- 著者
- Takashi HASEGAWA Yoshiki ARAKAWA Sachiko MINAMIGUCHI Yohei MINEHARU Satoshi NAKAJIMA Kohei NAKAJIMA Takanori HIROSE Hironori HAGA Susumu MIYAMOTO
- 出版者
- The Japan Neurosurgical Society
- 雑誌
- NMC Case Report Journal (ISSN:21884226)
- 巻号頁・発行日
- vol.9, pp.187-192, 2022-12-31 (Released:2022-06-21)
- 参考文献数
- 20
Tufted angioma is a benign vascular tumor in which immature endothelial and pericyte cells and lymphatic vascular endothelium grow. It manifests as a flat, painful erythema that gradually expands mainly on the trunk and extremities. Although tufted angiomas can also occur in other areas of the body and may be more locally invasive, they rarely occur intracranially. A 63-year-old man underwent magnetic resonance imaging (MRI) for a brain check-up 8 years before his visit to our institute, which detected a mass lesion with surrounding cerebral edema in the left frontal lobe. The patient was followed up with annual MRI analysis, which indicated slow tumor growth and gradual development of peritumoral edema. The tumor was treated by gross-total resection. Histological analysis showed a slightly dilated microvascular core surrounded by many capillary aggregates in the brain parenchyma. Immunohistochemical findings indicated that the vascular endothelial cells were positive for CD34 and Brahma-related gene-1 and were surrounded by smooth muscle actin-positive pericytes. These findings were consistent with tufted angioma. Intracranial tufted angioma is uncommon, but it should be considered in the differential diagnosis for intracranial tumorous lesions. Long-term follow-up is necessary to unravel the natural history of the disease.
- 著者
- Minami Matsumoto Shinya Yamamoto Takuya Morinishi Eishin Harima Shintaro Nakayasu Nobuki Iwamoto Yuki Muraoka Ayako Takahashi Sachiko Minamiguchi Motoko Yanagita
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.1436-22, (Released:2023-03-22)
- 参考文献数
- 15
The number of patients with syphilis has been rapidly increasing. Without treatment, syphilis can damage various organs and become life-threatening. We herein report a 29-year-old woman diagnosed with neurosyphilis, acute hydrocephalus, syphilitic uveitis combined with hypertensive retinopathy, and malignant hypertensive nephropathy. To our knowledge, this is the first report of syphilis complicated with malignant hypertensive nephropathy proven by a renal biopsy. Neurosyphilis was successfully treated with intravenous penicillin G, and severe hypertension subsequently resolved. However, delayed medical examinations and complications of syphilitic uveitis and hypertensive retinopathy resulted in irreversible visual loss. To prevent irreversible organ damage, early treatment is essential.
- 著者
- Hiroyuki Arai Shinya Yamamoto Takeshi Matsubara Takafumi Miyake Akira Tochio Akiko Mii Akira Shimizu Sachiko Minamiguchi Eri Muso Motoko Yanagita
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.1283-22, (Released:2023-01-15)
- 参考文献数
- 28
- 被引用文献数
- 2
Ponatinib is a novel multi-tyrosine kinase inhibitor (TKI) with potent inhibitory activity against refractory chronic myeloid leukemia (CML). Despite its high clinical efficacy, ponatinib induces various adverse events due to its multi-target characteristic. However, renal complications associated with ponatinib are rare. A 76-year-old woman had a history of chronic myeloid leukemia (CML) resistant to imatinib and nilotinib. Our patient developed proteinuria and renal function deterioration during treatment with ponatinib but not with imatinib or nilotinib. We herein report the first case of a patient with secondary focal segmental glomerulosclerosis (FSGS) with partial glomerular collapse induced by ponatinib treatment.
