Angiomyolipoma arising in the colon.

Extrarenal angiomyolipomas are very rare. Here we report the first case of surgically resected angiomyolipoma of the descending colon that developed in a 50-yr-old man. The patient had no signs of or family history of tuberous sclerosis. He underwent a partial colectomy because the tumor obstructed the colon. Histologically, the tumor consisted of three components: mature fat cells, blood vessels, and smooth muscle cells, and was thereby diagnosed as an angiomyolipoma. Immunohistochemically, the proliferating smooth muscle cells were positive for vimentin, alpha-smooth muscle actin, and desmin. The tumor cells were negative for HMB-45, which is consistently expressed in renal angiomyolipomas.

Improved detection rate of early breast cancer in mass screening combined with mammography.

A cohort study to compare mass screening with and without mammography was conducted in Miyagi Prefecture, Japan in order to establish whether the effectiveness of breast cancer screening would be improved when mammography was combined with physical examination. A trial of mass screening combined with mammography was carried out in 9634 women aged over 50. Lateral imaging of the breast using single-view film mammography was performed at the first stage of mass screening in addition to physical examination of the breast. Results in the trial were compared with those obtained in 35511 age-matched subjects without mammography. Thirty breast cancers were found in the trial with a detection rate of 0.31%, which was much higher than that (0.08%) obtained by physical examination without mammography. In 15 of the 30 patients the breast tumor was not palpated at the first screening, but abnormal findings were detected in the mammography. A higher rate (73%) of early breast cancer was obtained in the screening trial with mammography than that (39%) obtained in the screening with physical examination alone. Mass screening combined with mammography is superior to that without mammography for breast cancer screening, especially for the detection of non-palpable, early breast cancer.

Atrial natriuretic polypeptide (ANP) as protective agent of renal ischemia.

The effect of atrial natriuretic polypeptide (ANP) on hemodynamics and renal function was evaluated after the reconstructive surgery of the left renal artery in a patient with renovascular hypertension secondary to Takayasu's arteritis. The reconstructive surgery was done using the femoral artery, since we were unable to obtain adequate vein segments to fit the renal artery. The femoral artery was reconstructed by her saphenous vein segments. After 30 min of the aortorenal bypass operation, alpha-human ANP (alpha-hANP) was infused intravenously for 10 min at a rate of 0.1 microgram/kg/min. Although total peripheral resistance was decreased by alpha-hANP infusion, blood pressure was not changed because of the increased cardiac output. Glomerular filtration rate was increased markedly with concomitant increase in urine volume and urinary excretions of sodium, potassium and phosphate. Fractional excretions of water and sodium were not changed, but fractional excretion of phosphate and potassium clearance were increased. Thus, the infusion of alpha-hANP markedly improved the renal function of the ischemic kidney by the reconstructive surgery of the renal artery, suggesting that alpha-hANP seems clinically applicable as a protective agent in renal ischemia at renovascular surgery as well as the renal transplantation.

[Ultrastructural study of rat mammary tumors and human breast cancer cells following treatment with tamoxifen].

In order to predict the efficacy of hormonal therapy for breast cancer patients, early ultrastructural changes of rat mammary tumors and human breast cancer cells have been studied following treatment with tamoxifen. Following the treatment, complex nuclear bodies (CNB) were increased, and ring-shaped nucleoli were observed in both the rat mammary tumors and the human breast cancer cells. In the tamoxifen-treated human beast cancer patients, CNB increased, as estrogen receptor concentration rose. Shrunken nucleli and intranuclear rodlet were observed only in the tamoxifen-treated human cancer patients.

[Lipid-secreting carcinoma of the breast].

Lipid secreting carcinoma is a very rare tumor of the breast. This is regarded as a special type of breast carcinoma, which is characterized by abundant intracytoplasmic neutral lipid stained with Sudan IV. Two cases (75 and 42 year old females) of lipid secreting carcinoma of the breast are presented. No other reports of lipid secreting carcinoma have been available in the Japanese literature. In this report, the physical, mammographic and ultrasonographic diagnosis and pathological findings are described and discussed.