ABSTRACT
A man in his 60s with hyperamylasemia underwent contrast-enhanced computed tomography, which revealed masses in his pelvic cavity on the right side and in the left axilla. Hence, a detailed examination was performed. Upon performing Sonazoid® (perfluorobutane) contrast-enhanced ultrasound, it was discovered that the right-sided pelvic cavity mass exhibited centripetal contrast-enhancement right from the early stage. Subsequently, the contrast material disappeared from the center and was washed out in the postvascular phase. The mass was suspected to be caused by vascular malformations. The right-sided pelvic cavity mass was excised, and upon histopathological examination, it was detected to be composed of capillary malformations. Thus, it was found that Sonazoid® contrast-enhanced ultrasound examination could aid in diagnosing retroperitoneal masses.
Subject(s)
Contrast Media , Ferric Compounds , Iron , Oxides , Ultrasonography , Humans , Male , Fluorocarbons , Retroperitoneal Space/diagnostic imaging , Capillaries/diagnostic imaging , Capillaries/abnormalities , Capillaries/pathology , Vascular Malformations/diagnostic imaging , Middle AgedABSTRACT
Sleeve gastrectomy was covered by Japan's national health insurance as bariatric surgery for morbid obesity in 2014. There are a few cases of gastric bypass surgery, which is a different procedure. Given that the current incidence of gastric cancer in Japan is higher than that in the EU and US, the difficulty that gastric bypass surgery presents in examining the bypassed stomach necessitates a cautious approach to the indication of gastric bypass surgery in Japan. We present the case of a woman in her fifties who developed gastric cancer in the bypassed stomach 12 years after undergoing a laparoscopic Roux-en-Y gastric bypass. When a patient develops anemia and abdominal symptoms after bariatric surgery, the surgical procedure should be considered in the inspection.
Subject(s)
Gastric Bypass , Laparoscopy , Obesity, Morbid , Stomach Neoplasms , Female , Gastrectomy/methods , Gastric Bypass/adverse effects , Gastric Bypass/methods , Humans , Japan , Laparoscopy/methods , Obesity, Morbid/surgery , Stomach Neoplasms/etiology , Stomach Neoplasms/surgery , Treatment OutcomeABSTRACT
We report a case of a 68-year-old woman with chronic hepatitis C who presented with a small hepatocellular carcinoma in segment 8 (S8) of liver and a portal hepatic tumor. Transhepatic arterial infusion therapy was performed, followed by partial hepatic resection of S8 and excision of the portal hepatic tumor with lymph node metastasis. Histologically, the lymph nodes showed marked infiltration of large histiocytes with clear cytoplasm and emperipolesis in the specimen stained with hematoxylin-eosin. These findings were generally compatible with the histological features of Rosai-Dorfman disease (RDD). However, immunohistochemical analysis revealed the proliferating histiocytes were negative for CD1a, CD68 and S-100 protein, but positive for only lysozyme. Therefore, we finally diagnosed it as a disease similar to RDD. This was a difficult case diagnostically distinguish between metastasis and benign disease.
Subject(s)
Carcinoma, Hepatocellular/pathology , Histiocytosis, Sinus/pathology , Liver Neoplasms/pathology , Lymph Nodes/pathology , Lymphatic Diseases/pathology , Aged , Female , Histiocytosis, Sinus/diagnosis , Humans , Lymphatic Diseases/diagnosis , Lymphatic Metastasis/diagnosis , Lymphatic Metastasis/pathology , Portal SystemABSTRACT
The patient was a 61-year-old female with alcoholic liver cirrhosis, who was admitted to our hospital due to elevation of AFP.During the evaluation, both abdominal ultrasound and enhanced abdominal CT revealed a hepatocellular carcinoma measuring 4 cm in the S6-7 region, complicated with an arteriovenous shunt.Additionally, the lung CT examination showed 20 isolated bilateral lung tumors, all of which were less than 1.4 cm in diameter. Following the diagnosis, we performed a transcatheter arterial infusion chemotherapy of SMANCS at 3 mg through the right heptic artery. Thereafter, the AFP level returned to normal. Additionally, the tumors previously observed in both liver and lung, and exhibited by both lung CT and enhanced abdominal MRI, had disappeared.The patient has been in clinical remission more than 10 years to date.
Subject(s)
Carcinoma, Hepatocellular/drug therapy , Liver Neoplasms/drug therapy , Lung Neoplasms/drug therapy , Maleic Anhydrides/therapeutic use , Polystyrenes/therapeutic use , Zinostatin/analogs & derivatives , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/pathology , Disease-Free Survival , Female , Humans , Infusions, Intra-Arterial , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/secondary , Magnetic Resonance Imaging , Maleic Anhydrides/administration & dosage , Middle Aged , Polystyrenes/administration & dosage , Time Factors , Tomography, X-Ray Computed , Zinostatin/administration & dosage , Zinostatin/therapeutic useABSTRACT
We report a case of hemostatic treatment by transcatheter arterial embolization (TAE) of the left gastric artery and a branch of the left bronchial artery for oozing hemorrhage in the lower esophagus, because of incomplete endoscopic hemostasis. A 52-year-old woman with systemic lupus erythematosus was previously admitted three times to our hospital for endoscopic treatment of hemorrhage in the lower esophageal lesions. The procedure of TAE for esophageal hemorrhage seems to be a useful treatment for cases of incomplete endoscopic hemostasis.
