ABSTRACT
Iodine-131 is a radioisotope that is routinely used for the treatment of differentiated thyroid cancer after total or near-total thyroidectomy. However, there is some evidence that iodine-131 can induce liver injury . Here we report a rare case of drug-induced liver injury (DILI) caused by iodine-131 in a patient with regional lymph node metastasis after total thyroidectomy. A 47-year-old woman was admitted with elevated liver enzymes and symptoms of general weakness and nausea. Ten weeks earlier she had undergone a total thyroidectomy for papillary thyroid carcinoma and had subsequently been prescribed levothyroxine to reduce the level of thyroid-stimulating hormone. Eight weeks after surgery she underwent iodine-131 ablative therapy at a dose of 100 millicuries, and subsequently presented with acute hepatitis after 10 days. To rule out all possible causative factors, abdominal ultrasonography, endoscopic ultrasonography (on the biliary tree and gall bladder), and a liver biopsy were performed. DILI caused by iodine-131 was suspected. Oral prednisolone was started at 30 mg/day, to which the patient responded well.
Subject(s)
Female , Humans , Middle Aged , Abdomen/diagnostic imaging , Chemical and Drug Induced Liver Injury/diagnosis , Iodine Radioisotopes/chemistry , Lymph Nodes/pathology , Lymphatic Metastasis , Prednisolone/therapeutic use , Thyroid Neoplasms/drug therapy , Thyroidectomy , Thyroxine/therapeutic use , UltrasonographyABSTRACT
Juvenile polyposis is an uncommon condition characterized by the development of multiple juvenile polyps predominantly in the colon but also in the rest of the gastrointestinal tract. Patients with juvenile polyposis commonly present with rectal bleeding, diarrhea, abdominal pain, anemia, prolapse of the polyp. We experienced a juvenile polyposis in a 7 year-old male patient with protein losing enteropathy who was diagnosed by 99MTc-human serum albumin abdominal scintigraphy, colonoscopy, and small bowel series. Proctocolectomy with ileostomy was performed and then protein losing enteropathy was resolved.
Subject(s)
Child , Humans , Male , Abdominal Pain , Anemia , Colon , Colonoscopy , Diarrhea , Gastrointestinal Tract , Hemorrhage , Ileostomy , Polyps , Prolapse , Protein-Losing Enteropathies , Radionuclide Imaging , Technetium Tc 99m Aggregated AlbuminABSTRACT
A glomus tumor is a benign neoplasm arising from the neuromyoarterial glomus body, a specialized arteriovenous communication. It functions as a temperature regulator, predominantly in the skin. The glomus tumor occurs rarely in the stomach. The common presenting symptoms are upper gastrointestinal bleeding, epigastric discomfort, nausea, and vomiting. This benign tumor is seen as an intramural mass and is most frequently located in the gastric antrum. Because of its highly cellular nature, the frozen section is often misinterpreted as malignant, and an unduly extensive resection is sometimes performed. A 57-year-old woman was recently admitted due to hematemesis and melena for one day. A gastrofibroscopy was performed and a 3 4 cm sized submucosal mass with central ulceration was found on the anterior wall of the antrum. Fresh blood clots were noted on the ulcer base. Due to recurrent bleeding, a hemigastrectomy was performed. Pathologic findings, including immunoreactivity to alpha-smooth muscle actin and vimentin, was consistent with a glomus tumor of the stomach.
Subject(s)
Female , Humans , Middle Aged , Actins , Frozen Sections , Glomus Tumor , Hematemesis , Hemorrhage , Melena , Nausea , Pyloric Antrum , Skin , Stomach , Ulcer , Vimentin , VomitingABSTRACT
BACKGROUND/AIMS: Generally, candida esophagitis has a low incidence of occurrence, but the prevalence of candida esophagitis was found to be higher in cases involving patients with impaired immunity due to an underlying disease and thereby using immunosupressive drugs. This study was designed to evaluate the relation of symptoms, endoscopic findings, and pathologic findings of each patient. METHODS: Between January 1993 and August 1996, 14,090 upper digestive tract endoscopies were done in Inha hospital. Among those patients, 20 cases of candida esophagitis (0.14%) were confirmed by an endoscopic biopsy. During these same endoscopic sessions, retrospectively reviews were conducted.
Subject(s)
Humans , Biopsy , Candida , Esophagitis , Gastrointestinal Tract , Incidence , Prevalence , Retrospective StudiesABSTRACT
HLA antigen expression can show close relationship with some kinds of tumor cell immunologically. We investigated the relationship between the grade of bladder transitional cell carcinoma and HLA-DR expression to demonstrate the prognostic significance. Paraffin-embedded samples from 25 human transitional cell carcinoma cases were examined for the expression of MHC class R antigen with monoclonal antibody directed against HLA-DR using immunohistochemical methods. The tumors were classified according to the Ash grading system and the degree of the peritumoral mononuclear infiltrates. Both diffuse cytoplasmic and membrane HLA-DR staining were observed in 6 or 17 low grade (Grade I, II) tumors. All 8 high grade (Grade II IV)transitional cell carcinoma exhibited negative staining for HLA-DR antigen. Apart from the relatively high incidence of the positive expression of HLA-DR in low grade tumors, no clear statistical relationship was found between the expression or HLA antigens and the tumor grade. From these results, it may be suggested that the low grade transitional cell carcinoma shows a high incidence of HLA-DR expression and prognostic significance induced by immune response; T cell-mediated immune response against TCC proliferation is evoked. But the significance of these findings remains speculative at present. Therefore, further study should be performed to demonstrate the prognostic importance of HLA-DR expression in transitional cell carcinoma of the bladder.