[Show abstract][Hide abstract] ABSTRACT: A 58-year-old Japanese man was diagnosed with differentiated adenocarcinoma of the stomach. Histological findings of the resected specimen revealed well-to moderately-differentiated tubular adenocarcinoma (tub1, tub2), 13 mm in diameter, which invaded into the submucosa (SM1, 300 μm) and lymphovascular lumen (ly1). Serum antibody against Helicobacter pylori (Hp) and the13C-urea breath test were negative, and there were no atrophic changes in the tumor-adjacent mucosa. The immunohistochemical analysis showed that gastric mucin (MUC5AC) was strongly positive and intestinal mucin (MUC2) was weakly and partially positive. According to these results, the final diagnosis of Hp-negative well-differentiated early gastric cancer was made.
Full-text · Article · Nov 2015 · Internal Medicine
[Show abstract][Hide abstract] ABSTRACT: We describe a case of dysgeusia that developed gradually over one week after initiation of crizotinib administration for treatment of ALK-positive non-small cell lung cancer, necessitating discontinuation of the agent. The symptom was accompanied by progressive loss in appetite and body weight. Alectinib, a novel alternative ALK inhibitor, was administered and has been successfully continued without any toxicity, including dysgeusia. The present case indicates that dysgeusia is an important toxicity associated with crizotinib, which could adversely affect nutritional condition and quality of life. We describe the clinical course and present a review of crizotinib-induced dysgeusia.
[Show abstract][Hide abstract] ABSTRACT: An 86-year-old man was found to have a duodenal submucosal tumor (SMT)-like lesion by esophagogastroduodenoscopy (EGD) that was classified as an adenocarcinoma based on a biopsy specimen. He was referred to our hospital for further examination and treatment. The tumor was located on the second part of the duodenum and had a depression on its apical surface. It was identified as an early carcinoma by duodenography, endoscopic ultrasonoscopy, and computed tomography (CT). Based on these findings, we treated the patient with endoscopic mucosal resection (EMR). Histological examination of the resected specimen revealed a well differentiated tubular adenocarcinoma that had invaded the submucosa, but not the lymphatic vessels or vessels. Histologically, the adenocarcinoma originated from hyperplasic Brunner's glands, and therefore we diagnosed it as a duodenal adenocarcinoma of Brunner's gland origin. Immunohistochemical staining indicated positive results for gastric mucin markers such as MUC5AC and MUC6, and negative results for intestinal mucin markers such as MUC2 and CD10. Thus, his duodenal tumor was believed to be a duodenal carcinoma arising from Brunner's glands.
No preview · Article · Jul 2014 · Gastroenterological Endoscopy
[Show abstract][Hide abstract] ABSTRACT: A 59-year-old woman developed bowel obstruction and was suspected to have an ileal tumor with intussusception by computed tomography. She was referred to our hospital. We performed trans-oral and trans-anal single balloon enteroscopy, detecting a 40 mm sized submucosal tumor with denuded head in the ileum. Biopsy specimens showed granulation tissue with eosinophils and basophils without evidence of gastrointestinal stromal tumor or malignant lymphoma. By the specific, so-called glans penis-like shape of the tumor and pathological features, the tumor was diagnosed as an inflammatory fibroid polyp (IFP). We electively performed laparoscopy-assisted partial resection of the ileum. At the time of operation, the proximal bowel was found to invaginate, with the tumor as the leading part, into the distal segment. The intussuscepted bowel was manually repositioned and partial resection of the affected ileum was performed. Histopathologically, the tumor was mainly located in the submucosal layer and partially into the subserosa. It was composed of edematous granulation tissue-like stroma with prominent vascular proliferation and infiltration of eosinophils and basophils. Immunohistochemical staining of the tumor with CD34 and vimentin were both positive and c-kit negative. This tumor was histologically confirmed as IFP. Intestinal IFP was mostly found by intussusception, requiring emergency surgery. The cases with preoperative endoscopic diagnosis of intestinal IFP are extremely rare. With the progress of endoscopy in the field of small bowel, more frequent establishment of preoperative diagnosis and realization of elective therapy are expected.
No preview · Article · Oct 2013 · Endoscopic Forum for Digestive Disease
[Show abstract][Hide abstract] ABSTRACT: A 61-year-old man had been followed up in another hospital under diagnosis of branch duct type IPMN for 4 years. Contrast-enhanced CT scan for regular check performed 3 months ago revealed no increase of IPMN and no pancreatic tumor. However, he complained of back pain after that, MRI was performed. It revealed a solid tumor in size of 25mm diameter at the head of pancreas. The tumor was apparent from IPMN in several imaging modalities. Pancreatoduodenectomy was performed under diagnosis of invasive ductal carcinoma concomitant with IPMN. Post-operative pathological findings revealed IPMN was adenoma with mild atypia, and solid tumor was diagnosed invasive ductal carcinoma with solitary minute liver metastasis.
No preview · Article · Sep 2011 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology