JaLCDOI 10.18926/AMO/57377
フルテキストURL 73_5_457.pdf
著者 Iwamuro, Masaya| Takahara, Masahiro| Yamazaki, Tatsuhiro| Tanaka, Takehiro| Kondo, Yoshitaka| Hiraoka, Sakiko| Okada, Hiroyuki|
抄録 A 60-year-old Caucasian male was diagnosed with lung adenocarcinoma and multiple metastases to the bone, spleen, and brain. He underwent radiotherapy for the brain and lumbar spine metastases, plus chemotherapy (cisplatin and pemetrexed). The chemotherapy was discontinued due to vomiting and hyponatremia, and nivolumab was then administered. Eight months later, 18F-fluorodeoxyglucose positron emission tomography showed tracer uptake in the colon. Colonoscopy revealed a reddish multinodular polyp in the sigmoid colon. The polyp showed irregular microvessels. No colonic mucosal surface structures were observed. Colonic metastasis of the lung carcinoma was highly suspected; the polyp was therefore surgically removed. The histological analysis revealed granulation tissue and suppurative inflammation without neoplastic changes. We diagnosed the lesion as a granulation polyp. Despite the difficulty in diagnosing these lesions due to their rarity and similarity to metastatic colon tumors, we suggest that recognizing the endoscopic features of the polyp surface may allow a preoperative diagnosis.
キーワード colonoscopy colonic neoplasms granulation polyp
Amo Type Case Report
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 457
終了ページ 461
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649373
Web of Sience KeyUT 000491886600012
JaLCDOI 10.18926/AMO/55436
フルテキストURL 71_5_391.pdf
著者 Iwamuro, Masaya| Takata, Katsuyoshi| Hayashi, Eiko| Kawano, Seiji| Hiraoka, Sakiko| Kawahara, Yoshiro| Yoshino, Tadashi| Okada, Hiroyuki|
抄録  To evaluate the usefulness of colonoscopy for the detection of ileal involvement in patients with intestinal follicular lymphoma, seventeen patients with intestinal follicular lymphoma who underwent colonoscopy and biopsy sampling from the terminal ileum were enrolled. The patients were divided into 2 groups: cases with ileal involvement (n=6) and cases without ileal involvement (n=11). Patients’ clinical backgrounds were compared between the two groups. Subsequently, 10 board-certified endoscopists independently evaluated the endoscopic pictures and determined whether the ileum was involved with follicular lymphoma. Infiltration of follicular lymphoma cells were identified in 6 patients (35.3%). Cases with positive ileal involvement were diagnosed with follicular lymphoma at a younger age than were cases without ileal involvement (55.4±7.4 vs. 68.1±10.3 years, p=0.011). Macroscopically, in patients with ileal involvement, there were multiple polypoid elevations smaller than 5 mm in 4 cases, single polypoid elevation smaller than 5 mm in 1 case, and single polypoid elevation larger than 5 mm in 1 case. In patients without ileal involvement, there were no lesions in the terminal ileum in 7 cases, and multiple polypoid elevations smaller than 5 mm were seen in 4 cases. The accuracy of the macroscopic evaluation by 10 board-certified endoscopists was 68.8%. Colonoscopy is particularly recommended during the initial workup of patients with follicular lymphoma diagnosed at age ≤ 60 years. The diagnosis of ileal involvement based on morphology alone is difficult; thus, biopsy and pathologic diagnosis are required for accurate diagnosis.
キーワード follicular lymphoma colonoscopy ileal neoplasms terminal ileum small intestine
Amo Type Original Article
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 391
終了ページ 398
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042696
JaLCDOI 10.18926/AMO/55207
フルテキストURL 71_3_241.pdf
著者 Iwamuro, Masaya| Tanaka, Shouichi| Moritou, Yuki| Inaba, Tomoki| Higashi, Reiji| Kusumoto, Chiaki| Yunoki, Naoko| Ishikawa, Shin| Okamoto, Yuko| Kawai, Yoshinari| Kitada, Ken-ichi| Takenaka, Ryuta| Toyokawa, Tatsuya| Okada, Hiroyuki|
抄録  Most gastric bezoars can be treated with endoscopic fragmentation combined with or without cola dissolution, whereas laparotomy or laparoscopic surgery is generally inevitable for small intestinal bezoars because they cause small bowel obstruction. Therefore, early diagnosis and management of gastric bezoars are necessary to prevent bezoar-induced ileus. To investigate the incidence of overlooked gastric bezoars during the initial esophagogastroduodenoscopy, we retrospectively reviewed the cases of 27 patients diagnosed with gastrointestinal bezoars. The bezoars were diagnosed using esophagogastroduodenoscopy (n=25), abdominal ultrasonography (n=1), and barium follow-through examination (n=1). Bezoars were overlooked in 9/25 patients (36.0%) during the initial endoscopy examination because the bezoars were covered with debris in the stomach. Of the 9 patients, 8 had concomitant gastric ulcers, and the other patient had gastric lymphoma. Although a computed tomography (CT) scan was performed before the second-look endoscopy in 8 of the 9 patients, the bezoars were mistaken as food debris on CT findings and were overlooked in these patients. In conclusion, gastric bezoars may not be discovered during the initial esophagogastroduodenoscopy and CT scan. In cases with debris in the stomach, second-look endoscopy is essential to detect bezoars.
