- [Show abstract] [Hide abstract] ABSTRACT: Almost all mammary lesions are detected by a mammography and an ultrasound. However, a small part of lesions cannot be shown by only a magnetic resonance imaging (MRI). MRI-guided vacuum-assisted breast biopsy is a very useful means for the pathological diagnosis of these lesions. We performed MRI-guided vacuum-assisted breast biopsy to 4 patients with the lesions seen only by MRI. Biopsies were safely and easily performed using biopsy software (syngo BreVis). These biopsied specimens resulted cancer in 1, adenoma in 1 and benign lesions in 2. With an increase of the opportunity of MRI for the mammary lesions, we expect these lesions become increasingly large. We believe that MRI-guided vacuum-assisted breast biopsy will be an important diagnostic modality.
- [Show abstract] [Hide abstract] ABSTRACT: We treated a 69-year-old male with a 16-mm polyp of the gallbladder. Enhanced computed tomography demonstrated marked enhancement. With a tentative diagnosis of early polypoid cancer of the gallbladder, open cholecystectomy was performed. Intraoperative ultrasound showed hyperechoic spots on the surface of the polyp with an inner echopenic area. The histological diagnosis was an inflammatory polyp that manifested nonneoplastic, edematous stroma, and infiltration of lymphcytes and plasmacytes.
- [Show abstract] [Hide abstract] ABSTRACT: Computed tomography revealed a well-enhanced omental mass. Magnetic resonance imaging demonstrated a mass with low signal intensity on T1-weighted images (WI) and high signal intensity on T2-WI. Resected specimens immunohistochemically showed positive results for alpha-smooth muscle actin, muscle-specific actin (HHF35) and vimentin, and negative results for S-100 protein, CD34, desmin, EMA, keratin, calretinin, HBME1, and c-kit. This is the first case of an omental glomus tumor reported in the English literature.
- [Show abstract] [Hide abstract] ABSTRACT: Small bowel stenosis is a serious complication of intestinal anisakiosis. The aim of this report is to investigate whether severe stenosis of the small intestine can be conservatively managed. We treated two patients with severe stenosis of the small intestine caused by anisakiosis. Surgical intervention was eventually performed on the 23rd and 35th in the hospital, respectively. Histopathological examination of the resected specimens revealed that the intestinal wall had been completely damaged by the inflammatory reaction of anisakiosis, and that the damage was irreversible, thereby suggesting that laparotomy is needed in cases of severe small bowel stenosis caused by intestinal anisakiosis, even if a long period of conservative treatment for the intestinal anisakiosis allowed the patient to pass successfully through the acute phase.
- [Show abstract] [Hide abstract] ABSTRACT: A 49-year-old man was admitted to our hospital complaining of a large hepatic tumor with edema in the lower extremities. The patient had suffered from hypertension and bronchial asthma in his twenties and from cutaneous flushing in the face in his thirties. Echocardiography revealed tricuspid valve regurgitation and marked dilatation of the right ventricle. In an exploratory laparotomy, a 15 cm-size hepatic tumor was located in the right lobe with multiple satellite lesions in both lobes of the liver. Peritoneal disseminations were present. The tumor was histologically and immunohistochemically diagnosed to be a carcinoid tumor. The levels of serum serotonin and urinary 5-hydroxyindoleacetic acid (5-HIAA) were found to be significantly high. Imaging modalities and intraoperative findings showed no evidence of any tumors elsewhere. These findings led us to the diagnosis of a primary hepatic carcinoid tumor with carcinoid syndrome and carcinoid heart disease. The patient has been treated with hepatic artery embolization, oral chemotherapy and octreotide acetate. After six months of such treatment, the hepatic tumor has decreased slightly in size, and the levels of serum serotonin and urinary 5-HIAA have dropped
Article: Pneumatosis Cystoides Intestinalis[Show abstract] [Hide abstract] ABSTRACT: We herein present a case of pneumatosis cystoides intestinalis. A 56-year-old woman was admitted to Nagasaki Prefectoral Shimabara Hospital with diffuse and mild abdominal pain. A plain abdominal X-ray revealed free air in the right subphrenic space, and computed tomography showed an extraluminal gas-filled lesion adjacent to the small intestine. With a tentative diagnosis of perforation of the small intestine, a laparotomy was performed, although she had little tenderness and no rigidity on physical examination. Upon opening the peritoneal cavity, multiple bullae-like cysts were noted on approximately one meter of the ileal serosa; however, no site of perforation was detected. Removal of the portion of what appeared to be the affected bowel was the procedure of choice. The resected specimens histologically showed pneumatosis cystoides intestinalis without any perforation. Her postoperative course was uneventful and she has been doing well with no evidence of recurrence as of the end of June 2005.
- [Show abstract] [Hide abstract] ABSTRACT: Video-assisted thoracoscopic surgery (VATS) for a large, midesophageal diverticulum was successfully performed in a 77-year-old male who had dysphagia for one year. Postoperatively, the patient was well without any complications and was relieved of dysphagia. The VATS diverticulectomy was considered to be minimally invasive and constituted a good indication especially for patients of advanced age showing symptomatic esophageal diverticulum