Japanese Journal of Gastroenterology最新文献_第5页

[Neuroendocrine carcinoma of the extrahepatic bile duct:a case report]. 肝外胆管神经内分泌癌1例。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.59

Shohei Hirano, Koji Kubota, Akira Shimizu, Tsuyoshi Notake, Tomohiko Ikehara, Yudai Kuroiwa, Kenya Nakamura, Yuji Soejima

{"title":"[Neuroendocrine carcinoma of the extrahepatic bile duct:a case report].","authors":"Shohei Hirano, Koji Kubota, Akira Shimizu, Tsuyoshi Notake, Tomohiko Ikehara, Yudai Kuroiwa, Kenya Nakamura, Yuji Soejima","doi":"10.11405/nisshoshi.122.59","DOIUrl":"10.11405/nisshoshi.122.59","url":null,"abstract":"A 78-year-old male patient came to our hospital with a chief complaint of fever. Computed tomography revealed an indistinct tumor in the pancreatic head, along with dilatation of the bile duct and main pancreatic duct. An endoscopic transpapillary biopsy demonstrated adenocarcinoma in the glandular epithelium and a dense formation of quasi-round cells. Pathology results indicated positive CK AE1/AE3 and INSM-1, negative CD45, and a Ki67 index of about 80%, leading to a diagnosis of neuroendocrine carcinoma (NEC) Grade 3 of the pancreatic head. Consequently, a pancreatoduodenectomy was performed. Postoperative pathology revealed small cell NEC (SCNEC) at the pancreatic head, with infiltrative growth of atypical gland ducts around the bile ducts, indicating the presence of a well-differentiated adenocarcinoma. The adenocarcinoma contained in situ lesions and biliary intraepithelial neoplasia (BilIN), with SCNEC being contiguous. Therefore, the diagnosis was NEC originating from the extrahepatic bile duct, which invaded the pancreatic head. NEC of the extrahepatic bile duct is rare, accounting for approximately 0.2-2% of gastrointestinal neuroendocrine tumors, and it has a poor prognosis, similar to other gastrointestinal NECs, even when surgical treatment is performed. The patient remained an outpatient without recurrence 17 months postoperatively.","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 1","pages":"59-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980227","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

[Spontaneous reactivation of hepatitis B virus in an elderly patient: a case report and review of the literature]. [1例老年患者乙型肝炎病毒的自发再激活：病例报告和文献综述]。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.121

Haruo Nakayama, Satoshi Takai, Masanori Tosa, Toshiyuki Ikeda, Seiichi Takahashi, Shinichi Ikeya

{"title":"[Spontaneous reactivation of hepatitis B virus in an elderly patient: a case report and review of the literature].","authors":"Haruo Nakayama, Satoshi Takai, Masanori Tosa, Toshiyuki Ikeda, Seiichi Takahashi, Shinichi Ikeya","doi":"10.11405/nisshoshi.122.121","DOIUrl":"10.11405/nisshoshi.122.121","url":null,"abstract":"Reactivation of resolved hepatitis B virus (HBV) infection without any immunosuppressants has rarely been reported. Here, we describe the spontaneous HBV reactivation in a 78-year-old male patient with resolved HBV infection. Twenty-five years ago, he received interferon treatment for chronic hepatitis C. Concurrently, he was negative for HBsAg and positive for anti-HBcAb, and he achieved a sustained virological response (SVR). He developed hepatitis B infection without any cause at the age of 78 years. His serum was positive for HBsAg, HBeAg, and HBV DNA (4.9logIU/ml;genotype B), but negative for anti-HBc IgM and HCV RNA. A liver biopsy revealed A2F1. His serum HBsAg and HBV DNA levels became negative 2 months and 6 months after entecavir treatment, respectively. HBcrAg, the last remaining HBV marker, became negative after 2 years, and ETV treatment was completed after 27 months. No HBV reactivation was observed 4 years after the end of treatment. Full-genome HBV sequence analysis indicated that the patient was infected with HBV of subgenotype B1 and had no mutations in the S, the core promoter, and pre-core regions. This case developed de novo hepatitis B without any immunosuppressants, indicating that aging may have been responsible for the spontaneous HBV reactivation. Additionally, in this report, we summarized the reported cases of reactivation of resolved hepatitis B in elderly patients with no previous triggers.","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 2","pages":"121-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383504","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

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.425

Shuya Shigenobu, Akiyoshi Tsuboi, Yuka Matsubara, Issei Hirata, Ken Yamashita, Yuji Urabe, Toshio Kuwai, Hideki Ohdan, Koji Arihiro, Shiro Oka

