scholarly journals Preoperative Diagnosis of Intestinal Endometriosis by Magnifying Colonoscopy and Target Biopsy

2017 ◽  
Vol 11 (2) ◽  
pp. 494-499 ◽  
Author(s):  
Jun Tomiguchi ◽  
Hideaki Miyamoto ◽  
Kazutaka Ozono ◽  
Ryosuke Gushima ◽  
Takashi Shono ◽  
...  
Keyword(s):  
Colonic Mucosa ◽  
Submucosal Tumor ◽  
Magnifying Endoscopy ◽  
Endometrial Tissue ◽  
Pathological Examination ◽  
Intestinal Endometriosis ◽  
Lower Quadrant ◽  
Characteristic Finding ◽  
Magnifying Colonoscopy ◽  
Target Biopsy

Endometriosis can affect any portion of the gastrointestinal tract. A preoperative definitive diagnosis of intestinal endometriosis is difficult, because there is no characteristic endoscopic finding and the endoscopic biopsies usually sample insufficient endometrial tissue for pathologic diagnosis. To our knowledge, the magnifying endoscopic features of intestinal mucosal endometriosis have not been well documented. In this study, we report a case of intestinal endometriosis diagnosed preoperatively by magnifying image-enhanced colonoscopy and target biopsy. A 45-year-old woman was referred to our hospital with abdominal pain in the left lower quadrant. Colonoscopy showed a submucosal tumor-like lesion of approximately 30 mm in diameter exhibiting surface reddening and granular changes in the sigmoid colon. Magnifying endoscopy revealed sparsely distributed round pits in the granules. The mucosal biopsy specimen from the granule provided the diagnosis of intestinal endometriosis. Segmental sigmoidectomy was performed, and pathological examination revealed that the surface colonic mucosa was partially replaced by endometrial tissue, which accounted for the granular change detected in the colonoscopy. It can be speculated that the round pit might reflect the endometrial glands surrounded by endometrial stroma. This case illustrated the characteristic finding and utility of magnifying endoscopy for mucosal intestinal endometriosis.

A Case of Esophageal Xanthoma with Epithelial Reactive Inflammation with a Characteristic Finding of Narrow-Band Imaging Magnifying Endoscopy

2019 ◽  
Vol 38 (1) ◽  
pp. 85-88
Author(s):  
Hideki Mori ◽  
Motohiko Kato ◽  
Toshio Uraoka
Keyword(s):  
Biopsy Specimen ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Basal Layer ◽  
Excisional Biopsy ◽  
Magnifying Endoscopy ◽  
Thoracic Esophagus ◽  
Characteristic Finding ◽  
Capillary Loop ◽  
White Substance

A 75-year-old woman had a 5 mm slightly elevated yellowish lesion in her thoracic esophagus. Narrow-band imaging magnifying endoscopy (NBI-ME) revealed aggregations of a tiny white substance beneath each intrapapillary capillary loop with weaving, dilatation, and a different shape. In this case, an irregular caliber was absent. The biopsy specimen taken from the lesion showed cells with large nuclei and increased chromatin clumping in the basal layer. These cells were positive for p53. Endoscopic submucosal dissection was performed for the purpose of excisional biopsy. Finally, it was diagnosed as an esophageal xanthoma with a benign epithelial reactive inflammation. This is the first report of esophageal xanthoma showing the characteristic NBI-ME finding of esophageal xanthoma. Further studies are required to determine whether the characteristic finding of NBI-ME is generally found in esophageal xanthomas.

scholarly journals A rare case of right lower quadrant pain

2019 ◽  
Vol 5 (2) ◽  
pp. 20170024
Author(s):  
Eduardo Teiga ◽  
Aleksandar Radosevic ◽  
Juan Sánchez ◽  
Marcos Busto ◽  
Guadalupe Aguilar ◽  
...  
Keyword(s):  
Pathological Examination ◽  
Childbearing Age ◽  
Diagnostic Challenge ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Lower Back ◽  
Operative Findings ◽  
Right Lower Quadrant

Endometriosis of the appendix is a very rare entity and commonly affects females in childbearing age. Clinical presentation might be confusing varying from asymptomatic to acute abdominal pain and often mimicks acute appendicitis or chronic pelvic pain. Diagnosis is generally made after pathological examination as operative findings are usually non-specific. This condition poses a diagnostic challenge to radiologists and surgeons altogether and we therefore report a case of a middle aged female who presented with both right lower quadrant and right lower back pain. Recent literature is reviewed and radiological findings discussed.

