Publications by authors named "Rie Yamasaki"

14 Publications

  • Page 1 of 1

Risk factors of local recurrence following implant-based breast reconstruction in breast cancer patients.

BMC Womens Health 2021 Apr 10;21(1):147. Epub 2021 Apr 10.

Department of Breast Surgery, Hiroshima City Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan.

Background: The number of patients desiring implant-based breast reconstruction has been increasing. While local recurrence is observed in patients with breast reconstruction, only a few reports have focused on the risk factors for local recurrence and the prognosis after developing local recurrence.

Methods: We analyzed 387 patients who underwent implant-based breast reconstruction during the period from 2004 to 2017 in Hiroshima City Hospital. We retrospectively examined the risk factors for local recurrence and the outcomes of patients developing such recurrence after implant-based breast reconstruction.

Results: The median follow-up time was 59 months. The local recurrence rate was 3.1% (n = 12). The most common reason for detecting local recurrence was a palpable mass. Four patients with local recurrence had recurrence involving the skin just above the primary lesion and needle biopsy tract. All patients with local recurrence received surgery and systemic therapy and most patients received radiation therapy, all have remained free of new recurrence to date. Multivariate analysis showed lymphatic vessel invasion (HR, 6.63; 95% CI, 1.40-31.36; p = 0.017) and positive or < 2 mm vertical margin (HR, 9.72; 95%CI, 1.23-77.13; p = 0.047) to be associated with significantly increased risk of local recurrence.

Conclusions: The risk factors for local recurrence following implant-based breast reconstruction were lymphatic vessel invasion and positive or < 2 mm vertical margin. Removal of the skin just above the primary lesion and needle biopsy tract and adjuvant radiation therapy might improve local outcomes. Patients with local recurrence following implant-based breast reconstruction appear to have good outcomes with appropriate treatment.
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http://dx.doi.org/10.1186/s12905-021-01287-4DOI Listing
April 2021

Temporal arteritis as an initial manifestation of eosinophilic granulomatosis with polyangiitis: a case report and a literature review.

Mod Rheumatol Case Rep 2021 Mar 15:1-7. Epub 2021 Mar 15.

Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.

A 79-year-old woman was admitted for suspected giant cell arteritis (GCA). She had suffered from dizziness, headache, jaw claudication and visual disturbance. Her medical history included bronchial asthma and parasinusitis. Her superficial temporal arteries were markedly enlarged with tenderness. Laboratory data showed eosinophilia (6968/µL) and a positive result of myeloperoxidase-ANCA. A histological examination of the biopsied artery revealed granulomatous inflammation consisting of lymphocytes and eosinophils with a multinucleated giant cell. Her conditions met both the criteria for GCA and eosinophilic granulomatosis with polyangiitis (EGPA). We finally considered that she had temporal arteritis as an initial manifestation of EGPA after a comprehensive literature review. To our knowledge, this is the first case in which temporal arteritis with a giant cell developed as an initial and sole manifestation of EGPA.
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http://dx.doi.org/10.1080/24725625.2021.1893944DOI Listing
March 2021

Clinicopathological features of breast cancer in Japanese female patients with Lynch syndrome.

Breast Cancer 2019 May 16;26(3):359-364. Epub 2018 Nov 16.

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, 700-8558, Okayama, Japan.

Background: Lynch syndrome (LS) is a predominantly inherited syndrome caused by a pathological germline mutation in one of the mismatch repair (MMR) genes. Whether breast cancer (BC) is one of the LS-associated tumors is controversial. The aim of this retrospective cohort study was to evaluate the clinical features of BC in Japanese patients with LS.

Methods: Of 38 mutation carriers, 4 females with BC were examined in this study.

