本胆道学会, 2023年12月, 胆道, 37(5) (5), 918 - 923, 日本語
- Pheochromocytomas and paragangliomas (PPGLs) are rare tumors that secrete catecholamines and arise from the adrenal medulla or extra-adrenal sympathetic ganglia. These tumors secrete adrenaline and noradrenaline, but paragangliomas usually produce only noradrenaline because of the lack of phenylethanolamine N-methyltransferase (PNMT) expression. Composite paragangliomas, which are complex tumors consisting of multiple types of neuroblastic cells, are extremely rare. We present the case of a 46-year-old woman with an atypical catecholamine profile who was preoperatively diagnosed with pheochromocytoma. However, postoperative pathology revealed that the patient had an extra-adrenal paraganglioma accompanied by a ganglioneuroma, which led to the diagnosis of a composite tumor. Interestingly, PNMT is expressed in both paragangliomas and ganglioneuromas. In addition, we reviewed reported composite paragangliomas and compared their clinical features with those of composite pheochromocytomas. We also discuss various aspects of the etiology of composite paragangliomas and the mechanism by which PNMT is expressed in tumors.2023年11月, Endocrine journal, 英語, 国内誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2023年10月, 日本内分泌学会雑誌, 99(2) (2), 569 - 569, 日本語
- BACKGROUND: Abundant collagen deposition is a hallmark of pancreatic ductal adenocarcinomas (PDACs). This study clarified the interactive relationship between tumor-stromal collagen, molecular and immune characteristics, and tumor pr ogression in human PDAC. METHODS: We performed a comprehensive examination using an integrative molecular pathological epidemiology database on 169 cases with resected PDAC . The amount of tumor-stromal collagen was quantified through digital imaging analysis for Elastica van Gieson-stained whole-section tumor slides. We analyzed the association of tumor-stromal collagen with gene alterations (KRAS, TP53, CDKN2A/p16, and SMAD4), immune parameters (CD4+ tumor-infiltrating lymphocytes [TILs], CD8+ TILs, FOXP3+ TILs, and tertiary lymphoid structures), and patient prognosis. RESULTS: Low amounts of tumor-stromal collagen were associated with poor differentiation (multivariable OR = 3.82, 95%CI = 1.41-12.2, P = 0.008) and CDKN2A/p16 alteration (OR [95%CI] = 2.06 [1.08-4.02], P = 0.03). Tumors with low collagen levels had shorter overall survival (HR [95%CI] = 2.38 [1.59-3.56], P < 0.0001). In the S-1 and gemcitabine (GEM) treatment groups, low tumor-stromal collagen was linked to poor prognosis of patients with PDAC (S-1 group: multivariable HR [95%CI] = 2.76 [1.36-5.79], P = 0.005; GEM group: multivariate HR [95%CI] = 2.91 [1.34-6.71], P = 0.007). Additionally, low amounts of tumor-stromal collagen were also linked to low levels of CD4+ TILs (P = 0.046), CD8+ TILs (P = 0.09), and tertiary lymphoid structures (P = 0.001). CONCLUSIONS: Tumor-stromal collagen deposition may play a crucial role in modulating tumor-immune microenvironment and determining response to adjuvant chemotherapy and patient survival outcomes.2023年10月, Journal of gastroenterology, 58(10) (10), 1055 - 1067, 英語, 国内誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2023年10月, 日本内分泌学会雑誌, 99(2) (2), 569 - 569, 日本語ラトケ嚢胞における染色マーカーの有用性と臨床像の関連
- Intraductal papillary mucinous neoplasm (IPMN) is a premalignant lesion of the pancreas that can occasionally manifest as recurrent acute pancreatitis. In this report, we discuss a unique case of a 49-year-old woman who presented with recurrent acute pancreatitis of an unknown cause for several years. Workup using peroral pancreatoscopy eventually showed main-duct IPMN with high-grade dysplasia as the obscure cause of recurrent acute pancreatitis. This case report highlights the clinical course of main-duct IPMN and the evolving role of peroral pancreatoscopy in patients with recurrent acute pancreatitis.2023年10月, ACG case reports journal, 10(10) (10), e01165, 英語, 国際誌
- 2023年09月, Annals of surgical oncology, 30(9) (9), 5790 - 5791, 英語, 国際誌研究論文（学術雑誌）
- Pancreatic cancer primarily arises from microscopic precancerous lesions, such as pancreatic intraepithelial neoplasia (PanIN) and acinar-to-ductal metaplasia (ADM). However, no established method exists for predicting pancreatic precancerous conditions. Endoscopic ultrasonography (EUS) can detect changes in pancreatic parenchymal histology, including fibrosis. This study aimed to elucidate the relationship between pancreatic parenchymal EUS findings and microscopic precancerous lesions. We retrospectively analyzed 114 patients with pancreatobiliary tumors resected between 2010 and 2020 and evaluated the association between pancreatic parenchymal EUS findings and the number of PanIN, ADM, and pancreatic duct gland (PDG). Of the 114 patients, 33 (29.0%), 55 (48.2%), and 26 (22.8%) had normal EUS findings, hyperechoic foci/stranding without lobularity, and hyperechoic foci/stranding with lobularity, respectively. Multivariate analyses revealed that abnormal EUS findings were significantly associated with the frequency of PanIN (hyperechoic foci/stranding without lobularity: OR [95% CI] = 2.7 [1.0-7.3], with lobularity: 6.5 [1.9-22.5], Ptrend = 0.01) and ADM (hyperechoic foci/stranding without lobularity: 3.1 [1.1-8.2], with lobularity: 9.7 [2.6-36.3], Ptrend = 0.003) but not with PDG (hyperechoic foci/stranding without lobularity: 2.2 [0.8-5.8], with lobularity: 3.2 [1.0-10.2], Ptrend = 0.12). We observed a trend toward a significantly higher number of precancerous lesions in the following order: normal findings, hyperechoic foci/stranding without lobularity, and hyperechoic foci/stranding with lobularity. Pancreatic parenchymal EUS findings were associated with the increased frequency of PanIN and ADM. Lobularity may help predict the increased number of precancerous lesions.2023年07月, Scientific reports, 13(1) (1), 12052 - 12052, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Sarcopenia, defined as a loss of skeletal muscle mass and quality, is found in 30-65% of patients with pancreatic ductal adenocarcinoma (PDAC) at diagnosis, and is a poor prognostic factor. However, it is yet to be evaluated why sarcopenia is associated with poor prognosis. Therefore, this study elucidated the tumor characteristics of PDAC with sarcopenia, including driver gene alterations and tumor microenvironment. PATIENTS AND METHODS: We retrospectively analyzed 162 patients with PDAC who underwent pancreatic surgery between 2008 and 2017. We defined sarcopenia by measuring the skeletal muscle mass at the L3 level using preoperative computed tomography images and evaluated driver gene alteration (KRAS, TP53, CDKN2A/p16, and SMAD4) and tumor immune (CD4+, CD8+, and FOXP3+) and fibrosis status (stromal collagen). RESULTS: In localized-stage PDAC (stage ≤ IIa), overall survival (OS) and recurrence-free survival were significantly shorter in the sarcopenia group than in the non-sarcopenia group (2-year OS 89.7% versus 59.1%, P = 0.03; 2-year RFS 74.9% versus 50.0%, P = 0.02). Multivariate analysis revealed that sarcopenia was an independent poor prognostic factor in localized-stage PDAC. Additionally, tumor-infiltrating CD8+ T cells in the sarcopenia group were significantly less than in the non-sarcopenia group (P = 0.02). However, no difference was observed in driver gene alteration and fib.rotic status. These findings were not observed in advanced-stage PDAC (stage ≥ IIb). CONCLUSIONS: Sarcopenia was associated with a worse prognosis and decreased tumor-infiltrating CD8+ T cells in localized-stage PDAC. Sarcopenia may worsen a patient's prognosis by suppressing local tumor immunity.2023年05月, Annals of surgical oncology, 30(9) (9), 5776 - 5787, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2023年05月, 日本内分泌学会雑誌, 99(1) (1), 395 - 395, 日本語
- (一社)日本内分泌学会, 2023年05月, 日本内分泌学会雑誌, 99(1) (1), 295 - 295, 日本語
- (一社)日本内分泌学会, 2023年05月, 日本内分泌学会雑誌, 99(1) (1), 311 - 311, 日本語
- (一社)日本内分泌学会, 2023年05月, 日本内分泌学会雑誌, 99(1) (1), 295 - 295, 日本語免疫チェックポイント阻害薬が惹起した腫瘍随伴性ACTH単独欠損症
- (一社)日本内分泌学会, 2023年05月, 日本内分泌学会雑誌, 99(1) (1), 311 - 311, 日本語抗PIT-1下垂体炎新規2例を加えた9症例の臨床的特徴
- (一社)日本内分泌学会, 2023年05月, 日本内分泌学会雑誌, 99(1) (1), 395 - 395, 日本語BMAHにおけるアルドステロン自律性分泌の検討
- (一社)日本内分泌学会, 2023年03月, 日本内分泌学会雑誌, 98(5) (5), 1636 - 1636, 日本語
- (一社)日本内分泌学会, 2023年03月, 日本内分泌学会雑誌, 98(5) (5), 1624 - 1624, 日本語
- (一社)日本病理学会, 2023年03月, 日本病理学会会誌, 112(1) (1), 362 - 362, 日本語直腸癌術後の人工肛門造設部に発生した胎児型形質を伴う癌の一例
- (一社)日本病理学会, 2023年03月, 日本病理学会会誌, 112(1) (1), 362 - 362, 日本語直腸癌術後の人工肛門造設部に発生した胎児型形質を伴う癌の一例
