Clinical Journal of Gastroenterology最新文献_第9页

Advanced poorly differentiated gallbladder carcinoma with focal poorly cohesive and signet-ring cell features. 晚期低分化胆囊癌伴局灶性内聚性差和印戒细胞特征。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-03-07 DOI: 10.1007/s12328-026-02299-z

Hideo Takayama, Ryoka Masuda, Kohei Yasuda, Kaori Yoshimura, Kiichiro Kaji, Kuniaki Arai, Kenichi Harada, Taro Yamashita, Shuichi Terasaki

{"title":"Advanced poorly differentiated gallbladder carcinoma with focal poorly cohesive and signet-ring cell features.","authors":"Hideo Takayama, Ryoka Masuda, Kohei Yasuda, Kaori Yoshimura, Kiichiro Kaji, Kuniaki Arai, Kenichi Harada, Taro Yamashita, Shuichi Terasaki","doi":"10.1007/s12328-026-02299-z","DOIUrl":"https://doi.org/10.1007/s12328-026-02299-z","url":null,"abstract":"Cases of gallbladder carcinoma containing poorly cohesive and signet-ring cell components are extremely rare, and their clinical characteristics remain unclear. We report a case involving a 70-year-old man who presented with fever and abdominal pain. Imaging at admission revealed diffuse gallbladder wall thickening and peritoneal metastatic nodules around the gallbladder, leading to a diagnosis of advanced gallbladder carcinoma; however, concurrent cholecystitis was suspected because of persistent fever and elevated inflammatory markers. The patient showed no response to antimicrobial therapy or gallbladder drainage, raising concern for tumor-associated inflammation and cancer-related pain. Bile cytology did not yield a definitive diagnosis; the patient showed unusually rapid enlargement of peritoneal metastases and died 2 months after presentation. Autopsy with immunohistopathological analysis confirmed advanced poorly differentiated gallbladder carcinoma with focal poorly cohesive and signet-ring cell features. This case illustrates that rare histological subtypes of gallbladder carcinoma may progress rapidly with extensive peritoneal metastatic nodules. Moreover, in such atypical variants of gallbladder carcinoma, early consideration of oncologic treatment is important while simultaneously controlling the infection.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond the Flare: A Case of Disseminated Tuberculosis and Thrombosis Masquerading as IBD Exacerbation. 在耀斑之外：一例播散性结核和血栓伪装成IBD恶化。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-03-07 DOI: 10.1007/s12328-026-02303-6

Germán Ramírez-Olivencia, Celia Caravaca, Marta Sanz Alba, Álvaro de la Serna Gamboa, Ignacio Díaz Villalonga

{"title":"Beyond the Flare: A Case of Disseminated Tuberculosis and Thrombosis Masquerading as IBD Exacerbation.","authors":"Germán Ramírez-Olivencia, Celia Caravaca, Marta Sanz Alba, Álvaro de la Serna Gamboa, Ignacio Díaz Villalonga","doi":"10.1007/s12328-026-02303-6","DOIUrl":"https://doi.org/10.1007/s12328-026-02303-6","url":null,"abstract":"Differentiating inflammatory bowel disease (IBD) flares from infectious complications in patients on anti-TNFα therapy presents a significant diagnostic challenge. This case report describes a 54-year-old woman with ileocolic Crohn's disease on adalimumab who presented with systemic and gastrointestinal symptoms mimicking a flare. Initial computed tomography revealed enteritis, mesenteric lymphadenopathy, and extensive inferior vena cava thrombosis. Despite treatment with corticosteroids and broad-spectrum antibiotics, the patient developed respiratory symptoms. Further evaluation confirmed disseminated tuberculosis (TB) through PCR and culture from a bronchoalveolar lavage and histopathological analysis of a lymph node. Adalimumab was discontinued, and the patient was successfully treated with anti-tuberculous therapy and anticoagulation, leading to progressive clinical improvement. This case underscores the importance of a broad differential diagnosis in immunosuppressed IBD patients, as opportunistic infections like TB can mimic IBD flares and require invasive diagnostics for definitive confirmation, especially when systemic symptoms and thrombosis are present.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Histopathological predictor of response to mirikizumab in active ulcerative colitis. 活动性溃疡性结肠炎对米利珠单抗反应的组织病理学预测因子。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-03-06 DOI: 10.1007/s12328-026-02298-0