Target biopsy using magnifying endoscopy in clinical management of gastric mucosa-associated lymphoid tissue lymphoma

2011 ◽  
Vol 26 (7) ◽  
pp. 1133-1138 ◽  
Author(s):  
Shouko Ono ◽  
Mototsugu Kato ◽  
Yuji Ono ◽  
Urara Nishida ◽  
Keiko Yamamoto ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Clinical Management ◽  
Lymphoid Tissue ◽  
Magnifying Endoscopy ◽  
Target Biopsy

scholarly journals “Worm within worm”: acute appendicitis containing an adult Ascaris lumbricoïdes

2022 ◽  
Author(s):  
Ibrahima Niang ◽  
Coumba Khadija Dieng ◽  
Papa Malick Dibor Diouf ◽  
Cheikh Tidiane Diop ◽  
Ibrahima Bocar Welle ◽  
...  
Keyword(s):  
Digestive System ◽  
Helminth Infection ◽  
Pathological Examination ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Tropical Area ◽  
Intestinal Worms ◽  
Right Lower Quadrant

Appendicitis is the first aetiology for abdominal surgical emergency. Ascariasis is the most common helminth infection in tropical countries where it is endemic. The ability of intestinal helminths to wander through the digestive system means that it can end up in the appendix lumen and lead to appendicitis by luminal obstruction. However, this presentation is still rarely described in the literature. In fact, most of the diagnoses of roundworm associated with appendicitis are made retrospectively by the discovery of its eggs on the pathological examination of an appendectomy specimen. We report the case of a 7-year-old patient living in a tropical area who consulted for acute right lower quadrant pain. The ultrasound suspected the diagnosis of appendicitis and also revealed multiple intestinal worms including one in contact with the inflamed appendix. Surgical exploration confirmed appendicitis associated with roundworm partly in the appendicular lumen through a perforation.

scholarly journals Acute Appendicitis Caused by Previous Endoscopic Submucosal Dissection for an Adenoma Adjacent to the Appendiceal Orifice

2017 ◽  
Vol 11 (2) ◽  
pp. 271-276 ◽  
Author(s):  
Ryo Kato ◽  
Keita Harada ◽  
Kei Harada ◽  
Daisuke Takei ◽  
Yuusaku Sugihara ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Endoscopic Submucosal Dissection ◽  
Residual Tumor ◽  
Screening Colonoscopy ◽  
Pathological Examination ◽  
Resected Specimen ◽  
Tubular Adenoma ◽  
Lower Quadrant ◽  
Submucosal Dissection ◽  
Additional Surgery

Endoscopic submucosal dissection (ESD) is a groundbreaking treatment for tumors adjacent to the appendiceal orifice that are difficult to remove by conventional endoscopic mucosal resection, and successful cases are increasingly reported. However, little is known about the subsequent complications, especially long-term complications. A female in her early 70s with a 15-mm cecal tumor adjacent to the appendiceal orifice – discovered incidentally during a screening colonoscopy – underwent hybrid ESD of the lesion. We completely resected the tumor, and she was discharged 5 days later with a pathological diagnosis of high-grade tubular adenoma. Ten months postoperatively, she experienced sudden-onset right lower quadrant pain and was diagnosed with acute appendicitis at another hospital. Due to suspicion that her condition was the result of residual tumor, her surgeon performed an emergency laparoscopic cecectomy. The pathological examination of the resected specimen showed thick scarring adjacent to the appendiceal orifice and no residual tumor. The previous ESD was identified as the cause of the scar, and the scar was the only finding to account for the patient’s appendicitis. This case is significant because the patient required additional surgery due to a complication of ESD. Further, it indicates that acute appendicitis may be a late complication of submucosal dissection near the appendiceal orifice. As ESD becomes more widely used, it is likely that more cecal tumors will be treated endoscopically. It is important to be aware of the late complications of ESD for these tumors.

scholarly journals A Rare Case of Gastric Schwannoma: A Case Report and Literature Review

2020 ◽  
Vol 13 (1) ◽  
pp. 330-335 ◽  
Author(s):  
Senichiro Yanagawa ◽  
Kenichi Kagemoto ◽  
Hidehiro Tanji ◽  
Shinya Kodama ◽  
Yukio Takeshima ◽  
...  
Keyword(s):  
Submucosal Tumor ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Surgical Margin ◽  
Pathological Examination ◽  
Positive Staining ◽  
Gastric Schwannoma ◽  
Precise Diagnosis ◽  
S 100 ◽  
Laparoscopic Assisted

In general, schwannoma is a benign and slow-glowing neoplasm that rarely occurs in the gastrointestinal tract as a submucosal tumor (SMT), with the most common site being the stomach. As gastric schwannoma (GS) is a rare tumor, there is limited data in the literature about its clinical features. The diagnosis of schwannoma can only be made by pathological examination with positive staining for S-100 protein. It is necessary to obtain an accurate diagnosis to introduce optimal treatment options preoperatively. However, a precise diagnosis of GS is difficult, even with modern imaging techniques. On the other hand, a complete resection with a negative surgical margin (R0) of GS is considered the best treatment, with an excellent prognosis. We present a case of a 66-year-old female patient who underwent laparoscopic-assisted wedge gastrectomy for gastric SMT, pathologically diagnosed as GS, with positive staining for S-100 protein and negative for c-kit and CD34. At 12-month follow-up after surgery, there was no recurrence or metastasis of GS. Our treatment is appropriate and effective in case of GS exceeding 50 mm.

