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Gastrointestinal Variant of Lemierre Syndrome due to Fusobacterium nucleatum: A Case Report. 由核分枝杆菌引起的莱米埃尔综合征胃肠道变异:病例报告。
IF 0.6 Q3 Medicine Pub Date : 2024-03-18 eCollection Date: 2024-01-01 DOI: 10.1159/000536619
Reshad Salam, Abhiroop Verma, Michael Noeske, Lynna Alnimer, Eric M Sieloff, Marc S Piper

Introduction: Pyogenic liver abscess is a noteworthy health concern in North America, characterized by a mortality rate ranging from 2 to 12%. This condition is often polymicrobial, with Streptococcus species and Escherichia coli as the predominant causal pathogens in Western countries. Fusobacterium species, typically commensals of gastrointestinal, genital, and oral flora, have been implicated in the rare formation of tonsillar abscesses and Lemierre syndrome, including its gastrointestinal variant known as pylephlebitis.

Case presentation: We present the case of an immunocompetent male with a 2-week history of abdominal distention and pain. Abdominal magnetic resonance imaging revealed multiseptated cystic hepatic masses and portal vein thrombosis. A subsequent liver biopsy confirmed Fusobacterium nucleatum etiology. The patient was initiated on intravenous cefepime and oral metronidazole antibiotics. Unfortunately, the patient succumbed to cardiac arrest before a final diagnosis could be established.

Conclusion: Fusobacterium species-associated liver abscess, coupled with the rare gastrointestinal variant of Lemierre syndrome (pylephlebitis), poses a significant mortality risk. This case underscores the rarity and clinical challenges associated with these conditions. Increased awareness among clinicians is crucial for early diagnosis and prompt intervention, potentially improving outcomes in such cases.

导言:化脓性肝脓肿是北美地区一个值得关注的健康问题,其死亡率在 2% 到 12% 之间。这种疾病通常由多微生物引起,在西方国家,链球菌和大肠杆菌是主要的致病病原体。镰刀菌通常是胃肠道、生殖器和口腔菌群中的共生菌,与罕见的扁桃体脓肿和莱米埃尔综合征(包括其胃肠道变种,即脓疱疮)的形成有关:本病例为一名免疫功能正常的男性,两周前出现腹胀和腹痛。腹部磁共振成像检查发现了多囊肿性肝肿块和门静脉血栓形成。随后进行的肝活检证实了核酸镰刀菌病因。患者开始接受静脉注射头孢吡肟和口服甲硝唑抗生素治疗。不幸的是,在最终诊断确定之前,患者因心脏骤停而死亡:结论:分枝杆菌相关性肝脓肿,再加上罕见的莱米埃尔综合征胃肠道变异型(静脉炎),具有极大的死亡风险。本病例强调了这些病症的罕见性和临床挑战。提高临床医生的认识对于早期诊断和及时干预至关重要,这有可能改善此类病例的预后。
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引用次数: 0
Duodenal Papillary Metastasis of Lung Cancer with Bleeding Controlled by Endoscopic Treatment and Systemic Osimertinib Therapy: Case Report. 通过内镜治疗和奥希替尼全身治疗控制出血的十二指肠肺癌乳头状转移:病例报告。
IF 0.6 Q3 Medicine Pub Date : 2024-03-12 eCollection Date: 2024-01-01 DOI: 10.1159/000537778
Taiyo Hirata, Shinya Kawaguchi, Taisuke Akamatsu, Atsuko Inagawa, Tomoki Hikichi, Kohei Ohkawa, Kazuhisa Asahara, Tatsunori Satoh, Shinya Endo, Makoto Suzuki, Kazuya Ohno

Introduction: Solid organ malignancies rarely metastasize to the duodenal papilla. We describe a case of primary lung cancer with duodenal papillary metastasis in a patient who presented with melena. To the best of our knowledge, this is only the second report of duodenal papillary metastasis from lung cancer.