Ichitaro Horiuchi, Akira Horiuchi, Kaori Horiuchi

引用次数: 0

Long-term survival after multidisciplinary treatment including durvalumab for recurrent perihilar cholangiocarcinoma. 包括杜伐单抗在内的多学科治疗复发性肝门周围胆管癌后的长期生存率。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-03-04 DOI: 10.1007/s12328-026-02301-8

Takashi Miyata, Taigo Nagayama, Hisashi Nishiki, Saki Kuwata, Akifumi Hashimoto, Daisuke Kaida, Yasuto Tomita, Koichi Okamoto, Hideto Fujita, Hiroyuki Takamura

{"title":"Long-term survival after multidisciplinary treatment including durvalumab for recurrent perihilar cholangiocarcinoma.","authors":"Takashi Miyata, Taigo Nagayama, Hisashi Nishiki, Saki Kuwata, Akifumi Hashimoto, Daisuke Kaida, Yasuto Tomita, Koichi Okamoto, Hideto Fujita, Hiroyuki Takamura","doi":"10.1007/s12328-026-02301-8","DOIUrl":"https://doi.org/10.1007/s12328-026-02301-8","url":null,"abstract":"Perihilar cholangiocarcinoma is an aggressive malignancy with a poor prognosis even after curative resection, and recurrence is common. Systemic chemotherapy has long been the standard treatment for recurrent disease, but durable survival is rare. Recently, immune checkpoint inhibitors (ICIs) have been incorporated into first-line regimens for advanced biliary tract cancer, showing promising efficacy. We report a 61-year-old man who underwent extended left hepatectomy with caudate lobectomy, bile duct resection, and portal vein reconstruction for stage IVA perihilar cholangiocarcinoma. Twelve months later, para-aortic lymph node recurrence was detected and treated with gemcitabine plus cisplatin (GC), followed by S-1 and proton beam therapy for local recurrence. At 41 months post‑diagnosis, new intrahepatic metastases developed, and GC‑durvalumab (GCD) therapy was initiated. All lesions achieved radiological complete response within 2 years, with only grade 1 skin toxicity. The patient remains alive and well at 65 months after surgery and 53 months after recurrence, with sustained disease control. This case highlights the potential role of ICIs within multidisciplinary treatment strategies, demonstrating that even recurrent perihilar cholangiocarcinoma may achieve clinical complete response and long-term survival.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Classic hodgkin lymphoma associated with Epstein-Barr virus reactivation during vedolizumab therapy for ulcerative colitis. vedolizumab治疗溃疡性结肠炎期间与eb病毒再激活相关的经典霍奇金淋巴瘤

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-28 DOI: 10.1007/s12328-026-02302-7

Tatsuya Hasegawa, Masatsugu Kojima, Toru Miyake, Mai Noujima, Takayuki Imai, Soichiro Tani, Keiji Muramoto, Tomoharu Shimizu, Takuji Iwashita, Masaji Tani

{"title":"Classic hodgkin lymphoma associated with Epstein-Barr virus reactivation during vedolizumab therapy for ulcerative colitis.","authors":"Tatsuya Hasegawa, Masatsugu Kojima, Toru Miyake, Mai Noujima, Takayuki Imai, Soichiro Tani, Keiji Muramoto, Tomoharu Shimizu, Takuji Iwashita, Masaji Tani","doi":"10.1007/s12328-026-02302-7","DOIUrl":"https://doi.org/10.1007/s12328-026-02302-7","url":null,"abstract":"Epstein-Barr virus (EBV)-associated lymphoproliferative disorders have been reported in patients receiving immunosuppressive therapy for inflammatory bowel disease; however, the onset of classic Hodgkin lymphoma (cHL) during vedolizumab therapy is extremely rare. A 73 year-old woman with ulcerative colitis (UC) was steroid-dependent, showing disease exacerbation when prednisolone was tapered or discontinued. Azathioprine was administered eight years prior but was discontinued after a short period due to liver dysfunction. Vedolizumab was initiated 31 months before presentation. Despite initial improvements in UC with vedolizumab, hematochezia subsequently persisted. Other biologics or immunomodulators that could cause systemic immunosuppression were avoided because she was receiving treatment for breast cancer. Colonoscopy showed erosions in the transverse colon and an ulcerative lesion in the sigmoid colon. A biopsy revealed high-grade dysplasia in the transverse colon and inflammatory granulation tissue without malignancy in the sigmoid lesion; therefore, surgery was indicated. Laparoscopic total proctocolectomy was performed, and the surgical specimen contained Reed-Sternberg cells positive for CD20, CD30, PD-L1, and EBV-encoded RNA, establishing EBV-associated cHL. Although the development of cHL is likely multifactorial, clinicians should be aware that EBV-associated intestinal cHL may develop in patients with UC receiving vedolizumab when tumor-like ulcers or mural thickening are encountered.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot-assisted anterior resection for rectal cancer in a patient with Leriche syndrome: a case report. 机器人辅助直肠癌前切除术治疗Leriche综合征1例报告。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-27 DOI: 10.1007/s12328-026-02296-2

