Background and Aims: Radioimmunotherapy (RIT) appears as one of the most effective treatment options for patients with relapsed or resistant non-Hodgkin's lymphoma (NHL). Our aim was to evaluate the role of pre-RIT ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) as an early predictor of ⁹⁰Y-Ibritumomab tiuxetan treatment response. Methods: We included consecutive 20 patients with relapsed NHL (10 males; mean age, 58.5±8.9 years old) who were treated with ⁹⁰Y-Ibritumomab tiuxetan. FDG-PET/CT was performed before and after treatment. Semiquantitative parameters of all measurable FDG-avid lesions were measured and averaged. A measurable FDG-avid lesion was defined as a lesion that showed FDG uptake higher than liver with a diameter more than 1cm. Treatment response was determined by visual assessment based on a five-point score criteria from FDG-PET/CT after treatment. Results: Fourteen patients (70%) were classified as responders and the other six patients (30%) as non-responders. All semiquantitative parameters except for MTV demonstrated significantly lower values in the responders compared with the non-responders (p<0.05). Conclusions: Semiquantitative evaluation by SUVmax, SUVpeak, and TLG before treatment were useful as early predictors of ⁹⁰Y-Ibritumomab tiuxetan treatment response.

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2016年4月より小径腎腫瘍に対しロボット支援腎部分切除術（RAPN）が保険適応となり，当院でも同年5月よりRAPNを導入した．初期導入28症例まで経腹膜到達法で行ってきたが，今回開腹手術の既往症例に対して後腹膜到達法で行った．症例は70歳代，男性．右腎下極腫瘍，腫瘍径24 mm，腎背側に位置した．臨床病期cT1aN0M0 stage I，術前eGFR 68.8 ml/min，大腸癌術後，胆石症術後であり体表に腹部正中創，人工肛門を認めた．手術は全身麻酔，左側臥位，ジャックナイフ位で開始した．腎動脈の確保まで腹腔鏡鉗子操作で行った．手術時間3時間8分，コンソール時間49分，温阻血時間23分，出血少量であった．病理検体は7 g，Renal cell carcinoma，pT1a，断端陰性であった．術後6日目に退院し術後eGFR 50.4 ml/min，4ヵ月後eGFR 62.1 ml/minと腎機能は術前と同様の水準まで改善した．後腹膜到達法により腹腔内癒着の影響を受けることなくRAPNを安全に施行することが可能であった．

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患者は60歳代，男性．腹痛と下痢を主訴に来院した．急性腸炎と診断され，投薬を受けたが改善しなかった．再診時，腹部正中に圧痛を伴う手拳大の腫瘤を触知した．筋性防御や腹膜刺激症状は認めなかった．単純CTで，腹腔内に長さ約65 mmの，針状の異物を認め，周囲には膿瘍を伴う炎症性腫瘤が形成されていた．患者に異物誤飲の記憶はなかったが，爪楊枝をくわえる癖があった．認知機能に問題はなかった．異物誤飲による炎症性腫瘤の診断で，待機的に腫瘤摘出術を施行した．炎症性腫瘤は空腸に強く癒着しており，内部にはCTで描出された膿瘍と異物を認めた．異物は爪楊枝であった．穿孔部位と考えられた小腸病変部はすでに閉鎖していた．術後経過は良好であった．爪楊枝誤飲による小腸穿孔は比較的稀で，今回われわれは，この1例を経験したので文献的考察を加え報告する．

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A 14-year-old-boy presented with pain and a lump on his left lower leg. Magnetic resonance imaging (MRI) revealed a medullary lesions on T1-weighted images and medullary enhancement after contrast injection. Bone marrow biopsy with curettage revealed an active marrow without evidence of malignancy or infection. The patient had acne on his face and legs. Accordingly, he was diagnosed with chronic recurrent multiple osteomyelitis (CRMO) syndrome. A few months later, the patient developed shoulder joint pain, remittent fever, and an erythematous rash accompanied by a high fever. Blood tests revealed elevated levels of CRP (10.2 mg/dL) and ferritin (557 ng/mL), and hypoalbuminemia (2.8 g/dL). A second bone marrow biopsy revealed hemophagocytosis, but no malignancies. Subsequently, a diagnosis of systemic juvenile idiopathic arthritis (s-JIA) was established.

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