For an esophageal submucosal mass suspicious of granular cell tumor (GCT) based on gross appearance and endoscopic ultrasound findings, a sufficient number of biopsy specimens is required for a definite diagnosis using immunohistochemical examination. When the specimen obtained by forceps biopsy is insufficient, endoscopic ultrasound-fine needle aspiration (EUS-FNA) is believed to be an useful alternative. However, it may be difficult to obtain an adequate amount of tumor material using EUS-FNA. Mucosal incision-assisted biopsy (MIAB) is a simple method that can collect larger amounts of specimens. This procedure is helpful for physicians who encounter the problem of obtaining an adequate amount of biopsy material from esophageal tumors suspicious for GCT. We present a case of esophageal GCT that was successfully diagnosed through MIAB.

/pdf/a-case-of-esophageal-granular-cell-tumor-diagnosed-by-v0utaq4pkf.pdf

A case of esophageal granular cell tumor diagnosed by mucosal incision-assisted biopsy.

We report here a rare case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm. In an 80-year-old woman, an approximately 8-mm papillary mass was incidentally detected at the downstream edge of a dilatated main pancreatic duct lumen on CT and MRI. Main pancreatic duct dilatation in the pancreatic body and tail and parenchymal atrophy were observed in the upstream of the mass. Histopathologically, the tumor protruded into the downstream edge of the dilatated main pancreatic duct lumen in the pancreatic body. The tumor cells had highly atypical nuclei and abundant polymorphic structures, and showed positive staining for granulocyte colony-stimulating factor, which led to the diagnosis of undifferentiated carcinoma. A total of 13 cases of undifferentiated carcinoma with intraductal tumor growth have been reported to date. The case report by Bergmann et al. has been the smallest in histopathological specimen, and the present case is the smallest in size detected by radiological images. Since early undifferentiated carcinoma of the pancreas can resemble those of main-duct intraductal papillary mucinous neoplasm in cross-sectional images, we have to consider undifferentiated carcinoma in the differential diagnosis of the solitary and papillary mass with low contrast enhancement in early phase in the main pancreatic duct.

/pdf/a-case-of-undifferentiated-carcinoma-of-the-pancreas-5fkpmv1ups.pdf

A case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm (IPMN).

A case of anaplastic ductal carcinoma of the pancreas

症例は70歳代，女性．心窩部痛の精査目的に施行した腹部超音波検査にて主膵管の拡張を認め，精査目的に紹介となった．造影CTにて膵頭部に約15mm大の造影効果のある腫瘤性病変を認めた．同腫瘤に対してEUS-FNAを施行し，紡錘形細胞や大小不同を有する多形性の細胞，さらに破骨型多核巨細胞を伴っている異型細胞を認めた．これらの異型細胞は，免疫染色でCD68（KP-1）陽性であり，膵頭部の退形成癌と診断し，幽門輪温存膵頭十二指腸切除術を施行した．手術検体の病理組織学的検査で多形細胞を主として，紡錘形細胞や破骨型多核巨細胞を認め，多形細胞型退形成癌TS1，pT1cと診断された．現在，術後9か月で無再発生存中である．術前のEUS-FNAにて確定診断ができ，切除し得たTS1の退形成癌を経験したので，文献的考察を加えて報告する． 

/pdf/a-patient-with-pleomorphic-anaplastic-carcinoma-ts1-j9iomr8u.pdf

A patient with pleomorphic anaplastic carcinoma TS1 diagnosed preoperatively by EUS-FNA

https://doi.org/10.1016/j.ijscr.2022.107768

Hemorrhagic shock successfully treated with emergency pancreaticoduodenectomy for pancreatic carcinoma in radiochemotherapy: A case report

FDG-PETで集積亢進を呈したglucose transporter-1陽性食道平滑筋腫の1例

自然破裂による腹腔内出血を呈した退形成性膵管癌の1例を経験した. 症例は59歳の男性で, 腹痛を主訴に当院を受診した. 腹部US, CTにて膵体部腫瘍と多発肝転移を認めた.腹痛の増強を認めたため緊急入院し, CTにて腫瘍の著明な増大と大量の腹水が認められた. 試験的腹腔穿刺では血性腹水が吸引され腹腔内出血の診断で緊急開腹術を施行した. 腫瘍の破裂による出血と判明し, 膵体尾部切除術を施行した. 病理組織診断にて退形成性膵管癌と診断した. 術後, 化学療法を施行するも効果なく癌性悪液質が進行し, 術後18日目に死亡した. このように退形成性膵管癌は急速に増大する間に自然破裂を生じる可能性がある.

自然破裂による腹腔内出血を呈した退形成性膵管癌(巨細胞型)の1例

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市之川正臣

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FDG-PETで集積亢進を呈したglucose transporter-1陽性食道平滑筋腫の1例

自然破裂による腹腔内出血を呈した退形成性膵管癌(巨細胞型)の1例

市之川 正臣

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FDG-PETで集積亢進を呈したglucose transporter-1陽性食道平滑筋腫の1例

自然破裂による腹腔内出血を呈した退形成性膵管癌(巨細胞型)の1例

市之川正臣