A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple sm...A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple small bowel ulcerations with hemorrhage were seen on colonoscopy.Despite intensive therapy,the massive hematochezia worsened and the distal small bowel was resected.Multiple ulcerated lesions were identified pathologically as vasculitis caused by scrub typhus.This is the first reported case of pathologically proven small bowel involvement in scrub typhus infection.展开更多
Neuroendocrine carcinoma(NEC)is a rare tumor,comprising【1%of stomach cancers.A 55-year-old woman was referred to our hospital with biopsy-proven gastric cancer.A shallow ulcerative lesion was detected in the lesser c...Neuroendocrine carcinoma(NEC)is a rare tumor,comprising【1%of stomach cancers.A 55-year-old woman was referred to our hospital with biopsy-proven gastric cancer.A shallow ulcerative lesion was detected in the lesser curvature of the lower body.It was suspected to be early gastric cancerⅡA+ⅡC type.Thus,endoscopic submucosal dissection was performed.She was subsequently diagnosed with NEC,which is aggressive and carries a poor prognosis.We conducted a radical resection and a laparoscopic-assisted distal gastrectomy.The tumor had infiltrated the subserosal layer and6/42 lymph nodes were involved.The mitotic index was16/10 high power fields and the Ki-67 labeling index was 26%-50%.The final diagnosis of NEC was made according to the World health Organization 2010 criteria.She was suspected of having jumping metastasis to the proximal margin.The patient was treated with an oral anticancer drug(5-flurouracil based drug)for2 years.The patient has been followed up for 3 years without recurrence.展开更多
This is a very rare case of the recurrence of gastric cancer in the jejunal stump after radical total gastrectomy with Roux-en-Y reconstruction.In January 2008,a 65-year-old man underwent radical total gastrectomy wit...This is a very rare case of the recurrence of gastric cancer in the jejunal stump after radical total gastrectomy with Roux-en-Y reconstruction.In January 2008,a 65-year-old man underwent radical total gastrectomy with Roux-en-Y reconstruction for stageⅠB gastric cancer of the upper body.At a follow-up in December2011,the patient had a recurrence of gastric cancer on gastroduodenal fibroscopy.The gastroduodenal fibroscopic biopsy specimens show a well-differentiated tubular adenocarcinoma.Computed tomography showed no lymphadenopathy or hepatic metastases.At laparotomy,there was a tumor in the jejunal stump involving the pancreatic tail and spleen.Therefore,the patient underwent jejunal pouch resection,distal pancreatectomy and splenectomy.The patient was diagnosed with gastric cancer on histopathological examination.展开更多
文摘A 79-year-old man was diagnosed with scrub typhus based on fever,eschar,skin rash and a markedly elevated serum tsutsugamushi antibody and doxycycline was started.Five days later,hematochezia developed and multiple small bowel ulcerations with hemorrhage were seen on colonoscopy.Despite intensive therapy,the massive hematochezia worsened and the distal small bowel was resected.Multiple ulcerated lesions were identified pathologically as vasculitis caused by scrub typhus.This is the first reported case of pathologically proven small bowel involvement in scrub typhus infection.
文摘Neuroendocrine carcinoma(NEC)is a rare tumor,comprising【1%of stomach cancers.A 55-year-old woman was referred to our hospital with biopsy-proven gastric cancer.A shallow ulcerative lesion was detected in the lesser curvature of the lower body.It was suspected to be early gastric cancerⅡA+ⅡC type.Thus,endoscopic submucosal dissection was performed.She was subsequently diagnosed with NEC,which is aggressive and carries a poor prognosis.We conducted a radical resection and a laparoscopic-assisted distal gastrectomy.The tumor had infiltrated the subserosal layer and6/42 lymph nodes were involved.The mitotic index was16/10 high power fields and the Ki-67 labeling index was 26%-50%.The final diagnosis of NEC was made according to the World health Organization 2010 criteria.She was suspected of having jumping metastasis to the proximal margin.The patient was treated with an oral anticancer drug(5-flurouracil based drug)for2 years.The patient has been followed up for 3 years without recurrence.
文摘This is a very rare case of the recurrence of gastric cancer in the jejunal stump after radical total gastrectomy with Roux-en-Y reconstruction.In January 2008,a 65-year-old man underwent radical total gastrectomy with Roux-en-Y reconstruction for stageⅠB gastric cancer of the upper body.At a follow-up in December2011,the patient had a recurrence of gastric cancer on gastroduodenal fibroscopy.The gastroduodenal fibroscopic biopsy specimens show a well-differentiated tubular adenocarcinoma.Computed tomography showed no lymphadenopathy or hepatic metastases.At laparotomy,there was a tumor in the jejunal stump involving the pancreatic tail and spleen.Therefore,the patient underwent jejunal pouch resection,distal pancreatectomy and splenectomy.The patient was diagnosed with gastric cancer on histopathological examination.
