A 61-year-old man with a palpable mass lesion in the lower part of the abdomen was referred to our hospital for investigation and treatment. Laboratory data revealed a severe leukocytosis and a high C-reactive protein (CRP) level ; he did not have a fever. CT and MRI showed a large tumor in the lower abdomen. Based on 3D (vascular reconstruction)-enhanced CT the tumor was found to be fed by the ileocolic artery. The preoperative diagnosis was of a tumor arising from the ileal mesentery. A partial resection of the ileum was done. On histopathology, rounded histiocyte-like and spindle fibroblast-like tumor cells were arranged in a random or haphazard fashion and showed a storiform pattern ; there was a collection of xanthoma-like foamy cells and invasive inflammatory cells. A diagnosis of inflammatory malignant fibrous histiocytoma of the ileal mesentery was made. The postoperative course was uneventful and, the patient's severe leukocytosis improved immediately. The patient has remained disease-free for 2 years since the resection.

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A 61-year-old male patient came to our emergency room because of abdominal pain. On admission, he complained of left-sided abdominal tenderness, and localized peritonitis was diagnosed. Blood examinations showed severe inflammation. Abdominal computed tomography revealed a thickened small intestinal wall and free air in the abdominal cavity. Under a diagnosis of peritonitis due to perforation of the small intestine, an emergency operation was performed. On laparotomy, the jejunal wall was thickened and perforated, necessitating a partial resection of the jejunum. The postoperative pathological and immunohistochemical diagnosis was enteropathy-type T-cell lymphoma. Chemotherapy and stem cell transplantation were conducted, and a complete response was obtained. He has been doing well for 16 months, to date, since the operation. There is no evidence of recurrence. We present this case with a review of the relevant Japanese literature.

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Adventitial cystic desease is a rare condition which is a cause of intermittent claudication. We report the case of a 68-year-old man with adventitial cystic disease of the right popliteal artery which was diagnosed using IVUS. The patient complained of intermittent claudication and chest pain. Stenoses of the coronary artery and the right popliteal arteryere were found. PCI was performed to for this coronary artery disease. On IVUS the cause of the popliteal artery stenosis was found to be multiple cystic lesions. Therefore, the tumor was successfully treated by surgical excision followed by artificial graft replacement. The cystic tumor contained mucoid material and was partially lined by multiple rows of cells. The lumen of the removed vessel was normal. Sometimes, adventitial cystic disease of the popliteal artery can resolve spontaneously with the application of pressure, and the patient's various symptoms may disappear. In such cases, careful examination is necessary.

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A 20-year-old female with a history of mental retardation and obsessive-compulsive disorder ate meals with sewing needles for about 10 days in an effort to commit suicide. She was admitted to our hospital with a chief complaint of abdominal pain. Abdominal X-ray showed several needles in the abdomen. Although numerous needles were recognized throughout the entire digestive tract on a CT scan, neither free air nor symptoms of peritonitis were found. We retrieved 21 needles from the stomach using a gastrointestinal scope. High fever and right lower abdominal pain occurred on hospital day, Moreover, numerous needles remained in the cecum, descending colon and rectum. Therefore, we performed surgery. First, needles in the descending colon through rectum were retrieved by a colonoscopic procedure. Then the remaining needles were retrieved by laparoscopic surgery. In total, 31 needles were removed during these. Nine needles were excreted with defecation before surgery. We herein describe a case who ingested 61 needles which were successfully removed employing an endoscopic procedure and laparoscopic surgery.

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