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Endoscopic features and prognoses of mantle cell lymphoma with gastrointestinal involvement

World Journal of Gastroenterology 2010年第37期16卷 4661-4669页

作者： Masaya Iwamuro Hiroyuki Okada Yoshiro Kawahara Katsuji Shinagawa Toshiaki Morito tadashi yoshino Kazuhide Yamamoto Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Department of Hematology and Oncology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Department of Pathology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences

AIM: To evaluate the endoscopic manifestations and prognoses of gastrointestinal (GI) mantle cell lymphoma (MCL). METHODS: A database search at the Department of Pathology of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences revealed 57 MCL patients with GI involvement. Clinical records were available for 35 of the 57 patients from 21 institutions, and those 35 patients were enrolled in this study. We summarized the gross types of endoscopic features, event-free survival (EFS), and overall survival (OS) of those ***: Of the 35 patients, GI involvement in the esophagus, stomach, and duodenum was found in 2 (5.7%), 26 (74.3%), and 12 (34.3%) patients, respectively. Twenty-one of the 35 patients underwent colonoscopy; among them, GI involvement in the ileum, cecum, colon, and rectum was found in 10 (47.6%), 3 (14.3%), 12 (57.1%), and 10 (47.6%), respectively. Various lesions, such as superficial, protruded, fold thickening, or ulcerative, were found in the stomach, whereas multiple lymphomatous polyposis (MLP) was dominant from the duodenum to the rectum. Twelve patients were treated with a hyper-CVAD/MA regimen, and they had better OS (3-year rate, 88.3% vs 46.4%, P < 0.01) and better EFS (3-year rate, 66.7% vs 33.8%, P < 0.05) than the remaining 23 patients who were not treated with this regimen. CONCLUSION: MLP was a representative form of intestinal involvement, whereas a variety of lesions were found in the stomach. The hyper-CVAD/MA regimen may improve survival in these patients.

关键词： Chemotherapy Gastrointestinal lymphoma Mantle cell lymphoma Multiple lymphomatous polyposis Non-Hodgkin’s lymphoma

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Management of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene

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World Journal of Gastroenterology 2017年第33期23卷 6155-6163页

作者： Masaya Iwamuro Ryuta Takenaka Masahiro Nakagawa Yuki Moritou Shunsuke Saito Shinichiro Hori Tomoki Inaba Yoshinari Kawai Tatsuya Toyokawa Takehiro Tanaka tadashi yoshino Hiroyuki Okada Department of Gastroen-terology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical Sciences Department of Internal Medicine Tsuyama Chuo Hospital Department of Internal Medicine Hiroshima City Hospital Department of Gastroenterology Mitoyo General Hospital Department of Internal Medicine Okayama Saiseikai General Hospital Department of Gastroenterology Shikoku Cancer Center Department of Gastroenterology Kagawa Prefectural Central Hospital Department of Gastroenterology Onomichi Municipal Hospital Department of Gastroenterology Fukuyama Medical Center Department of Pathology Okayama University Hospital Department of Pathology Okayama University Graduate School of MedicineDentistryand Pharmaceutical Sciences

AIM To identify the clinical features of gastric mucosaassociated lymphoid tissue(MALT) lymphoma with extra copies of *** This is a multi-centered,retrospective study. We reviewed 146 patients with MALT lymphoma in the stomach who underwent fluorescence in situ hybridization analysis for t(11;18) translocation. Patients were subdivided into patients without t(11;18) translocation or extra copies of MALT1(Group A,n = 88),patients with t(11;18) translocation(Group B,n = 27),and patients with extra copies of MALT1(Group C,n = 31). The clinical background,treatment,and outcomes of each group were *** Groups A and C showed slight female predominance,whereas Group B showed slight male predominance. Mean ages and clinical stages at lymphoma diagnosis were not different between groups. Complete response was obtained in 61 patients in Group A(69.3%),22 in Group B(81.5%),and 21 in Group C(67.7%). Helicobacter pylori(H. pylori) eradication alone resulted in complete remission in 44 patients in Group A and 13 in Group C. In Group B,14 patients underwent radiotherapy alone,which resulted in lymphoma disappearance. Although the difference was not statistically significant,event-free survival in Group C tended to be inferior to that in Group A(P = 0.10).CONCLUSION Patients with t(11;18) translocation should be treated differently from others. Patients with extra copies of MALT1 could be initially treated with H. pylori eradication,similar to patients without t(11;18) translocation or extra copies of MALT1.

