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天利 紀子, 湧川 基史, 中内 洋一, 安藤 巖夫
2002 年 17 巻 3 号 p.
221-224
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report a rare case of adamantinoid basal cell carcinoma (BCC). A 75-year-old woman presented with a 7×7mm black nodule with bloody crust on her right jaw. The tumor was totally excised. Histopathological examination revealed that the tumor mass was mainly situated in the upper to deep dermis and in contact with the epidermis. At the periphery of the tumor, there were typical solid BCC nests, but within the majority of lobules, intercellular spaces were widened and cells were connected by stellate stretched thin cytoplasm. From these findings, this tumor was diagnosed as an adamantinoid BCC. [
Skin Cancer (Japan) 2002; 17 : 221-224]
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橋川 恵子, 桃崎 直也, 黒瀬 浩一郎, 名嘉眞 武国, 安元 慎一郎, 橋本 隆, 森脇 真一
2002 年 17 巻 3 号 p.
225-229
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
A 54-year-old male patient was admitted to the Kurume University Hospital for the treatment of a malignant melanoma arising on his scalp after a minor trauma. His condition had been diagnosed as xeroderma pigmentosum, and he had experienced surgeries on his face for BCC and SCC. The results of DNA repair tests such as the measurement of UV-induced unscheduled DNA synthesis and post-UV survival using primary fibroblasts from the patient's skin were compatible with those of xeroderma pigmentosum variant. The scalp tumor was finally classified as malignant melanoma stage III (T4N0M0) after the surgery. Alymph node metastasis was noticed 6 months later and it was resected.
We think that the choice of the modalities for advanced malignant melanoma in patients with xeroderma pigmentosum remain as clinically unsolved problems. [
Skin Cancer (Japan) 2002; 17: 225-229]
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酒井 司, 大塚 俊, 彭 志中, 山崎 雙次
2002 年 17 巻 3 号 p.
230-233
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report a case of a 59-year-old Japanese man with a black tumor on his right sole with satellite lesions. We diagnosed it as malignant melanoma (pT4aN0M0, stage III) . In December, 1997 he received wide resection and excision of the right inguinal lymph nodes. 3 courses of DAV-Feron chemotherapy were performed. In August, 1991 there was repeated local recurrence of in-transit lesions. We did simple excision and performed chemotherapy. 4 years and 6 months after the operation, the metastases were limited to in-transit lesions and evidence of distant metastasis was not noted. [
Skin Cancer (Japan) 2002; 17: 230-233]
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石澤 俊幸, 紺野 隆之
2002 年 17 巻 3 号 p.
234-237
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
A 78-year-old female visited our hospital, representing a swollen left leg with erythema. Physical examination revealed an 8×5××2cm in diameter on the left labia majus and minus pudendi, and a 3×2×1cm in diameter on the right labium minus pudendi. The histological findings of a biopsy specimen from these tumors showed a mass of Paget cells with deep dermal invasion. These were positive for immunohistochemical staining PAS, anti-CEA and CK7, but negative for CK20. Furthermore, the erythema lesion from the left leg revealed the lymph duct's ectasis containing the mass of aggregated Paget cells. The clinical appearance and histochemical findings of reddish and swollen lesions seen in this patient might be one of the characteristics of metastasis and infiltration of Paget's cells to the lymph duct. We diagnosed the condition as extramammary Paget's carcinoma (T4N2M1).We tried operation and low dose FP therapy. The redness and swelling in the leg was gradually decreased by the low dose FP therapy. The patient died about 5 months after visiting our hospital, but we conclude that the low dose FP therapy is worth trying against the inflammation of metastatic Paget's carcinoma of the lymph duct. [
Skin Cancer (Japan) 2002; 17: 234-237]
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小西 研史, 藤井 公男, 大郷 典子
2002 年 17 巻 3 号 p.
