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Undifferentiated Pleomorphic Sarcoma of the Cheek with Surface Ulceration: Mimicking Spindle Cell Squamous Cell Carcinoma

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Journal of Cosmetics, Dermatological Sciences and Applications 2013年第3期3卷 1-3页

作者： Fumiko Momma Chihiro Onami Takayuki Konno tamio suzuki Department of Dermatology Faculty of Medicine Yamagata University Yamagata Japan

Undifferentiated pleomorphic sarcoma (UPS), also called malignant fibrous histiocytoma (MFH), belongs to the soft tissue tumors and is more likely in elder patients. UPS currently accounts for approximately 18% of cutaneous soft tissue sarcoma except Kaposi sarcoma. The most common sites are the extremities and head and neck. UPS is rapidly enlarging, and easily invades subcutaneous tissue and muscle without overlying skin changes. UPS tumors, which are confined to subcutaneous tissue, have been reported to be less than 10%. On the other hand, the involvement of the epidermis, occasionally with ulceration, is rare. Here, we describe a case of UPS of the cheek with surface ulceration. An 83-year-old man presented with a 1-year history of a red nodule on his left cheek. The size of the nodule gradually increased. Clinical examination revealed a 55 × 45 mm red, hard mass in the center of his left cheek with a large cratershaped ulcer involving the subcutaneous tissue. The bottom of the ulcer contained necrotic tissue. No cervical lymph nodes were palpable. A biopsy revealed a high-grade, pleomorphic spindle cell neoplasm and frequent abnormal mitotic figures within the dermis. We temporarily diagnosed and suspected a soft tissue sarcoma, but we could not rule out spindle cell squamous cell carcinoma (SCSCC). The patient underwent tumor resection and skin grafting. The tumor had reached the muscle layer of his left cheek with invasion and ulceration of the overlying skin. Histopathological examination of the totally resected tumor revealed a neoplasm of mesenchymal origin, rich in cells with morphology and immunohistochemical characteristics compatible with UPS. Malignant cells were not found in the epidermis. Immunohistochemical analyses were positive for vimentin, α-anti-trypsin, α-smooth muscle actin (α-SMA), and CD10, and negative for cytokeratins (CAM5.2 and AE1/AE3), lysozyme, epithelial membrane antigen (EMA), CD34, S-100, desmin, and caldesmon. Two months after

关键词： Undifferentiated Pleomorphic Sarcoma Ulcer Spindle Cell Squamous Cell Carcinoma

Dermoscopic Features of Hyperpigmented Dots in Crista Cutis in Two Siblings in a Japanese Family with Inherited Acanthosis Nigricans

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第4期2卷 252-253页

作者： Shusuke Uchida Naoki Oiso tamio suzuki Akira Kawada Department of Dermatology Faculty of Medicine Kinki University Osaka Japan Department of Dermatology Yamagata Uni- versity School of Medicine Yamagata Japan

Acanthosis nigricans is characterized by papillomatous brownish lesions mainly in the intertriginous areas. We used dermoscopy to examine such lesions in a family with acanthosis nigricans. The dermoscopic images showed an aberrant skin structure of linear crista cutis and sulcus cutis, and hyperpigmented dots in crista cutis. The hyperpigmented dots, which could not be seen with the naked eyes, may contribute to the color of the pigmented skin. Dermoscopy can be useful for evaluating disorders involving the structure of area cutanea and a change in skin color.

关键词： Dermoscopy Acanthosis Nigricans Hyperpigmented Dots Crista Cutis Sulcus Cutis

Cholesterol Crystal Deposition in Basal Cell Carcinoma: An Investigation of 4 Cases

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Journal of Cosmetics, Dermatological Sciences and Applications 2015年第3期5卷 176-180页

作者： Ken Okamura Takayuki Konno Masakazu Kawaguchi Yuko Abe Yoriko Yaguchi Sayaka Ajima Yutaka Hozumi tamio suzuki Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan

Cholesterol crystals are a primary cause of cholesterol embolism if they appear in vessels. Various papers have reported the involvement of cholesterol crystal deposition in cutaneous diseases such as xanthoma. However, no cases of cholesterol crystal involvement in cutaneous cancer have been reported. We report four cases of basal cell carcinoma with cholesterol crystal deposition, and discuss the mechanism(s) of the condition. Disease duration, anatomical site, histopathological features, and serum lipid profiles were investigated. The median disease duration was 3.5 years, and the sites of the lesions were the scrotum (one patient) and the nose (three patients). Histopathologically, there was necrotized tissue around the clefts. In addition, we detected frequent apoptotic cells around the cholesterol clefts in two of the patients by using the terminal deoxynucleotidyl transferase dUTP nick-end labeling method. Serum lipid levels were slightly elevated in two of the patients. In conclusion, cholesterol crystal deposition in basal cell carcinoma was considered to relate to a long disease duration with a tumor in a region that was subject to external irritation. Histopathologically, apoptotic cells around the cholesterol clefts indicated that lipids from the tumor cell membranes were one of the causes of cholesterol crystal deposition.

关键词： Apoptosis Basal Cell Carcinoma Cholesterol Cleft Cholesterol Crystal

Hepatocellular carcinoma occurring in a Crohn’s disease patient

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World Journal of Gastroenterology 2010年第25期16卷 3215-3218页

作者： Mitsuaki Ishida Shigeyuki Naka Hisanori Shiomi Tomoyuki Tsujikawa Akira Andoh tamio Nakahara Yasuharu Saito Yoshi-hide Fujiyama Mikiko Takikita-suzuki Fumiyoshi Kojima Machiko Hotta Tohru Tani Yoshimasa Kurumi Hidetoshi Okabe Department of Clinical Lab-oratory Medicine and Division of Diagnostic Pathology Shiga University of Medical Science Otsu Shiga 520-2192 Japan Department of Surgery Shiga University of Medical Sci-ence Otsu Shiga 520-2192 Japan Department of Gastroenterology Shiga Uni-versity of Medical Science Otsu Shiga 520-2192 Japan Division of Endoscopy Shiga University of Medical Science Otsu Shiga 520-2192 Japan

We report a case of hepatocellular carcinoma (HCC) occurring in a patient with Crohn’s disease (CD) without chronic hepatitis or liver cirrhosis, and review the clinicopathological features of HCC in CD patients. A 37-year-old Japanese man with an 8-year history of CD and a medication history of azathioprine underwent resection of a liver tumor. The histopathology of the liver tumor was pseudoglandular type HCC. In the nonneoplastic liver, focal hepatocyte glycogenosis (FHG) was observed, however, there was no evidence of liver cirrhosis or primary sclerosing cholangitis. Only nine cases of HCC in CD patients have been reported previously in the English-language literature. Eight of 10cases (including the present case) had received azathioprine treatment, and four of these cases also showed FHG, which is considered a preneoplastic liver lesion, within the non-neoplastic liver. Although the precise mechanism of the development of HCC in CD patients is controversial, these results suggest that azathioprine therapy and FHG in the non-neoplastic liver contribute to the development of HCC. These findings also indicate that it is important to survey CD patients treated with prolonged azathioprine therapy for potential liver tumors.

关键词： Crohn’s disease Hepatocellular carcinoma Azathioprine Focal hepatocyte glycogenosis Hepato-carcinogenesis