A rare case of segmental ulcerative colitis

Background: Ulcerative colitis (UC) typically develops in the rectum and progresses proximally. Segmental UC is a rare condition that is often difficult to diagnose. We present a case of segmental UC mimicking colon cancer that developed in the transverse colon. Case presentation: An 83-year-old woman with abdominal pain visited our hospital. Total colonoscopy revealed a granular mass with stenosis in the transverse colon. Biopsy specimen showed infiltration of inflammatory cells. No mucosal inflammation was evident on the anal side of the colon and rectum. Abdominal computed tomography showed enhanced mural thicknening in the transverse colon. Enlarged regional lymph nodes were apparent. Although no malignancy was evident, cancerlike stenosis and swollen lymph nodes were identified, so colectomy with regional lymph node resection was performed. The resected specimen showed near-circumferential thicknening. Aggregated small polypoid lesions and a mucosal bridge were also revealed. Histological findings showed a wide range of crypt abscess. No cellular atypia was found. We finally diagnosed segmental UC. The patient was subsequently followed closely without treatment, and abdominal distension developed one and a half years later. Total colonoscopy showed mucosal redness and erosion in the residual transverse colon. Pharmacotherapy immediately improved symptoms. As of 10 years postoperatively, she has experienced no further recurrence. Conclusion: We encountered a rare case of segmental UC in the transverse colon. UC does not always develop from the rectum and progress towards the oral side. Early definitive diagnosis can achieve good results for treatment and the clinical course

A rare case of segmental ulcerative colitis

Background: Ulcerative colitis (UC) typically develops in the rectum and progresses proximally. Segmental UC is a rare conditionthat is often difficult to diagnose. We present a case of segmental UC mimicking colon cancer that developed in the transverse colon.Case presentation: An 83-year-old woman with abdominal pain visited our hospital. Total colonoscopy revealed a granular mass with stenosis in the transverse colon. Biopsy specimen showed infiltration of inflammatory cells. No mucosal inflammation was evident on the anal side of the colon and rectum. Abdominal computed tomography showed enhanced mural thicknening in the transverse colon. Enlarged regional lymph nodes were apparent. Although no malignancy was evident, cancerlikestenosis and swollen lymph nodes were identified, so colectomy with regional lymph node resection was performed. The resected specimen showed near-circumferential thicknening. Aggregated small polypoid lesions and a mucosal bridge were also revealed. Histological findings showed a wide range of crypt abscess. No cellular atypia was found. We finally diagnosed segmental UC. The patient was subsequently followed closely without treatment, and abdominal distension developed one and a half years later. Total colonoscopy showed mucosal redness and erosion in the residual transverse colon. Pharmacotherapy immediately improved symptoms. As of 10 years postoperatively, she has experienced no further recurrence. Conclusion: We encountered a rare case of segmental UC in the transverse colon. UC does not always develop from the rectum and progress towards the oral side. Early definitive diagnosis can achieve good results for treatment and the clinical course

Clinical and cytopathological characteristics of HTLV‐1 +

Abstract Background Human T‐lymphotropic virus‐1 (HTLV‐1)+ Hodgkin lymphoma (HL) is difficult to differentiate from adult T‐cell leukemia/lymphoma (ATLL) with HL‐like histology (HL‐like ATLL). Methods Cytological and immunohistological features, HTLV‐1 proviral DNA integration, and rearrangements of the T‐cell receptor (TCR) Cβ1 gene were examined in 11 HTLV‐1+ patients with HL‐like disease. Results Six patients were classified as HTLV‐1+ HL and five as HL‐like ATLL in accordance with genetic findings of HTLV‐1 proviral DNA integration and rearrangements of the TCR Cβ1 gene. Small ordinary looking lymphocytes with round nuclei were detected in the background of six patients with HTLV‐1+ HL, which were immunohistochemically negative for CD25 and CC chemokine receptor (CCR)4 and had a low MIB1 labeling index (mean: 28.3%). In the HL‐like ATLL specimens, small‐ and medium‐sized atypical lymphocytes with indented and irregular‐shaped nuclei were found, and were diffusely positive for CD25 and CCR4, with high MIB1 labeling (mean: 76%). Both groups had scattered CD30+ and CD15+ Hodgkin and Reed Sternberg (RS) giant cells, with or without CD20 expression and Epstein‐Barr virus infection. The 50% overall survival period was significantly longer for the HTLV‐1+ HL group (180 months) than for the HL‐like ATLL group (7.8 months; P = .004). Conclusions HTLV‐1+ HL showed typical small lymphoid cells with a low MIB1 labeling index in a background of Hodgkin and RS cells, with some scattered CD25+ and CCR4+ lymphocytes. In HTLV‐1 endemic areas, distinguishing HTLV‐1+ HL from HL‐like ATLL is important because of their differing treatment strategies and prognoses