238-240
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
A 79-year-old woman with Merkel cell carcinoma is reported. She noticed an asymptomatic red papule on her left thigh about 6 months previously. The papule expanded gradually despite application of steroid ointment. Therefore, she visited our hospital. She developed a red, domeshaped tumor, 5mm in diameter, at the flexor surface on her left thigh. Histologically, the tumor invaded the dermis and subcutaneous tissue and did not extend into the epidermis. Atypical small cells were seen, with a trabecular pattern. Immunohistochemistry revealed positivity to CK18, CK20, chromogranine A and NSE. We performed wide local excision. [
Skin Cancer (Japan) 2002; 17: 238-240]
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青柳 哲, 阿部 理一郎, 水野 修, 松村 和子, 清水 宏, 奥芝 俊一
2002 年 17 巻 3 号 p.
241-245
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report a case of genital and perianal Paget's disease which was treated with wide local excision without anorectal dysfunction. A 76-year-old man noticed erythema on his genital and perianal region.
Histopathological features of erythema on the genital and perianal region were, consistent with extramammary Paget's disease. A Computed tomography scan revealed a swollen lymph node in the right groin. The patient was treated by a wide local excision with a right inguinal lymph node dissection and a temporary colostomy. We reconstructed the natal cleft by a V-Y island flap. Microscopically, there were no metastases in the right inguinal lymph nodes.
We found six cases of perianal Paget's disease without causing disturbance to the anorectal function after surgery reported in Japan. A free split-thickness skin graft frequently develops severe contracture of the graft region which causes the anorectal dysfunction. A flap technique is a good indication of perianal Paget's disease to preserve anorectal function. [
Skin Cancer (Japan) 2002; 17: 241-245]
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松岡 由恵, 杉村 知江子, 勝浦 純子, 沼原 利彦, 窪田 泰夫, 石川 雅士, 羽場 礼次, 小林 省二
2002 年 17 巻 3 号 p.
246-250
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
For about a two-year duration, a patient (a 44-year-old male), had an 8×8×6cm, dome-shaped, elastic hard subcutaneous tumor on his central abdomen, close to his navel, which showed no adherence to the underlying muscles in a CT scan examination. We first performed a skin biopsy, and diagnosed DFSP. We then excised the whole tumor, and further fascia was additionally excised with a 2cm surgical margin. A histologic evaluation showed that the first biopsied tumor sample consisted of ordinary dermatofibrosarcoma protuberans (DFSP) composed of uniform spindle-shaped tumor cells in storiform patterns. The second sample, however, appeared to be compatible with fibrosarcoma in some areas, because it contained a dense proliferation of atypical spindle cells arranged in fascicular and herring-bone patterns. While immunohistochemical staining for CD34 was positive in the DFSP area, it was negative in the fibrosarcomatous area. No recurrence or metastasis was seen during the follow-up period of seven months. Furthermore, in this study we have reviewed and summarized the literature of ‘fibrosarcomatous variant of dermatofibrosarcoma protuberans’ in Japan. [
Skin Cancer (Japan) 2002; 17: 246-250]
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野田 さおり, 柴田 智子, 段 虹, 師井 洋一, 占部 和敬, 古賀 哲也, 古江 増隆, 熊本 芳彦, 小宮山 壮太郎, 中村 昭典
2002 年 17 巻 3 号 p.
251-253
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report a case of 30-year-old man with Bednar tumor (Pigmented Dermatofibrosarcoma Protuberans) arising on the right cheek.
Histopathological findings of an excised specimen revealed a proliferation of tumor cells in the dermis and in the subcutaneous adipose tissue, focally infiltrating the striated muscular tissue. The tumor was characterized by spindle-shaped cells admixed with a small population of melanin containing dendritic cells. The spindleshaped cells were not positive for CD34, and negative for α-smooth muscle actin and desmin. The melanin containing dendritic cells were positive for HMB-45, tyrosinase, melan-A and MITF while they were negative for CD34. Based on these pathological findings and clinical episodes of local recurrences, we made the diagnosis of Bednar tumor. The wound was reconstructed using a D-P flap and no tumor recurrence has been observed 8 months after the tumor resection. The face is a relatively rare location of Bednar tumor. [
Skin Cancer (Japan) 2002; 17: 251-253]
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米井 希, 山本 有紀, 廣井 彰久, 上出 康二, 古川 福実
2002 年 17 巻 3 号 p.
