Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 108, Issue 7
Displaying 1-14 of 14 articles from this issue
Special contribution
Review article
Monthly report; Progress in treatment of chronic hepatitis C
Round-table discussion
Case report
  • Shinji NAKAMURA, Fumikazu KOYAMA, Tadashi NAKAGAWA, Kazuaki UCHIMOTO, ...
    2011 Volume 108 Issue 7 Pages 1222-1230
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 63-year-old woman was admitted to our hospital because of tarry stool several years previously. At the time, café-au-lait spots and dermal nodules were found on her entire body, and a diagnosis of von Recklinghausen disease was established. Small bowel endoscopy revealed a submucosal tumor in the jejunum. Laparotomy was therefore performed on the suspicion of intestinal GIST. Numerous extramural tumors with a diameter of 3-5mm were observed along the jejunum and ileum, in addition to the primary tumor. Partial resection of the jejunum, including the primary tumor and only one small nodule was performed to prevent short bowel syndrome. Immunopathological studies of the tumors were positive for KIT and CD34 and we diagnosed multiple intestinal GISTs. Imatinib mesylate was not administered, but no growth of the residual tumors have been recognized for 10 months after surgery.
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  • Takateru YAMAMOTO, Akihiro SHINJI, Kenji MUKAWA, Hiroshi OHTA, Kenichi ...
    2011 Volume 108 Issue 7 Pages 1231-1236
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 33-year-old woman had hematochezia for 5 months. A total colonoscopy showed an easily-bleeding elevated lesion with a nodular lesion in the lower rectum. Histological findings of a conventional biopsy from the lesion showed MALT (mucosa-associated lymphoid tissue) lymphoma and she was diagnosed as stage I. The monoclonality of B-cells was not detected by polymerase chain reaction products for immunoglobulin heavy chain. We selected antibiotic therapy because Helicobacter pylori was detected in culture of the patient's gastric biopsy specimens. The antibiotic therapy was successful, but her symptoms worsened. We therefore gave her with 30Gy radiation therapy. She recovered a month after the radiation. Histological complete remission was confirmed 4 months after the radiation. Adverse events of the radiation therapy included anal pain for 1 month and premature ovarian failure. Radiation therapy may be useful for localized rectal MALT lymphoma.
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  • Hiroshi OHARA, Yukako KATO, Masaru NAKANO, Yasuhisa ISHII, Hiroshi SER ...
    2011 Volume 108 Issue 7 Pages 1237-1243
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 26-year-old Japanese woman was admitted to the hospital because of fever and general fatigue. A diagnosis of acute hepatitis B was given because of high levels of transaminase and positivity for HBs-Ag, HBe-Ag and HBc-IgM. On the 2nd day progression to fulminant hepatitis was suspected, and steroid pulse therapy, cyclosporin, entecavir, and interferon-β were started. Her laboratory data improved until transaminase showed an increase on 18th day, and steroid was once again administered. Abdominal CT scan and plain abdominal X-ray showed pneumatosis cystoides intestinalis (PCI) mainly along the ascending colon without any symptoms. After discontinuation of steroid therapy, abnormal gas gradually disappeared. This is a very rare case of PCI, which may have been caused by short-term steroid pulse therapy.
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  • Asumi HIGASHIYAMA, Mineo KUDO, Tomokazu NAGASAKO, Naoyuki KAWAMURA, Sa ...
    2011 Volume 108 Issue 7 Pages 1244-1251
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 71-year-old man with eosinophilia was given a diagnosis of poorly differentiated adenocarcinoma of the rectum. Further examination showed that it had invaded the bone marrow. He had disseminated intravascular coagulation (DIC) from disseminated carcinomatosis of the bone marrow after colostomy. Chemotherapy (mFOLFOX6) was succesful and his eosinophil count, DIC score and tumor markers normalized. We were able to continue chemotherapy after 5 months from the outbreak of disseminated carcinomatosis of the bone marrow. It is said that disseminated carcinomatosis of the bone marrow has a poor prognosis, but we were able to obtain a good response in this case by chemotherapy.