{"title":"[Methotrexate-related lymphoproliferative disease of the ileum with fistular formation between the small bowel and rectum:a case report].","authors":"Shuya Shigenobu, Akiyoshi Tsuboi, Yuka Matsubara, Issei Hirata, Ken Yamashita, Yuji Urabe, Toshio Kuwai, Hideki Ohdan, Koji Arihiro, Shiro Oka","doi":"10.11405/nisshoshi.122.425","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.425","url":null,"abstract":"Methotrexate (MTX), the first-line drug for rheumatoid arthritis, rarely causes malignant lymphomas, which have been reported as MTX-associated lymphoproliferative disorders (MTX-LPD). Herein, report a case of MTX-LPD in the ileum with fistula formation in the small bowel and rectum. At the end of January 2023, an 81-year-old man who had been taking MTX for rheumatoid arthritis since the age of 73 years complained of abdominal pain and was diagnosed with intestinal obstruction at a previous hospital. In the early February 2023, the patient was referred to our hospital for further examination and treatment. A computed tomography scan revealed a thickened terminal ileum wall and enlarged mesenteric lymph nodes. A retrograde double-balloon endoscopy (DBE) detected circumferential ulcerative lesions at the terminal ileum with deep depressions in parts of the ulcer base. In addition, submucosal tumor-like lesions with central depressions were observed in the rectum. Retrograde contrast imaging under DBE confirmed the presence of fistulae between the ileum and rectum. A biopsy of the ulcerative lesion revealed hyperplasia of germinal center cell-like cells, and immunohistochemistry demonstrated CD20 and CD79a positivity, but CD5, CD10, and cyclin D1 negativity. Ki-67 positivity was 90%, indicating B-cell lymphoma. Based on histopathological findings and patient's history, the patient was suspected to have MTX-LPD, resulting in ileal and high anterior rectal resection. Histopathological examination of the resected specimen revealed large atypical lymphocyte proliferation. Immunohistochemistry confirmed CD20 and CD79a positivity;CD5, CD10, and cyclin D1 negativity;a Ki-67 positivity rate of 70%;and Epstein-Barr virus-encoded small RNA in situ hybridization negativity, confirmming the MTX-LPD diagnosis, presenting as diffuse large B-cell lymphoma. Postoperatively, the patient was monitored with MTX discontinuation, and no recurrence occurred. The clinical course remained consistent with MTX-LPD.","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 6","pages":"425-433"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276181","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

[Anal high grade dysplasia associated with Crohn's disease:a case report]. [肛门高度发育不良伴克罗恩病1例]。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.564

Yuka Inaba, Kenji Tatsumi, Hirosuke Kuroki, Nao Obara, Akira Sugita, Hiroyuki Imaeda, Kazutaka Koganei

引用次数: 0

[Current status and prospects for PRRT in neuroendocrine tumors]. 【PRRT在神经内分泌肿瘤中的应用现状及展望】。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.550

Susumu Hijioka, Kimiteru Ito, Takuji Okusaka

引用次数: 0

[Current status and prospects of image enhanced endoscopy in the upper gastrointestinal tract]. 【上消化道图像增强内镜的现状与展望】。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.78

Mitsuru Kaise, Katsuhiko Iwakiri

引用次数: 0

[Recent advance of clinical management of inflammatory bowel disease]. [炎症性肠病的临床治疗进展]。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.445

Tadakazu Hisamatsu, Jun Miyoshi, Minoru Matsuura

引用次数: 0

[Vascular Ehlers-Danlos syndrome discovered after splenic aneurysm rupture: a case report]. 脾动脉瘤破裂后发现血管性埃勒-丹洛斯综合征1例。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.637