Masahiro Takahashi, Nobuyasu Yoshimoto, Ken Ishikawa, Satoru Takayama, Masaki Sakamoto, Keisuke Tomoda, Hiroto Suzuki, Mari Fukuda, Masataka Nakano, Hisanori Kani

引用次数: 0

A case of robotic-assisted distal gastrectomy and cholecystectomy for gastric cancer and cholelithiasis in a patient with severe kyphosis. 机器人辅助远端胃切除术和胆囊切除术治疗胃癌和严重后凸症胆石症1例。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-23 DOI: 10.1007/s12328-026-02294-4

Keisuke Ieta, Yasunari Ubukata, Masaki Suzuki, Shigeo Maki, Hideyuki Saito, Katsuya Osone, Yohei Miyamae, Keitaro Hirai, Ichiro Sakamoto, Tetsushi Ogawa

{"title":"A case of robotic-assisted distal gastrectomy and cholecystectomy for gastric cancer and cholelithiasis in a patient with severe kyphosis.","authors":"Keisuke Ieta, Yasunari Ubukata, Masaki Suzuki, Shigeo Maki, Hideyuki Saito, Katsuya Osone, Yohei Miyamae, Keitaro Hirai, Ichiro Sakamoto, Tetsushi Ogawa","doi":"10.1007/s12328-026-02294-4","DOIUrl":"https://doi.org/10.1007/s12328-026-02294-4","url":null,"abstract":"Severe kyphosis presents significant anatomical challenges in laparoscopic surgery, including a restricted operative field and limited instrument mobility. We report an 85-year-old woman with marked thoracolumbar kyphosis who underwent successful robotic-assisted distal gastrectomy and cholecystectomy for gastric cancer and cholelithiasis. Preoperative three-dimensional CT simulation was used to plan port placement. Because of the low-lying costal arches, conventional laparoscopic methods were unsuitable. The da Vinci Xi surgical system enabled effective elevation of the costal margin and liver using robotic arms and a soft silicone disc, securing a sufficient operative field. Despite anatomical difficulties, the procedures were completed safely with minimal blood loss. Pathological findings revealed pT4aN3bM0 pStage ⅢC disease. The patient was discharged without major complications. This case highlights how robotic-assisted surgery can overcome anatomical barriers and be a viable option in patients with spinal deformities.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic papillectomy for the complete resection of a pedunculated intra-ampullary papillary-tubular neoplasm confined within a choledochocele. 内镜下乳头切除术用于完全切除局限于胆总管内的带蒂壶腹内乳头-管状肿瘤。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-11-06 DOI: 10.1007/s12328-025-02238-4

Takahiro Miyake, Jun Ushio, Toshiyasu Iwao, Keiso Sasaki, Yamato Tada, Hisaki Kato, Yuki Kawasaki, Kazuya Sumi, Koji Yoshida

{"title":"Endoscopic papillectomy for the complete resection of a pedunculated intra-ampullary papillary-tubular neoplasm confined within a choledochocele.","authors":"Takahiro Miyake, Jun Ushio, Toshiyasu Iwao, Keiso Sasaki, Yamato Tada, Hisaki Kato, Yuki Kawasaki, Kazuya Sumi, Koji Yoshida","doi":"10.1007/s12328-025-02238-4","DOIUrl":"10.1007/s12328-025-02238-4","url":null,"abstract":"A woman in her 60s presented with epigastric pain and was diagnosed with acute cholangitis caused by a papillary tumor based on laboratory findings and imaging studies. An endoscopic evaluation was subsequently planned. Endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography revealed a pedunculated or subpedunculated polypoid lesion within a choledochocele. Histopathological examination of a biopsy specimen confirmed the diagnosis of intra-ampullary papillary-tubular neoplasm (IAPN), and an endoscopic papillectomy (EP) was performed. Choledochoceles are associated with an increased risk of cholangiocarcinoma due to pancreatic juice reflux. Although endoscopic treatments such as sphincterotomy and papillectomy have been reported, to our knowledge, no previous cases have described a tumor confined entirely within a choledochocele that was completely resected via EP. We report a rare case of IAPN within a choledochocele that was successfully treated with en bloc resection using the EP technique.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"113-119"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of immunoglobulin G4-related periarteritis mimicking pancreatic cancer. 一例罕见的免疫球蛋白g4相关的动脉周围炎模拟胰腺癌。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-11-18 DOI: 10.1007/s12328-025-02250-8

