RESUMO
Metastasis from lung cancer to the small bowel is rare and this accounts for 0.2% to 0.5% of all the cases of metastasis from lung cancer. In most cases, the patients are asymptomatic and they can show signs of bleeding, intestinal obstruction, perforation and so on. A better diagnostic approach to the small bowel has recently been made possible through capsule endoscopy and double balloon enteroscopy (DBE), and they have a higher diagnostic rate for small bowel bleeding compared with that of the previous diagnostic tests. DBE makes it possible to diagnose precisely due to the high quality endoscopic images and biopsy specimens. In addition, therapeutic DBE with a 2.8 mm channel enables performing more kinds of therapeutic procedures than diagnostic DBE with a 2.2 mm channel. If small bowel metastasis is suspected on 18FDG-PET/CT, then DBE can be considered for making a pathologic diagnosis. We report here on a case of small bowel metastasis from non small cell lung cancer in a 39-year-old woman who complained of hematochezia and we review the relevant literature.
Assuntos
Adulto , Feminino , Humanos , Biópsia , Endoscopia por Cápsula , Carcinoma Pulmonar de Células não Pequenas , Testes Diagnósticos de Rotina , Enteroscopia de Duplo Balão , Hemorragia Gastrointestinal , Hemorragia , Obstrução Intestinal , Pulmão , Neoplasias Pulmonares , Metástase Neoplásica , Carcinoma de Pequenas Células do PulmãoRESUMO
Rhabdomyosarcomas, malignant neoplasms exhibiting skeletal muscle differentiation, are the most common childhood sarcomas. Embryonal rhabdomyosarcomas of the genitourinary tract also occur in children but are rare in adults. We report a case of embryonal rhabdomyosarcoma arising in the bladder of a 29-year-old man who presented with dysuria and microscopic hematuria. A partial cystectomy was performed, and he received chemotherapy with vincristine and actinomycin.
Assuntos
Adulto , Criança , Humanos , Cistectomia , Dactinomicina , Disuria , Hematúria , Músculo Esquelético , Rabdomiossarcoma , Rabdomiossarcoma Embrionário , Sarcoma , Bexiga Urinária , VincristinaRESUMO
Rhabdomyosarcomas, malignant neoplasms exhibiting skeletal muscle differentiation, are the most common childhood sarcomas. Embryonal rhabdomyosarcomas of the genitourinary tract also occur in children but are rare in adults. We report a case of embryonal rhabdomyosarcoma arising in the bladder of a 29-year-old man who presented with dysuria and microscopic hematuria. A partial cystectomy was performed, and he received chemotherapy with vincristine and actinomycin.
Assuntos
Adulto , Criança , Humanos , Cistectomia , Dactinomicina , Disuria , Hematúria , Músculo Esquelético , Rabdomiossarcoma , Rabdomiossarcoma Embrionário , Sarcoma , Bexiga Urinária , VincristinaRESUMO
There are various causes of splenic infarction. Antiphospholipid antibody is associated with numerous thromboembolic phenomena. We report a case of young male who presented with acute abdominal pain and was diagnosed as a case of splenic infarction and acute pancreatitis with antiphospholid syndrome. He was positive for anticardiolipin antibody, showed splenic infarction on abdominal CT scan. The patient's clinical, laboratory and imaging finding were consistent with splenic infarction and acute pancreatitis associated with antiphospholipid syndrome.
Assuntos
Adulto , Humanos , Masculino , Doença Aguda , Síndrome Antifosfolipídica/complicações , Pancreatite/diagnóstico , Infarto do Baço/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Clevudine is a nucleoside analog of the unnatural beta-L configuration which has potent antiviral activity against hepatitis B virus (HBV). Clevudine is expected to have similar pattern of resistance profile as lamivudine. However, there was no report on the mutation associated with clevudine resistance in patients with chronic hepatitis B. We report a case of young male patient with chronic hepatitis B who presented with clevudine resistance. The patient had received lamivudine therapy for 5 months with reduced serum HBV DNA levels. Then, lamivudine was switched to clevudine monotherapy. After the 6 months of clevudine therapy, the patient developed virologic breakthrough (>1.0x10(8) copies/mL) as well as biochemical breakthrough, which was associated with the presence of rtM204I plus rtL80I mutant. After switching from clevudine to adefovir, the viral load decreased with biochemical improvement.
Assuntos
Adulto , Humanos , Masculino , Adenina/análogos & derivados , Substituição de Aminoácidos , Antivirais/uso terapêutico , Arabinofuranosiluracila/análogos & derivados , Sequência de Bases , DNA Viral/sangue , Farmacorresistência Viral Múltipla , Antígenos E da Hepatite B/metabolismo , Hepatite B Crônica/tratamento farmacológico , Lamivudina/uso terapêutico , Ácidos Fosforosos/uso terapêutico , Inibidores da Transcriptase Reversa/uso terapêuticoRESUMO
In a case of autoimmune chronic pancreatitis that relapsed despite maintenance therapy with low-dose steroid, high- dose steroid can induce remission of the disease, and maintenance therapy of steroid is usually recommended in that case. A 57-year-old man developed epigastric pain and jaundice. The patient was diagnosed with autoimmune chronic pancreatitis. The abnormalities in the clinical, laboratory and radiologic findings improved after oral steroid therapy. After two relapsed episodes, maintenance therapy of steroid with 5 mg prednisolone/day was administrated. In the studies for follow up, the level of serum IgG was increased and abdominal computed tomography showed calcification and pseudocyst in the pancreatic tail. To our knowledge, this is a rare case of autoimmune chronic pancreatitis aggravated rapidly despite oral steroid maintenance therapy.