- BACKGROUND: Tertiary lymphoid structure (TLS) reflects an intense immune response against cancer, which correlates with favorable patient survival. However, the association of TLS with tumor-infiltrating lymphocytes (TILs) and clinical outcomes has not been investigated comprehensively in pancreatic ductal adenocarcinoma (PDAC). METHODS: We utilized an integrative molecular pathological epidemiology database on 162 cases with resected PDAC, and examined TLS in relation to levels of TILs, patient survival, and treatment response. In whole-section slides, we assessed the formation of TLS and conducted immunohistochemistry for tumor-infiltrating T cells (CD4, CD8, CD45RO, and FOXP3). As confounding factors, we assessed alterations of four main driver genes (KRAS, TP53, CDKN2A [p16], and SMAD4) using next-generation sequencing and immunohistochemistry, and tumor CD274 (PD-L1) expression assessed by immunohistochemistry. RESULTS: TLSs were found in 112 patients with PDAC (69.1%). TLS was associated with high levels of CD4+ TILs (multivariable odds ratio [OR], 3.50; 95% confidence interval [CI] 1.65-7.80; P = 0.0002), CD8+ TILs (multivariable OR, 11.0; 95% CI 4.57-29.7, P < 0.0001) and CD45RO+ TILs (multivariable OR, 2.65; 95% CI 1.25-5.80, P = 0.01), but not with levels of FOXP3+ TILs. TLS was associated with longer pancreatic cancer-specific survival (multivariable hazard ratio, 0.37; 95% CI 0.25-0.56, P < 0.0001) and favorable outcomes of adjuvant S-1-treatment. TLS was not associated with driver gene alterations but tumor CD274 negative expression. CONCLUSIONS: Our comprehensive data supports the surrogacy of TLS for vigorous anti-tumor immune response characterized by high levels of helper and cytotoxic T cells and their prognostic role.2023年01月, Journal of gastroenterology, 英語, 国内誌研究論文（学術雑誌）
- INTRODUCTION: A recently discovered facet of paraneoplastic adrenocorticotropic hormone (ACTH) deficiency exists in two forms: a paraneoplastic spontaneous isolated ACTH deficiency (IAD) and an immune checkpoint inhibitor (ICI)-related hypophysitis. Autoantibodies against corticotrophs, such as circulating anti-proopiomelanocortin (POMC) antibodies are considered disease markers. However, the number of identified cases was limited, implying that the characteristics of these autoantibodies are not fully understood. METHODS: We investigate circulating autoimmune autoantibodies in detail through a novel case of IAD that developed as a paraneoplastic autoimmune ACTH deficiency. RESULTS: The patient developed IAD after 25 weeks of ICI therapy for metastasis of large-cell neuroendocrine carcinoma at 69 years of age. Ectopic ACTH expression and infiltration of CD3+, CD4+, CD8+, and CD20+ lymphocytes were observed in the tumor tissues and circulating anti-POMC antibodies were detected specifically in the patient's serum. Moreover, detailed analyses of immunofluorescence staining using patient serum revealed that the recognition site of the autoantibody was ACTH25-39, which had not been identified in previous cases of paraneoplastic autoimmune ACTH deficiency. CONCLUSION: This case involved a combination of paraneoplastic spontaneously acquired IAD and ICI-related hypophysitis occupying the middle ground. Moreover, our study reveals new aspects of anti-POMC antibodies in patients with paraneoplastic ACTH deficiency. This report expands our understanding of the immunological landscape and provides new insights for the identification of antibodies associated with paraneoplastic autoimmune ACTH deficiency.2023年, Frontiers in immunology, 14, 1284301 - 1284301, 英語, 国際誌研究論文（学術雑誌）
- 2022年12月, Pathology international, 73(1) (1), 61 - 63, 英語, 国際誌研究論文（学術雑誌）
- Pheochromocytoma is a rare but life-threatening condition due to catecholamine release induced by drug treatments such as β-blockers or glucocorticoids. We present a case of hypertensive crisis due to pheochromocytoma, induced after the initiation of dexamethasone and landiolol during intensive care for severe coronavirus disease 2019 (COVID-19). Based on a detailed medical history review, the patient was previously diagnosed with primary aldosteronism by confirmatory tests, moreover, an abdominal computed tomography scan identified an adrenal tumor 2 years before current admission. We tentatively diagnosed the patient with pheochromocytoma and initiated α-blockers without conducting a catecholamine report, leading to stable hemodynamics. We present a successfully managed case of pheochromocytoma concomitant with COVID-19, which has become a global crisis.2022年11月, Endocrine journal, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND AND AIM: Endoscopic ultrasonography (EUS) findings of the pancreatic parenchyma, such as hyperechoic foci/stranding and lobularity, may be associated with the severity of chronic pancreatitis (CP). However, the correlation between parenchymal EUS findings and histology remains unclear. We designed a large-scale retrospective study analyzing over 200 surgical specimens to elucidate the association between parenchymal EUS findings and histological features. METHODS: Clinical data of 221 patients with pancreatobiliary tumors who underwent preoperative EUS and pancreatic surgery between January 2010 and November 2020 were reviewed to investigate the association between parenchymal EUS findings and histological features at the pancreatic body. None of these patients met the definition of CP. RESULTS: Of the 221 patients, 87 (39.4%), 89 (40.2%), and 45 (20.4%) had normal EUS findings, hyperechoic foci/stranding without lobularity, and hyperechoic foci/stranding with lobularity, respectively. In the multivariate analyses, parenchymal EUS findings significantly correlated with histological CP findings of fibrosis, inflammation, and atrophy (hyperechoic foci/stranding without lobularity vs hyperechoic foci/stranding with lobularity, odds ratio [95% confidence interval]: 4.1 [2.2-7.9] vs 31.3 [9.3-105.6], Ptrend < 0.001; 3.9 [1.9-8.2] vs 21.8 [8.0-59.4], Ptrend < 0.001; and 4.0 [2.0-7.8] vs 22.9 [7.0-74.5], Ptrend < 0.001, respectively). Further, a trend toward higher histological grade was observed in the following order: normal findings, hyperechoic foci/stranding without lobularity, and hyperechoic foci/stranding with lobularity. CONCLUSIONS: Endoscopic ultrasonography findings of the pancreatic parenchyma may be associated with the histological conditions in CP, such as pancreatic fibrosis, inflammation, and atrophy. Lobularity reflects more severe histological conditions than does hyperechoic foci/stranding.2022年10月, Journal of gastroenterology and hepatology, 38(1) (1), 103 - 111, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2022年10月, 日本内分泌学会雑誌, 98(2) (2), 598 - 598, 日本語嚢胞形成を伴う褐色細胞腫4例の嚢胞内カテコラミン分画の検討
- (一社)日本内分泌学会, 2022年10月, 日本内分泌学会雑誌, 98(2) (2), 598 - 598, 日本語嚢胞形成を伴う褐色細胞腫4例の嚢胞内カテコラミン分画の検討
- Endoscopic papillectomy for early ampullary tumors is considered a minimally invasive and useful alternative to pancreatoduodenectomy; however, its indications remain unclear. This study aimed to clarify the advantages of endoscopic papillectomy by investigating the clinical outcomes of patients who underwent endoscopic papillectomy or pancreatoduodenectomy for early ampullary tumors. Patients diagnosed with early ampullary tumors (adenoma, Tis, T1a) who underwent endoscopic papillectomy or pancreatoduodenectomy between June 2008 and October 2019 were included, and their clinical outcomes were analyzed. Seventy-four patients (34 patients with adenomas and 40 patients with adenocarcinomas) were divided into two groups, namely endoscopic papillectomy (n = 43) and pancreatoduodenectomy (n = 31). The estimated 5-year overall survival rate of all early ampullary tumors was 92%. Complete resection rate was significantly lower for endoscopic papillectomy patients versus pancreatoduodenectomy patients (48.8% vs. 100%; p < 0.001). Recurrence was more common in the endoscopic papillectomy group compared to the pancreatoduodenectomy group (16.3% vs. 3.2%; p = 0.128), but all recurrences were controllable by endoscopic treatment. The median length of hospital stay for the endoscopic papillectomy group was significantly shorter compared to the endoscopic papillectomy group (11 days vs. 42 days; p < 0.001). The Comprehensive Complication Index was significantly lower in the endoscopic papillectomy group compared to the pancreatoduodenectomy group (14.8 vs 22.6%; p = 0.002). Endoscopic papillectomy for early ampullary tumors is useful and may be an alternative treatment for pancreatoduodenectomy in selected cases.2022年09月, Scientific reports, 12(1) (1), 15134 - 15134, 英語, 国際誌研究論文（学術雑誌）
- 2022年08月, Scientific reports, 12(1) (1), 13238 - 13238, 英語, 国際誌
- ACTH産生下垂体腺腫(ACTHoma)において、患者のグルココルチコイドの状態が腫瘍浸潤Tリンパ球に与える影響を明らかにするため2つの検討を行った。検討1として、未治療のACTHoma 29例と対照群(GH産生腫瘍10例、ゴナドトロフ産生腫瘍10例)の浸潤リンパ球数を比較した。検討2として、コルチコトロフ腫瘍53例を対象とし、術前にメチラポンを投与した群(13例)と投与しなかった群(29例)、および臨床的に非機能性腺腫であるsilent corticotroph adenoma群(11例)に分け、浸潤リンパ球数を比較した。その結果、患者のコルチゾールレベルに関係なくコルチコトロフ腫瘍に共通してT細胞浸潤が少ないことと、術前投薬によりコルチゾールを是正することで腫瘍へのCD4陽性T細胞浸潤が回復することが明らかになった。(一社)日本内分泌学会, 2022年08月, 日本内分泌学会雑誌, 98(Suppl.HPT) (Suppl.HPT), 34 - 37, 日本語