Results: Two of the four patients had multiple BC. Their median age at the diagnosis of BC was 63 (range, 47-84) years. The TNM (6th revision) stages of the six BCs were as follows: stage I, 33% (2/6); stage IIA, 50% (3/6); and stage IIB, 17% (1/6). Histological examination revealed four scirrhous, one papillotubular, and one medullary carcinoma. The positive ratios for estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth receptor 2 (HER2) were 83.3% (5/6), 83.3% (5/6), and 16.7% (1/6), respectively. Two of the three specimens showed MSI-H and one showed MSS. These MSI-H BCs had tumor-infiltrating lymphocytes. Two of the three specimens showed an absence of MLH1 and PMS2 proteins on immunohistochemistry. The cumulative risks for a person with LS to develop BC were 4.35% at the age of 50 years, 8.70% at 60 years, and 21.5% at 70 years.

Conclusions: Our study results showed BC in Japanese females with LS to be an MSI-H tumor, which was ER and PgR positive and HER2 negative.
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http://dx.doi.org/10.1007/s12282-018-0931-zDOI Listing
May 2019

Synchronous coexistence of liver metastases from cecal leiomyosarcoma and rectal adenocarcinoma: A case report.

World J Gastroenterol 2017 Mar;23(9):1725-1734

Hideki Aoki, Takashi Arata, Masashi Utsumi, Yutaka Mushiake, Tomoyoshi Kunitomo, Isao Yasuhara, Fumitaka Taniguchi, Koh Katsuda, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, Iwakuni Clinical Center, Yamaguchi 740-8510, Japan.

Multiple liver tumors represent a challenging condition for abdominal surgeons both in the selection of technique and the rarity of diagnosis. There are no case reports on co-existence of liver metastases from both intestinal leiomyosarcoma and adenocarcinoma. The patient described in this report successfully underwent resection of both primary lesions and liver metastases in combination with chemotherapy. As for the leiomyosarcoma, the primary cecal lesion was revealed more than three years after the patient's first visit. Peritoneal, lymph-node, and lung recurrences were observed afterward, and thus surgeries on those regions were performed. Pathologically, the peritoneal and lung recurrences comprised leiomyosarcoma and the lymph-node recurrence was diagnosed as adenocarcinoma. Despite newly discovered multiple lung recurrences and regional lymph-node metastases, the patient lived a normal life for 73 mo after the initial operation based on multidisciplinary therapy. He ultimately died of liver failure due to invasive lymph-node recurrence from the rectal adenocarcinoma, in addition to multiple lung recurrences from the leiomyosarcoma. Hepatic recurrence did not occur in this patient's case, which appears to be one reason for his long-term survival.
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http://dx.doi.org/10.3748/wjg.v23.i9.1725DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340824PMC
March 2017

Granulocyte Colony-Stimulating Factor-Producing Gallbladder Cancer.

Acta Med Okayama 2016 Oct;70(5):393-396

Department of Surgery and Iwakuni Clinical Center, National Hospital Organization, Iwakuni, Yamaguchi 740-0041,

We report a case of a granulocyte colony-stimulating factor (G-CSF)-producing gallbladder tumor associated with fever in a middle-aged female. Preoperative blood analysis showed leukocytosis with elevated levels of C-reactive protein and G-CSF. We resected the liver at S4a+S5, with regional lymph node dissection and partial resection of the duodenum. Histology revealed undifferentiated carcinoma with spindle and giant cells and papillary adenocarcinoma. Immunohistochemistry revealed Stage IIIB G-CSF-producing gallbladder cancer. Postoperatively, leukocyte and serum G-CSF levels decreased to within normal limits. Adjuvant gemcitabine chemotherapy was administered for 16 months, and she has been recurrence-free for 48 months.
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http://dx.doi.org/10.18926/AMO/54599DOI Listing
October 2016

Localized Amyloid Deposition at the Ampulla of Vater.

Intern Med 2016;55(15):2111-2. Epub 2016 Aug 1.

Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center, Japan.

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http://dx.doi.org/10.2169/internalmedicine.55.6870DOI Listing
August 2016

[A case of HER2-positive esophagogastric junction cancer treated by using a neoadjuvant chemotherapy regimen consisting of trastuzumab].

Gan To Kagaku Ryoho 2014 Nov;41(12):2285-6

Dept. of Surgery, National Hospital Organization, Iwakuni Clinical Center.