Periappendiceal Dermoid: A Rare Cause of Right Lower Quadrant Pain

2008 ◽  
Vol 74 (1) ◽  
pp. 56-58
Author(s):  
Marcelo M. Ghersi ◽  
Sergio A. Carrillo ◽  
Payman Danielpour ◽  
Irvin Willis
Keyword(s):  
The Body ◽  
Pathological Examination ◽  
General Surgeon ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Associated Symptoms ◽  
Stratified Squamous Epithelium ◽  
Right Lower Quadrant

Dermoids are mature teratomas lined with a stratified squamous epithelium. They are known to present anywhere in the body, mostly with minimal or no associated symptoms. The authors present the case of a 44-year-old man who presented with an acute abdomen suggestive of appendiceal disease. On surgical exploration, the patient was found to have an inflamed cystic lesion in the mesoappendix that was resected and diagnosed as a dermoid cyst on pathological examination. This is the seventh case in the literature of a periappendiceal dermoid, but the first that presents in such a manner. This report is presented because of its important clinical applications for the general surgeon.

scholarly journals Gastric calcifying fibrous tumor suspected to be complicated with immunoglobulin G4-related disease treated by laparoscopy and endoscopy cooperative surgery: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Ryoga Hamura ◽  
Tomoki Koyama ◽  
Masahiko Kawamura ◽  
Takeshi Kawamura ◽  
Mayo Nakamura ◽  
...  
Keyword(s):  
Submucosal Tumor ◽  
Wedge Resection ◽  
Pathological Examination ◽  
Upper Gastrointestinal Endoscopy ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Serum Igg4 ◽  
Calcifying Fibrous Tumor ◽  
Fibrous Tumor

Abstract Background Calcifying fibrous tumor (CFT) is a rare benign soft tissue lesion. Case presentation A 30-year-old woman was admitted to our hospital with complaints of epigastralgia. A 15-mm submucosal tumor was identified in the greater curvature of the superior body of the stomach by upper gastrointestinal endoscopy. Endoscopic ultrasonography revealed a hypoechoic lesion with an acoustic shadow consistent with calcification. Computed tomography showed a gastric tumor with calcification. A gastrointestinal stromal tumor was diagnosed, and gastric wedge resection was performed by laparoscopy and endoscopy cooperative surgery. On pathological examination, the tumor was identified to be a CFT. Postoperative serum IgG4 levels were 26.0 mg/dl, which supported the diagnosis of probable immunoglobulin G (IgG) 4-related disease, according to the comprehensive diagnostic criteria of IgG4-related disease. The patient was discharged on postoperative day 7 and remains well with no evidence of tumor recurrence for 2 years after resection. Conclusion We herein reported a patient with a gastric CFT suspected to be complicated with immunoglobulin G4-related disease that was successfully treated by laparoscopy and endoscopy cooperative surgery.

scholarly journals Importance of Eosinophilic Infiltration of the Colonic Mucosa in Ulcerative Colitis Patients who are Refractory to Maintenance Therapy

2022 ◽  
Author(s):  
Takahiro Miyazu ◽  
Natsuki Ishida ◽  
Yusuke Asai ◽  
Satoshi Tamura ◽  
Shinya Tani ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Maintenance Therapy ◽  
Colonic Mucosa ◽  
Eosinophilic Infiltration ◽  
Pathological Examination ◽  
Clinical Activity ◽  
Short Term ◽  
Steroid Use ◽  
Steroid Administration ◽  
Before And After

Abstract Eosinophilic infiltration is sometimes observed histologically in ulcerative colitis (UC), but the effect of the degree of infiltration on the treatment course for UC is not completely studied. We investigated whether short-term steroid administration in UC patients refractory to maintenance therapy, with high eosinophilic infiltration in the colonic mucosa, contributed to clinical and endoscopic improvement. Ten patients with endoscopically active and pathologically high eosinophilic infiltration, based on pathological examination using endoscopic biopsy, were examined for clinical background when starting steroid treatment; clinical and endoscopic improvement before and after steroid use were assessed prospectively. The average initial steroid dosage and duration of use were 21.0 mg and 102.7 days, respectively. The mean values before and after steroid use of clinical activity index, Mayo endoscopic subscore, and UC endoscopic index of severity were 2.4 and 1.0, 1.8 and 0.7, and 3.9 and 1.1, respectively. All these scores improved significantly after steroid use (P=0.04, P<0.01, P<0.01, respectively). Steroids were discontinued in all patients; no patients required steroid re-administration. There may be cases of UC with eosinophilic infiltration into the colonic mucosa and resistant to maintenance treatment, suggesting that short-term steroid administration may contribute to clinical and endoscopic improvements.

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