キーワード bezoar gastric ulcer foreign bodies phytobezoar
Amo Type Original Article
発行日 2017-06
出版物タイトル Acta Medica Okayama
71巻
3号
出版者 Okayama University Medical School
開始ページ 241
終了ページ 247
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28655944
JaLCDOI 10.18926/AMO/54977
フルテキストURL 71_2_97.pdf
著者 Iwamuro, Masaya| Kondo, Eisei| Tanaka, Takehiro| Hagiya, Hideharu| Kawano, Seiji| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki|
抄録 We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.
キーワード cytomegalovirus duodenum esophagogastroduodenoscopy esophagus stomach
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 97
終了ページ 104
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420890
タイトル(別表記) Changes of colonic mucosa caused by long-term use and discontinuation of anthraquinone
著者 岩野 英二| 岩室 雅也| 岡田 裕之|
抄録 Anthraquinone, an anthracene derivatives, is widely used as a purgative medicine. The long-term use of anthraquinone is known to cause melanosis coli and elevated lesions in the colon. However, the clinical course of patients who take anthraquinone over a long term and those who discontinue the drug has not been fully investigated. Here we investigated 22 patients who had colonic mucosal changes ( i.e., melanosis coli and elevated lesions) who had been taking anthraquinone for at least one year and discontinued it. We classified the elevated lesions into two subtypes:the small-lesion, which included multiple small nodules that were < 2 mm in dia., and the large-lesion, which included a single or multiple nodules of ≥ 2-mm dia. We used colonoscopy to investigate the changes of colonic lesions between before and after the discontinuation of anthraquinone. The results indicated that the nodules of the small-lesion group were lymphoid follicle hyperplasia. In the large-lesion group, adenoma was most frequently observed ( n=118) , followed by hyperplastic polyp ( n=52) and inflammatory changes with edema ( n=22) . Melanosis coli and elevated lesions were decreased or invisible after the discontinuation of anthraquinone. Our findings thus suggest that the long-term use of anthraquinone may cause some type of elevated lesions due to chronic inflammation. It is recommended that the use of anthraquinone be limited to a short term.
キーワード アントラセン誘導体(anthracene derivatives) アントラキノン(anthraquinone) 大腸黒皮症(melanosis coli) 大腸メラノーシス(pseudomelanosis coli) リンパ濾胞過形成(lymphoid follicle hyperplasia)
出版物タイトル 岡山医学会雑誌
発行日 2017-04-03
129巻
1号
開始ページ 23
終了ページ 30
ISSN 0030-1558
言語 Japanese
著作権者 Copyright (c) 2017 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.129.23
著者 Iwamuro, Masaya| Urata, Haruo| Tanaka, Takehiro| Ando, Akemi| Nada, Takahiro| Kimura, Kosuke| Yamauchi, Kenji| Kusumoto, Chiaki| Otsuka, Fumio| Okada, Hiroyuki|
発行日 2017-02
出版物タイトル Acta Medica Okayama
71巻
1号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/54828
著者 後藤田 達洋| 川野 誠司| 河野 吉泰| 三浦 公| 神崎 洋光| 岩室 雅也| 河原 祥朗| 田中 健大| 吉野 正| 白川 靖博| 田端 雅弘| 谷本 光音| 岡田 裕之|
発行日 2016-12-01
出版物タイトル 岡山医学会雑誌
128巻
3号
資料タイプ 学術雑誌論文
著者 岩室 雅也| 岡田 裕之| 原田 馨太| 神崎 洋光| 堀 圭介| 喜多 雅英| 川野 誠司| 河原 祥朗| 田中 健大| 山本 和秀|
発行日 2016-12-01
出版物タイトル 岡山医学会雑誌
128巻
3号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/54504
フルテキストURL 70_4_279.pdf
著者 Nishimura, Yoshito| Iwamuro, Masaya| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Hanayama, Yoshihisa| Kondo, Eisei| Tanaka, Takehiro| Otsuka, Fumio|
抄録 A 61-year-old Japanese man with IgG4-related autoimmune pancreatitis was referred to our hospital because of perspiration during food intake. Abdominal computed tomography (CT) with contrast media revealed multiple mesenteric lymphadenopathies. An open surgical abdominal biopsy and subsequent histopathological analysis revealed abnormally large lymphoid cells that were negative for CD3, CD5, and c-myc and positive for CD20 and bcl-2, leading to a diagnosis of diffuse large B-cell lymphoma. Here, we discuss the risk of malignancies, particularly malignant lymphoma in patients with IgG4-related disease. The importance of pathological analysis to reach the appropriate diagnosis in such cases should be emphasized.
