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1.
Intern Med ; 61(5): 657-662, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-34483207

ABSTRACT

Disseminated carcinomatosis of the bone marrow (DCBM) is often accompanied by disseminated intravascular coagulation (DIC) and has a poor prognosis. DCBM develops most frequently in gastric cancer and is rarely associated with intrahepatic cholangiocarcinoma. A 41-year-old man was incidentally found to have DIC on his regular visit for ulcerative colitis and was diagnosed with DCBM with intrahepatic cholangiocarcinoma. He received intensive care, including chemotherapy, but died suddenly from hyperkalemia, possibly due to tumor lysis syndrome (TLS). The autopsy showed the periductal infiltrating type of intrahepatic cholangiocarcinoma and tumor necrosis, possibly due to chemotherapy, indicating the effectiveness of chemotherapy for DCBM with intrahepatic cholangiocarcinoma.


Subject(s)
Bile Duct Neoplasms , Bone Marrow Neoplasms , Cholangiocarcinoma , Disseminated Intravascular Coagulation , Jaundice , Peritoneal Neoplasms , Stomach Neoplasms , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Autopsy , Bile Duct Neoplasms/complications , Bile Duct Neoplasms/diagnosis , Bile Duct Neoplasms/drug therapy , Bile Ducts, Intrahepatic/pathology , Bone Marrow/pathology , Bone Marrow Neoplasms/complications , Bone Marrow Neoplasms/diagnosis , Cholangiocarcinoma/complications , Cholangiocarcinoma/diagnosis , Cholangiocarcinoma/drug therapy , Disseminated Intravascular Coagulation/drug therapy , Humans , Jaundice/drug therapy , Male , Peritoneal Neoplasms/complications , Stomach Neoplasms/complications , Stomach Neoplasms/diagnosis , Stomach Neoplasms/drug therapy
2.
Clin J Gastroenterol ; 13(1): 1-5, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31350718

ABSTRACT

A 52-year-old woman was treated for colorectal diffuse large B-cell lymphoma (DLBCL) after a prolonged treatment period of azathioprine (AZA) and infliximab (IFX) for Crohn's disease (CD). She had been diagnosed as having colonic CD at the age of 24 years and received AZA from age 29. IFX was added at 47 years of age. She experienced massive hematochezia and anal pain at the age of 52 years and was transferred to our hospital. Endoscopic examination revealed a deep rectal ulcer with arterial bleeding. A stoma constructed at the transverse colon for refractory CD relieved her symptoms. Four months later, computed tomography showed increased thickness of the rectal wall. DLBCL was diagnosed from biopsy specimens of the rectum. Treatment with 6 courses of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone along with additional radiation therapy for remnant rectal lymphoma has resulted in complete remission for over 5 years. Although colorectal malignant lymphoma coexisting with active CD was rare and the lesions were difficult to detect, intensive therapy for CD helped in the diagnosis and successful treatment of the patient.


Subject(s)
Antirheumatic Agents/therapeutic use , Azathioprine/therapeutic use , Colorectal Neoplasms/diagnosis , Crohn Disease/drug therapy , Infliximab/therapeutic use , Lymphoma, Large B-Cell, Diffuse/diagnosis , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colorectal Neoplasms/complications , Colorectal Neoplasms/pathology , Colorectal Neoplasms/therapy , Crohn Disease/complications , Crohn Disease/pathology , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Female , Humans , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/pathology , Lymphoma, Large B-Cell, Diffuse/therapy , Middle Aged , Prednisone/therapeutic use , Radiotherapy , Rituximab/therapeutic use , Tomography, X-Ray Computed , Vincristine/therapeutic use
3.
Pathology ; 47(7): 647-52, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26517627