254-258
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
An 82-year-old woman, having a pinkish nodule on her left nasolabial area, visited our clinic. Total excision was performed, and then reconstructed by Abbe flap. Histopathologically, the tumor had two characteristic areas. Basaloid cells with cribriform pattern proliferated in the major portion of the tumor, in which peripheral palisading, clefts and follicular differentiated horn cysts were seen. Another portion in the tumor showed small solid aggregations, in which hair germ-like structures were budding and some of them were surrounded by a thick rim of homogeneous, eosinophilic basement membrane-like materials. No tubular differentiation was seen. Keratin 15, keratin 20, CD 34, S-100 protein, or CEA were not demonstrated immunohistochemically in the tumor cells. Finally, we diagnosed this tumor as nodular-cystic basal cell carcinoma. [
Skin Cancer (Japan) 2002; 17: 254-258]
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渡邉 徹心, 宮本 亨, 奥山 典秀, 寺元 典弘, 吉野 正, Ma.Rosario P. Rivera, 葉狩 良孝, 三原 基之
2002 年 17 巻 3 号 p.
259-263
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report here a case of an 89-year-old man with bilateral axillary apocrine adenocarcinoma. He first noticed the nodule on his left axilla in March 2000. We excised the nodule in November 2000. Histopathologically, the tumor was composed of nests with atypical epithelial cells and glands with abundant eosinophilic cytoplasm that exhibited decapitation secretion. Immunohistochemically, the tumor cells were positive for GCDFP-15; thus, we diagnosed this tumor as apocrine adenocarcinoma. In September 2001, he noticed a similar nodule on his right axilla and it was excised again. The histopathological feature of this tumor was almost the same as the tumor on his left axilla. [
Skin Cancer (Japan) 2002; 17: 259-263]
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柴田 雅彦, 加藤 直子, 伊藤 圭, 木村 久美子, 相川 啓子
2002 年 17 巻 3 号 p.
264-268
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We presented a case of myelodysplastic syndrome with myelofibrosis associated with multiple skin eruptions. Examination showed leukocytosis with myeloblast, anemia, thrombocytopenia, and multilineage dysplasia in peripheral blood, myelofibrosis in a bone marrow biopsy, and hepatosplenomegaly. Asymptomatic reddish nodules appeared on the face and scalp. Histopathologic features of a skin biopsy revealed infiltration of megakaryocytes and myeloblasts in the dermis and subcutaneous adipose tissue. After three weeks' administration of cytosine arabinoside, these eruptions disappeared while blasts in peripheral blood faded away. Infiltration of megakaryocytes in the skin is a rare phenomenon exclusive of special disorders like myelofibrosis. We concluded the cutaneous eruption in this case was the specific skin lesion of myelodysplastic syndrome. [
Skin Cancer (Japan) 2002; 17: 264-268]
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和田 隆, 伊藤 康裕, 浅野 一弘, 高橋 英俊, 山本 明美, 橋本 喜夫, 飯塚 一
2002 年 17 巻 3 号 p.
269-273
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report the case of a 12-year-old male child with malignant melanoma on his left thigh. Sentinel node biopsy was preformed with blue dye and radioisotope using gamma probe.
99mTc-stannous phytate (particle size: 200-1000nm) was used as a radiolabeled tracer. Prophylactic inguinal lymph node dissection was also performed in parallel with sentinel node dissection, which resulted in two radioactive blue nodes among 14 nodes dissected. Although the guidelines for sentinel node biopsy in Japan have not been established, a survey of the literature suggests that sentinel node biopsy is a more appropriate modality for the treatment of malignant melanoma. The tentative criterion for sentinel nodes in our institute is all nodes that show at least 10% counts of the hottest radioactive node and/or all blue-dye stained nodes. [
Skin Cancer (Japan) 2002; 17: 269-273]
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伊藤 里美, 波部 幸司, 玉田 享子, 森 如, 袴田 新, 磯田 憲一, 水谷 仁
2002 年 17 巻 3 号 p.
