Yukihiro Shirota

Ovarian cancer mimicking pancreatic cancer

Takafumi Nakagawa, Akihiko Kida, Yuji Hodo, Yukihiro Shirota et autres

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Hidden danger beneath a pedunculated polyp: T3 N1 skip metastasis despite complete endoscopic resection

Akihiko Kida, Yuji Hodo, Azusa Kawasaki, Hajime Takatori et autres

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Population-Based Screening for Chronic Liver Disease Using the FIB-4 Index in An Ageing Society: A Real-World Implementation Study from Japan

Rika Horii, Tetsuro Shimakami, Hajime TAKATORI, Ichiro Araki et autres

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Localized light chain amyloidosis of the stomach that regressed after eradication of Helicobacter pylori over 15 years of follow-up: a case report and new hypothesis

Yukihiro Shirota, Yoshimichi Ueda, Katsuaki Sato, Takayoshi Koura et autres

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Perihilar Cholangiocarcinoma Originating in Peribiliary Glands: Insights from a Case without Precancerous Lesions

Yukihiro Shirota, Yoshimichi Ueda, Yasuni Nakanuma, Yuichi Yoshie et autres

BACKGROUND Recent studies have shown that peribiliary glands may be the potential cell origin of cholangiocarcinoma, and that precancerous lesions such as biliary intraepithelial neoplasms and intraductal papillary neoplasms of the bile duct may arise from these peribiliary glands. However, whether and …

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Endoscopic treatment of bile duct stones with benign choledochojejunal anastomotic stenosis

Akihiko Kida, Yukihiro Shirota, Hideaki Shunto, Noriho Iida et autres

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A case of intraductal papillary-mucinous carcinoma of the pancreas, invasive with a markedly elevated serum IgG4 concentration and swollen papilla of Vater due to abundant IgG4-positive plasma cell infiltration, suggesting an association with autoimmune pancreatitis

Tokio Wakabayashi, Hirohito TAKEDA, Yuji HOUDOU, Yukihiro Shirota et autres

症例は90歳，女性．右大腿骨骨折による入院時の腹部単純CTで膵腫大と膵管拡張を指摘された．造影CT，MRIにて膵頭体境界領域腹側に不均一に濃染される腫瘤を認めたが，体尾部はソーセージ様に腫大し，実質の均一な遅延性濃染像に加え，拡張部からの移行が平滑な主膵管狭細像とびまん性の分枝膵管拡張を認めた．血清IgG4値は757mg/dlであった．上部消化管内視鏡検査では，著明なIgG4陽性形質細胞浸潤を伴った十二指腸乳頭の腫大に加え，十二指腸球部に浸潤・穿破した粘液を排出する瘻孔開口部のイクラ状隆起からの生検で高度異型を呈する乳頭状の胃型粘液性上皮を認め，間質に豊富なIgG4陽性形質細胞浸潤を伴って高度異型腺管が散在していた．以上より，浸潤性IPMCと診断したが，AIP併存の可能性が強く示唆された．癌性腹水が出現し初診8か月後死亡した．AIP合併浸潤性IPMCの報告はなく，貴重な症例と考えられた．

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A resected case of a simple mucinous cyst of the pancreas that was difficult to differentiate from a mucinous cystic neoplasm before surgery

Tokio Wakabayashi, Yukihiro Shirota, Yuichi Yoshie, Yoshiharu TOMITA et autres

症例は73歳，女性．単純腹部CTで，膵尾部に増大傾向を有する18mm径の嚢胞性病変を指摘された．造影MRIおよび超音波内視鏡検査では，嚢胞内面は平滑で結節成分を指摘しえなかったが，隔壁構造と早期相から濃染される厚さ2mmの明瞭な被膜を認めた．小型で充実成分がないことより経過観察の方針となったが，その後も増大傾向が続き1年6か月後には30mm×35mm大となったため，膵粘液嚢胞性腫瘍（MCN）を疑って膵尾側切除術を施行した．術後病理検査では，ほとんどが単層粘液性上皮に被覆され，異型に乏しく，膵管との交通や卵巣様間質を認めなかったことから，simple mucinous cyst（SMC）と診断された．SMCはMCNとは異なる新しく提唱された粘液性膵嚢胞の概念で，その疾患特性は十分に解明されていないが，悪性リスクは低いと考えられており，MCNの鑑別疾患の一つとして認識する必要がある．

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[A rare case of intraductal tumor of the pancreas in which an intraductal tubulopapillary neoplasm was mixed with a widely spreading gastric-type intraductal papillary-mucinous neoplasm].

Tokio Wakabayashi, Yukihiro Shirota, Yasuhito Takeda, Yuji Hodo et autres

A 70-year-old man receiving treatment for diabetes mellitus presented with a cystic mass in the border area of the pancreatic body and tail on plain computed tomography (CT) due to impaired glucose intolerance. Contrast-enhanced CT showed a faint hyperattenuated nodular mass extending …

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Endoscopic clip-induced acute appendicitis in a patient on chronic hemodialysis: a case report with literature review

Daichi Yomogida, Yuhei Fujisawa, Akari Takeji, Yasuhito Takeda et autres

Abstract Background Foreign body-induced acute appendicitis is rare but could most often be caused by fish bones; those caused by endoscopic clips are highly rare. Herein, we report a case of acute appendicitis caused by endoscopic clips that developed 2 years after …

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Fatal Fulminant Legionnaires’ Disease Complicated with Rhabdomyolysis, Acute Kidney Injury, and Non-Occlusive Mesenteric Ischemia: An Autopsy Case Report

Yuhei Fujisawa, Tatsuhito Miyanaga, Akari Takeji, Yukihiro Shirota et autres

BACKGROUND Legionnaires' disease is one of the most common types of community-acquired pneumonia. It can cause acute kidney injury and also occasionally become severe enough to require continuous renal replacement therapy (CRRT). Non-occlusive mesenteric ischemia (NOMI) is a condition characterized by ischemia …

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Eosinophilic Granulomatosis with Polyangiitis Presenting as Steroid-Responsive Sclerosing Cholangitis and Cholecystitis: A Rare Case Report

Yuhei Fujisawa, Yukihiro Shirota, Tokio Wakabayashi

BACKGROUND Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitic condition characterized by bronchial asthma and eosinophilia. While biliary involvement is uncommon in EGPA, we present a unique case of EGPA presenting as steroid-responsive sclerosing cholangitis and cholecystitis. This case highlights …

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