RESUMEN
Small bowel lesions located in long and multiple complex loop configurations were difficult to diagnose early because of vague clinical manifestations and because of the poor diagnostic yield of conventional examination methods. In this setting, double-balloon enteroscopy (DBE) was an epoch-making diagnostic and therapeutic tool for the management of patients with small bowel disease. Single-balloon enteroscopy (SBE), lacking a balloon at the endoscopic tip, is also a useful method for investigating and managing suspected small bowel lesions. Mucosa associated lymphoid tissue (MALT) lymphoma of the small bowel is relatively uncommon and remains a localized disease for long periods in most patients. Recently, we experienced a case of advanced-stage MALT lymphoma in the jejunum. A 60-year old female, with a history of anemia of unknown etiology and who was suspected of having a small bowel lesion, presented with complaints of vague abdominal pain and dizziness. She had undergone SBE via the oral route. She was diagnosed with MALT lymphoma of the jejunum and treated with medical management.
Asunto(s)
Femenino , Humanos , Dolor Abdominal , Anemia , Mareo , Enteroscopía de Doble Balón , Yeyuno , Tejido Linfoide , Linfoma , Linfoma de Células B de la Zona Marginal , Membrana MucosaRESUMEN
Glomus tumors are benign lesions that originate from modified smooth muscle cells of the glomus body. These tumors are commonly observed in the dermis or subcutis, but they are only rarely found in the stomach. We describe here a 37-year- old male patient who presented with intermittent epigastric pain and in whom a submucosal tumor was encountered during performance of upper gastrointestinal endoscopy. A gastrofibroscopy demonstrated a 12 mm sized submucosal mass with central ulceration on the greater curvature-posterior wall of the high body. Endoscopic ultrasonography revealed a circumscribed inhomogeneneous hypo- echoic mass with a focal hyperechoic mass in the third layer of the stomach. We resected the entire mass using an endoscopic resection technique, and there were no complications. Histologically, the tumor cells had uniform small nucleuses with inconspicuous nucleoli. Immunochemical analysis of the tumor cells showed positivity for smooth muscle actin and negativity for CD34, KIT, S100 protein and desmin. This is the first case of a glomus tumor of the stomach that was resected by endoscopic resection.
Asunto(s)
Humanos , Masculino , Actinas , Dermis , Desmina , Endoscopía Gastrointestinal , Endosonografía , Tumor Glómico , Músculo Liso , Miocitos del Músculo Liso , Estómago , ÚlceraRESUMEN
Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas filled cysts in the intestinal wall. The diagnosis of PCI is usually made by colonoscopy, histology, or radiologic findings. We report a case of PCI in a 35-year-old man. The patient initially complained of watery diarrhea and abdominal bloating for 2 weeks. Simple abdominal X-ray demonstrated numerous, small, round, air densities on the right upper abdomen along the ascending and proximal transverse colon. Colonoscopy revealed numerous, 5-20 mm sized, sessile polypoid, balloon-like distended, protruding subepithelial masses covered with normal colonic mucosa from cecum to proximal transverse colon. We performed a CT colonoscopy and confirmed PCI with multiple air-filled cystic masses along the colonic wall from cecum to proximal transverse colon. The patient was treated with antibiotics and oxygen inhalation for 2 weeks. Follow-up CT colonoscopy revealed marked regression in the number and size of the air-filled cystic masses. Herein, we report the first case of the PCI in Korea diagnosed by CT colonoscopy. Follow-up evaluation with CT colonoscopy was performed after the treatment of the PCI. CT colonoscopy is a useful non-invasive diagnostic tool for the diagnosis of pneumatosis cystoides intestinalis.
Asunto(s)
Adulto , Humanos , Masculino , Enfermedades del Colon/patología , Colonografía Tomográfica Computarizada , Mucosa Intestinal/patología , Neumatosis Cistoide Intestinal/patologíaRESUMEN
A 54-year-old male was admitted due to lung cancer and polyarthralgia involving wrist, hand, shoulder, and ankle joints. Five months ago, he had been diagnosed as adenocarcinoma of the lung, and treated with three cycles of chemotherapy using gemcitabine and cisplatin. In the course of chemotherapy, he had complained symmetrical polyarthralgia of hand and shoulder joints, resembling rheumatoid arthritis (RA). After treatment with chemotherapeutic agents, he still had severe polyarthritis refractory to anti-rheumatic drugs, including prednisolone, hydroxychloroquine, and methotrexate, and thus referred to our hospital. We changed the previous anti-cancer regimens to cisplatin plus docetaxel, a semisyntheic taxane molecule, which is known to suppress experimental polyarthritis. With additional three cycles of cisplatin plus docetaxel, RA disease activity as well as polyarthralgia was nearly completely resolved, and the extent of lung cancer was not aggravated. Although RA patients have an increased risk of malignancy, the outbreak of RA was very rare in lung cancer patients. Here we report a case of coincident lung cancer and rheumatoid arthritis, which was successfully treated by docetaxel plus cisplatin chemotherapy.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma , Articulación del Tobillo , Antirreumáticos , Artralgia , Artritis , Artritis Reumatoide , Cisplatino , Quimioterapia , Mano , Hidroxicloroquina , Neoplasias Pulmonares , Pulmón , Metotrexato , Prednisolona , Hombro , Articulación del Hombro , MuñecaRESUMEN
We experienced a rare case of trachea diverticula combined with the sequela of tuberculosis and a fungus ball. The patient had complained of coughing and hemoptysis for a long time after experiencing tuberculosis. He was admitted due to hemoptysis and the aggravation of coughing. The CT scan showed a variable sized trachea diverticula combined with tuberculosis sequela and a fungus ball in the right lung fields. The diagnosis was made by bronchoscopy and a CT scan. After bronchial artery embolization and conservative treatment, the patient's symptoms improved and the patient was discharged.
