Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
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Volume 109, Issue 7
Displaying 1-13 of 13 articles from this issue
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Review article
Monthly report; Prevention of digestive tract cancer
Round-table discussion
Original article
Case report
  • A case of stomach metastasis of pleomorphic carcinoma of the lung with hypercalcemia
    Toshiyuki NAKAZAWA, Yasuo HIRONO, Kenji KONERI, Hideki NAGANO, Makoto ...
    2012 Volume 109 Issue 7 Pages 1204-1212
    Published: 2012
    Released on J-STAGE: July 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.1204
    JOURNAL FREE ACCESS
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    A 69-year-old man was admitted with fatigue, anorexia, and slight fever. Gastroscopy showed a tumor in the stomach, and biopsy revealed a poorly differentiated adenocarcinoma. CT scan revealed a tumor of the stomach, a tumor in the lower lobe of the right lung, and multiple tumors in the liver. Moreover, he was drowsy, probably caused by severe hypocalcemia thought to be caused by parathyroid hormone related protein. We treated him with S-1, but the gastric tumors progressed rapidly and massive pleural effusion developed. He died on the 16th day after admission. At autopsy, the histology of the lung tumor was found to be pleomorphic carcinoma, and that had metastasized to the stomach, the liver, and other abdominal organs. We treated a rare case of pleomorphic carcinoma with hypercalcemia that was discovered due to gastric metastasis.
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  • Portal hepatic lymphadenopathy involved by Rosai-Dorfman disease-like changes in a patient with hepatocellular carcinoma
    Hideo TAKAGI, Hitoshi NISHIO, Tetsu GOTO, Koutaro MORITA, Masahide UCH ...
    2012 Volume 109 Issue 7 Pages 1213-1222
    Published: 2012
    Released on J-STAGE: July 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.1213
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    We report a case of a 68-year-old woman with chronic hepatitis C who presented with a small hepatocellular carcinoma in segment 8 (S8) of liver and a portal hepatic tumor. Transhepatic arterial infusion therapy was performed, followed by partial hepatic resection of S8 and excision of the portal hepatic tumor with lymph node metastasis. Histologically, the lymph nodes showed marked infiltration of large histiocytes with clear cytoplasm and emperipolesis in the specimen stained with hematoxylin-eosin. These findings were generally compatible with the histological features of Rosai-Dorfman disease (RDD). However, immunohistochemical analysis revealed the proliferating histiocytes were negative for CD1a, CD68 and S-100 protein, but positive for only lysozyme. Therefore, we finally diagnosed it as a disease similar to RDD. This was a difficult case diagnostically distinguish between metastasis and benign disease.
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  • Progression of hepatic fibrosis observed by repeated liver biopsies in an adult case of COACH syndrome
    Yuki MAKINO, Takumi IGURA, Yasuharu IMAI, Kazuto FUKUDA, Yoshiyuki SAW ...
    2012 Volume 109 Issue 7 Pages 1223-1229
    Published: 2012
    Released on J-STAGE: July 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.1223
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    A 30-year-old man was admitted to Osaka University Hospital for the treatment of gastric varices and assessment of indication for liver transplant. When he was 6 years old, liver dysfunction was pointed out and diagnosed as chronic inactive hepatitis by liver biopsy. At 13 years of age, the second liver biopsy proved congenital hepatic fibrosis (CHF). The third liver biopsy was performed when he was 30 years old, and the progression of hepatic fibrosis was confirmed. Besides CHF, we recognized oligophrenia, cerebellar ataxia, hypoplasia of cerebellar vermis and coloboma, leading to the diagnosis of COACH syndrome. COACH syndrome is quite rare, and our case is especially valuable because he was diagnosed as an adult case and the progression of hepatic fibrosis could be followed through several liver biopsies. We should be aware of COACH syndrome in mind when we encounter CHF patients.
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  • Large serous cystic adenoma at the pancreas tail mimicking mucinous cystic neoplasm
    Chisako NAGAKURA, Masataka KIKUYAMA, Kazuyoshi MATSUMURA, Kazumori ARA ...
    2012 Volume 109 Issue 7 Pages 1230-1235
    Published: 2012
    Released on J-STAGE: July 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.1230
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    A 62-year-old woman presented with left abdominal pain. A large and multi-cystic lesion at the pancreas tail was recognized on imaging examinations. MRI revealed low and high signal intensity on T1- and T2-weighted imaging, with focal and bright components in the nodule adjacent to the septum on T2-weighted imaging. Distal pancreatectomy was performed, and the cystic lesion was diagnosed as serous cystic adenoma with hemorrhage. The characters of serous cystic components on imaging examinations could help to distinguish the lesion from mucinous cystic neoplasm.
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  • A case of severe acute pancreatitis with hyperlipidemia in a pregnant woman
    Yumi IDO, Ryosuke GUSHIMA, Tetsu OZAKI, Youko MAKI, Kouichi NONAKA, Ei ...
    2012 Volume 109 Issue 7 Pages 1236-1242
    Published: 2012
    Released on J-STAGE: July 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.1236
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    A 29-year-old pregnant woman was referred to our hospital with suspected acute pancreatitis. On admission, the serum levels of pancreatic enzyme, total cholesterol and triglyceride were markedly elevated, which suggesting acute pancreatitis with hyperlipidemia. Treatment consisted of continuous hemodiafiltration, LDL apheresis, heparin and insulin combination therapy. On the 24th day of hospitalization, a cesarean section delivery resulted in the birth of a healthy infant. We reported a case of hyperlipidemia-induced acute pancreatitis in a woman with second trimester pregnancy, where multidisciplinary treatment was quite effective.
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  • Successful endoscopic transpapillary pancreaticobiliary drainage for omental panniculitis by hepatocellular carcinoma complicated by biliary fistula and pancreatic fistula
    Yuji SHINDO, Hiroyuki MIYATANI, Takeshi UEHARA, Takashi IKEYA, Kenichi ...
    2012 Volume 109 Issue 7 Pages 1243-1249
    Published: 2012
    Released on J-STAGE: July 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.1243
    JOURNAL FREE ACCESS
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    A 78-year-old man with hepatocellular carcinoma treated by chemoembolization and percutaneous ethanol injection was admitted to our hospital because of acute abdomen. The CT scan showed biliary fistula caused by hepatocellular carcinoma protruding from S3. Endoscopic retrograde cholangiopancreatography showed disruption of an intrahepatic duct and the main pancreatic duct, and contrast agent leaked into the peritoneal cavity from each duct. Omental panniculitis with biliary fistula and pancreatic fistula was diagnosed. The symptoms improved by endoscopic nasobiliary drainage and endoscopic pancreatic stenting. On the 13th day after admission, we added endoscopic nasopancreatic drainage because his abdominal pain had been exacerbated by pancreatic juice leakage. Omental panniculitis by hepatocellular carcinoma complicated by biliary fistula and pancreatic fistula is extremely rare. Endoscopic transpapillary pancreaticobiliary drainage was effective for omental panniculitis in this case.
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