- Cases in which bilateral adrenal 123I-Metaiodobenzylguanidine (123I-MIBG) scintigraphy accumulation is sometimes shown, with mildly elevated catecholamine (CA) or metanephrine (MN) levels (within 3 times the upper reference limit) are diagnostic dilemmas. We experienced 3 cases of adrenal incidentalomas with this dilemma in the differential diagnosis. The clinical diagnosis was subclinical Cushing's syndrome in 2 cases, and primary aldosteronism in 1. Despite suspected CA excess in clinical symptoms and imaging findings, the pathological findings of all these tumors were revealed to be cytochrome P450 family 11 subfamily B member 1 (CYP11B1) positive adrenocortical adenomas. Interestingly, adrenal medullary hyperplasia (AMH) was detected in the adrenal parenchyma of all those backgrounds. To clarify the clinical features of such cases, a cross-sectional study was conducted at the Kobe University Hospital from 2014 to 2020. One-hundred sixty-four patients who had undergone 123I-MIBG scintigraphy were recruited. Among them, 10 patients (6.1%) met the above criteria, including the presented 3 cases. Plasma adrenaline, noradrenaline, urinary metanephrine, and normetanephrine had values of 0.05 ± 0.05 ng/mL, 0.63 ± 0.32 ng/mL, 0.22 ± 0.05 mg/day, and 0.35 ± 0.16 mg/day, respectively. Nine cases were complicated with hypertension, and symptoms related to CA excess were observed. Half of them (5 cases) including presented 3 cases had unilateral adrenal tumors. These suggest that in cases of bilateral adrenal uptake on 123I-MIBG, AMH needs to be considered. Adrenocortical adenomas may be associated with AMH and further larger investigation is needed for this pathology.2022年06月, Scientific reports, 12(1) (1), 9276 - 9276, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN) is defined as PDAC occurring apart from IPMN. This study comprehensively investigated the molecular biologic characteristics of PDAC concomitant with IPMN in major genetic alterations, tumor microenvironment, and prognosis by contrast with those of conventional PDAC. METHODS: The study retrospectively reviewed the data of 158 surgically resected PDAC patients. The driver gene alteration status (KRAS, TP53, CDKN2A, SMAD4, and GNAS) together with the immune and fibrotic status in tumor was evaluated. The prognosis of PDAC concomitant with IPMN and that of conventional PDAC also were compared. RESULTS: No statistically significant difference was found between PDAC concomitant with IPMN and conventional PDAC in the alteration frequency analysis of the major driver genes and the immune and fibrotic status in the tumor microenvironment. Overall survival and disease-free survival between patients who had PDAC concomitant with IPMN and those who had conventional PDAC did not show statistically significant differences in propensity-matched subjects. Furthermore, the co-existence of IPMN was not a poor prognostic factor in the multivariable-adjusted Cox proportional hazards model (hazard ratio, 0.95; 95 % confidence interval, 0.51-1.78). CONCLUSIONS: In this study, PDAC concomitant with IPMN had tumor characteristics similar to those of conventional PDAC in terms of the major driver gene alterations, tumor microenvironment, and prognosis.2022年05月, Annals of surgical oncology, 29(8) (8), 4924 - 4934, 英語, 国際誌研究論文（学術雑誌）
- 2022年05月, Annals of surgical oncology, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: To clarify the characteristics of Cushing's disease (CD) patients who respond to the desmopressin (DDAVP) test and its underlying mechanisms. METHODS: Forty-seven patients with CD who underwent DDAVP testing were included. Patients were divided into two groups: DDAVP test (+) (adrenocorticotropic hormone [ACTH] levels increased by ≥ 1.5-fold during the DDAVP test) and DDAVP test (-) (ACTH levels increased by < 1.5-fold). AVP receptor expression levels in these tumors were quantified using quantitative RT-PCR and immunohistochemistry. AVP receptor promoter activity was analyzed using a dual-luciferase reporter assay system. RESULTS: Females (96.9%) and USP8 mutants (85.7%) were more prevalent in the DDAVP test (+) than in the DDAVP test (-). Indeed, the ACTH and cortisol responsiveness to DDAVP was greater in USP8 mutation positive tumors than that in USP8 wild type tumors (3.0-fold vs. 1.3-fold, 1.6-fold vs. 1.1-fold, respectively). Responsiveness to DDAVP was correlated with the expression levels of AVPR1B, but not with those of AVPR2. Comparably, Avpr1b promoter activity was enhanced by the overexpression of mutant USP8 compared to the wild type. CONCLUSIONS: We found that the responsiveness of ACTH to DDAVP in CD was greater in tumors with USP8 mutations. The present data suggest that USP8 mutations upregulate the AVPR1B promoter activity. Additionally, we showed that the DDAVP test can predict the presence of USP8 mutations.2022年04月, Pituitary, 25(3) (3), 496 - 507, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2022年03月, 日本内分泌学会雑誌, 97(5) (5), 1622 - 1622, 日本語
- (一社)日本病理学会, 2022年03月, 日本病理学会会誌, 111(1) (1), 308 - 308, 日本語Adrenohepatic fusionを背景に発生した副腎皮質腺腫の1例
- Placental mesenchymal dysplasia (PMD) is a rare placental abnormality that is closely related to severe pregnancy complications. A 27-year-old woman with fetal growth restriction and placenta previa was referred to a university hospital at 22 gestational weeks (GW). She was suspected of having a twin pregnancy with a complete or partial hydatidiform mole and coexisting normal live fetus, because two separate placentas, an enlarged one with multiple cystic lesions and a normal one, were shown on ultrasound examinations. At 27 GW, she experienced a sudden intrauterine fetal death (IUFD) after bleeding due to placenta previa, despite confirmation of fetal well-being at 2 h before bleeding. After delivery, histopathological examination confirmed the diagnosis of PMD. This is the first documented case of a woman with PMD and placenta previa who had a sudden IUFD after bleeding. Patients with both PMD and placenta previa should be considered at extremely high risk for IUFD.2021年11月, The journal of obstetrics and gynaecology research, 47(11) (11), 4087 - 4092, 英語, 国際誌
- (一社)日本内分泌学会, 2021年10月, 日本内分泌学会雑誌, 97(2) (2), 539 - 539, 日本語
- (一社)日本内分泌学会, 2021年10月, 日本内分泌学会雑誌, 97(2) (2), 501 - 501, 日本語
- (一社)日本内分泌学会, 2021年10月, 日本内分泌学会雑誌, 97(2) (2), 501 - 501, 日本語USP8変異はV1b受容体発現、DDAVP試験反応性亢進と関連する
- (一社)日本内分泌学会, 2021年10月, 日本内分泌学会雑誌, 97(2) (2), 539 - 539, 日本語paragangliomaとganglioneuromaの混合腫瘍の1例
- We herein report three cases of mature teratomas with pineal gland differentiation, which is a less recognized phenomenon. Case 1 was a 6-year-old male with a neck mass, Case 2 was a 23-year-old female with a retroperitoneal mass, and Case 3 was a 45-year-old female with a retroperitoneal mass. Each case showed the typical macroscopic and histological findings of mature teratoma, such as solid and cystic lesions mainly lined with a mature squamous epithelium. All cases also showed glial differentiation. Small foci of lobulated cell nests were detected in the center of or adjacent to mature glial tissue. Cells had a clear to pale eosinophilic cytoplasm with small round nuclei. Immunohistochemically, cells were positive for synaptophysin, neurofilament protein with a perivascular "club-shaped swelling" pattern, and cone-rod homeobox protein. To the best of our knowledge, this is the first report of pineal gland differentiation arising in mature teratoma, which may be easily overlooked or misdiagnosed as somatic-type tumors, particularly neuroendocrine tumors. To avoid overtreatment, pathologists need to be aware that pineal gland differentiation may occur in mature teratomas.Wiley, 2021年09月, Pathology international, 71(11) (11), 771 - 776, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (公社)日本医学放射線学会, 2021年08月, 日本医学放射線学会秋季臨床大会抄録集, 57回, S455 - S455, 日本語耳管軟骨から生じたと考えられる軟骨系腫瘍の1例
- (公社)日本医学放射線学会, 2021年08月, 日本医学放射線学会秋季臨床大会抄録集, 57回, S455 - S455, 日本語耳管軟骨から生じたと考えられる軟骨系腫瘍の1例
- Objective: This study aimed to investigate risk factors predictive of local recurrence and/or lymph node metastasis after transoral resection of early hypopharyngeal cancer. Methods: Forty-nine consecutive patients who underwent transoral videolaryngoscopic surgery (TOVS) as an initial treatment for hypopharyngeal cancer were evaluated. On univariate and multivariate analysis, local recurrence rates were assessed respectively using log-rank test and cox regression analysis according to the following parameters: subsite, pT, mucosal margin, lymphatic invasion, vessel invasion, tumor thickness (> 4 mm vs ≤4 mm), history of esophageal cancer, and multiple Lugol-voiding lesions (LVLs) in the esophagus. Categorical variables were evaluated for their associations with lymph node metastasis using chi-squared test or Fisher's exact test. Result: The subsites of primary lesions were piriform sinus in 24 patients, posterior wall in 15 patients, and postcricoid in 10 patients. Thirty patients had esophageal cancer. Local recurrence occurred in 14 patients. Three patients had lymph node metastasis at the time of diagnosis and four patients developed lymph node metastasis after the initial treatment, resulting a total of seven patients having lymph node metastasis. While mucosal margin and LVLs showed significant associations with local recurrence on univariate analysis, only LVLs remained as a significant risk factor on multivariate analysis (P = .0395; hazard ratio = 8.897; 95% confidence interval, 1.113-71.15). Most cases of local recurrence were satisfactorily controlled by repeated TOVS. While multivariate analysis could not be performed due to the small number of the patients with lymph node metastases, venous invasion (P = .0166) and tumor thickness (P = .0092) were significantly associated with lymph node metastasis on univariate analysis. Conclusions: Local recurrence was more frequent in patients with LVLs, but most of them were salvaged by repeated TOVS. Patients with venous invasion and/or tumor thickness greater than 4 mm should be followed up with special attention to lymph node metastasis.Level of Evidence: 3.2021年08月, Laryngoscope investigative otolaryngology, 6(4) (4), 756 - 763, 英語, 国際誌研究論文（学術雑誌）