关键词： Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue Gastric neoplasms Esophagogastroduodenoscopy t(11 18) translocation Trisomy 18

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Usefulness of positron emission tomography in primary intestinal follicular lymphoma

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World Journal of Gastroenterology 2013年第12期19卷 1992-1996页

作者： Akira Tari Hideki Asaoku Masaki Kunihiro Shinji Tanaka tadashi yoshino Division of Gastroenterology Department of Internal Medicine Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital Department of Clinical Laboratory Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital Department of Endoscopy Hiroshima University Hospital Department of Pathology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences

Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thickening and stenosis. Additionally, video capsule endoscopy cannot be performed in such cases because of the risk of retention. Here, we report 4 cases of primary follicular lymphoma of the gastrointestinal tract that could be detected using 18F-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET-CT). The endoscopic findings of these 4 cases included lesions with wall thickening, which comprised macroscopically clusters of nodules, dense clusters of whitish granules or small nodules, fold thickening and ulcers with irregular margins that occupied the whole lumen with edematous mucosa. All patients fulfilled the World Health Organization grade 1 criteria. 18 F-fluorodeoxyglucose PET-CT can help predict the risks that may result from certain endoscopic examinations, such as DBE and video capsule endoscopy.

关键词： Capsule endoscopy Double-balloon enteroscopy Follicular lymphoma Positron-emission tomography Computed tomography Small intestine

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Diagnosis of follicular lymphoma of the gastrointestinaltract:A better initial diagnostic workup

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世界胃肠病学杂志：英文版 2016年第4期22卷 1674-1683页

作者： Masaya Iwamuro Eisei Kondo Katsuyoshi Takata tadashi yoshino Hiroyuki Okada Department of General Medicine Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558Japan Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558Japan Department of Pathology Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558Japan Department of Endoscopy Okayama University HospitalOkayama 700-8558Japan

Due to an increasing incidence and more frequent recognition by endoscopists, gastrointestinal follicular lymphoma has been established as a variant of follicular lymphoma. However, due to its rarity, there are no established guidelines on the optimal diagnostic strategy for patients with primary gastrointestinal follicular lymphoma or secondary gastrointestinal involvement of systemic follicular lymphoma. This review offers an overview and pitfalls to avoid during the initial diagnostic workup of this disease entity. Previously reported case reports, case series, and retrospective studies are reviewed and focus on the disease's endoscopic and histological features, the roles of computed tomography and positron emission tomography scanning, the clinical utility of the soluble interleukin-2 receptor, and the possible pathogenesis.

关键词： Follicular lymphoma Gastrointestinallymphoma Duodenal neoplasms Intestinal neoplasms Gastrointestinal endoscopy

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Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma

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World Journal of Gastroenterology 2012年第43期18卷 6263-6268页

作者： Takehiro Tanaka Atsushi Fujimura Koichi Ichimura Hiroyuki Yanai Yasuharu Sato Katsuyohi Takata Hiroyuki Okada Seiji Kawano Shunsuke Tanabe tadashi yoshino Department of Pathology Okayama University Hospital Okayama 700-8558 Japan Department of Physiology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama 700-8558 Japan Department of Pathology Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama 700-8558 Japan Department of Endoscopy Okayama University Hospital Okayama 700-8558 Japan Department of Gastroenterological Surgery Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama 700-8558 Japan

AIM:To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett's adenocarcinoma in Japan. METHODS:We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett's adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative ***:HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett's adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients. CONCLUSION:Our results suggest that HER2-positive Barrett's adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage.

关键词： Barrett's adenocarcinoma Human epidermal growth factor receptor 2 p53 Mucin phenotype

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Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

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World Journal of Gastroenterology 2012年第44期18卷 6427-6436页

作者： Masaya Iwamuro Hiroyuki Okada Katsuyoshi Takata Katsuji Shinagawa Shigeatsu Fujiki Junji Shiode Atsushi Imagawa Masashi Araki Toshiaki Morito Mamoru Nishimura Motowo Mizuno Tomoki Inaba Seiyu Suzuki Yoshinari Kawai tadashi yoshino Yoshiro Kawahara Akinobu Takaki Kazuhide Yamamoto Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Endoscopy Okayama University HospitalOkayama 700-8558Japan Department of Pathology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Hematology and Oncology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Internal Medicine Tsuyama Central HospitalTsuyama 708-0841Japan Department of Internal Medicine Okayama Saiseikai General HospitalOkayama 700-8511Japan Department of Gastroenterology Mitoyo General HospitalKanonji 769-1695Japan Department of Internal Medicine Kagawa Rosai HospitalMarugame 763-8502Japan Department of Anatomic Pathology Kagawa Rosai HospitalMarugame 763-8502Japan Department of Internal Medicine Okayama Citizens' HospitalOkayama 700-8557Japan Department of Internal Medicine Hiroshima City HospitalHiroshima 730-8518Japan Department of Gastroenterology Kagawa Prefectural Central HospitalTakamatsu 760-8557Japan Department of Internal Medicine Sumitomo Besshi HospitalNiihama 792-8543Japan Department of Gastroenterology Onomichi Municipal HospitalOnomichi 722-8503Japan

