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A 74-year-old-man was referred to our hospital to undergo examination and therapy for a rectal polypoid lesion. MALT lymphoma of the rectum (stage IE) was diagnosed by performing a biopsy of the tumor during colonoscopy. The patient received eradication therapy against Helicobacter pylori (H. pylori) because of chronic gastritis due to H. pylori, and a complete remission was documented after this therapy. However, MALT lymphoma recurred 18 months later. Our observations in this case suggest that eradication therapy against H. pylori may be useful not only for gastric MALT lymphoma but also for colorectal MALT lymphoma.

Disseminated carcinomatosis of the bone marrow derived from solid cancer has a very poor prognosis, with disseminated intravascular coagulation(DIC). A 72-year-old man was admitted to our hospital after detection of a tumor in the pancreatic tail by CT imaging. Several images revealed that he suffered from cancer of the tail of the pancreas with multiple liver and bone metastases. Endoscopic ultra-sonography-guided fine needle aspiration detected adenocarcinoma cells from the tumor of the pancreatic tail. We also performed bone marrow aspiration, which confirmed adenocarcinoma cells in the bone marrow. We started to administer 1,000 mg/m2 of gemcitabine weekly. Laboratory data revealed that thrombocytopenia had occurred, and it developed into DIC after the first the administration of gemcitabine. In spite of the DIC state with thrombocytopenia, we were able to provide anticancer treatment using combination gemcitabine and S-1. He recovered from his DIC state, and the primary tumor was shrunk with a decrease of tumor markers after 2 courses of combination chemotherapy. Chemotherapy might be required for disseminated carcinomatosis of the bone marrow in order to promote tumor shrinkage and to prolonged expected survival, even if DIC was developed.

We report a rare case which had been followed up for hepatic hemangioma and in whom was surgical resection revealed with cholangiolocellular carcinoma (CoCC) combined with intrahepatic cholangiocarcinoma (ICC). A 69-year-old man who was an HBV carrier had been regularly followed up with hepatic hemangioma from November, 2005. Because the arterial phase of dynamic CT scan exhibited an enhanced lesion in the dorsal portion of the hemangioma on November, 2009, the patient was admitted for intensive examination of the liver tumor. After surgical resection of the tumor, histological examination revealed small irregular tubules in the outer part and scattered small duct structures in the inner part of the tumor. In addition, immunohistochemical analysis demonstrated that cytokeratin (CK) 7, CK19 and epithelial membrane antigen (EMA) were all positive in the outer part, and EMA was only negative in the inner part of the tumor. From these findings, this case was diagnosed as CoCC combined with ICC.

A 52-year-old man presented with a pulmonary bulky mass, fever and cough. Chest CT showed a necrotizing bulky mass 10 cm in diameter in the right lung lower lobe. Transbronchial biopsy and CT-guided biopsy of the tumor and endobronchial ultrasound-guided transbronchial needle aspiration of the right hilar lymph node did not yield a definitive diagnosis, but the histological findings showed necrosis. We performed CT-guided biopsy of the part of the lesion where a high uptake of FDG-PET was observed. The histological diagnosis was diffuse large B-cell lymphoma. The immunohistochemical findings were positive for Epstein-Barr virus (EBV). Because the patient was more than 50 years old and had no underlying diseases, he was given a diagnosis of EBV-positive diffuse large B-cell lymphoma of an elderly patient. The pulmonary manifestation of this disease as a bulky tumor is extremely rare. In spite of the presence of a bulky pulmonary tumor, the EBV-positive diffuse large B-cell lymphoma contained necrotizing tissue, and it was difficult to obtain tissue specimens for histological examination.

A 57-year-old woman complained of a huge and rapid growing mass with bleeding in the left breast. Breast imaging (CT and MRI)showed a large, irregular and unevenly enhanced tumor with lymph node swelling in the left axilla. Mastectomy and axillary lymph node dissection were performed for control of bleeding from the tumor in the left breast. Pathological diagnosis was spindle cell carcinoma of the breast with transition from papillotubular carcinoma. Although the patient was treated with adjuvant chemotherapy and trastuzumab according to the treatment guideline for conventional breast cancer, she had an early relapse with mediastinal metastasis and died 9 months after operation. The tumor showed metaplastic change from epithelial tumor to spindle cell carcinoma. Because the epithelial part expressed weakly positive estrogen receptor(ER), progesterone receptor(PgR)-negative and HER2-positive, we used trastuzumab for adjuvant therapy. However, part of the spindle cell tumor mainly showed triple-negative, and ER, PgR and HER2 expression were negative, which might explain her poor prognosis for resistance to trastuzumab.