- 症例1は70歳代女性、症例2は50歳代で症例1の長男であった。難治性高血圧症の精査より、原発性両側性大結節副腎皮質過形成(PBMAH)によるサブクリニカルクッシング症候群(SCS)と診断した。症例1は保存的治療中に急性大動脈解離(Stanford A型)を発症し死亡し、症例2は腹腔鏡下左副腎摘出術後に急性大動脈解離(StanfordB型)を発症し保存加療された。血液およびDNA解析よりARMC5遺伝子変異を認めた。次男が他院にて高血圧症と両側副腎大結節を指摘されていたため血液解析を行い、長男と同様にARMC5遺伝子変異を認めた。全例がCSの特徴的な身体所見を認めずコルチゾール分泌量がそれほど過大でないSCSで、ARMC5遺伝子変異を持つPBMAHの家族例3例中2例に重篤な急性大動脈解離を発症した特異的症例である。(一社)日本内分泌学会, 2021年07月, 日本内分泌学会雑誌, 97(Suppl.Update) (Suppl.Update), 62 - 65, 日本語
- (株)文光堂, 2021年06月, 病理と臨床, 39(6) (6), 611 - 616, 日本語
- (株)文光堂, 2021年06月, 病理と臨床, 39(6) (6), 611 - 616, 日本語
- Beta-catenin-activated hepatocellular adenoma is potentially malignant and warrants careful follow-up and surgical resection. Here, we report a 48-year-old man in whom a 55 mm single liver tumor was incidentally detected in the S1 segment. Contrast-enhanced computed tomography scans showed no enhancement in the early phase and a slight defection in the late phase. The tumor was enhanced hyperintensity in the hepatobiliary phase on Gd-ethoxybenzyl-diethylenetriaminepentaacetic acid-enhanced magnetic resonance imaging. The histologic features of ultrasound-guided fine-needle aspiration biopsy indicated hepatocellular adenoma, and the tumor was immunohistochemically positive for glutamine synthetase and β-catenin. Considering the risk of malignant transformation, he underwent laparoscopic-assisted partial liver resection. The resected tumor did not contain any malignant lesions. This case indicates that aspiration needle biopsy and immunohistochemistry were useful for histological diagnosis and treatment decisions based on the molecular definition of hepatocellular adenoma.2021年06月, Clinical journal of gastroenterology, 14(3) (3), 831 - 835, 英語, 国内誌研究論文（学術雑誌）
- A 78-year-old man who underwent right nephrectomy for renal cell carcinoma (RCC) 18 years ago visited our hospital complaining of abdominal pain. Imaging revealed that the pancreatic head tumor obstructed the Santorini duct. We suspected a pancreatic intraductal tumor, such as an intraductal tubulopapillary neoplasm or intraductal papillary mucinous neoplasm. Thus, the patient underwent subtotal stomach-preserving pancreaticoduodenectomy. Pathological findings confirmed the diagnosis of metastatic RCC. Herein, we report a case of pancreatic metastasis of an RCC that presented with a tumor in the pancreatic duct.2021年06月, Clinical journal of gastroenterology, 14(3) (3), 905 - 909, 英語, 国内誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 225 - 225, 日本語
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 259 - 259, 日本語
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 286 - 286, 日本語
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 224 - 224, 日本語高レニン、高アルドステロンを呈したDOC産生副腎皮質癌の一例
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 259 - 259, 日本語ACTH産生下垂体腺腫における腫瘍微小環境解析
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 286 - 286, 日本語治療抵抗性高血圧症、低カリウム血症を呈し、レニン産生が疑われた副腎皮質癌の一例
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 223 - 223, 日本語妊娠中に高血圧と精神症状を呈した副腎皮質・髄質混合腫瘍の1例
- (一社)日本内分泌学会, 2021年04月, 日本内分泌学会雑誌, 97(1) (1), 347 - 347, 日本語カテコラミン軽度上昇を呈するMIBG両側副腎集積例の検討
- Capicua transcriptional repressor (CIC)-rearranged sarcoma is an Ewing-like sarcoma with an aggressive clinical course and poor prognosis. No standard treatment has been established. The present study describes a case of CIC-rearranged sarcoma with lung metastases developing in a 24-year-old woman as a therapy-associated malignancy following chemotherapy for anaplastic large cell lymphoma at nine years old. This was treated with palliative regimens used for Ewing sarcoma. The patient achieved disease control for one year. Of note, ifosfamide and etoposide (IE), which were used as a second line treatment lead to a partial response. The case described in the present study indicated that treatment with Ewing regimens is a reasonable option for patients with metastatic CIC-rearranged sarcoma, including those with a second malignant case.2021年04月, Molecular and clinical oncology, 14(4) (4), 68 - 68, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本病理学会, 2021年03月, 日本病理学会会誌, 110(1) (1), 325 - 325, 日本語腫瘍内にびまん性に粘液を認め、悪性度の評価に難渋した副腎皮質腫瘍の一例
- (一社)日本病理学会, 2021年03月, 日本病理学会会誌, 110(1) (1), 261 - 261, 日本語松果体分化を伴う成熟奇形腫の3例
- (一社)日本病理学会, 2021年03月, 日本病理学会会誌, 110(1) (1), 325 - 325, 日本語腫瘍内にびまん性に粘液を認め、悪性度の評価に難渋した副腎皮質腫瘍の一例
- Advanced mandibular osteoradionecrosis (ORN) sometimes requires extended resection (e.g., hemimandibulectomy). Bacterial infection contributes to ORN pathogenesis. To control infection and determine the extent of debridement required, an understanding of bacterial spread within sites of mandibular ORN is important. The current study used a histopathological approach to assess bacterial colonization in the mandibular condyle and elucidate possible paths of bacterial spread towards the mandibular condyle. Four hemimandibulectomy specimens were selected. Areas of bone destruction were macroscopically assessed and confirmed using hematoxylin and eosin staining. Bacterial presence within mandibular condyle was confirmed with Gram staining. Bone exposure was observed in the molar area in all specimens. Macroscopic bone destruction was apparent especially near the medial side of the cortical wall. Gram staining revealed bacterial colonization of the mandibular condyle in three of the four specimens. In conclusion, bacteria tended to spread posteriorly and through the medial side of the mandibular cortical wall. In patients with advanced ORN, the potential for bacterial colonization of the mandibular condyle should be considered during treatment.2021年, International journal of dentistry, 2021, 9998397 - 9998397, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is associated with acute pancreatitis (AP) in some cases, however its causes have not been fully elucidated. We investigated the association of the incidence of AP with epithelial subtypes and pancreatic volume in IPMN. METHODS: This retrospective study included 182 consecutive surgically resected IPMN patients between January 2000 and December 2018. The relationship between the incidence of AP and epithelial subtypes of IPMN and pancreatic volume was investigated. Epithelial subtypes of IPMN were classified into gastric (G type: N = 116), intestinal (I type: N = 49), pancreatobiliary (PB type: N = 14), and oncocytic types (O type: N = 3). Pancreatic volume of the contrast-enhanced computed tomography scan was measured using Ziostation2 software. Histological pancreatic parenchymal atrophy was also evaluated. RESULTS: AP occurred more frequently in I-types (I-type vs. G-type, 22.4% [11/49] vs 3.4% [4/116], P = 0.003) and PB-types (PB type vs. G-type, 35.7% [5/14] vs. 3.4% [4/116], P = 0.007) in comparison with G-types, which constituted the majority of the resected IPMNs. AP occurred more frequently in I-type patients with high pancreatic volumes (I-type with high pancreatic volume vs. I-type with low pancreatic volume, 37.0% [10/27] vs. 4.7% [1/21], P = 0.02). However, histological atrophy did not show an additional influence on the association between the incidence of AP and epithelial subtypes. The elevation of serum pancreatic enzymes was not significantly related to epithelial subtypes. CONCLUSION: Epithelial subtypes and the degree of pancreatic volume may be closely associated with the incidence of AP in IPMN.2021年01月, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 21(1) (1), 138 - 143, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内分泌学会, 2020年10月, 日本内分泌学会雑誌, 96(2) (2), 494 - 494, 日本語
- (一社)日本内分泌学会, 2020年10月, 日本内分泌学会雑誌, 96(2) (2), 542 - 542, 日本語血中遊離メタネフリン分画が鑑別に有用であった副腎腺腫の1例
- Oral lichenoid conditions (OLC), including oral lichen planus (OLP), oral lichenoid lesions and oral lichenoid dysplasia, differ in pathogenesis and biological malignancy. However, distinguishing them based on clinical or histological features is difficult. It is well known that CD163+ macrophages are associated with oral cancer aggressiveness. We recently demonstrated that CD163+ macrophages of noncancerous lesions infiltrate the stroma, not the intraepithelial area. In this report, we describe a case of OLC that was not detected as malignant by the first local biopsy. Furthermore, we evaluated the malignant potency of OLC by retrospectively comparing the histological findings between local biopsy and resected specimens focusing on CD163+ macrophages. A 72-year-old man with a white lesion in the unilateral buccal mucosa was diagnosed with OLP through the biopsy although invasive cancer was detected two years later. Intraepithelial CD163+ macrophages were found not only on the resected specimen but also biopsy. This is the first report to demonstrate that intraepithelial CD163+ macrophages may be noteworthy indicators to identify the malignant potency of OLC.MDPI AG, 2020年08月, Diagnostics, 10(9) (9), 624 - 624, 国際共著していない[査読有り]研究論文（学術雑誌）