- 著者
- Shinya Yamamoto Ken Wells Keisuke Morita Katsuya Tanigaki Koji Muro Minami Matsumoto Hirotsugu Nakai Yasuyuki Arai Shuji Akizuki Ken Takahashi Sachiko Minamiguchi Shingo Fukuma Motoko Yanagita
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.1178-22, (Released:2023-02-01)
- 参考文献数
- 26
- 被引用文献数
- 2
Finding the ideal balance between efficacy and safety of immunosuppression is challenging, particularly in cases of severe TAFRO syndrome. We herein report a 60-year-old man diagnosed with grade 5 TAFRO syndrome mimicking hepatorenal syndrome that was successfully treated by glucocorticoid, tocilizumab, and cyclosporin despite virus infection. Furthermore, by examining 14 peer-reviewed remission cases, we revealed that the recovery periods among inflammation, renal dysfunction, and thrombocytopenia were quite different, with recovery from thrombocytopenia notably slow. All patients requiring dialysis were successfully withdrawn from dialysis, and the reversibility from kidney injury was good. This clinical information will help clinicians plan treatments and tailor the intensity of immunosuppression.
- 著者
- Satoshi Otani Aki Kido Yuki Himoto Akihiko Sakata Tomoaki Otani Ryo Kuwahara Yusaku Moribata Naoko Nishio Ryo Yajima Kyoko Nakao Yasuhisa Kurata Sachiko Minamiguchi Masaki Mandai Yuji Nakamoto
- 出版者
- Japanese Society for Magnetic Resonance in Medicine
- 雑誌
- Magnetic Resonance in Medical Sciences (ISSN:13473182)
- 巻号頁・発行日
- pp.mp.2021-0003, (Released:2021-09-03)
- 参考文献数
- 26
- 被引用文献数
- 4
Purpose: To compare the diagnostic performance of dynamic contrast-enhanced-MR (DCE-MR) and delayed contrast-enhanced (CE)-MRI added to unenhanced MRI, including diffusion weighted image (DWI) for differentiating malignant adnexal tumors, conducting a retrospective blinded image interpretation study.Methods: Data of 80 patients suspected of having adnexal tumors by ultrasonography between April 2008 and August 2018 were used for the study. All patients had undergone preoperative MRI and surgical resection at our institution. Four radiologists (two specialized in gynecological radiology and two non-specialized) were enrolled for blinded review of the MR images. A 3-point scale was used: 0 = benign, 1 = indeterminate, and 2 = malignant. Three imaging sets were reviewed: Set A, unenhanced MRI including DWI; Set B, Set A and delayed CE-T1WI; and Set C, Set A and DCE-MRI. Imaging criteria for benign and malignant tumors were given in earlier reports. The diagnostic performance of the three imaging sets of the four readers was calculated. Their areas under the curve (AUCs) were compared using the DeLong method.Results: Accuracies of Set B were 81%–88%. Those of Set C were 81%–85%. The AUCs of Set B were 0.83 and 0.89. Those of Set C were 0.81–0.86. For two readers, Set A showed lower accuracy and AUC than Set B/Set C (less than 0.80), although those were equivalent in other readers. No significant difference in AUCs was found among the three sequence sets. Intrareader agreement was moderate to almost perfect in Sets A and B, and substantial to almost perfect in Set C.Conclusion: DCE-MR showed no superiority for differentiating malignant adnexal tumors from benign tumors compared to delayed CE-T1WI with conventional MR and DWI.
- 著者
- Masahiro Nagano Takashi Ayaki Natsuko Koita Toshiyuki Kitano Momoko Nishikori Naoki Goda Sachiko Minamiguchi Akio Ikeda Akifumi Takaori-Kondo Ryosuke Takahashi
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.58, no.6, pp.849-854, 2019-03-15 (Released:2019-03-15)
- 参考文献数
- 20
- 被引用文献数
- 4 8
Primary central nervous system lymphoma (PCNSL) and chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) can share clinical features and may be indistinguishable, even after brain biopsy. We encountered a case of Epstein-Barr virus-positive (EBV+) PCNSL recurrence in a patient with clinical features of CLIPPERS, and repeat brain biopsy was required to reach the correct diagnosis. Four years after the initial diagnosis and treatment of PCNSL, "peppering" punctate enhanced lesions with transient steroid responsiveness were detected during brain magnetic resonance imaging (MRI). A second brain biopsy supported a diagnosis of CLIPPERS, while a third biopsy confirmed the diagnosis of recurrent PCNSL.