Asunto(s)
Humanos , Arterias Bronquiales , Broncoscopía , Tos , Diagnóstico , Divertículo , Hongos , Hemoptisis , Pulmón , Tomografía Computarizada por Rayos X , Tráquea , TuberculosisRESUMEN
PURPOSE: C4d detection in peritubular capillaries in acute allograft rejection has been regarded as a poor prognostic factor for graft kidney survival. We investigated the clinical importance of C4d positivity in renal transplant recipients with acute rejection. METHODS: Forty eight renal allograft biopsies were selected, which were available for immunofluorescence study. The samples were divided into two groups, one which was diagnosed as acute rejection clinically (n=30), the other which underwent protocol biopsy 2 weeks after transplantation (n=18). Among the acute rejection group, C4d staining was positive in 50% of acute rejection cases (C4d (+), n=15) and negative in the others. (C4d (-), n=15). We compared the C4d (+) group and the C4d (-) group in terms of clinical parameters and graft survival duration. RESULTS: Renal function was reduced in the C4d (+) group compared to the C4d (-) group. In the C4d (+) group, 8 of 15 cases resulted in graft loss, but only one graft loss developed in the C4d (-) group. Graft survival duration after kidney biopsy was reduced in the C4d (+) group compared to the C4d (-) group. CONCLUSION: Renal transplant recipient with C4d-positive acute rejection shows inferior graft survival duration. So tight management in addition to steroid pulse therapy should be considered for these patients.
Asunto(s)
Humanos , Aloinjertos , Biopsia , Capilares , Técnica del Anticuerpo Fluorescente , Supervivencia de Injerto , Riñón , Trasplante de Riñón , Trasplante , TrasplantesRESUMEN
We experienced a case of pulmonary cryptococcosis in an immunocompetent patient who presented with uncommon radiological findings. He complained of a dry cough for 3 weeks. The chest X-ray and CT showed multiple, variable sized, and irregular patch consolidations with cavities combined with some ground glass opacities in both lower lung fields. The diagnosis was made histologically via a thoracoscopic lung biopsy. The patient was administered oral fluconazole has since been well.
Asunto(s)
Humanos , Biopsia , Tos , Criptococosis , Diagnóstico , Fluconazol , Vidrio , Pulmón , TóraxRESUMEN
Amyloidosis is defined by the extracellular deposition of fibrillar proteinacious material that binds Congo red dye. Amyloid fibrils can be deposited locally, but can involve virtually every organ system of the body. Hereditary, autosomal dominant amyloidosis, caused by mutations in the genes encoding transthyretin, fibrinogen Aalpha-chain, lysozyme or apolipoprotein A-I, is-extremely rare. A case of familial amyloidosis, involving the heart, was identified, where the patient complained exertional dyspnea. The echocardiographic findings were the markedly thickened the interventricular septum and right ventricular wall, as well as a granular sparkling appearance in the interventricular septum. On admission, the patient, and his younger brother, underwent endomyocardial biopsies, and the results of the Congo red staining and EM were consistent with amyloidosis. The patient was managed conservatively, and discharged without complication.
Asunto(s)
Humanos , Amiloide , Amiloidosis , Amiloidosis Familiar , Apolipoproteína A-I , Biopsia , Rojo Congo , Disnea , Ecocardiografía , Fibrinógeno , Corazón , Muramidasa , Prealbúmina , HermanosRESUMEN
Amyloidosis is defined by the extracellular deposition of fibrillar proteinacious material that binds Congo red dye. Amyloid fibrils can be deposited locally, but can involve virtually every organ system of the body. Hereditary, autosomal dominant amyloidosis, caused by mutations in the genes encoding transthyretin, fibrinogen Aalpha-chain, lysozyme or apolipoprotein A-I, is-extremely rare. A case of familial amyloidosis, involving the heart, was identified, where the patient complained exertional dyspnea. The echocardiographic findings were the markedly thickened the interventricular septum and right ventricular wall, as well as a granular sparkling appearance in the interventricular septum. On admission, the patient, and his younger brother, underwent endomyocardial biopsies, and the results of the Congo red staining and EM were consistent with amyloidosis. The patient was managed conservatively, and discharged without complication.