- 67歳男。味覚変化の原因精査目的で当科を紹介受診した。諸検査の結果から完全型中枢性尿崩症と診断した。下垂体MRIで下垂体茎の肥厚、後葉の腫大、造影増強効果を認め、髄液中の胚細胞腫関連マーカーは陰性で、下垂体前葉機能は正常であったことから、中枢性尿崩症の原因疾患としてリンパ球性漏斗下垂体後葉炎の可能性が考えられた。この時点では組織診断等の原因精査に患者の同意が得られなかったため、補充療法を優先してデスモプレシン投与を開始し、症状は寛解した。しかし、初診の11ヵ月後に誘因なく倦怠感と食思不振が出現し、内分泌学的検査で汎下垂体機能低下症の併発が判明した。MRIで下垂体の腫大、血液検査でIgG4高値を認め、経鼻的下垂体生検によりIgG4関連下垂体炎と診断した。プレドニゾロン30mg/日投与を開始したところ下垂体腫大は劇的に縮小した。(一社)日本内分泌学会, 2020年08月, 日本内分泌学会雑誌, 96(Suppl.HPT) (Suppl.HPT), 17 - 20, 日本語
- (一社)日本内分泌学会, 2020年08月, 日本内分泌学会雑誌, 96(1) (1), 249 - 249, 日本語
- (一社)日本内分泌学会, 2020年08月, 日本内分泌学会雑誌, 96(1) (1), 372 - 372, 日本語
- (一社)日本内分泌学会, 2020年08月, 日本内分泌学会雑誌, 96(1) (1), 374 - 374, 日本語
- PURPOSE: Multidisciplinary team meetings (MDMs) to address various clinical problems have become common, especially for cancer care. However, the impact of MDMs on adrenal tumor care has rarely been reported. We organized an endocrine tumor MDM including adrenal tumors in August 2014. The objective of this study was to assess the impact of our adrenal tumor MDMs on patient clinical outcomes. We compared several parameters measuring clinical outcomes before and after MDMs were instituted. METHODS: The adrenal tumor MDMs included an endocrinologists, urologists, radiologists, pathologists, and residents. We analyzed 128 consecutive cases of functioning adrenal tumors (primary aldosteronism (PA), n = 53; Cushing's syndrome (CS), n = 24; pheochromocytoma (PCC), n = 51) who underwent surgery in Kobe University Hospital from 2008 to 2019, and compared clinical parameters before (n = 68) and after (n = 60) MDMs were instituted. RESULTS: Twenty-one selected cases including PA, CS, PCC, adrenocortical carcinoma, and metastatic adrenal tumor were discussed in the MDM. In the analysis of 128 cases, the difference between pre- and postoperative systolic BP (ΔBP) in patients with PA after MDMs were instituted was smaller compared with those before (p = 0.02). In CS, preoperative steroid synthesis inhibitors were used more often (33 vs. 100%, p < 0.01), postoperative plasma ACTH levels were higher (29.1 vs. 84.5 pg/mL, p < 0.01), and postoperative decrease in systolic BP was milder (p < 0.01) after MDMs were instituted. In PCC, doses of preoperative doxazosin were higher (p < 0.01) after MDMs institution. Operating time, bleeding volume, and cure rate did not differ between each tumor type. CONCLUSIONS: These data suggest that instituting MDMs improved the perioperative management of functioning adrenal tumors.2020年07月, Endocrine, 69(3) (3), 519 - 525, 英語, 国際誌, 国際共著していない[査読有り]研究論文（学術雑誌）
- The Endocrine Society, 2020年07月, Journal of the Endocrine Society, 4(9) (9), 国際誌, 国際共著していない
Abstract Adrenal corticomedullary mixed tumors (CMMTs) are extremely rare: with only 20 cases being reported to date the pathogenesis has remained elusive. A 31-year-old woman developed gestational hypertension with psychiatric disturbances persistent to postpartum, diagnosed with pheochromocytoma, for which adrenalectomy was performed. Histological findings showed mixed adrenocortical adenoma and pheochromocytoma. Double immunostaining of inhibin and INSM1 (insulinoma-associated protein 1) showed that the two tumor components had distinct functional properties. Exome analysis of peripheral leukocytes and tumor (singular as anatomically it is only one mass) revealed a homozygous germline FGFR4-G388R variant. As a readout of the variant, serine phosphorylation of signal transducer and activator of transcription 3 (STAT3) was detected only in the nucleus of adrenocortical adenoma component but not in the pheochromocytoma component. No tyrosine phosphorylation of STAT3 was detected. We report a case of CMMT with the germline FGFR4-G388R variant. Although additional studies are required, our immunohistochemical analysis suggests that the variant may play a role in the development of the adrenocortical component within the pheochromocytoma, leading to CMMT.[査読有り]研究論文（学術雑誌） - Elsevier BV, 2020年07月, Radiology Case Reports, 15(7) (7), 1023 - 1028, 国際共著していない[査読有り]研究論文（学術雑誌）
- Sarcomas and related proliferative lesions of the specialized stroma of the prostate are very rare and have been classified into prostate stromal sarcoma (PSS) and prostatic stromal tumor of uncertain malignant potential based on histology. We herein describe a case of PSS. A 40-year-old male presented at a hospital with urinary distention. Magnetic resonance imaging revealed a large prostate mass, and the diagnosis was prostate sarcoma of uncertain differentiation by ultrasound-guided needle biopsy. Total pelvic exenteration was performed and a pathological diagnosis of PSS was ultimately reached. Ten months later, there have been no signs of metastasis or recurrence.2020年06月, Journal of surgical case reports, 2020(6) (6), rjaa165, 英語, 国際誌研究論文（学術雑誌）
- We herein describe soft tissue tumor arising in the lower extremity of a pediatric patient. The tumor displayed a unique and wide range of histological features, sheet-like and cohesive growth pattern consisting of enlarged round to epithelioid atypical cells with a large alveolar and pseudopapillary histological architecture, focally mimicking alveolar soft part sarcoma and MiT family translocation renal cell carcinoma. Tumor cells were focally immunoreactive for cytokeratin, S-100, and EMA. RNA sequencing identified a novel in-frame NR1D1 (exon 5)-MAML1 (exon 2) gene rearrangement resulting in the formation of a putative chimeric protein containing the N-terminal C4-type zing finger domains of NR1D1 and the C-terminal MAML1 protein, which was confirmed by subsequent RT-PCR, Sanger sequencing, and FISH assay. To the best of our knowledge, NR1D1-MAML1 fusion has not yet been described in any neoplasms, suggesting the emergence of a novel tumor entity.2020年05月, Virchows Archiv : an international journal of pathology, 477(6) (6), 891 - 895, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- 日本胆道学会, 2020年05月, 胆道, 34(2) (2), 244 - 250, 日本語
- (公社)日本臨床細胞学会, 2020年05月, 日本臨床細胞学会雑誌, 59(Suppl.1) (Suppl.1), 343 - 343, 日本語原発推定に苦慮した転移性脊椎腫瘍の一例
- (公社)日本臨床細胞学会, 2020年05月, 日本臨床細胞学会雑誌, 59(Suppl.1) (Suppl.1), 343 - 343, 日本語原発推定に苦慮した転移性脊椎腫瘍の一例
- 2020年04月, Genes, chromosomes & cancer, 59(4) (4), 249 - 254, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- 泌尿器科紀要刊行会, 2020年03月, 泌尿器科紀要, 66(3) (3), 100 - 100, 日本語下大静脈平滑筋肉腫の1例
- (一社)日本病理学会, 2020年03月, 日本病理学会会誌, 109(1) (1), 386 - 386, 日本語右側頭葉に発生したhistiocytic sarcomaの一例
- (一社)日本内分泌学会, 2020年02月, 日本内分泌学会雑誌, 95(4) (4), 1693 - 1693, 日本語
- (一社)日本内分泌学会, 2019年10月, 日本内分泌学会雑誌, 95(2) (2), 722 - 722, 日本語中枢性尿崩症で発症し原因疾患の同定に難渋した67歳男性の症例[査読有り]
- (一社)日本病理学会, 2019年04月, 日本病理学会会誌, 108(1) (1), 395 - 395, 日本語リンパ節転移を認めた副腎ganglioneuromaの1例
- (一社)日本内分泌学会, 2019年04月, 日本内分泌学会雑誌, 95(1) (1), 404 - 404, 日本語
- Japan Gastroenterological Endoscopy Society, 2019年, Gastroenterological Endoscopy, 61(4) (4), 374 - 380, 日本語研究論文（学術雑誌）
- 2019年01月, Placenta, 75, 62 - 67, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本病理学会, 2018年10月, 日本病理学会会誌, 107(2) (2), 117 - 117, 日本語多形型脂肪肉腫様成分を有する後腹膜脱分化型脂肪肉腫の一例[査読有り]
- Carcinoma arising in lingual thyroid is an extremely rare entity accounting for only 1% of all reported ectopic thyroids. Here, we report a case of carcinoma arising in lingual thyroid, which has been successfully managed by transoral resection and bilateral neck dissections. A lingual mass 4-cm in diameter with calcification was incidentally detected by computed tomography at medical check-up. No thyroid tissue was observed in normal position. Ultrasound examination showed bilateral multiple lymphadenopathies. Fine needle aspiration biopsy from lymph node in his right neck was diagnosed as Class III and thyroglobulin level of the specimen was 459ng/ml. Due to the difficulty in performing FNA of the lingual masses, right neck dissection was performed in advance for diagnostic purpose. Pathological examination showed existence of large and small follicular thyroid tissues in several lymph nodes, suggesting lymph node metastasis from thyroid carcinoma. Two months after the initial surgery, video-assisted transoral resection of lingual thyroid with simultaneous left neck dissection was performed. Postoperative course was uneventful. Papillary carcinoma was found in the lingual thyroid and thyroid tissues were also found in left cervical lymph nodes. Video-assisted transoral resection was useful for the treatment of thyroid cancer arising in lingual thyroid.2018年10月, Auris, nasus, larynx, 45(5) (5), 1127 - 1129, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本内分泌学会, 2018年09月, 日本内分泌学会雑誌, 94(2) (2), 713 - 713, 日本語
