A case of Trousseau syndrome associated with a mucosa-associated lymphoid tissue lymphoma disseminated to the mesenteric adipose tissue.

A 66-year-old man with recurrent stroke within a short period of time was referred to our department from the neurology department to rule out any malignancy. An endoscopic examination revealed a white depressed lesion in the body of the stomach, and computed tomography revealed a high-density area in the mesentery around the stomach. A mucosa-associated lymphoid tissue (MALT) lymphoma was detected from both the stomach biopsy and resected mesenteric specimen. Systemic chemotherapy was administered for the MALT lymphoma (Lugano classification stage IV). Cerebral infarction did not occur after the treatment. We concluded that Trousseau syndrome associated with the MALT lymphoma disseminated to the mesenteric adipose tissue. A MALT lymphoma has a small probability of occurring in Trousseau syndrome.

[Case of acute necrotizing esophagitis associated with AA amyloidosis secondary to bronchiectasis].

An 82-year-old woman with a history of bronchiectasis for 20 years was admitted to our hospital with anorexia and diarrhea. Sigmoidoscopy showed multiple mucosal erythematous areas and erosions. Histologic examination with Congo red stain revealed massive amyloid deposition around the submucosal vessels as well as in the parenchyma of the mucosa and submucosa. With immunohistochemistry, the diagnosis of secondary/reactive AA amyloidosis was confirmed. Esophagogastroduodenoscopy demonstrated diffuse dark brown mucosa, establishing the diagnosis of acute necrotizing esophagitis. Ischemia associated with amyloid deposition of the vessels in the esophagus was considered to be a possible etiology of acute necrotizing esophagitis. Additionally, gastric outlet obstruction and gastroesophageal reflux associated with gastroduodenal erosions caused by amyloid deposition were supposed to be another factor. Amyloid deposition in the esophageal mucosa may cause a reduction in mucosal defense that is responsible for the pathogenesis. We report the first case of acute necrotizing esophagitis associated with amyloidosis.

Biological characteristics of gene expression features in pancreatic cancer cells induced by proton and X-ray irradiation.

BACKGROUND: Radiation therapy is an important alternative treatment for advanced cancer. The aim of the current study was to disclose distinct alterations of the biological characteristics of gene expression features in pancreatic cancer cells, MIAPaCa-2, following proton and X-ray irradiation. MATERIALS AND METHODS: Using cDNA microarray, we examined the gene expression alterations of MIAPaCa-2 cells following proton or X-ray irradiation. We also isolated the surviving MIAPaCa-2 cells after irradiation and analyzed their gene expression profiles. RESULTS: Although the cytocidal effects of both types of irradiation were similar at sufficient doses in vitro and in vivo, the affected gene expression profile alterations of MIAPaCa-2 cells irradiated with protons were distinct from those irradiated with X-ray. Interestingly, clustering analysis of gene expression of the surviving MIAPaCa-2 cells was also completely discernible between the two types of irradiation. However, a similar cytocidal effect was still observed in the proton- and X-ray-irradiated surviving cells after re-irradiation, commonly showing biological effects related to apoptosis and cell cycle processes. CONCLUSIONS: Proton irradiation treatment for pancreatic cancer provides the distinct biological effect of steady gene expression alterations compared to X-ray irradiation; however, surviving cells from both types of irradiation were still susceptible to the cytocidal effects induced by proton re-irradiation treatment.

Common transcriptional signature of tumor-infiltrating mononuclear inflammatory cells and peripheral blood mononuclear cells in hepatocellular carcinoma patients.

Hepatocellular carcinoma (HCC) is frequently associated with infiltrating mononuclear inflammatory cells. We performed laser capture microdissection of HCC-infiltrating and noncancerous liver-infiltrating mononuclear inflammatory cells in patients with chronic hepatitis C (CH-C) and examined gene expression profiles. HCC-infiltrating mononuclear inflammatory cells had an expression profile distinct from noncancerous liver-infiltrating mononuclear inflammatory cells; they differed with regard to genes involved in biological processes, such as antigen presentation, ubiquitin-proteasomal proteolysis, and responses to hypoxia and oxidative stress. Immunohistochemical analysis and gene expression databases suggested that the up-regulated genes involved macrophages and Th1 and Th2 CD4 cells. We next examined the gene expression profile of peripheral blood mononuclear cells (PBMC) obtained from CH-C patients with or without HCC. The expression profiles of PBMCs from patients with HCC differed significantly from those of patients without HCC (P < 0.0005). Many of the up-regulated genes in HCC-infiltrating mononuclear inflammatory cells were also differentially expressed by PBMCs of HCC patients. Analysis of the commonly up-regulated or down-regulated genes in HCC-infiltrating mononuclear inflammatory cells and PBMCs of HCC patients showed networks of nucleophosmin, SMAD3, and proliferating cell nuclear antigen that are involved with redox status, the cell cycle, and the proteasome system, along with immunologic genes, suggesting regulation of anticancer immunity. Thus, exploring the gene expression profile of PBMCs may be a surrogate approach for the assessment of local HCC-infiltrating mononuclear inflammatory cells.