Co-chaperone HOP (also called stress-inducible protein 1) is a co-chaperone that interacts with the cytosolic 70-kDa heat shock protein (HSP70) and 90-kDa heat shock protein (HSP90) families using different tetratricopeptide repeat domains. HOP plays crucial roles in the productive folding of substrate proteins by controlling the chaperone activities of HSP70 and HSP90. Here, we examined the levels of HOP, HSC70 (cognate of HSP70, also called HSP73), and HSP90 in the tumor tissues from colon cancer patients, in comparison with the non-tumor tissues from the same patients. Expression level of HOP was significantly increased in the tumor tissues (68% of patients, n=19). Levels of HSC70 and HSP90 were also increased in the tumor tissues (95% and 74% of patients, respectively), and the HOP level was highly correlated with those of HSP90 (r=0.77, p<0.001) and HSC70 (r=0.68, p<0.01). Immunoprecipitation experiments indicated that HOP complexes with HSC70 or HSP90 in the tumor tissues. These data are consistent with increased formation of co-chaperone complexes in colon tumor specimens compared to adjacent normal tissue and could reflect a role for HOP in this process.

Six autopsy cases of non-traumatic gas gangrene in the abdomen are reported. Five of the six were caused by clostridia, as identified by culture or histology. There were associated underlying diseases, such as alcoholism, liver cirrhosis, diabetes mellitus, and malignant disease. Three of the six patients had gas gangrene in the liver. Bacterial proliferation and gas accumulation were found in the sinusoids of the liver, and congestion and edema with extensive gas embolism were found in the lungs. Pulmonary gas embolism was considered to be the direct cause of death in these three patients. The other three patients had intestinal clostridial gas gangrene, with alcoholism as an underlying condition. None of the six patients was clinically diagnosed as having gas gangrene. We suggest that gas gangrene should be considered in any patient with abdominal infection. A review of 19 autopsy cases of gas gangrene in the abdomen reported in the Japanese literature is also presented.

A case of endometrioid adenocarcinoma arising from adenomyosis is reported. The patient was a 53-year-old woman who complained of vulvar itching. Smear cytology of the endometrium revealed adenocarcinoma. Magnetic resonance imaging of the pelvis revealed a lesion with a slightly high intensity in the uterine fundus on a T2-weighted image. Semiradical total hysterectomy and bilateral adnexectomy were performed, followed by chemotherapy. Histologically, the lesion in the uterine fundus was composed mostly of adenocarcinoma with stromal invasion. There were many adenomyotic foci in and around the carcinoma, including some showing transition to adenocarcinoma. There was no malignant finding in the normally situated endometrium. The carcinoma invaded in the myometrium, involving the uterine serosa, but no dissemination to the peritoneal cavity was found. The carcinoma was, therefore, considered to be endometrioid adenocarcinoma arising from adenomyosis. Immunohistochemistry showed expression of p53 oncoprotein and Ki-67 antigen in the carcinoma cells. The value of immunohistochemistry in predicting prognosis is discussed.

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INTRODUCTIONPancreatic metastasis from the lungs is rare and accounts for less than 5% of pancreatic malignancies that are not detected on autopsy (1). The most common indication for pancreatic metastasectomy is spread from renal cell carcinoma (RCC), whereas the most common metastatic sites of lung cancer are the adrenal glands, liver, brain, and bones (2,3). A previous systematic review identified only 27 publications with data from 32 patients who underwent pancreatic metastasectomy for metastases from lung cancer (4). Therefore, detection of metastatic lung cancer to the pancreas is relatively rare in a living patient (i.e., not on autopsy). Furthermore, detection of small pancreatic tumors and differentiating between malignant and benign etiologies are difficult. Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) is a useful modality to improve the diagnosis of pancreatic tumors and to guide the treatment plan (5). In this study, we described a rare case of pancreatic metastasis from non-small-cell lung cancer (NSCLC) that was diagnosed using EUS-FNAB. CASE PRESENTATIONA 56-year-old man with a smoking history of 42 packyears underwent regular follow-up computed tomography (CT) scans for adult-onset type II citrullinemia and idiopathic pulmonary fibrosis. In 2015, CT scan revealed a right upper lobe nodule measuring 31 mm in diameter; no mass was observed in the pancreas (Figure 1). Bronchoscopy was performed, and he was diagnosed with adenocarcinoma using brush cytology. Positron emission tomography/CT (PET/CT) showed high fluorodeoxyglucose uptake in the right upper lobe nodule and no abnormal uptake in the hilar and mediastinal lymph nodes, as well as in other organs, including the pancreas (Figure 2).Based on a clinical staging of cT2aN0M0 (stage IB), we decided to surgically resect the lung cancer. Two months after the nodule was detected, we performed a repeat CT scan (Synapse Vincent; Fujifilm Medical, Tokyo, Japan) to prepare a preoperative three-dimensional imaging of the pulmonary vessels and bronchi. 2017; 28: 502-4 Pancreatic metastasis from non-small-cell lung cancer diagnosed using endoscopic ultrasound-guided fine needle aspiration biopsy: A case report 502 ABSTRACT A 56-year-old man presented with a chest computed tomography (CT) finding of a right upper lobe nodule, which was diagnosed using brush cytology as adenocarcinoma stage IB (cT2aN0M0). Repeat CT scan for preoperative evaluation revealed a small, slightly hypodense spot in the pancreatic body, which was diagnosed as pancreatic metastasis from lung cancer using endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB). Because of the presence of distant metastasis, surgical resection was deferred and chemotherapy was chosen instead. Pancreatic metastasis from non-small-cell lung cancer (NSCLC) is rare and might present with few symptoms when the tumor is small. EUS-FNAB is a useful modality for detecting and providing accurate histological diagnosis of pancreatic tumors. Although pancreatic metastasis...