- 2018年09月, Pathology international, 68(9) (9), 524 - 529, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本透析医学会, 2018年08月, 日本透析医学会雑誌, 51(8) (8), 517 - 523, 日本語
- 2017年02月, Int Surg, 英語[査読有り]研究論文（学術雑誌）
- Our objective is to elucidate the usefulness of maspin/p53 double immunostaining on biliary brushing cytology specimens. We first examined the expression of maspin in the biliary epithelium with variable degrees of dysplasia using surgically resected specimens (n = 56). Maspin appeared to be overexpressed in a stepwise manner from benign to malignant cholangiocytes: the reactive epithelium (20%), biliary intraepithelial neoplasia (~50%), and invasive cholangiocarcinomas (>90%). Next, an automated sequential double immunostaining protocol for maspin and p53 was applied to paraffin-embedded cell blocks of the biliary brushing cytology specimens obtained from 58 consecutive patients. Cell block preparation was successful in 44 cases (76%), which were morphologically diagnosed as adenocarcinoma (n = 16), atypical cells not diagnostic for malignancy (n = 10), and benign (n = 18). Double positive cells were observed in 14/16 (88%) morphologically malignant, 6/10 (60%) borderline, and 0/18 benign cases. All 20 positive cases were proven to have pancreatobiliary malignancies by subsequent imaging or pathological analyses. A similar staining protocol for S100P and p53 was also applied to the same cohort; however, the positive frequency was slightly lower than those of maspin and p53 (36% vs. 45%). In conclusion, Maspin/p53 double immunostaining on cell blocks contributes to the detection of malignant cells in biliary brushing cytology specimens.2017年02月, Pathology international, 67(2) (2), 91 - 98, 英語, 国際誌[査読有り]
- AIMS: The aim of this study was to achieve a better definition of intraductal papillary neoplasms of the bile duct (IPNBs). METHODS AND RESULTS: Biliary tumours that showed predominantly intraductal papillary growth were provisionally classified as IPNBs (n = 25) and papillary cholangiocarcinomas (n = 27). IPNB was defined as a neoplasm that is confined to the epithelium or is regularly arranged in a high-papillary architecture along thin fibrovascular stalks, whereas the term 'papillary cholangiocarcinoma' was used for tumours with more complex papillary structures (e.g. irregular papillary branching or mixed with solid-tubular growth). In our consecutive cohort of biliary neoplasms, 5% were classified as IPNBs, and 10% as papillary cholangiocarcinomas. IPNBs differed from papillary cholangiocarcinomas by less advanced invasion, gross mucin overproduction (72% versus 7%), and their prevalent location (84% of IPNBs in intrahepatic/hilar ducts; 70% of papillary cholangiocarcinomas in extrahepatic ducts). Gastric-type and oncocytic-type tumours were only detected in IPNBs. Expression of mucin core proteins and cytokeratin 20 significantly differed between the two groups. KRAS and GNAS were wild-type genotypes in all but one case of KRAS-mutated IPNB. Patients with IPNB had better recurrence-free survival than those with papillary cholangiocarcinoma (P = 0.007). In multivariate analysis, in which several other prognostic factors (e.g. stromal invasion and lymph node metastasis) were applied, the classification of the two papillary tumours was an independent prognostic factor (P = 0.040). CONCLUSIONS: Given the significant contrast in clinicopathological features between IPNBs and papillary cholangiocarcinomas, it may be more appropriate to use the diagnostic term 'IPNB' for selected tumours that show regular papillary growth, separately from papillary cholangiocarcinomas.2016年12月, Histopathology, 69(6) (6), 950 - 961, 英語, 国際誌[査読有り]
- We herein examined the immunohistochemical expression of 2 hepatocyte-specific transporters (bile salt export pump [BSEP] and multidrug-resistance protein 3 [MDR3]) in hepatocellular carcinomas (HCCs, n=54), intrahepatic cholangiocarcinomas (n=34), combined hepatocellular and cholangiocarcinomas (n=23), and hepatoid carcinomas originated from extrahepatic organs (n=27) to compare their diagnostic values with those of arginase-1 (ARG1) and hepatocyte paraffin-1 (HepPar-1). BSEP was expressed in 91% of HCCs and MDR3 in 83%. Although their sensitivities were slightly lower than those of ARG1 (96%) and HepPar-1 (93%), the 2 transporters appeared to be more specific for HCCs. ARG1 and HepPar-1 were expressed in intrahepatic cholangiocarcinomas (9% and 6%) and hepatoid carcinomas (22% and 44%, respectively), whereas BSEP and MDR3 were entirely negative in these neoplasms, except for 1 case of BSEP-positive hepatoid carcinoma of the esophagus. The highly specific expression of BSEP and MDR3 in hepatocytes was recapitulated in additional examinations of combined hepatocellular and cholangiocarcinomas, in which the expression of the transporters was restricted to morphologically hepatocellular areas. In contrast, ARG1 and HepPar-1 were also variably positive in areas of biliary or indeterminate differentiation. We also applied BSEP and MDR3 immunohistochemistry to 8 biopsy cases of poorly differentiated primary liver cancer, in which the original diagnosis was not conclusive. The diagnosis of HCC was retrospectively suggested in 2 cases expressing both BSEP and MDR3. In conclusion, given the highly specific expression of BSEP and MDR3 in HCCs, immunohistochemistry for these transporters will be useful not only for determining hepatocellular differentiation in primary liver cancers but also for discriminating HCCs from hepatoid carcinomas.2016年05月, The American journal of surgical pathology, 40(5) (5), 689 - 96, 英語, 国際誌[査読有り]
- 2016年03月, Pathology international, 66(3) (3), 158 - 163, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- 症例は62歳男性．健診異常に対する精査目的で施行した下部消化管内視鏡検査で，上行結腸に約35mm大の粘膜下腫瘍を認めた．CTで不均一な造影パターンを示し，FDG-PETでは集積亢進を呈したため，GISTなどの腫瘍を疑った．腫瘍に対してボーリング生検を行ったが，病理組織学的診断は得られなかった．今回われわれはスライディングチューブおよびガイドワイヤ補助下に前方斜視型コンベックス型超音波内視鏡を上行結腸に挿入し，粘膜下腫瘍に対しEUS-FNAを施行した．EUS-FNAにて術前診断しえた上行結腸Schwannomaの1例を経験したため報告する．一般社団法人 日本消化器内視鏡学会, 2016年, 日本消化器内視鏡学会雑誌, 58(3) (3), 176 - 181, 日本語
- A 65-year-old man presenting with an esophageal lesion underwent esophagogastroduodenoscopy and computed tomography and an upper esophageal submucosal mass was found. Endoscopic ultrasound-guided fine-needle aspiration led to the diagnosis of mucosa-associated lymphoid tissue lymphoma of the esophagus. Positron emission tomography showed abnormal uptake in the internal iliac lymph nodes, and laparoscopic biopsy findings confirmed the diagnosis of esophageal cancer. The patient declined treatment of any kind and has been followed up for 39 months with no progression of the lymphoma.2016年, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 113(1) (1), 63 - 70, 日本語, 国内誌[査読有り]
- 日本膵臓学会, 2015年12月, 膵臓, 30(6) (6), 805 - 811, 日本語EUS-FNAで診断し得た膵腺房細胞癌の2例[査読有り]
- (株)南江堂, 2015年10月, 内科, 116(4) (4), 716 - 716, 日本語Photo Report 後腹膜線維症の1剖検例[査読有り]
- (株)癌と化学療法社, 2014年11月, 癌と化学療法, 41(12) (12), 2408 - 2410, 日本語
- BACKGROUND: Solitary fibrous tumor (SFT), a rare neoplasm, usually originates in the pleura. Extrapleural SFTs occasionally occur in the head and neck. METHODS: In this study, the extirpation of a rare case of recurrent SFT invading the atlas is discussed. RESULTS: Ten years after surgical resection of an SFT in the right parapharyngeal space, the patient returned with a complaint of swelling sensation in the right neck. MRI and CT showed an enhanced lobulated mass invading the right lateral C1 vertebral body and canal and encasing the right vertebral artery. Extirpation of the recurrent tumor with a combined transcervical and midline posterior approach was successful. The surgical margin was negative for cancer and the postoperative course was uneventful. CONCLUSION: Although an SFT is generally benign, recurrence can occur even after several years, therefore, careful long-term follow-up is essential for early detection. A combined transcervical and midline posterior approach proved useful for resection of the atlas body.2014年11月, Head & neck, 36(11) (11), E121-4, 英語, 国際誌[査読有り]
- [A case of resection margin involvement gastric carcinoma that relapsed late after additional gastrectomy].We report a case of a patient with resection margin involvement gastric carcinoma that recurred 5.5 years after additional resection. A 64-year-old man underwent distal gastrectomy for advanced gastric carcinoma (sig+por2, pSE, pN0, pStage IIB) in January 2008. A total gastrectomy was performed 2 months after the initial gastrectomy because of proximal resection line involvement, and curative resection was obtained. Adjuvant chemotherapy with S-1 was completed, and follow-up surveillance was finished 5 years after the additional surgery. In November 2013, the patient experienced bouts of vomiting, and a computed tomography (CT) scan showed an abdominal abscess that had spread to the liver and communicated with the intestine. Despite abscess drainage and antibiotic therapy, infection control was difficult and the patient died 20 days after hospitalization. An autopsy showed the recurrence lesions had diffusely spread to the peritoneum and was also disseminated around the Roux-Y jejunum. These findings suggest that peritoneal recurrence might lead to penetration of the intestine and abscess formation.2014年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 41(12) (12), 2408 - 10, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- 日本脳腫瘍病理学会, 2014年05月, Brain Tumor Pathology, 31(Suppl.) (Suppl.), 159 - 159, 日本語小児膠芽腫の一例[査読有り]