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  • Yoshiyuki MURAWAKI, Michimori KONO, Masahiko MIURA, Takaaki SUGIHARA, ...
    2011 Volume 108 Issue 7 Pages 1252-1262
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 72-year-old man visited for imaging examination of alcoholic cirrhosis in April 2007. Enhanced CT images were revealed a 7mm early enhanced lesion in segment 6 of the liver. The lesion was increased gradually to 40mm on MRI images 21 months later. We performed ultrasound liver biopsy 3 times. Histology showed angiosarcoma with high-grade atypia and it was positive for CD31, CD34 and factor VIII-related antigen. The doubling time of this tumor was 42-108 days. Although we performed transarterial chemoembolization and interleukin-2 therapy, the patient died 34 months after the initial detection of tumor. We observed the clinical course with periodic imaging examination from the early stage of hepatic angiosarcoma and obtained a pathologic diagnosis by liver biopsy.
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  • Maiko TAKITA, Eisuke IWASAKI, Ken HATOGAI, Ryohei KISHINO, Eri SEKI, M ...
    2011 Volume 108 Issue 7 Pages 1263-1270
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 57-year-old man with advanced gallbladder cancer and accompanying hepatic, colonic and duodenal invasion and para-aortic lymph node metastasis was referred to our hospital. Gemcitabine plus S-1 administration was chosen. Gemcitabine was administered intravenously at a dose of 1000mg/m2 on days 1 and 15, and repeated every 4 weeks. S-1 was administered orally at a dose of 40mg/m2 b.i.d. on days 1-14. Chemotherapy was effective for the primary gallbladder tumor and lymph node metastasis. The primary tumor and metastatic lymph nodes were shown to have disappeared by a FDG-PET CT study after 10 courses of chemotherapy. Informed consent was obtained prior to performing surgery of the primary lesion. Pathological examination showed fibrosis and a small focus of residual cancer in the resected gallbladder. Complete resection was achieved as all the margins were negative. The findings suggest that gemcitabine plus S-1 treatment may be effective against advanced gallbladder cancer.
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  • Yasushi SHIBASAKI, Takanori SAKAGUCHI, Raisuke NISHIYAMA, Takefumi MOR ...
    2011 Volume 108 Issue 7 Pages 1271-1279
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 40-year-old man underwent right hemihepatectomy with biliary reconstruction for hilar bile duct cancer, and the surgical margin being negative. The tumor, showing atypical intraductal growth, was solid adenocarcinoma with rich mucinous component, although it was negative for MUC1, MUC2 and MUC5AC, suggesting that the tumor was not an intraductal papillary neoplasm of the bile duct (IPN-B). Eight years after operation, abdominal and cervical lymph node metastases were found on computed tomography and 18F-deoxyglucose positron emission tomography examination. Late remote recurrence after curative resection of the extrahepatic bile duct cancer is relatively rare. The recurrence in the present case maybe explained by the tumor dormancy theory.
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  • Yasunobu YAMASHITA, Kei ITO, Yutaka NODA, Go KOBAYASHI, Takashi OBANA, ...
    2011 Volume 108 Issue 7 Pages 1280-1287
    Published: 2011
    Released on J-STAGE: July 06, 2011
    JOURNAL FREE ACCESS
    A 40-year-old woman was hospitalized because of acute pancreatitis. CT showed a monolocular cyst thought to be a pseudocyst. The patient was followed as an outpatient. The size of the cyst decreased 6 years later. Ultrasonography 10 years later demonstrated an enlarged cyst with a cyst-in-cyst formation. A tendency to increase in size and the irregular wall thickening indicated that the cyst was a malignant mucinous cystic neoplasm (MCN) and distal pancreatectomy was performed. The tumor was diagnosed histologically as a mucinous cystadenoma. A case of MCN resected after long-term follow-up is extremely rare. The present case is thought to be important for elucidation of the natural history of MCNs.
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