Takuya Mizugami, Hiroyuki Yuasa, Takao Omori, Yu Nobuoka, Makoto Shimomura

{"title":"[Vascular Ehlers-Danlos syndrome discovered after splenic aneurysm rupture: a case report].","authors":"Takuya Mizugami, Hiroyuki Yuasa, Takao Omori, Yu Nobuoka, Makoto Shimomura","doi":"10.11405/nisshoshi.122.637","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.637","url":null,"abstract":"We report a case of vascular Ehlers-Danlos syndrome in a 30-year-old male patient. He presented to his local doctor with sudden onset of epicardial pain at around 5:00 p.m. on July 3, XXXX. On the same day, he was transferred to our hospital for extensive intra-abdominal hemorrhage suspected on abdominal computed tomography (CT). During emergency transport, his abdomen was flat, soft, and tender in the pericardial area, and blood biochemistry tests revealed a decreased hemoglobin of 10.2g/dL. He was admitted to our hospital, and conservative treatment was initiated. Five years ago, he underwent Hartmann procedure at another hospital for idiopathic perforation of the sigmoid colon. A month after discharge from the hospital, he had to undergo emergency surgery again at our hospital for colon resection and colostomy reconstruction due to colon perforation at the mouth side of the colostomy. He reported a history of colorectal perforation on the mouth side of the colostomy. After 6 months, a colostomy was performed and he was diagnosed with a terminal illness. Based on a family history of idiopathic colorectal perforation on his mother's side and the ruptured aneurysm, vascular-type Ehlers-Danlos syndrome was suspected. After admission, his symptoms of pericardial pain improved, but a CT scan on the 16th day revealed enlarged hepatic and splenic aneurysms. On July 24, he was transferred to a local hospital for splenic artery aneurysm treatment and underwent coiling the next day. His postoperative course was good, and he was transferred back to our hospital on July 26. He continued to show good progress and was discharged from the hospital on August 1. After discharge, he visited the outpatient genetic clinic for further examination. However, on October 9 of the same year, he developed aortic dissection and passed away.","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 9","pages":"637-642"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034158","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

[Liver transplantation for patients with acute liver failure and acute-on-chronic liver failure]. [急性肝衰竭和急性伴慢性肝衰竭患者的肝移植]。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.615

Satoshi Mochida

引用次数: 0

[Pancreatic serous cystadenoma resected after repeated biliary hemorrhage due to perforation into the common bile duct:a case report]. 【胰浆液性囊腺瘤因胆总管穿孔反复胆道出血后切除1例】。

Japanese Journal of Gastroenterology Pub Date : 2025-01-01 DOI: 10.11405/nisshoshi.122.643

Takaki Okuyama, Ryo Harada, Kazuhiro Kojima, Yutaka Akimoto, Tomohiro Toji

{"title":"[Pancreatic serous cystadenoma resected after repeated biliary hemorrhage due to perforation into the common bile duct:a case report].","authors":"Takaki Okuyama, Ryo Harada, Kazuhiro Kojima, Yutaka Akimoto, Tomohiro Toji","doi":"10.11405/nisshoshi.122.643","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.643","url":null,"abstract":"An 86-year-old woman was under follow-up at the Breast Surgery Department of our hospital for postoperative treatment for right breast cancer. During this period, a 22-mm cystic mass was identified in the pancreatic head. Its size gradually increased, and she was eventually referred to our department. Abdominal computed tomography revealed a cystic mass with a faintly enhanced septum in the pancreatic head as well as stenosis and dilation of the hepatic bile duct. Imaging suggested a serous cystic neoplasm (SCN);however, considering that the mass was growing and the patient had periodic liver dysfunction and abdominal pain, which were indicative of cholangitis, further assessment was required. The patient declined surgery, and endoscopic ultrasonography-guided tissue acquisition was performed for a definitive diagnosis of SCN. Cholangitis episodes were infrequent and resolved spontaneously, and the patient was monitored through follow-up. After 2 years, cholangitis occurred more frequently, and the SCN showed further growth. Moreover, the patient developed obstructive jaundice. The patient refused surgery again despite our recommendation. As a result, endoscopic retrograde cholangiopancreatography (ERCP) was performed, and a covered metallic stent was placed in the common bile duct to resolve bile duct stricture. Three years after diagnosis, the patient was hospitalized for recurrent orbital pain. ERCP revealed a filling defect in the stent and upper bile duct with proximal bile duct dilation. Balloon curettage resulted in the drainage of bile sludge and thrombus. The patient presented with cholangitis complicated by biliary hemorrhage, and an endoscopic nasobiliary drainage (ENBD) tube was placed to relieve obstruction caused by the thrombus. However, frequent bleeding from the ENBD tube suggested recurrent biliary hemorrhage, probably due to SCN, thereby requiring surgical intervention. At the request of the patient and her family, a pylorus-preserving pancreaticoduodenectomy was performed. The resected specimen was a large, 50-mm nodular lesion in the pancreatic head, extending from the pancreatic parenchyma to the bile duct, with stent compression and scarring from previous drainage. The lesion had a lobulated surface with cysts ranging from <1mm to 15mm, some of which exhibited hemorrhage. Surgical resection is the preferred treatment for symptomatic SCN. Although this patient eventually required surgery due to repeated biliary bleeding, the possibility that stent placement contributed to the hemorrhage suggests that surgical resection should remain the first-line treatment for SCN with obstructive jaundice.","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 9","pages":"643-651"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034310","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