The case herein pertains to a 78-year-old man, who was referred to our department and in whom esophagogastric junctional cancer, triggering weight loss, was indicated. A 0.75 xx circumferential Type 3 lesion was observed in the esophagogastric junction via upper gastrointestinal endoscopy, and a biopsy revealed a moderately differentiated adenocarcinoma with overexpression of human epidermal growth factor type 2 (HER2). Contrast-enhanced computed tomography (CT) showed multiple enlarged lymph nodes on the lesser curvature of the stomach. The preoperative diagnosis was T4a (SE) N2M0, Stage IIIB esophagogastric adenocarcinoma. Four courses of preoperative chemotherapy consisting of capecitabine plus cisplatin and trastuzumab were administered. The primary lesion showed cicatrization after chemotherapy, and enlarged lymph nodes were not visible on a CT scan. Total gastrectomy, splenectomy, and D2 lymph node dissection were performed. Only a small amount (approximately 5 mm) of the primary lesion remained beneath the abdominal and esophageal mucosa, and the treatment effectiveness was Grade 2. The final diagnosis was T1b (SM) N0M0, Stage IA esophagogastric adenocarcinoma. Survival with no recurrence was confirmed 6 months after surgery. These findings suggest that inclusion of trastuzumab in preoperative chemotherapy regimens improves the degree of curability of HER2-positive esophagogastric junction cancers.
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November 2014

[A case of gastric cancer developed after pylorus-preserving gastrectomy in a patient with lynch syndrome].

Gan To Kagaku Ryoho 2014 Nov;41(12):2264-5

Dept. of Surgery, National Hospital Organization, Iwakuni Clinical Center.

Lynch syndrome is an inherited autosomal dominant disorder caused by germ-line mutation of mismatch repair genes, in which a malignant tumor develops at a young age in the colon, endometrium, stomach, or other tissues. A 54-year-old patient with gastric cancer received pylorus-preserving gastrectomy, and a genetic examination confirmed a pathological variation of the MLH1 gene. Five years after surgery, an upper gastrointestinal endoscopy revealed a residual 0 -IIa+IIc gastric tumor approximately 2 cm in size extending from the anastomotic site to the lesser curvature side of the stomach. The remaining stomach was completely removed. The final diagnosis was T1b (SM) N1M0, StageIB gastric cancer. Microsatellite instability was positive, and we attributed the cancer to Lynch syndrome. In Lynch syndrome, the risk of multicentric gastric cancer is higher than normal, and for the initial therapy, preventive total gastrectomy should be considered as an option.
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November 2014

[Tumor-infiltrating lymphocytes can be used to screen for lynch syndrome - a case report].

Gan To Kagaku Ryoho 2014 Nov;41(12):1602-4

Dept. of Surgery, National Hospital Organization, Iwakuni Clinical Center.

Lynch syndrome is an inherited syndrome associated with the development of colorectal and various other cancers. A 65- year-old male underwent a laparoscopic-assisted right hemi-colectomy for ascending colon cancer (cStage II). Histologically, his tumor was diagnosed as a poorly differentiated adenocarcinoma. Lymphocytic reactions, such as tumor-infiltrating lymphocytes (TIL), and Crohn's-like reactions, were observed. Genetic testing revealed the presence of a pathogenic mutation in the MLH1. In the Lynch syndrome, the most frequently observed findings include the accumulation of mutations, and an early onset of familial colon cancer. Although the case presented here did not show the typical clinical findings of Lynch syndrome, histological examination of the lymphocytic reactions proved useful for screening for Lynch syndrome. Herein, we establish the important role of the pathologist in alerting the clinician to the possibility of Lynch syndrome when the findings of TIL and Crohn's-like reactions are detected.
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November 2014

Low-grade B-cell lymphoma presenting primarily in the bone marrow.

Hum Pathol 2014 Jul 26;45(7):1379-87. Epub 2014 Feb 26.

Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, 700-8558, Japan.

