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Shimane Prefecture, Japan

Miyaoka Y.,Shimane Prefecture Central Hospital | Tsukano K.,Shimane Prefecture Central Hospital | Ueno S.,Shimane Prefecture Central Hospital | Yamanouchi S.,Shimane Prefecture Central Hospital | And 6 more authors.
Gastroenterological Endoscopy | Year: 2015

A 29-year-old man who had received a diagnosis of Crohn's disease (CD) in 2001 was referred to our department because of relapse of CD. Upper gastrointestinal endoscopy revealed white stipple-like exudates and red linear furrows in the esophagus, and pathological examination of biopsied specimens showed infiltration of eosinophils which was confirmed by the presence of more than 20 eosinophils in every high-power field. Eosinophilic esophagitis (EoE) was suspected ; however, only treatment for CD was started, because the patient was asymptomatic for EoE with no dysphagia, food impaction nor heartburn. After induction of remission of CD, the patient developed food impaction and heartburn without a change in endoscopic and pathological findings. Therefore, the diagnosis of EoE was confirmed. Swallowed fluticasone therapy was provided for 8 weeks. The patient's symptoms improved immediately, and the endoscopic and histologic findings improved as well. EoE in patients with CD is very rare. Source


Miyaoka Y.,Shimane Prefecture Central Hospital | Izumi D.,Shimane Prefecture Central Hospital | Mikami H.,Shimane Prefecture Central Hospital | Yasaki T.,Shimane Prefecture Central Hospital | And 6 more authors.
Gastroenterological Endoscopy | Year: 2011

A 59-year-old woman has been undergoing treatment for asymptomatic primary biliary cirrhosis since 2003. She was admitted to our hospital because of further examination and for treatment of a gastric lesion in July, 2009. Endoscopic examination showed a normal and slightly discolored flat lesion and its extra-border was unclear. Besides, examinations had revealed almost no change for two years and three months. Histology of the biopsy specimens revealed a normal gastric mucosa in 2007 and 2008. However, in April 2009 the possibility of gastric carcinoma was suspected based on HE staining and Ki-67 immunohistochemical analysis. ESD was performed in July, 2009. Histopathology of the resected specimen revealed an extremely well differentiated adenocarcinoma [SM1, 0-IIb, ly0, v0]. The surface of mucosa consisted of normal epithelium. The tumor's phenotype was classified as gastric-type. Besides, Pepsinogen-I immunohistochemistry was positive, so this tumor was identified fundic gland type. No recurrence has been seen in our patient for about seventeen months after ESD. Source


Uno G.,Shimane Prefecture Central Hospital | Miyaoka Y.,Shimane Prefecture Central Hospital | Hukazawa K.,Shimane Prefecture Central Hospital | Kamiyama S.,Shimane Prefecture Central Hospital | And 6 more authors.
Gastroenterological Endoscopy | Year: 2011

A 65-year-old man was admitted for epigastralgia and tarry stools. The diagnosis, based on the examination findings, was that the tumor with a stalk from the pylorus had invaginated into the duodenum. We conducted distal gastrectomy. The histopathological findings revealed that the tumor was composed of both carcinomatous and sarcomatous components which had an epithelial character. The pathologic diagnosis of the tumor was "so-called carcinosarcoma". About 67 cases of gastric carcinosarcoma have been reported in Japan previously. We summarized the clinical presentation. Our case is a rare pattern in which the tumor invaginated into the duodenum. We report herein on the case together with some discussion from the relevant literature. Source

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