Case presentation: A 65-year-old woman presented with complaints of anorexia, weight loss, and black stool. Imaging studies led to a clinical diagnosis of stage IVB lung cancer, and anticoagulants were initiated to treat pulmonary artery thrombosis. However, endoscopic hemostasis was challenging because of bleeding from a duodenal papillary tumor. Fortunately, the patient was positive for the plasma epidermal growth factor receptor (EGFR) gene mutation, and osimertinib, an EGFR tyrosine kinase inhibitor, was administered, successfully achieving hemostasis. Subsequently, endoscopic ultrasonography-guided transbronchial needle aspiration of an enlarged mediastinal lymph node and duodenal papillary tumor biopsy confirmed duodenal papillary metastasis of the primary lung adenocarcinoma.

Conclusion: Although duodenal papillary metastasis is extremely rare, a good clinical outcome was achieved in this case by considering duodenal papillary metastasis from lung cancer as the differential diagnosis and administering systemic osimertinib therapy.

导言:实体器官恶性肿瘤很少转移到十二指肠乳头。我们描述了一例原发性肺癌伴十二指肠乳头转移的病例,患者曾出现血便。据我们所知,这是第二例肺癌十二指肠乳头转移病例:一名 65 岁的妇女主诉厌食、体重减轻和黑便。通过影像学检查,临床诊断为肺癌 IVB 期,并开始使用抗凝药物治疗肺动脉血栓。然而,由于十二指肠乳头状肿瘤出血,内镜止血面临挑战。幸运的是,患者的血浆表皮生长因子受体(EGFR)基因突变呈阳性,于是使用了表皮生长因子受体酪氨酸激酶抑制剂奥希替尼,成功实现了止血。随后,在内镜超声引导下对肿大的纵隔淋巴结进行了经支气管针吸术,并对十二指肠乳头状肿瘤进行了活检,证实了原发肺腺癌的十二指肠乳头状转移:尽管十二指肠乳头转移瘤极为罕见,但通过将肺癌十二指肠乳头转移瘤作为鉴别诊断并给予奥希替尼全身治疗,该病例取得了良好的临床疗效。
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引用次数: 0
Treatment of Gastrointestinal Bleeding in the Biliopancreatic Limb with Embolization in a Patient with Duodenal Switch Anatomy 用栓塞术治疗一名十二指肠开关解剖患者的胆胰管胃肠道出血
IF 0.6 Q3 Medicine Pub Date : 2024-03-08 DOI: 10.1159/000536095
Alice S. Pang, Robert Adamo, Robert M Coben
Abstract Introduction Biliopancreatic diversion with duodenal switch (BPD/DS) is an uncommon type of bariatric surgery that can rarely lead to bleeding in the biliopancreatic limb. The altered anatomy poses significant diagnostic and therapeutic challenges. Case Presentation We present an unusual case of a woman status post-BPD/DS nearly a decade ago who presented with gastrointestinal bleeding in the duodenum of the biliopancreatic limb, a rare phenomenon given the unique surgery. Conclusion We illustrate a promising minimally invasive option of successfully treating the bleeding by interventional radiology (IR) embolization as an alternative to more invasive and challenging options of balloon-assisted enteroscopy, lumen-apposing metal stent placement and surgical intraoperative enteroscopy.
摘要 引言 带十二指肠转换的胆胰转流术(BPD/DS)是一种不常见的减肥手术,很少会导致胆胰肢体出血。解剖结构的改变给诊断和治疗带来了巨大挑战。病例介绍 我们介绍了一例不寻常的病例,该病例是一名女性在近十年前接受胆胰分离手术后出现的胃肠道出血,出血部位位于胆胰段十二指肠,鉴于手术的特殊性,这是一种罕见的现象。结论 我们说明了一种很有前景的微创方案,即通过介入放射学(IR)栓塞术成功治疗出血,以替代更具创伤性和挑战性的球囊辅助肠镜、腔内金属支架置入术和术中肠镜手术。
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引用次数: 0
Phlegmonous Colitis after Cold Snare Polypectomy in an Immunosuppressed Patient: A Case Report. 免疫抑制患者冷卡式息肉切除术后的痰性结肠炎:病例报告。
IF 0.6 Q3 Medicine Pub Date : 2024-03-07 eCollection Date: 2024-01-01 DOI: 10.1159/000536487
Karen Kimura, Chikamasa Ichita, Chihiro Sumida, Takashi Nishino, Miki Nagayama, Jun Kubota, Haruto Hirose, Akiko Sasaki

