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Hata, Japan

Akimori T.,Hata Kenmin Hospital | Maeda H.,Cancer Treatment Center | Okamoto K.,Cancer Treatment Center | Usui T.,Tano Hospital | Kobayashi M.,Cancer Treatment Center
Annals of Cancer Research and Therapy | Year: 2015

Background: Peliosis is characterized by multiple cyst-like blood-filled cavities, and is potentially hazardous because of he possibility of spontaneous rupture. Herein, we describe a patient with ectopic spleen accompanied by peliosis and epithelial yst, which mimicked a pancreatic cystic neoplasm. ase: A 44-year-old asymptomatic male patient was referred for treatment of an enlarged mass in the pancreatic tail. bdominal computed tomography and magnetic resonance imaging revealed a 3.5-cm cystic lesion with a clear, thick, and mooth cyst wall, which was enhanced by contrast media. Under a tentative diagnosis of mucinous cystic neoplasm of the ancreas, the patient underwent distal pancreatectomy. Postoperative pathological examination identified the lesions as eliosis and epithelial cyst of the intrapancreatic heterotopic spleen. onclusion: Cystic formations in the intrapancreatic spleen mimic mucin-producing neoplastic lesions and can be misdiagnosed. eliosis may cause rapid growth of the cysts, mistakenly indicating a malignant potential of the lesion. © 2015, PJD Publications Ltd. All rights reserved.

Kataoka Y.,Hata Kenmin Hospital
Magnetic Resonance in Medical Sciences | Year: 2011

We report 2 cases of primary breast cancer with swelling of the parasternal lymph nodes detected on diffusion-weighted imaging (DWI) as small parasternal nodules. After neoadjuvant chemotherapy, DWI showed disappearance of one node but a focus of subtle signal hyperintensity in the other. DWI findings correlated with the results of conventional breast contrast-enhanced magnetic resonance imaging before and after neoadjuvant chemotherapy.

Namikawa T.,Kochi Medical School | Ozaki S.,Hata Kenmin Hospital | Okabayashi T.,Kochi Medical School | Dabanaka K.,Kochi Medical School | And 3 more authors.
Journal of Clinical Gastroenterology | Year: 2011

Background and Goals: Idiopathic perforation of the colon (IPC) is an extremely rare disease, the pathogenesis of which remains poorly understood. We investigate the clinical characteristics of IPC to help improve the diagnosis and treatment of this rare condition. Study: We performed a retrospective evaluation of 16 IPC cases diagnosed from 1999 to 2009 which included clinical findings, laboratory data, treatment procedure, and outcome. Results: The most common site of colon perforation was the sigmoid colon (56.3%) followed by the transverse colon (25%). The median age of the IPC patient group was 72.5 years (range: 50 to 86 y) and the mortality rate for the IPC patient group was 18.8%. Eleven patients (68.8%) had a history of chronic constipation. Creatine phosphokinase (CPK) levels were significantly higher in the survivor group than the deceased group (182 U/L vs. 50 U/L; P=0.024), and CPK levels were higher in patients with constipation than in those without constipation (187 U/L vs. 46 U/L; P=0.024). Computed tomography images showed either free air or a dirty mass that indicated extraluminal feces in all cases. The median size of a perforation was 2.0 cm (range: 0.5 to 8.0 cm). Fourteen patients had resection of the perforation segment and colostomy and 2 of these patients had resection without diverting colostomy. Conclusions: IPC most commonly occurs in the sigmoid colon of elderly people who have chronic constipation. Although chronic constipation is correlated with high CPK levels, other factors, such as poor nutrition status or a delay in treatment, may be associated with an increased mortality rate in IPC patients. Copyright © 2011 by Lippincott Williams & Wilkins.

Akimori T.,Hata Kenmin Hospital | Kanagawa T.,Hata Kenmin Hospital | Fujisawa K.,Hata Kenmin Hospital | Kamioka N.,Hata Kenmin Hospital | And 2 more authors.
Annals of Cancer Research and Therapy | Year: 2015

Pneumatosis intestinalis is a condition characterized by the presence of gas within the wall of the small or large intestine. The causes, clinical features, and prognosis vary among individual cases, and careful assessment is crucial for appropriate treatment. Herein, we describe three cases of pneumatosis intestinalis with different clinical features. The small intestine was involved in two patients, whereas the ascending colon was involved in the third patient. Surgical intervention was chosen in two patients because of severe abdominal pain, decreased base excess, and the presence of portal venous gas (in one patient). However, there were no signs of intestinal necrosis on pathological examination. In the third case, computed tomography revealed free air within the peritoneum. Despite this, the patient was not experiencing any severe abdominal pain or deterioration of vital signs, and was treated successfully with fasting and antibiotics. The third patient was on several medications, such as immunosuppressant, prednisolone for cutaneous malignant lymphoma, and α-glucosidase inhibitor for diabetes mellitus, and the condition was suggested as drug-induced pneumatosis intestinalis. In conclusion, patients with pneumatosis intestinalis present with various clinical features from critical to mild conditions. Some are accompanied by severe signs such as portal venous gas, intraperitoneal free air, and metabolic acidosis, necessitating urgent intervention; contrarily, the other can be managed conservatively. For successful treatment, the evaluation of the severity of the disease and the accompanying conditions such as perforation and necrosis of the intestine is mandatory.

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