Kazunori Onuma, Yoshiharu Masaki, Tomoya Nakamura, Yujiro Kawakami, Ayako Murota, Akio Katanuma, Hiroshi Nakase

{"title":"A rare case of immunoglobulin G4-related periarteritis mimicking pancreatic cancer.","authors":"Kazunori Onuma, Yoshiharu Masaki, Tomoya Nakamura, Yujiro Kawakami, Ayako Murota, Akio Katanuma, Hiroshi Nakase","doi":"10.1007/s12328-025-02250-8","DOIUrl":"10.1007/s12328-025-02250-8","url":null,"abstract":"Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a systemic inflammatory disorder characterized by abundant infiltration of IgG4-positive lymphocytes and plasma cells with fibrosis in the involved organs. Periarterial lesions are relatively rare manifestations of IgG4-RD, and their clinical and imaging findings remain unclear. A 66-year-old man presented with persistent upper abdominal pain. Contrast-enhanced computed tomography (CECT) showed a gradually enhanced 47 mm soft tissue mass lesion adjacent to the pancreatic uncinate and spreading around the superior mesenteric artery. Considering the imaging findings, pancreatic cancer could not be ruled out. We decided to perform an endoscopic ultrasound-guided fine-needle biopsy to confirm the histological diagnosis; however, we could not obtain a sufficient amount of tissue. Finally, the patient was diagnosed with IgG4-related periarteritis by performing a percutaneous biopsy of the lesion. The patient was treated with oral prednisolone (PSL) and approximately six months after PSL induction, CECT revealed marked shrinkage of the lesion. Although imaging findings are important for diagnosis, histopathological findings are essential for accurate clinical diagnosis. All possible means, including percutaneous targeted biopsy, should be attempted to acquire sufficient tissue to confirm the pathological diagnosis to enable appropriate treatment.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"182-189"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cytomegalovirus-associated ulceration complicating immune checkpoint inhibitor-related colitis. 巨细胞病毒相关溃疡并发免疫检查点抑制剂相关结肠炎。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-02-01 Epub Date: 2025-12-19 DOI: 10.1007/s12328-025-02263-3

Michiko Yamada, Tomoyuki Abe, Seiyu Kubota, Shota Chiba, Seiya Saito, Makoto Usami, Michihiro Ono, Masahiro Maeda, Miri Fujita

{"title":"Cytomegalovirus-associated ulceration complicating immune checkpoint inhibitor-related colitis.","authors":"Michiko Yamada, Tomoyuki Abe, Seiyu Kubota, Shota Chiba, Seiya Saito, Makoto Usami, Michihiro Ono, Masahiro Maeda, Miri Fujita","doi":"10.1007/s12328-025-02263-3","DOIUrl":"10.1007/s12328-025-02263-3","url":null,"abstract":"We present a case of cytomegalovirus (CMV)-associated rectal ulceration that developed as a secondary complication of immune checkpoint inhibitor-induced colitis. A 74-year-old man who received pembrolizumab for metastatic squamous cell carcinoma of the lung developed severe immune-related colitis and required high-dose corticosteroid therapy. Although his condition initially improved, his symptoms recurred approximately four weeks after the initiation of steroid tapering. Colonoscopy revealed a circumferential, band-shaped ulcer located just above the dentate line, and a histopathological examination demonstrated nuclear inclusion bodies suggestive of CMV infection. The diagnosis was confirmed by immunohistochemical staining. Treatment with valganciclovir resulted in complete clinical and virological remission within four weeks. This case highlights the need for monitoring opportunistic infections during immunosuppressive therapy for immune-related adverse events (irAEs). It also underscores the importance of early recognition and prompt intervention for clinical deterioration.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"274-281"},"PeriodicalIF":0.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0