- Sorting nexins (SNXs) are a large, diverse group of cytoplasmic and membrane-associated proteins that function in a variety of cellular processes, including endocytosis, protein trafficking, and the retrieval of transmembrane proteins. In this study, we demonstrated that SNX2 is expressed in columnar and active thyroid follicular cells but not in flattened inactive thyrocytes. Morphometric analysis revealed a significant correlation between SNX2 positivity and columnar cell morphology. Immunohistochemical staining of serial sections of the thyroid tissue indicated that SNX2 localization was similar to sortilin, a protein expressed by active thyrocytes. Expression of SNX2 in thyrocytes is particularly marked and extensive in most hyperstimulated thyroid disorders, including Graves disease (diffusely SNX2 positive in 73.3% patients) and functioning nodules (93.8% patients). SNX2 immunolocalization in hyperstimulated follicular epithelial cells was specific among the SNXs family members examined. These results support the utility of SNX2 as a novel marker of active thyrocytes and reflect the endosomal trafficking activity in these cells.2014年04月, Applied immunohistochemistry & molecular morphology : AIMM, 22(4) (4), 302 - 7, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本病理学会, 2014年03月, 日本病理学会会誌, 103(1) (1), 385 - 385, 日本語婦人科郭清リンパ節内に偶発的に発見された微小なリンパ脈管筋腫症4例の報告研究論文（研究会，シンポジウム資料等）
- 症例は40歳の女性で月経時に一致する左鼠径部の疼痛・膨隆を主訴に，当院を受診した．骨盤単純CT検査では，左鼠径部に径3cm大のspace occupying lesion （SOL）を認めた．SOLは腹腔内臓器と交通は認めないこと，さらに疼痛・腫大の発症時期が月経周期に一致することから子宮内膜症を伴ったNuck管水腫と術前推察し，手術を施行した．鼠径管を開放したところ，暗赤色の嚢胞性腫瘤を認め，さらに線維性結合織により内鼠径輪から腹膜へとつながっていた．Nuck管水腫を切除した後，メッシュ・プラグ法を施行した．病理組織診断検査の結果，術前の推察どおり子宮内膜症を伴ったNuck管水腫であることが確認できた．月経随伴症状を伴う鼠径部の腫瘤では，異所性に子宮内膜組織が存在することも考慮に入れた管理が必要であると考えた．〔産婦の進歩66（2）：93-98，2014（平成26年5月）〕近畿産科婦人科学会, 2014年, 産婦人科の進歩, 66(2) (2), 93 - 98, 日本語
- 要旨：症例は75歳男性。2011年11月膵癌に対し，膵頭十二指腸切除術ならびに空腸瘻造設術を施行した。術後経過は良好で術後22日目に空腸瘻チューブを抜去，術後34日目に退院した。以後外来にて経過観察中，2012年6月腹痛を主訴に当院受診した。腹部CT検査では肝表面に腹水の貯留およびfree airを認め，消化管穿孔の診断のもと，緊急手術を行った。手術所見では空腸瘻の腹壁固定部が裂け，遅発性空腸瘻穿孔と診断，穿孔部を含めて空腸を切除し，機能的端々吻合を施行した。患者は術後7日目にイレウスを呈したものの保存的に軽快し，術後30日に退院した。Japanese Society for Abdominal Emergency Medicine, 2013年09月, 日本腹部救急医学会雑誌 = Journal of abdominal emergency medicine, 33(6) (6), 1013 - 1017, 日本語
- 2013年09月, 泌尿器科紀要, 59(9号) (9号), 635, 日本語救済GEM/CBDCA療法にて腫瘍マーカーが陰性化した難治性精巣腫瘍の1例[査読有り]研究論文（その他学術会議資料等）
- (株)医学書院, 2013年06月, 臨床外科, 68(6) (6), 744 - 748, 日本語腹腔鏡下に摘出した脾臓sclerosing angiomatoid nodular transformationの1例[査読有り]
- 2013年04月, 日本皮膚科学会雑誌, 123(5号) (5号), 967, 日本語MTX関連リンパ増殖症とMTX誘導性多発リウマチ結節を合併した皮膚筋炎、関節リウマチの一例研究論文（その他学術会議資料等）
- 2013年04月, 日本病理学会会誌, 102(1号) (1号), 346, 日本語WNT5Aによる胃癌細胞の上皮・間葉移行と癌幹細胞性獲得調節研究論文（その他学術会議資料等）
- (一社)日本病理学会, 2013年04月, 日本病理学会会誌, 102(1) (1), 395 - 395, 日本語神経線維腫症1型の若年男性に発症した中脳水道rossette-forming glioneuronal tumorの1例研究論文（その他学術会議資料等）
- (一社)日本病理学会, 2013年04月, 日本病理学会会誌, 102(1) (1), 393 - 393, 日本語初発及び再発時に血管肉腫と神経鞘腫、再々発時に血管肉腫と髄膜腫の混合像を呈した小脳橋角部腫瘍の1例研究論文（その他学術会議資料等）
- 2013年04月, 日本病理学会会誌, 102(1号) (1号), 451, 日本語粘表皮癌を合併した甲状腺低分化癌の1例研究論文（その他学術会議資料等）
- 2013年04月, 日本病理学会会誌, 102(1号) (1号), 422, 日本語EGFR遺伝子変異陽性の肺原発大細胞神経内分泌細胞癌の1例研究論文（その他学術会議資料等）
- 2013年04月, 日本病理学会会誌, 102(1号) (1号), 393, 日本語横紋筋様変化を伴った小脳血管芽腫の一例研究論文（その他学術会議資料等）
- (一社)日本病理学会, 2013年04月, 日本病理学会会誌, 102(1) (1), 406 - 406, 日本語Embryonal hyperplasia of Bowman's capsular epitheliumを合併した終末期摘出腎の1例研究論文（その他学術会議資料等）
- UNLABELLED: Gastric plasmacytoma (GP) is a rare variant of gastric lymphomas. In the exceptional event that a patient presents with GP, the lesion occupies the mucosal layer in the vast majority of cases. Here we report a case of nodular plasmacytoma confined to the submucosa with no evidence of Helicobacter pylori (Hp) infection. The patient was a 59-year old female presenting with no particular symptoms. The tumor was well-demarcated and consisted of a diffuse monomorphic proliferation of plasma cells with numerous lymphoid follicles scattered throughout the tumor. The mucosal surface was intact and not associated with any tumor nodules. The cells were diffusely positive for CD79a, Bob1, EMA and IgA and consistently negative for CD3, CD19, CD20, PAX5, CD56, IgM and IgG. Additionally, in situ hybridization demonstrated clonality in the form of λ light-chain restriction. This submucosal nodular proliferation pattern of plasmacytoma is poorly recognized and considered to be a novel variant of lymphoma. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3489998708673079.2013年02月, Diagnostic pathology, 8, 30 - 30, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本東洋医学会, 2013年01月, 日本東洋医学雑誌, 64(1) (1), 27 - 31, 日本語腸管スピロヘータ症治療に大建中湯エキスを用いた一例[査読有り]
- [A case of groove pancreatitis associated with duodenal ulcer].We describe a 69-year-old man with a history of multiple gastroduodenal ulcers, presenting with the onset of obstructive jaundice. Abdominal CT, MRI and EUS demonstrated a sheet-like mass in the pancreaticoduodenal groove. EUS-FNA did not reveal malignancy. Conservative treatment did not improve his clinical condition and repeated acute pancreatitis occurred during his treatment. Thus, pancreaticoduodenectomy was performed. Histopathological findings showed a duodenal ulcer penetrating the pancreas and infiltration of inflammatory cells and fibrosis in the pancreaticoduodenal groove. The spread of inflammation associated with the duodenal ulcer may have been one of the causes of groove pancreatitis.2013年01月, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 110(1) (1), 88 - 94, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- OBJECTIVE: Direct interaction with cancer-associated fibroblasts triggers WNT5A expression in human gastric carcinoma (GC) cells. In this study, we performed gene transduction experiments to investigate the significance of WNT5A in the GC tumor microenvironment. METHODS: Gene transduction (pWNT5A and shWNT5A) was performed in human GC-derived MKN-7 cells. Altered gene expression was examined by RT-PCR and cDNA microarray analysis. Immunohistochemical examination was carried out in human GC tissues. RESULTS: Transduction of exogenous WNT5A expression into MKN-7 cells upregulated genes related to the epithelial-mesenchymal transition (EMT) and cancer stem cells (CSCs), and the pWNT5A transfectant showed high tumorigenicity in vivo. These results were confirmed by knockdown experiments using a lentivirus expressing shWNT5A. A cDNA microarray analysis suggested that depletion of endogenous WNT5A downregulated genes involved in intracellular signaling, chemokine-cytokine interaction and focal adhesion. High levels of WNT5A expression were observed in 66% of GC cases, with significant correlation with histological type. Interestingly, in intestinal-type GCs, WNT5A expression was detected in the periphery of tumor nests. CONCLUSIONS: WNT5A regulates the induction of EMT and the maintenance of CSC properties in MKN-7 cells. WNT5A may play an important role in constructing an advantageous tumor microenvironment for the progression and development of human GC.2013年, Pathobiology : journal of immunopathology, molecular and cellular biology, 80(5) (5), 235 - 44, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本病理学会, 2012年03月, 日本病理学会会誌, 101(1) (1), 303 - 303, 日本語胎盤内絨毛癌の1例[査読有り]
- (一社)日本病理学会, 2012年03月, 日本病理学会会誌, 101(1) (1), 337 - 337, 日本語腎静脈発生intravenous capillary hemangiomaの一例[査読有り]
- (一社)日本病理学会, 2012年03月, 日本病理学会会誌, 101(1) (1), 388 - 388, 日本語免疫組織化学染色で扁平上皮癌マーカーが陽性となる肺原発腺癌の組織学的特徴の検討[査読有り]
- (株)癌と化学療法社, 2011年11月, 癌と化学療法, 38(12) (12), 2030 - 2032, 日本語肺癌肝転移の診断でRFAを施行した肝内胆管癌の1例[査読有り]
- [A case report of intrahepatic cholangiocarcinoma diagnosed as lung cancer with liver metastasis treated with radiofrequency ablation].In December 2008, a 43-year-old male who had been pointed out a nodular shadow in the right upper field on a chest radiography was admitted to hospital. A 35 mm mass infiltrating to superior vena cava in the right upper lobe of the lung, and 32 mm mass in the liver at S7 were detected by CT. Pathological diagnosis of the liver tumor was adenocarcinoma. Under the diagnosis of lung carcinoma and liver metastasis, systemic chemotherapy was started from January 2009. Radiofrequency ablation (RFA) therapy was added for liver S7 mass in February, and radiation therapy was performed for lung mass in December. The lung lesion has markedly reduced, but the liver lesion recurred in October 2009, which continued to grow up to 80 mm until August 2010. He presented to our hospital with the diagnosis of liver metastasis of controlled primary lung cancer. In October, we performed right hepatectomy with diaphragma and right lung resection. The pathological diagnosis was intrahepatic cholangiocarcinoma. Multiple recurrences in remnant liver, lung and peritoneal metastasis were detected in January 2011. For intrahepatic cholangiocarcinoma, hepatectomy is the only established treatment, and RFA treatment remains controversial. Clinical diagnosis of multiple cancers should be decided with caution.2011年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 38(12) (12), 2030 - 2, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- (公社)日本医学放射線学会, 2011年09月, 日本医学放射線学会秋季臨床大会抄録集, 47回, S553 - S553, 日本語小児の気管支腫瘍の一例
