We encountered a patient with primary cervical leiomyoma with remarkable calcification and ossification. A 68-year-old man presenting with induration and swelling of the left submandibular region was found to have nodular lesions with calcifications in the left submandibular region and the upper mediastinum on CT. Fine needle aspiration biopsies (FNAB) of the left submandibular lesion revealed no malignancy. Resection was performed for definitive diagnosis and treatment. The resected specimen contained a solid tumor, which was markedly calcified and ossified on the cut surface. Histopathological examination showed proliferating spindle cells in a tangled and crossed arrangement. Immunohistochemically, the spindle cells were stained intensely with α-SMA and h-caldesmon, consistent with smooth muscle cells. These findings led to a definitive diagnosis of leiomyoma with calcification and ossification. This is extremely rare and the preoperative differentiation from other tumors of the head and neck was very difficult. By resection of the submandibular tumor, both definitive diagnosis of leiomyoma by histopathological and immunohistochemical analyses and treatment could be carried out. However, as the tumor in the upper mediastinum was most likely to be leiomyoma with calcification, he did not wish to undergo its biopsy and resection immediately. We have continued the follow-up.
During vertebrate inner ear development, compartmentalization of the auditory and vestibular apparatuses along two axes depends on the patterning of transcription factors expressed in a region-specific manner. Although most of the patterning is regulated by extrinsic signals, it is not known how Nkx5.1 and Msx1 are patterned. We focus on Dan, the founding member of the Cerberus/Dan gene family that encodes BMP antagonists, and describe its function in morphogenesis and patterning. First, we confirmed that Dan is expressed in the dorso-medial region of the otic vesicle that corresponds to the presumptive endolymphatic duct and sac (ed/es). Second, we used siRNA knockdown to demonstrate that depletion of Dan induced both a severe reduction in the size of the ed/es and moderate deformities of the semicircular canals and cochlear duct. Depletion of Dan also caused suppression of Nkx5.1 in the dorso-lateral region, suppression of Msx1 in the dorso-medial region, and ectopic induction of Nkx5.1 and Msx1 in the ventro-medial region. Most of these phenotypes also appeared following misexpression of the constitutively active form of BMP receptor type Ib. Thus, Dan is required for the normal morphogenesis of the inner ear and, by inhibiting BMP signaling, for the patterning of the transcription factors Nkx5.1 and Msx1.
Hyalinizing clear cell carcinoma (HCCC), so-called clear cell carcinoma, not otherwise specified (CCC (NOS)), of the salivary glands is a rare and low-grade malignant tumor. We report a case of HCCC so-called CCC (NOS) (referred to as HCCC) of the minor salivary gland of the buccal mucosa. A 52-year-old woman had presented with a gradually growing and indolent mass in the right buccal mucosa for about two years. The first biopsy histopathologically suggested the possibility of malignancy derived from the minor salivary glands. A month later, she visited our hospital. The tumor measured approximately 1.5 cm in diameter and was elastic hard, smooth, and well movable. Image examinations demonstrated internal homogeneity of the lesion, which had a smooth margin, in the right buccal mucosa. Complete tumor resection followed by covering with a polyglycolic acid sheet and fibrin glue spray was performed without surgical flap reconstruction. Histopathological findings revealed proliferating tumor cells with clear cytoplasm surrounded by hyalinizing stroma in the submucosal minor salivary glands. Immunohistochemical stains revealed these tumor cells to be positive for epithelial cell markers but negative for myoepithelial ones. These findings confirmed the diagnosis of HCCC. Good wound healing and no evidence of local recurrence and metastasis have been shown since surgery.
. The subjects were divided into three groups. Seventy-four subjects who reported dizziness that exacerbated after the earthquake and visited the hospital for a repeat checkup before the scheduled date were designated as the dizziness exacerbated group ( ) after the earthquake group. Thirty-four subjects who had no previous history of dizziness and first experienced it after the earthquake were designated as dizziness developed after the earthquake group. Further, one-hundred and six subjects who did not show any exacerbation of dizziness after the earthquake and visited the hospital for dizziness checkup as scheduled, were designated as the dizziness exacerbated ( ) after the earthquake group. The relationship between dizziness after the earthquake and kinetosis (motion sickness experienced in childhood or after becoming an adult) was studied. The results revealed that in the dizziness exacerbated ( ) after the earthquake group a significant difference (P 0.001) was observed with respect to being less prone to motion sickness on reaching adulthood. The relationship between the susceptibility to motion sickness after becoming an adult, and dizziness exhibited after the earthquake was also studied. In a comparison between the dizziness exacerbated ( ) after the earthquake group and dizziness exacerbated ( ) after the earthquake group, the latter showed a significant difference (0.02 P 0.05) with respect to being susceptible to motion sickness after becoming an adult. Similarly, a comparison between the dizziness exacerbated ( ) after the earthquake group and dizziness developed after the earthquake group, in the latter a significant difference (P 0.01) was observed with respect to being susceptible to motion sickness on reaching adulthood. The results suggested that the number of subjects who were susceptible to motion sickness in childhood and continued to be susceptible after becoming an adult was higher in the dizziness exacerbated ( ) after the earthquake group and the dizziness developed after the earthquake group. The results also suggested that, more often than not, subjects who could not adapt well to vestibular stimu-
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