Introduction: Cold snare polypectomy (CSP) is a procedure with a low risk of complications. Here, we present our experience of a rare case of submucosal abscess following CSP in an immunosuppressed patient.

Case presentation: Seventy-eight-year-old man underwent CSP, developing a fever, chills, and right lower abdominal pain 8 days later. Ultrasound and computed tomography revealed wall thickening of the ascending colon, presenting as whitening and thickening of the same region, and excretion of pus was observed after biopsy. The diagnosis was made as phlegmonous colitis, for which antibiotic therapy was commenced. The patient was diagnosed with chronic myelomonocytic leukemia (CMML) during admission. We considered the following reasons as possible causes of infectious complications after CSP: (1) the patient had a highly immunosuppressed state with comorbidities such as CMML as well as diabetes mellitus and (2) disruption of the mucosal barrier occurred during endoscopic resection.

Conclusion: Although CSP is generally considered safe, our case highlights the potential for serious complications in immunosuppressed patients. Therefore, the decision to perform CSP in such patients should be made with caution to avoid unnecessary interventions. In instances where treatment is essential, thorough bowel preparation and prophylactic antibiotic use may be necessary to mitigate the risks.

简介冷套管息肉切除术(CSP)是一种并发症风险较低的手术。在此,我们介绍一例罕见的免疫抑制患者在接受 CSP 术后出现粘膜下脓肿的病例:78岁的男性接受了CSP手术,8天后出现发热、寒战和右下腹疼痛。超声波和计算机断层扫描显示升结肠壁增厚,表现为同一区域发白和增厚,活检后观察到脓液排出。诊断结果为痰性结肠炎,并开始使用抗生素治疗。患者入院时被诊断为慢性粒细胞白血病(CMML)。我们认为以下原因可能是 CSP 术后感染并发症的原因:(1)患者处于高度免疫抑制状态,患有 CMML 等合并症和糖尿病;(2)内镜切除时破坏了粘膜屏障:虽然 CSP 通常被认为是安全的,但我们的病例强调了免疫抑制患者发生严重并发症的可能性。因此,在决定对此类患者实施 CSP 时应慎之又慎,以避免不必要的干预。在必须进行治疗的情况下,可能有必要进行彻底的肠道准备并预防性使用抗生素,以降低风险。
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引用次数: 0
Laparoscopic Resection of Transverse Colon Cancer with an Anomaly of the Middle Colic Artery Originating from the Splenic Artery: A Case Report. 腹腔镜横结肠癌切除术,伴有源自脾动脉的结肠中动脉异常:病例报告。
IF 0.6 Q3 Medicine Pub Date : 2024-03-04 eCollection Date: 2024-01-01 DOI: 10.1159/000536672
Maeda Yoshiaki, Nozomi Minagawa, Takuya Kato, Naoki Okada, Takuto Suzuki, Chihiro Ishizuka, Akihisa Fukuda, Yoichi Mori

Introduction: We encountered a colon cancer case with a very rare anomaly of the middle colic artery (MCA) originating from the splenic artery (SA).

Case presentation: A woman was referred to our hospital for transverse colon cancer. Three-dimensional computed tomography (3D-CT) angiography showed an anomalous MCA originating from the SA rather than from the superior mesenteric artery (SMA) as is typical. Laparoscopic left hemicolectomy with D3 lymph node dissection was performed. The lymph nodes around the SMA were dissected from the caudal view, confirming the absence of a typical MCA. An anomalous SA-originating MCA was identified just below the pancreas, where it was clipped and ligated; subsequently, total mesenteric excision was achieved.

