ABSTRACT
Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited colon cancer-predisposing disorder, characterized by the development of innumerable adenomas in the large intestine. Polyps are present in the upper gastrointestinal tract in almost all FAP patients and there is a peculiar predilection for adenomatous change in the duodenum. Colonic adenomas in FAP are commonly observed as polyps but nonpolypoid adenomas can also be seen in the upper gastrointestinal tract. Careful endoscopic examination is needed for detecting such nonpolypoid lesions. At present, the adenoma-carcinoma sequence is thought to exist also in the duodenum, and malignancy of the duodenum represents one of the most common causes of mortality among patients with FAP. Therefore, careful periodic follow-up of upper intestinal endoscopies are recommended in patients with this disease, in consideration to the possible development of duodenal nonpolypoid adenomatous lesions. A case involving an experience of antral and duodenal nonpolypoid adenomas in a patient with FAP is herein reported.
Subject(s)
Humans , Adenoma , Adenomatous Polyposis Coli , Colon , Duodenum , Follow-Up Studies , Intestine, Large , Mortality , Polyps , Pyloric Antrum , Upper Gastrointestinal TractABSTRACT
Atrial fibrillation occurs in 10 to 25% of patients with thyrotoxicosis. Several recent studies have found a high frequency of cerebral thromboembolism in such patients. Thus anticoagulation has been recommended for patients with thyrotoxic atrial fibrillation to prevent embolic complications especially when associated with predictors of an increased risk of arterial thromboembolism in nonrheumatic atrial fibrillation such as recent congestive heart failure, history of hypertension, previous thromboembolism, left atrial enlargement, and global left ventricular dysfunction. Most reported cases of embolic events involving central nervous system in thyrotoxic atrial fibrillation affected cerebrum, and cerebellar embolic infarction from the heart was rarely seen. We herein report our experience of a case of cerebellar embolism in thyrotoxic atrial fibrillation.
Subject(s)
Humans , Atrial Fibrillation , Central Nervous System , Cerebrum , Embolism , Heart , Heart Failure , Hepatitis , Hypersensitivity , Hypertension , Infarction , Thromboembolism , Thyrotoxicosis , Ventricular Dysfunction, LeftABSTRACT
Phlegmonous esophagitis is an uncommon disease characterized by purulent infection of the esophageal wall, sparing the mucosa. Bacterial infection of the eosphagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most victims are immunocompromised hosts. A case was experienced involving an acute phlegmonous esophagitis in an 21-year-old man who was immunologically normal and whose main symptoms were epigastric pain and fever for one day. Esophagographic examination revealed a large ulceration of the eosphagus with exudation, and submucosal lesions. Due to its rarity, this case is herein reported with a review of the corresponding literature.
Subject(s)
Humans , Young Adult , Bacterial Infections , Cellulitis , Esophagitis , Fever , Immunocompromised Host , Mucous Membrane , UlcerABSTRACT
The most common pancreatic cystic lesion is pancreatic pseudocyst which represents about 85%. Primary cystic neoplasms represent about 10 to 15% of the lesion. Pathologically cystic neoplasms can be classified into serous cystadenoma, mucinous cystadenoma and papillary cystic neoplasm by epithelial lining-cell, whereas pseudocyst is characterized by fibrotic capsules. Mucinous form is known to be premalignant or malignant and serous cystadenoma was known to be benign in the past, but recently 4 cases of malignant transformation have been reported. Serous cystadenoma is described under a variety of names, including microcystic adenoma and glycogen-rich cystadenoma but recently macroqystic variants have been reported. Serous cystadenoma is most commonly seen in middle aged women with symptoms of vague upper abdominal pain or palpable mass. It is sometimes associated with extra- pancreatic diseases such as gallstones, diabetes mellitus, hypertension, duodenal ulcers, sterility, obesity and thymic dysfunction, but coexisting papillary thyroid cancer have been reported in only 2 cases to our knowledge. The pathogenesis of associated diseases is unknown and appears to be due to function of age of the patients or incidental occurrence. Herein, we report a patient who had a pancreatic serous cystadenoma coexisting with papillary thyroid cancer. Since pancreatic serous cystadenoma can occur in association with papaillary thyroid cancer, examination of thyroid seems to be advisable when pancreatic serous cystadenoma is found.
Subject(s)
Female , Humans , Middle Aged , Abdominal Pain , Adenoma , Capsules , Cystadenoma , Cystadenoma, Mucinous , Cystadenoma, Serous , Diabetes Mellitus , Duodenal Ulcer , Gallstones , Hypertension , Infertility , Mucins , Obesity , Pancreatic Cyst , Pancreatic Diseases , Pancreatic Pseudocyst , Thyroid Gland , Thyroid NeoplasmsABSTRACT
Peutz-Jeghers syndrome is a genetic disorder consisting of mucocutaneous pigmentation and gastrointestinal polyposis. Although the polyp may be found in a solitary fashion in this syndrome, such a case is exceedingly rare and would result in a case report even in other countries. A solitary Peutz-Jeghers polyp had not been reported domestically until now, and thereby, the authors here present a case of a clinical experience of Peutz-Jeghers syndrome with a solitary hamartomatous polyp in the duodenum.