274-278
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
A 55-year-old Japanese male consulted our clinic complaining of a large tumor on his left ankle. The tumor was black colored with papillomatous proliferation and sized 15×18×12cm. Histopathologically the tumor was identified as malignant melanoma. Plasma serum 5-S-CD level was as high as 99.7nM/L. Based on the large inguinal lymphadenopathy and paraaortic nodal metastasis by CT, the patient was diagnosed as having malignant melanoma pT4a, bN2Mla. After surgical removal of the primary tumor, he was treated with lesional IFN-gamma, OK-432 and nodal irradiation followed by 4 courses of DAC-Tam combination chemotherapy. The tumors responded remarkably. The patient has been tumor free for more than 15 months without elevation of serum 5-S-CD level. [
Skin Cancer (Japan) 2002; 17: 274-278]
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吉野 公二, 青木 見佳子, 北川 泰之, 川名 誠司
2002 年 17 巻 3 号 p.
279-282
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We reported a case of a 51-year-old man of extraskeletal myxoid chondrosarcoma. Thirteen years ago, he noticed a slowly progressive subcutaneous tumor of the right inguinal region. Aspiration biopsy was done resulting in a diagnosis of extraskeletal myxoid chondrosarcoma.
We found lung metastasis. In general, the treatment for extraskeletal myxoid chondrosarcoma is an operation, chemotherapy and radiation therapy. However, this patient only received radiation therapy for the inguinal subcutaneous tumor. One year later, the subcutaneous tumor had disappeared. [
Skin Cancer (Japan) 2002; 17: 279-282]
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新井 栄一
2002 年 17 巻 3 号 p.
283-287
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
A 49-year-old female noticed a gradually enlarging tumor on her right cheek in August, 1993. She had had no general symptoms, insect bite or injury. The tumor was 13mm in diameter, dark-red and dome-shaped without tenderness or adhesion to the fascia. The lesion was diagnosed as a benign lymphocytoma cutis by biopsy and resected in November 10, 1993. Histopathologically there was a grenz zone with in the epidermis and massive dense lymphocytic infiltration from the upper dermis to the subcutis. Plasma cells had infiltrated the peripheral zone and scattered lymphoid follicles were seen. The tumor cells had some mitoses and infiltration to the sweat glands. Immunohistochemically tumor cells were diffusely positive for CD20, CD79a and their positivity was more than three times as abundant as CD3's. There was a light chain restriction for λ-chain. The polymerase chain reaction method using DNA extracted from a paraffin section showed a rearrangement band of the IgH chain gene. After the resection the subject has never had involvement to lymph nodes or internal organs. [
Skin Cancer (Japan) 2002; 17: 283-287]
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二神 綾子, 青木 見佳子, 川名 誠司
2002 年 17 巻 3 号 p.
288-292
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
Extranodal marginal zone B-cell lymphoma, which is a low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type, can occur in the gastrointestinal tract, salivary gland, thyroid, orbit, lung, breast and skin.
We report two cases of primary cutaneous marginal zone B-cell lymphoma. The first case was a 53-year-old man who presented with multiple cutaneous nodules on his back. The second case was a 35-year-old female who presented with a solitary cutaneous nodule on her left forearm. Histologically, both tumors were characterized by reactive lymphoid follicles and proliferation of centrocyte-like cells and plasma cells. Centrocyte-like cells were shown a CD20+, but CD5- and CD10-immunophenotype. Furthermore, a monoclonal pattern of immunoglobulin light chain in plasma cells was found in both cases. Monoclonal rearrangement of the JH gene was detected via PCR. [
Skin Cancer (Japan) 2002; 17: 288-292]
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長阪 晶子, 北嶋 敏之, 山田 伸夫, 島田 眞路, 中村 和人, 柳 光章
2002 年 17 巻 3 号 p.
