Search

We herein report a case of heterotopic gastric mucosa in the hilar bile duct. An asymptomatic 58-year-old male was noted to have mild liver dysfunction in March 2009 during the follow-up for angina pectoris. Abdominal-enhanced CT revealed wall thickening from the upper common hepatic bile duct to the left hepatic bile duct. Endoscopic retrograde cholangiopancreatography (ERCP) showed stenosis at the junction of the left hepatic bile duct. Although the patient's serum tumor markers were all within the normal ranges, the possibility of malignant disease of the biliary tree could not be ruled out. Left hepatectomy with the caudate lobe and resection of the extrahepatic bile duct were performed. Histopathologically, the resected specimen showed a polypoid lesion measuring 2 × 2 cm in size that projected into the lumen of the left hepatic bile duct. Microscopic examination revealed this polypoid lesion to be composed of mucous glands resembling gastric fundic glands, with parietal and chief cells. We also review eight other reports of heterotopic gastric mucosa in the biliary tree previously published in the English literature.

肺原発淡明細胞腺癌の報告は極めてまれである．今回，上縦隔までリンパ節転移を伴った淡明細胞腺癌の1例を胸腔鏡補助下に完全切除したので報告する．症例は69歳，女性．CTにて右肺S8に23mm大の結節を認め，PET-CTで結節，肺門および縦隔リンパ節に集積を指摘された．術前診断はcT1bN2M0 Stage III Aの右下葉肺癌で，胸腔鏡補助下右下葉切除＋ND2aをおこなった．組織学的所見では，病変の90％以上を淡明細胞が占め，上縦隔リンパ節を含めた19/23のリンパ節に転移を認めた．免疫組織学的にThyroid transcription factor-1（TTF-1）陽性であり，画像検査においても他の部位に腫瘍はなく，肺原発淡明細胞腺癌と診断した．術後病理診断はpT1aN2M0 Stage III Aであったため，術後はシスプラチン（CDDP）とビノレルビン（VNR）施行後，テガフール・ウラシル（UFT）内服に変更し補助化学療法を継続している．

Our uncommon experience with a case of accessory breast cancer is described. A 67-year-old woman was seen at the hospital because of a left axillary tumor. An excisional biopsy of the tumor revealed medullary carcinoma with mammary gland, without connection to the proper mammary gland. There was no other primary lesion in general exploration and clinical findings also offered a suspicion of accessory breast cancer. A wide local resection with lymph nodes dissection level III was carried out. She is doing well without any evidence of recurrence, as of 10 months after the operation.

Angiomyolipomas are benign mesenchymal tumors mostly arising from the kidney. Angiomyolipoma of the colon is extremely rare. Here we report the findings of a 51-year-old man who presented with a submucosal tumor covered with normal mucosa and hemorrhage in the descending colon. He underwent a partial resection of the descending colon. A histopathological examination showed that the tumor of 5.7 cm in diameter included smooth muscle (spindle cell type), mature adipose tissue, and vessels, and therefore a diagnosis of angiomyolipoma was made. A submucosal type of angiomyolipoma of the colon is extremely rare. If a renal angiomyolipoma is larger than 4 cm, there is a risk of rupture. When colonoscopy shows a submucosal tumor of the colon with hemorrhage, angiomyolipoma should be considered. If an angiomyolipoma of the colon is large, surgical resection should be considered as a treatment option due to the risk of hemorrhage.

The partial purification and characterization of a hepatocyte proliferation stimulatory factor (HPSF) isolated from the liver of D-galactosamine-treated rats are described. The HPSF was a heat-labile, acid-stable and trypsin-sensitive protein. The partially purified HPSF stimulated DNA synthesis and increased the labeling index of parenchymal hepatocytes at 5 micrograms/ml and maximally at 50 micrograms/ml. The effect of HPSF in stimulating DNA synthesis was synergistic with that of insulin plus epidermal growth factor (EGF). The HPSF was scarcely detected in normal rat liver. The results obtained indicate that this HPSF is distinct from insulin, multiplication-stimulating activity (MSA), EGF and other hepatocyte growth factors previously reported, and suggest a plausible role for HPSF in the regeneration of liver tissue following hepatotoxic damage.