Cases of low-grade B-cell lymphoma presenting primarily in the bone marrow are rare, and its clinicopathology remains unclear. We retrospectively examined patients with low-grade B-cell lymphoma presenting primarily in the bone marrow. Fourteen patients met the inclusion criteria, including 5 with lymphoplasmacytic lymphoma (LPL), 3 with chronic lymphocytic leukemia/small lymphocytic lymphoma, 2 with follicular lymphoma (FL), and 4 with low-grade B-cell lymphoma not otherwise specified (LGBCL-NOS). The median age was 69.5 years (range, 42-89 years), and a slight male predominance was noted (9 men and 5 women, 1.8: 1). Immunohistochemically, all cases were positive for CD20. One case was positive for CD138. Both cases of FL were positive for CD10 and B-cell lymphoma 2 (BCL-2), and immunoglobulin heavy locus (IgH)/B-cell lymphoma 2 rearrangement was observed by fluorescence in situ hybridization. The myeloid differentiation primary response gene (88) leucine to proline mutation was observed in 3 of 5 LPL, 1 of 2 FL, and 2 of 4 LGBCL-NOS patients. Paraproteinemia was observed in 10 patients; IgM and IgG paraproteinemia were observed in 6 and 3 patients, respectively. In this patient series, 3 patients had died at a median follow-up of 36.5 months; the cause of death of 1 LPL patient was malignant lymphoma itself. Thus, low-grade B-cell lymphoma presenting primarily in the bone marrow has various subtypes, and approximately one-third of the patients had LGBCL-NOS. The immunophenotypic features and myeloid differentiation primary response gene (88) leucine to proline mutation data of LGBCL-NOS suggested that some cases present with characteristics similar to those of LPL or marginal zone lymphoma.
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http://dx.doi.org/10.1016/j.humpath.2014.02.010DOI Listing
July 2014

[A case of lynch syndrome treated laparoscopically for multiple colon cancers].

Gan To Kagaku Ryoho 2013 Nov;40(12):1909-11

Dept. of Surgery, National Hospital Organization, Iwakuni Clinical Center.

Lynch syndrome is an inherited syndrome associated with the development of colorectal, endometrial, stomach, and other cancers; it is caused by defects in the mismatch repair genes. Such patients are at risk of developing multiple abdominal cancers after colectomy, and the presence of adhesions may render future abdominal surgeries difficult. We recommend that patients with Lynch syndrome should be considered good candidates for laparoscopic surgery. A 43-year-old Japanese man was admitted following a positive fecal occult blood test result. The patient was diagnosed with multiple colon cancers in the right colon. He had undergone endoscopic mucosal resection for a colon polyp when he was 24 years of age. Two people among his father's second-degree relatives had colorectal cancer, and he fulfilled the revised Bethesda guidelines. He underwent laparoscopic-assisted right hemicolectomy and D3 lymph node dissection. Microsatellite instability testing indicated the presence of MSI-H, and genetic testing demonstrated a pathogenic mutation of MLH-1.
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November 2013

Primary hepatic leiomyosarcoma with liver metastasis of rectal cancer.

World J Gastroenterol 2012 Oct;18(38):5479-84

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.

Primary hepatic leiomyosarcoma is a particularly rare tumor with a poor prognosis. Curative resection is currently the only effective treatment, and the efficacy of chemotherapy is unclear. This represents the first case report of a patient with primary hepatic leiomyosarcoma co-existing with metastatic liver carcinoma. We present a 59-year-old man who was diagnosed preoperatively with rectal cancer with multiple liver metastases. He underwent a curative hepatectomy after a series of chemotherapy regimens with modified FOLFOX6 consisting of 5-fluorouracil, leucovorin and oxaliplatin plus bevacizumab, FOLFIRI consisting of 5-fluorouracil, leucovorin and irinotecan plus bevacizumab, and irinotecan plus cetuximab. One of the liver tumors showed a different response to chemotherapy and was diagnosed as a leiomyosarcoma following histopathological examination. This case suggests that irinotecan has the potential to inhibit the growth of hepatic leiomyosarcomas. The possibility of comorbid different histological types of tumors should be suspected when considering the treatment of multiple liver tumors.
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http://dx.doi.org/10.3748/wjg.v18.i38.5479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471119PMC
October 2012

Serum antibodies to Helicobacter pylori and its heat-shock protein 60 correlate with the response of gastric mucosa-associated lymphoid tissue lymphoma to eradication of H. pylori.