293-295
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
Angiotropic lymphoma is a rare lymphoproliferative disease that affects vessels of all organs especially including the skin and central nervous system. We report a 67-year-old woman with angiotropic B cell lymphoma. Examination revealed striking telangiectasia on the skin of the chest and upper back as the major manifestation. She also had subacute slight disorientation.
Laboratory abnormalities showed elevated serum lactic dehydrogenase (LDH) (2027U/l) . A skin biopsy from the telangiectasia revealed the presence of many intravascular, large, atypical lymphoid cells with hyperchromatic nuclei.
On immunohistochemical analysis, neoplastic cells showed reactivity for CD20 but not CD45RO. These findings were consistent with angiotropic B cell lymphoma. By combination chemotherapy (VAB-COP: cyclophosphamide, adriamycin, etoposide, vincristin, bleomycin and prednisolone), the telangiectasia and disorientation were dramatically improved during the follow-up period. An early diagnosis and subsequent combinatio chemotherapy may contribute to longer survival in angiotropic lymphoma. [
Skin Cancer (Japan) 2002; 17: 293-295]
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野尻 万紀子, 清水 宏和, 玉田 康彦, 松本 義也, 原 一夫, 清水 一之, 沼田 時男
2002 年 17 巻 3 号 p.
296-299
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report a 77-year-old man with CD8-positive cutaneous T-cell lymphoma (CTCL) diagnosed with a difficulty.
Immunohistochemical studies on a skin biopsy from a red elevated nodule of the elbow region of the left upper extremity revealed the phenotypes of CD3+, CD8+ T cell with TIA-1 marker. The differential diagnosis between the reactive T-cell and CTCL in the dermis was difficult because of the presence of eosinophils and plasma cells in chronic dermatitis. However, the diagnosis of CTCL was confirmed by findings of T-cells with clear atypia on the specimen stained for CD8 at higher magnification.
This case is considered to be an extremely rare CD8-positive CTCL, successfully, treated with a combination chemotherapy. [
Skin Cancer (Japan) 2002; 17: 296-299]
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若杉 正司, 城野 昌羲, 荒木 嘉浩, 栄 仁子, 井上 雄二, 小野 友道
2002 年 17 巻 3 号 p.
300-303
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
In recent years, a distinct clinicopathological variant considered to be an expression of mycosis fungoides (MF) has been described, characterized clinically by protein follicular lesions and histopathologicallyby folliculotropic infiltrates but with minimal or no involvement of the overlying epidermis. In contrast to the well-known MF-associated follicular mucinosis variant, there is a striking absence of mucin deposition. We describe the clinical, histopathological and immuno-histochemical features of one case of this variant, for which we prefer the term pilotropic cutaneous T-cell lymphoma (pilotropic CTCL; pilotropic MF, follicular CTCL, follicular MF). In this case, Langerhans cells may participate in the formation of pilotropic lymphoma. [
Skin Cancer (Japan) 2002; 17: 300-303]
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宮本 秀明, 村上 通敏
2002 年 17 巻 3 号 p.
304-307
発行日: 2002/12/27
公開日: 2010/08/05
ジャーナル
フリー
We report a 71-year-old Japanese man with breast cancer. The patient had first noticed a papule on the right areola in 1996. Because the papule had gradually enlarged, and begun to bleed and cause pain, the patient came to our clinic in September 2001. The tumor measured 59×55×15 mm and gave off an unpleasant odor. Skin biopsy revealed breast cancer (solid-tubular scirrhous carcinoma). A roentgenography of the chest showed multiple pulmonary metastases, and a CT scan revealed metastases in the right lymph nodes. Auchincloss' operation and lymphadenectomy were performed. Fifteen of 20 lymph nodes taken from the right axilla were positive for tumor cells. Because post-surgical hormonal therapy using anastrozole did not improve the pulmonary metastases, chemotherapy consisting of cyclophosphamide, fluorouracil and epirubicin hydrochloride was added in February 2002. Currently, at six months after the chemotherapy, the pulmonary metastases have not enlarged. [
Skin Cancer (Japan) 2002; 17: 304-307]
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