キーワード IgG4-related disease autoimmune pancreatitis immunophenotyping diffuse large B-cell lymphoma
Amo Type Case Report
発行日 2016-08
出版物タイトル Acta Medica Okayama
70巻
4号
出版者 Okayama University Medical School
開始ページ 279
終了ページ 283
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27549673
Web of Sience KeyUT 000384748600008
JaLCDOI 10.18926/AMO/54422
フルテキストURL 70_3_217.pdf
著者 Waseda, Koichi| Ocho, Kazuki| Hasegawa, Kou| Kimura, Kosuke| Iwamuro, Masaya| Hanayama, Yoshihisa| Kondo, Eisei| Miyahara, Nobuaki| Otsuka, Fumio|
抄録 KL-6 is a glycoprotein found predominantly on type II pneumocytes and alveolar macrophages, and often shows increased serum levels in patients with interstitial pneumonia. We report a case of mycobacterium avium complex (MAC) infection whose disease activity was correlated with KL-6 levels in serum. During treatment of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) with prednisolone, chest image findings improved in association with decreased KL-6 levels. Following tapering of prednisolone, chest image findings deteriorated again as levels of KL-6 increased, suggesting recurrence of RA-ILD. Bronchoscopic examination revealed active MAC infection. Treatment of MAC infection not only improved chest image findings but also decreased KL-6 levels in serum, suggesting that KL-6 was increased by active MAC infection by itself, not by recurrence of RA-ILD. To the best of our knowledge, this is the first documentation of KL-6 elevation in serum in association with active MAC infection.
キーワード KL-6 mycobacterium avium complex pulmonary nontuberculous mycobacterium infection rheumatoid arthritis-associated interstitial lung disease bronchial alveolar lavage
Amo Type Case Report
発行日 2016-06
出版物タイトル Acta Medica Okayama
70巻
3号
出版者 Okayama University Medical School
開始ページ 217
終了ページ 221
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27339212
Web of Sience KeyUT 000379406100010
JaLCDOI 10.18926/AMO/53912
フルテキストURL 69_6_365.pdf
著者 Kawano, Seiji| Hiraoka, Sakiko| Okada, Hiroyuki| Akita, Mitsuhiro| Iwamuro, Masaya| Yamamoto, Kazuhide|
抄録 Several studies have identified a relationship between myelodysplastic syndrome and Behçetʼs disease (BD), especially intestinal BD, and trisomy 8 appears to play an important role in these disorders. Despite this, only few case reports or series have been reported in gastroenterology, meaning that endoscopic findings and characteristics of intestinal BD have not been clarified yet. In this report, we describe three cases of intestinal BD associated with myelodysplastic syndrome and trisomy 8, and discuss the clinical features and problems of these disorders from a gastroenterology perspective.
キーワード Behçetʼs disease trisomy 8 myelodysplastic syndrome
Amo Type Case Reports
発行日 2015-12
出版物タイトル Acta Medica Okayama
69巻
6号
出版者 Okayama University Medical School
開始ページ 365
終了ページ 369
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26690248
Web of Sience KeyUT 000368434500007
JaLCDOI 10.18926/AMO/53679
フルテキストURL 69_5_319.pdf
著者 Hagiya, Hideharu| Iwamuro, Masaya| Tanaka, Takehiro| Hanayama, Yoshihisa| Otsuka, Fumio|
抄録 A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion;however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.
キーワード antigenemia cytomegalovirus (CMV) gastrointestinal infection methotrexate opportunistic infection
Amo Type Case Report
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 319
終了ページ 323
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490030
Web of Sience KeyUT 000365519600009
JaLCDOI 10.18926/AMO/53676
フルテキストURL 69_5_301.pdf
著者 Seki, Anna| Iwamuro, Masaya| Yoshioka, Masao| Fujii, Nobuharu| Okada, Hiroyuki| Nose, Soichiro| Takata, Katsuyoshi| Yoshino, Tadashi| Yamamoto, Kazuhide|
抄録 A 41-year-old woman was diagnosed with duodenal follicular lymphoma. She had no other lesions and was assigned to a "watch and wait" policy. Swelling of the inguinal lymph nodes appeared 45 months later, and rituximab monotherapy resulted in complete remission. However, follicular lymphoma recurred in the stomach, rectum and mesenteric and external iliac lymph nodes 81 months after the therapy. The patient received rituximab monotherapy again and has remained in complete remission in the fifteenth year after the initial diagnosis. This case suggests the usefulness of rituximab monotherapy in the long-term management of intestinal follicular lymphoma.