Conclusion: As D3 lymph node dissection for transverse colon cancer is technically difficult, 3D-CT angiography is useful for identifying vascular anomalies preoperatively, thereby avoiding intraoperative injury. This is the first case report of laparoscopic colectomy associated with a SA-originating MCA anomaly.

导言:我们遇到了一个结肠癌病例,其结肠中动脉(MCA)起源于脾动脉(SA),这种异常非常罕见:我们遇到了一个结肠癌病例,其结肠中动脉(MCA)起源于脾动脉(SA),这种异常情况非常罕见:一名女性因横结肠癌转诊至我院。三维计算机断层扫描(3D-CT)血管造影显示,异常的 MCA 起源于脾动脉(SA),而不是典型的肠系膜上动脉(SMA)。患者接受了腹腔镜左半结肠切除术和 D3 淋巴结清扫术。从尾部视角解剖了SMA周围的淋巴结,证实没有典型的MCA。在胰腺下方发现了异常的起源于SA的MCA,对其进行了剪切和结扎;随后进行了肠系膜全切:结论:横结肠癌的 D3 淋巴结清扫术在技术上有一定难度,3D-CT 血管造影有助于术前发现血管异常,从而避免术中损伤。这是首例腹腔镜结肠切除术伴有SA源性MCA异常的病例报告。
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引用次数: 0
Endoscopic Hemostatic Treatment with a Novel Self-Assembling Peptide Gel for Precut Fistulotomy-Related Bleeding. 用新型自组装肽凝胶进行内窥镜止血治疗,治疗瘘管切开术前出血。
IF 0.6 Q3 Medicine Pub Date : 2024-03-04 eCollection Date: 2024-01-01 DOI: 10.1159/000536620
Kimitoshi Kubo, Xinhan Zhang, Ikko Tanaka

Introduction: Precut fistulotomy is of interest as one of the salvage techniques for selective bile duct cannulation using endoscopic retrograde cholangiopancreatography. Of the various endoscopic treatments reported to date for bleeding associated with papillotomy incision, endoscopic hemostasis treatment with a novel self-assembling peptide (SAP) matrix-forming gel (TDM-621) (3-D Matrix Ltd., Tokyo, Japan) remains only insufficiently reported in the literature.

Case presentation: We herein report 6 cases of precut fistulotomy-related bleeding successfully treated with endoscopic hemostasis treatment with TDM-621, i.e., 5 and 1 cases during and after precut fistulotomy, respectively, in 2 males and 4 females aged 68-96 years (mean age, 85 years), 3 of whom had been on antithrombotic drugs. Types of bleeding treated included oozing bleeding (n = 5) and oozing bleeding from a visible vessel (n = 1). In all cases, complete hemostasis was achieved with TDM-621 without causing rebleeding.

Conclusion: Endoscopic hemostasis with TDM-621 may prove effective for precut fistulotomy-related bleeding and represent a potential modality of first choice in hemostasis. In addition, endoscopic hemostasis with combined modality therapy using TDM-621 and endoscopic hemoclips may prove effective for bleeding from visible vessels.