- (NPO)日本肺癌学会, 2011年04月, 肺癌, 51(2) (2), 147 - 148, 日本語空洞形成を呈したrhabdoid形質を伴う肺大細胞癌の1例
- (一社)日本病理学会, 2011年03月, 日本病理学会会誌, 100(1) (1), 391 - 391, 日本語組織球様形態を示し診断に難渋した急性前骨髄性白血病の一例 組織球様の形態を示したmyeloid sarcomaの一例[査読有り]
- (一社)日本病理学会, 2011年03月, 日本病理学会会誌, 100(1) (1), 405 - 405, 日本語気管支に発生したPNETの一例[査読有り]
- (一社)日本病理学会, 2011年03月, 日本病理学会会誌, 100(1) (1), 431 - 431, 日本語クラミジア感染に伴う糸球体腎炎の一例[査読有り]
- (一社)日本病理学会, 2011年03月, 日本病理学会会誌, 100(1) (1), 478 - 478, 日本語頭蓋骨発生と考えられたalveolar soft part sarcomaの1例[査読有り]
- 79歳，男性．心窩部痛を主訴に近医を受診し，上部消化管内視鏡検査にて前庭部胃癌と十二指腸乳頭部癌を認め当院に紹介された．術前生検ではいずれも腺癌と診断され，標準膵頭十二指腸切除術により両者を一期的に切除した．病理組織学的検索では胃は腺癌（por2>tub2，pT2（MP），pN1，fStage II）で，十二指腸乳頭部病変は免疫組織学的検索にてsynaptophysin，chromogranin A陽性の内分泌細胞癌（pT3，pN1，fStage III）と診断された．また，複数のリンパ節に内分泌細胞癌および腺癌の起源の異なる転移を認めた．術後6カ月目で内分泌細胞癌が肝転移再発をきたし，13カ月目に癌死した．Japan Surgical Association, 2011年01月, 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association, 72(1) (1), 203 - 208, 日本語
十二指腸乳頭部内分泌細胞癌の報告は複数あるが，胃癌との重複例はこれまで皆無であった．また，自験例は膵頭十二指腸切除術により両者の切除が一期的に可能であった興味ある症例と考え報告する． - (一社)日本病理学会, 2010年10月, 診断病理, 27(4) (4), 294 - 297, 日本語成人肝芽腫の1例[査読有り]
- A 78-year-old woman presented with leg edema and exertional dyspnea. Echocardiography revealed a smooth-surfaced mass adjacent to the left atrium in the pericardial cavity with a massive pericardial effusion. Pericardiocentesis resulted in the drainage of a bloody effusion. Magnetic resonance imaging documented a mass having isointensity on T1- and hyperintensity on T2-weighted images. In addition, the mass was evenly enhanced with gadolinium 10 min after administration. By surgical resection, a 25 × 30 mm in diameter tumor was excised together with a left atrial wall portion. The pathological examination made a final diagnosis as hemangioma. Based on these findings, we report the rare case of pericardial hemangioma with a bloody pericardial effusion, which presented with heart failure symptoms. Although bloody pericardial effusion is considered a supportive characteristic for malignant tumors, we could preoperatively make a precise diagnosis of benign hemangioma by means of several imaging modalities.2010年08月, Journal of cardiology cases, 2(1) (1), e15-e19, 英語, 国内誌[査読有り]
- 2025年, ENDOCRINE JOURNAL, 72(10) (10), 英語書評論文,書評,文献紹介等
- 2025年, 日本内分泌学会雑誌, 101(1) (1)神経線維腫症1型に合併したComposite pheochromocytomaの1例
- 2025年, 日本内分泌学会雑誌, 101(1) (1)嗅神経芽細胞腫の加療中に異所性ACTH産生症候群が新規に発症し,治療中にACTH低下を認めた症例
- 2025年, 日本内分泌学会雑誌, 101(1) (1)嗅神経芽細胞腫の加療中に異所性ACTH産生症候群が新規に発症し,治療中にACTH低下を認めた症例
- 2025年, 日本内分泌学会雑誌, 101(1) (1)SDHB病的バリアントを有し,脳及び肺多発転移が疑われる若年性PGLの一例
- 2024年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 28thPituitary neuroendocrine tumor(PitNET)の術中迅速診断に迅速鍍銀法は有用か
- 2024年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 28th副腎性コルチゾール産生腫瘍における稀な病態と髄質との連関
- 2024年, ACTH Related Peptides (CD-ROM), 35コルチゾール暴露環境がコルチコトロフ腫瘍における免疫細胞浸潤に与える影響
- 2024年, 間脳・下垂体・副腎系研究会プログラム・抄録集(Web), 35thコルチゾール暴露環境がコルチコトロフ腫瘍における免疫細胞浸潤に与える影響
- 2024年, 日本内分泌学会雑誌, 100(1) (1)GH,PRL完全欠損に至る過程を観察し得た抗PIT-1下垂体炎
- 2023年, 日本間脳下垂体腫瘍学会プログラム・抄録集, 33rdGH/PRLの自律性分泌が疑われたsilent corticotroph tumorの一例
- 2023年, 日本病理学会会誌, 112(1) (1)副腎皮質腫瘤の病理診断
- 2023年, 日本内分泌学会雑誌, 99(1) (1)123I-MIBGシンチグラフィにて両側副腎に集積が見られた原発性アルドステロン症の1例
- 2023年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 27thCushing病の病理像をどう臨床に生かすか
- 2023年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 27thBMAHにおけるアルドステロン自律性分泌とその病理学的検討
- 2022年, 日本消化器画像診断研究会プログラム・抄録集, 75th特異な画像を呈した膵神経内分泌癌の1例
- 2022年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 26thコルチコトロフ腫瘍におけるtumor associated macrophages(TAMs)の免疫組織化学的解析
- 2022年, 日本臨床細胞学会雑誌(Web), 61未固定手術検体より採取した,副腎腫瘍細胞像連続19症例の比較・検討
- 2022年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 26thGonadotroph tumorとsomatotroph tumorのcollisionと考えられた一例
- 2022年, 日本間脳下垂体腫瘍学会プログラム・抄録集, 32ndCorticotroph adenomaにおける腫瘍微小環境とコルチゾールの関連性
- 2022年, 日本間脳下垂体腫瘍学会プログラム・抄録集, 32ndUSP8変異はAVPR1b受容体高発現を介してクッシング病のDDAVP試験反応性と関連する
- 2021年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 25thCorticotroph adenomaにおける腫瘍微小環境は非炎症性を呈する
- 2021年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 25th両側副腎での123I-MIBG陽性例における臨床的,病理学的検討
- (一社)日本内分泌学会, 2020年02月, 日本内分泌学会雑誌, 95(4) (4), 1693 - 1693, 日本語特発性アルドステロン症を合併したサブクリニカルクッシング症候群の1例
- 2020年, 日本内分泌学会雑誌, 96(Suppl. HPT (Web)) (Suppl. HPT (Web))プロラクチノーマとして治療されていたaggressiveな機能性FSH産生下垂体腺腫の1例
- 2020年, 胆道(Web), 34(2) (2)肝外胆管に発育したIntraductal papillary neoplasm of the bile duct(IPNB)
- 2020年, 日本間脳下垂体腫瘍学会プログラム・抄録集, 30thプロラクチノーマとして治療されていたaggressiveな機能性FSH産生下垂体腺腫の1例
- (一社)日本内分泌学会, 2019年10月, 日本内分泌学会雑誌, 95(2) (2), 706 - 706, 日本語前立腺癌に異所性ACTH発現を認めたACTH単独欠損症の一例
- (一社)日本内分泌学会, 2019年10月, 日本内分泌学会雑誌, 95(2) (2), 706 - 706, 日本語前立腺癌に異所性ACTH発現を認めたACTH単独欠損症の一例
- (一社)日本内分泌学会, 2019年04月, 日本内分泌学会雑誌, 95(1) (1), 404 - 404, 日本語副腎神経節腫の合併を認めた特発性低ゴナドトロピン性性腺機能低下症の1例
- 2019年, 日本間脳下垂体腫瘍学会プログラム・抄録集, 29th髄液漏対策に苦慮したPRL,GH同時産生巨大下垂体腺腫の一例
- (一社)日本内分泌学会, 2018年12月, 日本内分泌学会雑誌, 94(4) (4), 1698 - 1698, 日本語妊娠中に高血圧と精神異常を呈した副腎皮質・髄質混合腫瘍の1例
- (一社)日本内分泌学会, 2018年12月, 日本内分泌学会雑誌, 94(4) (4), 1698 - 1698, 日本語妊娠中に高血圧と精神異常を呈した副腎皮質・髄質混合腫瘍の1例
- (一社)日本内分泌学会, 2018年09月20日, 日本内分泌学会雑誌, 94(2) (2), 704 - 704, 日本語褐色細胞腫とコルチゾール産生副腎腺腫が混在した妊婦の一例
- 日本脳腫瘍病理学会, 2018年09月, Brain Tumor Pathology, 35(Suppl.) (Suppl.), 186 - 186, 日本語頭蓋内胚細胞腫より悪性転化したと考えられる粘液癌の一症例
- (一社)日本内分泌学会, 2018年09月, 日本内分泌学会雑誌, 94(2) (2), 704 - 704, 日本語パラガングリオーマと原発性アルドステロン症を合併した1例
- (公社)日本医学放射線学会, 2018年09月, 日本医学放射線学会秋季臨床大会抄録集, 54回, S536 - S536, 日本語翼口蓋窩に生じた筋上皮腫の1例
- (一社)日本病理学会, 2018年04月, 日本病理学会会誌, 107(1) (1), 452 - 452, 日本語粘液癌への悪性転化が疑われた松果体部奇形腫の1例
- (一社)日本病理学会, 2018年04月, 日本病理学会会誌, 107(1) (1), 452 - 452, 日本語異型多形脂肪腫様腫瘍と考えられた1例[査読有り]会議報告等
- (一社)日本内分泌学会, 2018年04月, 日本内分泌学会雑誌, 94(1) (1), 314 - 314, 日本語
- 2018年, 日本臨床内分泌病理学会学術総会プログラム・抄録集, 22nd, 78, 日本語妊娠中に高血圧と精神異常を呈した副腎皮質・髄質混合腫瘍の1例
- 2016年07月, PANCREAS, 45(6) (6), 926 - 927, 英語Two Cases of Pancreatic Acinar Cell Carcinoma Diagnosed by Ultrasound-Guided Fine Needle Aspiration研究発表ペーパー・要旨（国際会議）
- Lippincott Williams and Wilkins, 2014年12月11日, Pathology Case Reviews, 19(6) (6), 289 - 292, 英語書評論文,書評,文献紹介等
- 2013年02月, NEUROLOGY, 80, 英語Histopathological and Electrophysiological Findings in Musculoskeletal Chronic Graft-Versus-Host Disease (cGVHD)[査読有り]研究発表ペーパー・要旨（国際会議）
- (一財)日本消化器病学会, 2013年01月, 日本消化器病学会雑誌, 110(1) (1), 88 - 94, 日本語
- (一社)日本病理学会, 2012年09月, 日本病理学会会誌, 101(2) (2), 43 - 43, 日本語急性リンパ性白血病に対する骨髄移植後に関節拘縮、筋力低下を来した1剖検例会議報告等
- A 30-year-old woman with intermittently persisting high fever from 2007 was referred to our hospital. On admission Oct 2008, she complained of high fever and back pain. CT revealed a large cystic liver tumor with papillary projections locating mainly in the left lobe. Distinct mucin secretion from papilla of Vater were observed during ERC. Under the diagnosis of IPNB with metastases to the ovary and lymph nodes, she underwent extended left lobectomy of the liver, bile duct resection, biliary reconstruction and ovariectomy because reductive surgery may appear to be beneficial. Mucinous tumor was founded on the left lobe of the liver, and metastatic lymph nodes around pancreas and paraaortic region were found. After the operation she was received chemotherapy with gemcitabine and S-1. Although metastatic lymph nodes and local recurrence were developing gradually, she is still doing well in 2 and half years after operation.日本胆道学会, 2012年05月, 胆道, 26(2) (2), 231 - 236, 日本語
- 2011年, 日本臨床口腔病理学会総会・学術大会プログラム・抄録集, 22nd舌縁部に発生した平滑筋腫の一例
- 2010年, Abstracts. Annual Symposium. Japanese Society for the Advancement of Women’s Imaging, 11th (Web)悪性Brenner腫瘍の一例
- 第109回日本病理学会総会, 2020年07月急性B型肝炎による劇症肝炎より回復し、組織学的検索が可能であった1例ポスター発表
- 第93回 日本内分泌学会学術総会, 2020年06月妊娠中に高血圧と精神症状を呈した副腎皮質・髄質混合腫瘍の1例
- 第23回 日本臨床内分泌病理学会学術総会, 2019年10月特発性アルドステロン症を合併したサブクリニカルクッシング症候群の1例口頭発表（一般）
- 第108回日本病理学会総会, 2019年05月リンパ節転移を認めた副腎ganglioneuromaの1例ポスター発表
- 第22回日本臨床内分泌病理学会学術総会, 2018年09月, 日本語, 徳島, 国内会議妊娠中に高血圧と精神異常を呈した副腎皮質・髄質混合腫瘍の1例口頭発表（一般）
- 第107回日本病理学会総会, 2018年06月, 日本語, 札幌, 国内会議粘液癌への悪性転化が疑われた松果体部奇形腫の1例ポスター発表
- 第107回日本病理学会総会, 2018年06月, 日本語, 札幌, 国内会議異型多形脂肪腫様腫瘍と考えられた1例ポスター発表
- 第64回日本病理学会秋期特別総会, 2018年, 日本語, 呉, 国内会議多形型脂肪肉腫様成分を有する後腹膜脱分化型脂肪肉腫の一例ポスター発表
- 第218回近畿地方会, 2017年12月, 日本語, 日本内科学会近畿支部, 神戸, 国内会議悪性リンパ腫との鑑別に難渋した多中心性細網組織球症（MRH）の1例口頭発表（一般）
- 15th Japan-Korea Joint Slide Conference of International Academy of Pathology (IAP), 2017年12月, 英語, Japan Division of IAP, 神戸市, 国際会議Soft tissue tumor in the back of the neck口頭発表（一般）
- 第148回関西骨軟部腫瘍研究会, 2017年11月, 日本語, 関西骨軟部腫瘍研究会, 大阪, 国内会議手部軟部腫瘍の1例口頭発表（一般）
- 第103回日本病理学会総会, 2014年04月, 日本語, 日本病理学会, 広島市, 国内会議婦人科郭清リンパ節内に偶発的に発見された微小なリンパ脈管筋腫症4例の報告ポスター発表
- 第103回日本病理学会総会, 2014年04月, 日本語, 日本病理学会, 広島, 国内会議脳室内出血で発症した甲状腺濾胞癌脳室転移の1例ポスター発表
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