キーワード follicular lymphoma duodenum rituximab
Amo Type Case Report
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 301
終了ページ 306
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490027
Web of Sience KeyUT 000365519600006
JaLCDOI 10.18926/AMO/53120
フルテキストURL 69_1_37.pdf
著者 Iwamuro, Masaya| Okada, Hiroyuki| Takata, Katsuyoshi| Kawai, Yoshinari| Kawano, Seiji| Nasu, Junichiro| Kawahara, Yoshiro| Tanaka, Takehiro| Yoshino, Tadashi| Yamamoto, Kazuhide|
抄録 The sensitivity and specificity of magnified endoscopic features for differentiating follicular lymphoma from other diseases with duodenal whitish lesions have never been investigated. Here we compared the magnified endoscopic features of duodenal follicular lymphoma with those of other whitish lesions. We retrospectively reviewed the cases of patients with follicular lymphoma (n=9), lymphangiectasia (n=7), adenoma (n=10), duodenitis (n=4), erosion (n=1), lymphangioma (n=1), and hyperplastic polyp (n=1). The magnified features of the nine follicular lymphomas included enlarged villi (n=8), dilated microvessels (n=5), and opaque white spots of various sizes (n=9). The lymphangiectasias showed enlarged villi, dilated microvessels, and white spots, but the sizes of the white spots were relatively homogeneous and their margin was clear. Observation of the adenoma and duodenitis revealed only whitish villi. Although the lymphangioma was indistinguishable from the follicular lymphomas by magnified features, it was easily diagnosed based on the macroscopic morphology. In conclusion, magnified endoscopic features, in combination with macroscopic features, are useful for differentiating follicular lymphomas from other duodenal diseases presenting whitish lesions.
キーワード duodenal neoplasm follicular lymphoma gastrointestinal lymphoma magnifying endoscopy
Amo Type Original Article
発行日 2015-02
出版物タイトル Acta Medica Okayama
69巻
1号
出版者 Okayama University Medical School
開始ページ 37
終了ページ 44
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 25703169
Web of Sience KeyUT 000349740300004
著者 Uchida, Daisuke| Shiraha, Hidenori| Kato, Hironari| Nagahara, Teruya| Iwamuro, Masaya| Kataoka, Junro| Horiguchi, Shigeru| Watanabe, Masami| Takaki, Akinobu| Nouso, Kazuhiro| Nasu, Yasutomo| Yagi, Takahito| Kumon, Hiromi| Yamamoto, Kazuhide|
発行日 2014-05
出版物タイトル Journal of Gastroenterology and Hepatology
29巻
5号
資料タイプ 学術雑誌論文
タイトル(別表記) Fermented persimmon extract (kaki-shibu) is useful as a standard for component analyses of persimmon phytobezoars
フルテキストURL 126_127.pdf
著者 岩室 雅也| 岡本 裕子| 村田 年弘| 河合 良成| 白羽 英則| 岡田 裕之| 山本 和秀|
抄録 The definite diagnosis of persimmon phytobezoar (i.e., diospyrobezoar) is often accomplished by a component analysis using infrared spectroscopy. However, no studies have been conducted to investigate which substance is the best as a standard for the component analysis. Here we analyzed tannic acid, Japanese persimmon (kaki), fermented persimmon extract (kaki-shibu), conventional dried persimmon, and dried persimmon smoked in sulfur (ampo-kaki) by infrared spectroscopy to determine which would be optimal as a component analysis standard. The spectrum between 1,600 to 600cm-1 of a persimmon phytobezoar was quite similar to the spectrum of kaki-shibu rather than that of tannic acid. Consequently, we conclude that kaki-shibu should be used as a standard for infrared spectroscopy analyses of persimmon phytobezoars.
キーワード 柿胃石(gastric phytobezoar) タンニン酸(tannic acid) 消化管異物(gastrointestinal foreign body) 成分分析(component analysis)
出版物タイトル 岡山医学会雑誌
発行日 2014-08-01
126巻
2号
開始ページ 127
終了ページ 131
ISSN 0030-1558
言語 Japanese
著作権者 Copyright (c) 2014 岡山医学会
論文のバージョン publisher
DOI 10.4044/joma.126.127
NAID 130004685263