AIM:To investigate the capacity for 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography(PET) to evaluate patients with gastrointestinal lesions of follicular ***:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October *** for endoscopic,radiological,and biological examinations performed were retrospectively reviewed from clinical records.A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value(SUVmax).Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed,patients were subdivided into two *** identify potential predictive factors for 18F-FDG positivity,these two groups were compared with respect to gender,age at diagnosis of lymphoma,histopathological grade,pattern of follicular dendritic cells,mitotic rate,clinical stage,soluble interleukin-2 receptor levels detected by 18F-FDG-PET,lactate dehydrogenase(LDH) levels,hemoglobin levels,bone marrow involvement,detectability of gastrointestinal lesions by computed tomography(CT) scanning,and follicular lymphoma international prognostic index(FLIPI) ***:Involvement of follicular lymphoma in the stomach,duodenum,jejunum,ileum,cecum,colon,and rectum was identified in 1,34,6,3,2,3,and 6 patients,*** patient had esophageal *** total,19/41(46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal *** contrast,false-negative 18F-FDG uptake was detected in 24 patients(58.5%),while false-positive 18F-FDG uptake was detected in 5 patients(12.2%).In the former case,2/19 patients had both 18F-FDG-positive lesions and 18F-FDGnegative lesions in the gastrointestinal *** patients with 18F-FDG avidity,the SUVmax value of the involved gast

关键词： Follicular lymphoma Gastrointestinal endoscopy F-fluorodeoxyglucose positron emission tomography Gastrointestinal lymphoma Duodenal neoplasm

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Primary intestinal follicular lymphoma:How to identify follicular lymphoma by routine endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第1期5卷 34-38页

作者： Masaya Iwamuro Yoshinari Kawai Katsuyoshi Takata Seiji Kawano tadashi yoshino Hiroyuki Okada Kazuhide Yamamoto Department of Gastroenterology Onomichi Municipal HospitalOnomichi 722-8503 Japan Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Pathology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Endoscopy Okayama University HospitalOkayama 700-8558Japan

A 69-year-old Japanese female was diagnosed with primary intestinal follicular lymphoma. Esophagogas-troduodenoscopy with high-definition imaging revealed not only the typical feature of whitish polyps of up to 2 mm in diameter in the duodenal second and third portions, but also more detailed morphology, such as enlarged whitish villi and tiny whitish depositions. These findings appeared to reflect the pathological structures; infiltration of lymphoma cells into the villi were probably seen as enlargement of the villi, and the formation of lymphoid follicles were shown as opaque white spots or tiny white depositions. Thus, the above features might contribute to the distinct diagnosis of intestinal follicular lymphoma. This case indicates that routine esophagogastroduodenoscopy can visualize microsurface structures, which can be pathognomonic and help to diagnose intestinal follicular lymphoma, even without magnifying endoscopy.

关键词： Follicular lymphoma Gastrointestinal endoscope Duodenal neoplasms Gastrointestinal lymphoma Microsurface structures

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TNF-<i>α</i>and RANKL facilitates the development of orthodontically-induced inflammatory root resorption

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Open Journal of Stomatology 2013年第9期3卷 52-58页

作者： tadashi Kojima Masaru Yamaguchi Tomokazu yoshino Mami Shimizu Kunihiko Yamada Takemi Goseki Kazutaka Kasai Department of Orthodontics Nihon University School of Dentistry at Matsudo Chiba Japan

Background: The objective of this study was to determine the levels of tumor necrosis factor-alpha (TNF-α) and receptor activator of NF-kB ligand (RANKL) in the gingival crevicular fluid (GCF) in patients with severe root resorption after orthodontic treatment. Materials and Methods: Ten patients who had been receiving orthodontic treatment (5-control subjects and 5-severe root resorption subjects) participated in this study. GCF was collected from all patients. Subjects with severe root resorption (>1/3 of the original root length) were identified. Control group subjects with no loss of the root structure undergoing orthodontic treatment were also identified. The GCF was collected non-invasively from the mesial and distal sides of each of the upper central and lateral incisors using filter paper strips. The eluted GCF was used for a Western blot analysis with Antibodies against TNF-α and soluble RANKL (sRANKL). Ten male 6-week-old Wistar rats were subjected to orthodontic force of 50 g to induce a mesially tipping movement of the upper first molars for 7 days. The expression levels of TNF-α and RANKL proteins were determined in periodontal ligament (PDL) by immunohistochemical analysis. Results: The Western blot analysis showed that the TNF-α and sRANKL expressions were significantly higher in the severe root resorption group than in the control group. In the experimental tooth movement in vivo, resorption lacunae with multinucleated cells were observed in 50 g group. The immunoreactivity for TNF-α and RANKL was detected in PDL tissue subjected to the orthodontic force on day 7. Conclusion: These results suggest that TNF-α and RANKL play important roles in inducing or facilitating the development of orthodontically-induced inflammatory root resorption (OIIRR).

关键词： TNF-α sRANKL Orthodontic Root Resorption Gingival Crevicular Fluid

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