Helicobacter 2004 Jun;9(3):194-200

Department of Medicine and Medical Science (Medicine 1), Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.

Background And Aims: Eradication of Helicobacter pylori leads to regression of mucosa-associated lymphoid tissue (MALT) lymphomas. In this study, we measured serum antibodies to H. pylori and H. pylori-recombinant heat-shock protein 60 (rHSP60) in patients with gastric MALT lymphoma to determine whether humoral immune responses to the bacterial antigens correlate with the efficacy of eradication therapy.

Methods: Serum samples were obtained from 33 patients with H. pylori-positive gastric MALT lymphoma before undergoing therapy to eradicate the bacteria. Anti-H. pylori antibodies were measured in a commercial assay and in immunoassays to lysates and rHSP60 which were prepared from ATCC 43504 strain.

Results: Helicobacter pylori were eradicated in all 33 patients, and the lymphoma completely regressed histologically in 26 patients (79%). Pre-treatment titers of serum antibody to H. pylori and to rHSP60 in the patients whose tumor regressed were significantly higher than titers in patients whose tumors did not regress (p =.0011 and.035, respectively). By logistic regression analysis, age (odds ratio = 0.88, 95% confidence interval = 0.80-0.99), endoscopic appearance (0.053, 0.004-0.65), titers of anti-H. pylori antibodies (67.6, 2.5-1800), and titers of anti-rHSP60 antibody (6.4, 1.2-36) were identified as significantly associated factors with the outcome of MALT lymphoma.

Conclusions: Measurement of serum antibodies to H. pylori and HSP60 might be useful for predicting the response of gastric MALT lymphoma to eradication of H. pylori.
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http://dx.doi.org/10.1111/j.1083-4389.2004.00225.xDOI Listing
June 2004

Immune response in Helicobacter pylori-induced low-grade gastric-mucosa-associated lymphoid tissue (MALT) lymphoma.

J Med Microbiol 2004 Jan;53(Pt 1):21-29

Departments of Pathology1, Bacteriology2 and Medicine and Medical Science3, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan 4Department of Infection and Immunity, Jichi Medical School, 3311-1 Yakushiji, Minami-kawauchi, Tochigi 326-0498, Japan 5National Cancer Center, Central Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

We have reported previously that heat-shock protein 60 kDa (hsp60) of Helicobacter pylori is an important antigen in the pathogenesis of gastric mucosa-associated lymphoid tissue (MALT) lymphoma. In order to investigate associations with host immune reactions and hsp60 antigen, CD40 ligand (CD40L) expression and cytokine production were analysed following stimulation with hsp60. To provide a clear antigen-driven immune response, peripheral blood mononuclear cells (PBMC) from patients with low-grade MALT lymphoma and gastritis and those from healthy volunteers were stimulated with recombinant H. pylori hsp60 and H. pylori cell lysate in the presence of cytokines (IL4 and granulocyte-macrophage colony-stimulating factor). mRNA expression was also analysed by a cDNA microarray containing 1100 genes. Expression of CD40L on PBMCs of patients with MALT lymphoma was increased by cytokines or by combination with stimulation with hsp60 antigens. The production of IL4 in PBMC cultures was increased in patients with MALT lymphoma; however, production of IFN-gamma was at low levels. DNA microarray analysis indicated increased levels of HLA-DR and integrin mRNAs. In cases of low-grade MALT lymphoma, adaptive immune responses against hsp60 may be enhanced by host factors, such as antigen presentation and T-cell activation, resulting in B-cell proliferation, which can be demonstrated during chronic H. pylori infection.
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http://dx.doi.org/10.1099/jmm.0.05348-0DOI Listing
January 2004