- 著者
- Koyo Kido Reiko Yamada Yuri Maegawa Takamitsu Tanaka Yuhei Umeda Yohei Ikenoyama Hiroki Yukimoto Akina Shigehuku Junya Tsuboi Misaki Nakamura Masaki Katsurahara Yasuhiko Hamada Kyosuke Tanaka Noriyuki Horiki Hayato Nakagawa
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.0003-22, (Released:2022-10-05)
- 参考文献数
- 9
A 64-year-old man with a history of diabetes and gallstones was admitted to our institution with suspected pancreatic malignancy. Computed tomography (CT) revealed multiple pancreatic cysts and massive ascites, and endoscopic ultrasonography (EUS) revealed a 28×27-mm hypoechoic mass in the pancreatic head. An EUS-guided fine-needle aspiration biopsy was performed, and there were no malignant findings. Based on the test results and imaging findings, type 1 autoimmune pancreatitis was suspected. The patient was administered 30 mg of prednisolone daily. After 11 days, CT revealed that the pancreatic cysts and ascites had reduced in size.
- 著者
- Ryuta Shigefuku Kyoko Yoshikawa Mone Tsukimoto Hirono Owa Yasuyuki Tamai Masahiko Tameda Suguru Ogura Ryosuke Sugimoto Hideaki Tanaka Akiko Eguchi Kazushi Sugimoto Hiroshi Hasegawa Motoh Iwasa Hayato Nakagawa
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.9701-22, (Released:2022-06-21)
- 参考文献数
- 14
- 被引用文献数
- 5
A 70-year-old man was diagnosed with hepatocellular carcinoma (HCC) with portal vein invasion and lung metastases, for which atezolizumab plus bevacizumab (ATZ/BEV) was initiated. After two months, computed tomography revealed tumor growth accompanied by ascites, right ventricular invasion, exacerbation of the lung metastases, and main portal vein invasion. However, continuation of ATZ/BEV caused remarkable size reductions in all lesions, finally resulting in the disappearance of the vascular invasion and lung metastases after nine cycles of treatment. The tumor growth was considered to reflect pseudoprogression, which is difficult to distinguish from hyperprogression. We herein report a remarkable HCC case of pseudoprogression on ATZ/BEV.
- 著者
- Yasuhiko Hamada Yuhei Umeda Yohei Ikenoyama Akina Shigefuku Hiroki Yukimoto Misaki Nakamura Masaki Katsurahara Kyosuke Tanaka Noriyuki Horiki Yuka Sugimoto Hayato Nakagawa
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.9733-22, (Released:2022-06-21)
- 参考文献数
- 22
A 44-year-old woman presented with severe anemia. We strongly suspected gastrointestinal bleeding; however, esophagogastroduodenoscopy, colonoscopy, and computed tomography showed no bleeding sources. Video capsule endoscopy revealed an actively bleeding submucosal lesion within the jejunum. Double-balloon enteroscopy revealed a 20-mm continuously bleeding submucosal lesion in the distal jejunum. We suspected small intestinal vascular malformation and performed surgical resection. The resected specimen pathologically comprised dilated, thin-walled lymphatic channels and blood vessels involving the small intestinal submucosa. Therefore, the patient was diagnosed with small intestinal lymphatic-venous malformation. Postoperatively, the patient recovered well, and recurrence was not observed.
- 著者
- Tetsuro Harada Yasuhiko Hamada Kyosuke Tanaka Noriyuki Horiki Hayato Nakagawa
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.9594-22, (Released:2022-06-07)
- 参考文献数
- 20
A 74-year-old man with anemia underwent colonoscopy, which revealed a 4-mm polyp in the ascending colon. The polyp was subsequently diagnosed as an adenomatous lesion according to the narrow-band imaging (NBI) International Colorectal Endoscopic classification/Japan NBI Expert Team classification and resected via cold snare polypectomy (CSP). However, a pathological examination revealed a well-differentiated adenocarcinoma with a positive vertical margin. We performed additional endoscopic resection at the CSP scar area, revealing residual submucosal cancer with lymphatic involvement. The patient then underwent additional surgical resection. In such cases, additional endoscopic resection might be a treatment option.