Subcutaneous porocarcinoma clinically presenting as a soft tissue tumor

Porocarcinoma is a rare malignancy with glandular adnexal differentiation. A 38‐year‐old Japanese man noticed a subcutaneous mass in right inguinal region about 20 years prior to being examined. Radiological examinations demonstrated the mass, 11 × 10 cm in size, was in the subcutaneous fat tissue. Recently, the mass grew rapidly, and it was biopsied by an orthopedist based on clinical diagnosis of primary soft tissue tumor. Histopathological examination of the resected specimens also revealed that the tumor lacked involvement to the skin. Microscopically, the tumor was mainly composed of poroid cells with partially obvious squamous differentiation, accompanied by focal ductal structures immunoreactive for CEA and EMA. The tumor contained a low‐grade area consisting of poroid cells and high‐grade area with squamous differentiation. This histopathological heterogeneity suggested malignant transformation from poroma. The patient had the tumor in almost same size over the period of 20 years, which is the longest in the previous reports. This unique case of subcutaneous porocarcinoma is reported.     

Subtraction CT angiography with controlled-orbit helical scanning for detection of intracranial aneurysms.

PURPOSEOur goal was to evaluate the utility of subtraction three-dimensional CT angiography for the detection of intracranial aneurysms.METHODSThirty-six patients with intracranial aneurysms were examined using newly devised controlled-orbit helical scanning and conventional angiography. Three-dimensional CT angiograms and subtraction 3-D CT angiograms were compared with conventional angiograms for their characterization of intracranial aneurysms.RESULTSFifty aneurysms were depicted on conventional angiograms, of which 48 (96%) were seen on the 3-D CT angiograms. Three-dimensional CT angiography was superior or equivalent to conventional angiography for depicting the shape, direction, and location of 33 (66%) of 50 aneurysms; however, it was often less useful than conventional angiography in delineating intracranial aneurysms adjacent to bone. Subtraction 3-D CT angiograms were obtained in 32 patients with a total of 46 aneurysms (in four cases, aneurysms were not depicted owing to excessive motion artifacts), and were superior or equivalent to conventional angiograms in all 46 cases.CONCLUSIONSSubtraction 3-D CT angiography with the use of controlled-orbit helical scanning is effective in the detection of intracranial aneurysms.     

Detection of lymphatic invasion in resected cases of primary pancreatic cancer based on immunohistochemistry of D2-40

We investigated the presence of lymphatic invasion detected by D2-40 immunostaining compared to conventional hematoxylin-eosin (HE) staining in primary pancreatic cancer. We also compared the alkaline phosphatase-fast red detection method with the 3,3′-diaminobenzidine (DAB) detection method. We reviewed 25 cases of pancreatic cancer with lymph node (LN) metastases and 15 cases without LN metastases and evaluated the detection rate of lymphatic invasion by HE stain slide alone and D2-40 immunostains. Regarding the cases with positive LN metastasis, 4 (16%) of the 25 cases showed lymphatic invasion by HE slide alone, whereas 7 cases (28%) demonstrated positive lymphatic invasion by D2-40 immunostain. On the other hand, even in cases with negative LN metastasis, 3 of the 15 cases revealed lymphatic invasion by D2-40 immunostaining. Lymphatic invasion was easily detected by alkaline phosphatase-fast red technique, especially at the lower magnification. Regarding the location of lymphatic invasion, it was recognized not only at the peripheral portion but also in the central part of the tumors by D2-40 immunostains; this was difficult to identify by HE stain slide alone. Our study indicates that lymphatic invasion may be overlooked when only HE stain slides are used. In addition, the alkaline phosphatase-fast red detection method (vivid red color) is a distinctive advantage compared with the DAB detection method (brown color), especially in detecting lymphatic invasion at the lower magnification.     

Acoustic radiation force impulse elastography of the liver: can fat deposition in the liver affect the measurement of liver stiffness?

Purpose  

The aim of this study was to compare acoustic radiation force impulse (ARFI) results between livers with and without fat deposition.