导言:预切瘘管切开术是使用内镜逆行胰胆管造影进行选择性胆管插管的挽救技术之一,因此备受关注。迄今为止,针对乳头切开术切口相关出血的各种内镜治疗方法中,使用新型自组装肽(SAP)基质形成凝胶(TDM-621)(3-D Matrix Ltd.,日本东京)进行内镜止血治疗的文献报道仍然不足:我们在此报告了 6 例与瘘管切开术前相关的出血病例,通过使用 TDM-621 进行内窥镜止血治疗获得成功,其中 5 例发生在瘘管切开术前,1 例发生在瘘管切开术后,患者为 2 男 4 女,年龄在 68-96 岁之间(平均年龄 85 岁),其中 3 人曾服用抗血栓药物。治疗的出血类型包括渗出性出血(5 例)和可见血管渗出性出血(1 例)。在所有病例中,TDM-621都能实现完全止血,且不会导致再出血:结论:使用TDM-621进行内镜下止血可有效治疗瘘管切开术前相关出血,是一种潜在的首选止血方式。此外,使用TDM-621和内镜血夹的内镜止血联合疗法可能对可见血管出血有效。
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引用次数: 0
Rare Benign Focal Lesions of the Liver: Report of 2 Cases and Literature Review. 罕见的肝脏良性病灶:2例病例报告和文献综述。
IF 0.6 Q3 Medicine Pub Date : 2024-03-04 eCollection Date: 2024-01-01 DOI: 10.1159/000536111
Kristína Cmarková, Lenka Nosáková, Miroslav Pindura, Martin Vojtko, Peter Bánovčin, Juraj Miklušica

Introduction: Benign lesions of the liver are very common findings, usually randomly discovered, especially during examinations for other indications. The frequent use of imaging modalities may be responsible for the statistical increase in the incidence of these findings.

Case presentation: In this publication, we present the cases of 2 female patients with benign liver lesions, the occurrence of which is considered rare, and only a few dozen cases have been described worldwide. In both cases, clinical symptoms, diagnostic approach, and surgical treatment are presented.

Conclusion: Due to increasing availability of imaging methods, the occurrence of previously considered rare benign liver lesions increases as well. In many cases, the malignant potential of these findings remains unclear. Decision-making process should include a multidisciplinary board.

导言肝脏良性病变是非常常见的检查结果,通常是随机发现的,尤其是在因其他适应症进行检查时。影像学手段的频繁使用可能是导致此类病变发病率统计数字增加的原因:在这篇论文中,我们介绍了两名女性肝脏良性病变患者的病例,这种病变的发生被认为是罕见的,全世界仅有几十例。本文介绍了这两例患者的临床症状、诊断方法和手术治疗:结论:由于影像学方法的日益普及,以前被认为罕见的肝脏良性病变的发生率也在增加。在许多病例中,这些发现的恶性可能性仍不明确。决策过程应包括多学科委员会。
{"title":"Rare Benign Focal Lesions of the Liver: Report of 2 Cases and Literature Review.","authors":"Kristína Cmarková, Lenka Nosáková, Miroslav Pindura, Martin Vojtko, Peter Bánovčin, Juraj Miklušica","doi":"10.1159/000536111","DOIUrl":"10.1159/000536111","url":null,"abstract":"<p><strong>Introduction: </strong>Benign lesions of the liver are very common findings, usually randomly discovered, especially during examinations for other indications. The frequent use of imaging modalities may be responsible for the statistical increase in the incidence of these findings.</p><p><strong>Case presentation: </strong>In this publication, we present the cases of 2 female patients with benign liver lesions, the occurrence of which is considered rare, and only a few dozen cases have been described worldwide. In both cases, clinical symptoms, diagnostic approach, and surgical treatment are presented.</p><p><strong>Conclusion: </strong>Due to increasing availability of imaging methods, the occurrence of previously considered rare benign liver lesions increases as well. In many cases, the malignant potential of these findings remains unclear. Decision-making process should include a multidisciplinary board.</p>","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tumor-Induced Osteomalacia in a Patient with Crohn's Disease: A Case Report and Approach to Investigating Hypophosphatemia. 一名克罗恩病患者因肿瘤引发的骨质疏松症:病例报告和低磷血症的调查方法。
IF 0.6 Q3 Medicine Pub Date : 2024-02-26 eCollection Date: 2024-01-01 DOI: 10.1159/000536136
Kate Hawke, Anthony Croft, Syndia Lazarus

Introduction: Hypophosphatemia occurs commonly in inflammatory bowel disease (IBD) patients and can cause considerable morbidity. The differential diagnoses in IBD include nutritional causes and hypophosphatemia induced by some formulations of intravenous iron infusions.