Liver resection for metastases of tracheal adenoid cystic carcinoma: Report of two cases

Introduction: Tracheal adenoid cystic carcinoma (ACC) is rare and accounts for <1% of all lung cancers. Although ACC is classified as a low-grade tumor, metastases are frequently identified in the late period. Extrapulmonary metastases are rare, and their resection has rarely been reported. Presentation of case: Case 1: A 77-year-old man underwent tracheal resection for ACC with postoperative radiation (60 Gy) 14 years before (at the age of 63). He underwent two subsequent pulmonary resections for metastases. Fourteen years after the first operation, he underwent extended right posterior segmentectomy with resection of segment IV and radiofrequency ablation for metastases of ACC to the liver. He was diagnosed with metastases to the kidney with peritoneal dissemination 4 years after the liver resection and died of pneumonia 2 years later. Case 2: A 53-year-old woman underwent a two-stage operation involving tracheal resection for ACC and partial resection of liver segments II and V for metastases of ACC to the liver. The tracheal margin was histopathologically positive. Postoperative radiation was performed, and she was tumor-free for 10 months after the liver resection. Discussion: Complete resection of tracheal ACC provides better survival. Radiotherapy is also recommended. However, the optimal treatment for metastases of ACC is unclear, especially because liver resection for metastases of tracheal ACC is rarely reported. Our two cases of metastases of tracheal ACC were surgically managed with good outcomes. Conclusion: Liver resection for metastases of tracheal ACC may contribute to long survival

Correction: Regeneration of esophagus using a scaffold-free biomimetic structure created with bio-three-dimensional printing.

[This corrects the article DOI: 10.1371/journal.pone.0211339.]

Regeneration of esophagus using a scaffold-free biomimetic structure created with bio-three-dimensional printing

Various strategies have been attempted to replace esophageal defects with natural or artificial substitutes using tissue engineering. However, these methods have not yet reached clinical application because of the high risks related to their immunogenicity or insufficient biocompatibility. In this study, we developed a scaffold-free structure with a mixture of cell types using bio-three-dimensional (3D) printing technology and assessed its characteristics in vitro and in vivo after transplantation into rats. Normal human dermal fibroblasts, human esophageal smooth muscle cells, human bone marrow-derived mesenchymal stem cells, and human umbilical vein endothelial cells were purchased and used as a cell source. After the preparation of multicellular spheroids, esophageal-like tube structures were prepared by bio-3D printing. The structures were matured in a bioreactor and transplanted into 10-12- week-old F344 male rats as esophageal grafts under general anesthesia. Mechanical and histochemical assessment of the structures were performed. Among 4 types of structures evaluated, those with the larger proportion of mesenchymal stem cells tended to show greater strength and expansion on mechanical testing and highly expressed α-smooth muscle actin and vascular endothelial growth factor on immunohistochemistry. Therefore, the structure with the larger proportion of mesenchymal stem cells was selected for transplantation. The scaffold-free structures had sufficient strength for transplantation between the esophagus and stomach using silicon stents.The structures were maintained in vivo for 30 days after transplantation. Smooth muscle cells were maintained, and flat epithelium extended and covered the inner surface of the lumen. Food had also passed through the structure. These results suggested that the esophagus-like scaffold-free tubular structures created using bio-3D printing could hold promise as a substitute for the repair of esophageal defects