We report a case of histologically proved bronchiolitis obliterans organizing pneumonia (BOOP) associated with ruptured distal aortic arch aneurysm (DAAA) into the lung. A 63-years-old male with preoperative episode of hemosputum and hemoptysis was diagnosed DAAA. Preoperative computed tomographic scanning demonstrated that the aneurysm was surrounded with the structure of 2 layers of the enhanced high density external layer and the not enhanced low density internal layer. Combined resection of the left upper lobe and the aneurysm was performed safely because of marked adhesion between the lung and the aneurysm. Postoperative histological examination revealed that the perianeurysmal structure was due to BOOP.

Type IV collagen the major component of basement membrane (BM), is composed of six genetically distinct alpha chains. In normal breast tissue, benign breast tumors, and in the intraductal components of invasive ductal carcinoma, alpha 1 (IV) and alpha 2 (IV) chains were stained in all BM, whereas alpha 5 (IV) and alpha 6 (IV) chains were restrictively localized in a linear pattern in the epithelial BM. However, in invasive ductal carcinoma, alpha 1 (IV) and alpha 2 (IV) chains were discontinuously or negatively stained in the cancer cell nest, and the assembly of alpha 5 (IV) and alpha 6 (IV) chains into the BM was completely inhibited. The results indicate that the mammary gland forms a second network of BM composed of alpha 5 (IV)/alpha 6 (IV) chains, in addition to the classic network of alpha 1 (IV)/alpha 2 (IV) chains. Remodeling of type IV collagen alpha chains during the development of invasive breast cancer seems to be differentially regulated, and to be associated with modification of histopathological findings.

The activity of induce tumor necrosis factor alpha (TNF alpha) production of several mycoplasmas, including AIDS associated mycoplasmas was investigated. M. penetrans which was detected and isolated from urine and tissue of Kaposi's sarcoma of patients with AIDS markedly exhibited the induction of TNF alpha production of both THP-1 cells and murine peritoneal macrophages to compare to other mycoplasmas. Each amount of M. penetrans, M. fermentans, M. incognitus, Acholeplasma ladilawii, M. orale, M. salivarium, M. hominis required for induction of 50% cytotoxicity to L cells in the supernatants of mouse peritoneal macrophages cultured with those microorganisms was 0.65 micrograms/ml, 11.3 micrograms/ml, 19.6 micrograms/ml, 6.6 micrograms/ml, 7.7 micrograms/ml, 6.3 micrograms/ml, 5.7 micrograms/ml respectively. Next, the components of M. penetrans were extracted by Bligh-Dyer method, in order to investigate chemical component to induce TNF alpha-production. The activity of TNF alpha induction was mainly found in the methanol-phase, but not in the chloroform-phase, where lipid and glycolipid of the microorganisms were generally thought to be accumulated. The binding of the active component to concanavalin A-Sepharose was blocked in the presence of Methyl alpha-D-mannopyranoside and Methyl alpha-D-glucopyranoside. These results suggest that the component possess mannoside and glucoside active site.

A 58-year-old man was admitted complaining of hemoptysis and dyspnea. Chest roentgenogram demonstrated bilateral alveolar infiltrates in the middle and lower lung fields. Diffuse alveolar filling shadows were seen on standard chest CT images. His symptoms and pulmonary infiltrates gradually resolved after administration of high-dose corticosteroids and erythromycin. Immunoelectrophoresis showed increased IgM of lambda type. Transbronchial lung biopsy specimens revealed amyloid deposits in the alveolar septa and blood vessel walls. Cervical lymph node biopsy specimen also showed amyloid deposits. The amyloid in this case stained positively with anti-A lambda type amyloid antibody. A diagnosis of primary systemic amyloidosis was made.