ABSTRACT

CD44 has been identified as a cancer stem cell (CSC) biomarker in various malignancies. The aim of this study was to elucidate the clinicopathological features of CD44v9 positive cells in duodenal adenocarcinoma (DA).Twenty-nine DA patients were selected from medical archives at our hospital. CD44v9 expression was analysed together with that of MUC2, MUC5AC, and MUC6 by immunohistochemistry. High levels of CD44v9 expression weakly correlated with inflammatory cell infiltration (r = 0.431, p = 0.020) and MUC6 expression (r = 0.425, p = 0.022). Furthermore, double immunofluorescence staining of CD44v9 and Ki-67 or cleaved caspase 3 (CC3) was performed. High- and low-density areas of CD44v9 positive cells were designated as CD44v9 positive and negative areas, respectively. Within CD44v9 positive areas, the level of Ki-67 positivity among CD44v9 positive cells was significantly lower than that of CD44v9 negative cells (p = 0.002). Meanwhile, the level of CC3 positivity among CD44v9 positive cells was significantly lower than that of CD44v9 negative cells (p < 0.001).CD44v9 expression may be affected by mononuclear cell infiltration and MUC6 expression in DA. CD44v9 positive cells also have a low mitotic activity and resist apoptosis. These characteristics suggest that CD44v9 positive cells possess CSC-like properties in DA.


Subject(s)
Adenocarcinoma/pathology , Duodenal Neoplasms/pathology , Hyaluronan Receptors/genetics , Neoplastic Stem Cells/pathology , Adenocarcinoma/mortality , Aged , Alternative Splicing , Apoptosis , Biomarkers, Tumor/analysis , Duodenal Neoplasms/mortality , Female , Fluorescent Antibody Technique , Humans , Hyaluronan Receptors/analysis , Hyaluronan Receptors/biosynthesis , Immunohistochemistry , Kaplan-Meier Estimate , Male , Middle Aged , Proportional Hazards Models , Protein Isoforms
4.
Acta Histochem Cytochem ; 48(6): 193-204, 2015 Dec 25.
Article in English | MEDLINE | ID: mdl-26855452

ABSTRACT

The biological characteristics and roles of insulin-like growth factor II mRNA-binding protein 3 protein (IMP3) expression in small-intestinal adenocarcinoma were investigated. The value of IMP3 immunostaining in the diagnosis of small-intestinal epithelial lesions was also evaluated. Immunohistochemical expression of IMP3 in normal small-intestinal mucosa adjacent to adenoma and adenocarcinoma lesions, and inflamed duodenal and ileal mucosa was analyzed. Samples assessed were: duodenal ulcer (n=6), Crohn's disease (n=5), low-grade small-intestinal adenoma (n=10), high-grade small-intestinal adenoma (n=13), small-intestinal adenocarcinoma (n=23), lymph node metastases (LNM; n=7), and preoperative biopsies of small-intestinal adenocarcinoma (n=6). Immunohistochemical expression of Ki-67 and p53 was also analyzed in adenoma and adenocarcinoma samples. IMP3 was not expressed in normal epithelium, but weakly expressed in reparative epithelium. Meanwhile, increased IMP3 expression was associated with a higher degree of dysplasia in adenomas, higher T classification, LNM, Ki-67 positivity, histological differentiation, and lower 5-year disease-free survival, but not p53 expression in adenocarcinoma. IMP3 expression appears to be a late event in the small-intestinal carcinogenesis. Assessing the IMP3 staining pattern can be useful in the diagnosis of small-intestinal epithelial lesions when used in conjunction with other histological criteria.

5.
Intern Med ; 53(18): 2061-5, 2014.
Article in English | MEDLINE | ID: mdl-25224188

ABSTRACT

An adolescent girl presented with inappetence. Upper gastrointestinal endoscopy showed rough and cracked mucosa at the gastric antrum with a scarred duodenal ulcer, and a biopsy sample demonstrated abundant eosinophils. We therefore diagnosed the patient as having eosinophilic gastroenteritis. Eradication therapy for Helicobacter pylori (H. pylori) did not improve her symptoms; however, proton pump inhibitor therapy was effective in resolving her chief complaints. There are several reports of eosinophilic gastroenteritis complicated with H. pylori infection in which the association between eradication therapy and the patient's symptoms is unclear. In the present case, the patient's symptoms did not improve with eradication therapy, and there appeared to be no relationship between the two.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Enteritis/complications , Eosinophilia/complications , Gastritis/complications , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Pyloric Antrum/microbiology , Adolescent , Diagnosis, Differential , Endoscopy, Gastrointestinal , Enteritis/diagnosis , Eosinophilia/diagnosis , Female , Gastritis/diagnosis , Helicobacter Infections/complications , Helicobacter Infections/drug therapy , Humans , Pyloric Antrum/pathology
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