Case presentation: We present the case of a 37-year-old man with active Crohn's disease, presenting with difficulty walking and fractures of the vertebrae and calcaneus. He had long-standing hypophosphatemia. Nutritional causes for hypophosphatemia were considered in the first instance given the presence of chronic diarrhea and vitamin D deficiency; however, there was minimal response to appropriate supplementation with oral phosphorous and vitamin D. Iron infusion-induced hypophosphatemia was then considered, but the nadir phosphate level preceded any iron infusion. Therefore, work-up was undertaken for less common causes. He was ultimately diagnosed with tumor-induced osteomalacia, caused by excess fibroblast growth factor 23 (FGF23) secretion from a phosphaturic mesenchymal tumor about the knee. He had complete resolution of symptoms and biochemical abnormalities following successful resection of the tumor.

Conclusion: This case illustrates the approach to investigation of hypophosphatemia in IBD patients. If the time course and response to phosphate supplementation are not as expected for nutritional or iron infusion-induced hypophosphatemia, less common causes should be considered.

导言:低磷酸盐血症常见于炎症性肠病(IBD)患者,可导致相当高的发病率。IBD 的鉴别诊断包括营养原因和由静脉注射铁剂引起的低磷血症:本病例是一名患有活动性克罗恩病的 37 岁男子,表现为行走困难、椎骨和小腿骨骨折。他长期患有低磷血症。由于存在慢性腹泻和维生素 D 缺乏症,低磷酸盐血症首先考虑了营养原因;然而,对口服磷和维生素 D 的适当补充反应甚微。因此,医生又对一些不太常见的原因进行了检查。他最终被诊断为肿瘤诱发的骨软化症,原因是膝关节磷酸盐间质瘤分泌过多的成纤维细胞生长因子23(FGF23)。成功切除肿瘤后,他的症状和生化异常完全消失:本病例说明了检查 IBD 患者低磷酸盐血症的方法。如果营养或铁输注引起的低磷血症的时间过程和对磷酸盐补充剂的反应与预期不符,则应考虑不太常见的原因。
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引用次数: 0
Portal Vein Aneurysm in a Patient with Cirrhosis Type C Controlled by Direct-Acting Antiviral Treatment 通过直接作用抗病毒治疗控制一名 C 型肝硬化患者的门静脉动脉瘤
IF 0.6 Q3 Medicine Pub Date : 2024-02-16 DOI: 10.1159/000535957
Sena Higashi, T. Nakabori, Kaori Mukai, Yusuke Seiki, Ko Watsuji, Takeru Hirao, Yasuharu Kawamoto, M. Urabe, Yugo Kai, R. Takada, Takuo Yamai, K. Ikezawa, Hiroyuki Uehara, K. Ohkawa
Abstract Introduction Portal vein aneurysm (PVA) is a rare saccular or fusiform portal vein dilatation. The management and optimal treatment of PVA remain unknown. Case Presentation A 53-year-old man with hepatitis C virus (HCV) infection was diagnosed with PVA measuring 28 mm in diameter. Under observation, his liver fibrosis progressed, and the PVA diameter gradually increased to 52 mm. The patient was treated with elbasvir-grazoprevir for 12 weeks, and HCV disappeared. After achieving sustained virological response, liver fibrosis improved and the PVA progression ceased. Conclusion HCV clearance by direct-acting antiviral treatment not only regressed liver fibrosis but may have also restrained the progression of PVA in a patient with cirrhosis type C and PVA.
摘要 引言 门静脉瘤(PVA)是一种罕见的囊状或纺锤形门静脉扩张。门静脉瘤的处理和最佳治疗方法尚不清楚。病例介绍 一名 53 岁的丙型肝炎病毒(HCV)感染者被诊断出患有直径 28 毫米的门静脉瘤。在观察期间,他的肝纤维化进展,PVA 直径逐渐增加到 52 毫米。患者接受了为期12周的艾伯沙韦-格拉唑吡韦治疗,HCV消失。在获得持续病毒学应答后,肝纤维化得到改善,PVA 进展停止。结论 通过直接作用抗病毒治疗清除 HCV 不仅能缓解肝纤维化,还能抑制 C 型肝硬化合并 PVA 患者的 PVA 进展。
{"title":"Portal Vein Aneurysm in a Patient with Cirrhosis Type C Controlled by Direct-Acting Antiviral Treatment","authors":"Sena Higashi, T. Nakabori, Kaori Mukai, Yusuke Seiki, Ko Watsuji, Takeru Hirao, Yasuharu Kawamoto, M. Urabe, Yugo Kai, R. Takada, Takuo Yamai, K. Ikezawa, Hiroyuki Uehara, K. Ohkawa","doi":"10.1159/000535957","DOIUrl":"https://doi.org/10.1159/000535957","url":null,"abstract":"Abstract Introduction Portal vein aneurysm (PVA) is a rare saccular or fusiform portal vein dilatation. The management and optimal treatment of PVA remain unknown. Case Presentation A 53-year-old man with hepatitis C virus (HCV) infection was diagnosed with PVA measuring 28 mm in diameter. Under observation, his liver fibrosis progressed, and the PVA diameter gradually increased to 52 mm. The patient was treated with elbasvir-grazoprevir for 12 weeks, and HCV disappeared. After achieving sustained virological response, liver fibrosis improved and the PVA progression ceased. Conclusion HCV clearance by direct-acting antiviral treatment not only regressed liver fibrosis but may have also restrained the progression of PVA in a patient with cirrhosis type C and PVA.","PeriodicalId":9614,"journal":{"name":"Case Reports in Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gastric Adenocarcinoma with Enteroblastic Differentiation Resected through Endoscopic Submucosal Dissection: A Case Report. 通过内镜粘膜下剥离术切除的肠细胞分化型胃腺癌:病例报告。
IF 0.6 Q3 Medicine Pub Date : 2024-02-08 eCollection Date: 2024-01-01 DOI: 10.1159/000535954
Akira Ishikawa, Koki Nakamura

Introduction: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare histological type of gastric adenocarcinoma that occurs in the stomach and is known for its aggressive behavior. GAED is diagnosed histopathologically and is often advanced at the time of diagnosis.

Case presentation: We report the case of a 70-year-old male with a 20-mm superficial depressed lesion on the anterior wall of the antrum. Histological examination of the endoscopic submucosal dissection specimen revealed that the tumor was composed of dilated or slit-like branching tubules; additionally, the tumor cells had clear cytoplasm resembling that of the fetal digestive tract. Immunohistochemically, the tumor cells were positive for Glypican-3 and alpha-fetoprotein. A pathological diagnosis of GAEDs was established. GAED was found in approximately 30% of all the tumor cells and showed lymphatic invasion. The patient has been under recurrence-free follow-up for approximately 1 year after the endoscopic submucosal dissection.

Conclusion: In order to detect a large number of cases, immunostaining should be aggressively performed if morphological findings are suspicious for GAED.

简介有肠细胞分化的胃腺癌(GAED)是一种发生在胃部的罕见组织学类型的胃腺癌,以其侵袭性著称。GAED 通过组织病理学诊断,确诊时往往已是晚期:我们报告了一例 70 岁男性的病例,他的胃窦前壁有一个 20 毫米的浅表凹陷性病变。内镜粘膜下剥离标本的组织学检查显示,肿瘤由扩张或裂缝状的分支小管组成;此外,肿瘤细胞的细胞质清晰,与胎儿消化道的细胞质相似。免疫组化结果显示,肿瘤细胞的 Glypican-3 和甲胎蛋白呈阳性。病理诊断确定为 GAED。所有肿瘤细胞中约有 30% 发现了 GAED,并显示出淋巴侵袭。内镜粘膜下剥离术后,患者随访约 1 年无复发:为了发现更多的病例,如果形态学结果怀疑是 GAED,则应积极进行免疫染色。
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引用次数: 0
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Case Reports in Gastroenterology
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