Ischemic enteritis with intestinal stenosis

A 75-year-old man was admitted to our hospital with sudden onset of vomiting and abdominal distension. The patient was taking medication for arrhythmia. Computed tomography showed stenosis of the ileum and a small bowel dilatation on the oral side from the region of stenosis. A transnasal ileus tube was placed. Enteroclysis using contrast medium revealed an approximately 6-cm afferent tubular stenosis 10 cm from the terminal ileum and thumbprinting in the proximal bowel. Transanal double-balloon enteroscopy showed a circumferential shallow ulcer with a smooth margin and edema of the surrounding mucosa. The stenosis was so extensive that we could not perform endoscopic balloon dilation therapy. During hospitalization, the patient's nutritional status deteriorated. In response, we surgically resected the region of stenosis. Histologic examination revealed disappearance of the mucosal layer and transmural ulceration with marked fibrosis, especially in the submucosal layer. Hemosiderin staining revealed sideroferous cells in the submucosal layers. Based on the pathologic findings, the patient was diagnosed with ischemic enteritis. The patient's postoperative course was uneventful

A case of thoracic SMARCA4‐Deficient undifferentiated tumor successfully treated with combination Ipilimumab–Nivolumab

Abstract Thoracic SMARCA4‐deficient undifferentiated tumors are rare, with poor prognosis. A 73‐year‐old man presented to our hospital with dyspnea. Computed tomography‐guided biopsy revealed a SMARCA4‐deficient undifferentiated tumor. The patient was treated with combination ipilimumab‐nivolumab. The tumor reduced in size after two courses

Diabetic nephropathy with marked extra-capillary cell proliferation: a case report

Abstract Background Extra-capillary hypercellularity is a common finding in crescentic glomerulonephritis (GN) and focal segmental glomerulosclerosis (FSGS). In diabetic nephropathy (DN), extra-capillary hypercellularity is often observed as a finding of complications such as IgA nephropathy or microscopic polyangiitis superimposed on DN. However, in rare cases, epithelial cell proliferation may accompany DN. We experienced a case of nodular diabetic glomerulosclerosis with marked extra-capillary hypercellularity and revealed the origin of this atypical lesion using immunostainings. Case presentation A man in his 50 s was admitted to the hospital with nephrotic syndrome, and a renal biopsy was performed. Diffuse nodular lesions and extra-capillary hypercellularity were observed, but the results of serological examination or immunofluorescent assays did not implicate any other crescentic GN. Immunostaining for claudin-1 and nephrin was performed to identify the origin of the extra-capillary lesions. Given the clinical course and pathological findings, a diagnosis of DN-associated extra-capillary cell proliferation was made. Conclusions Extra-capillary hypercellularity, which resembles FSGS or crescentic GN, is a rare finding in DN and should therefore be treated with caution. In such cases, co-staining for claudin-1 and nephrin may facilitate the diagnosis of DN

Squamous Cell Carcinoma of the Scalp Arising in a Site of Synthetic Hair Grafts

Summary:. Synthetic hair implantation was developed in the 1970s and initially gained popularity until major cutaneous complications, such as facial swelling, severe dermatitis, recurrent cellulitis, and cicatricial alopecia, became an issue. In particular, the procedure has been suggested to have a possible causal relationship with squamous cell carcinoma (SCC). This article describes the third reported case in the English literature of SCC arising in a site of synthetic hair grafts. The patient was an 80-year-old man with a prominent verrucous tumor in the parietal region; he had undergone synthetic hair implantation for the past 28 years. The pathological diagnosis of SCC was made by dermal punch biopsy, and computed tomography images revealed cranial osteolytic changes, with possible direct dural tumor invasion. Extensive resection of the tumor and reconstruction were performed following downsizing radiotherapy. The protruding tumor was excised with the adjacent portion of the parietal bone. Several synthetic hair grafts were found stuck in the cranium. The defect area was reconstructed with a synthetic bone material and a free latissimus dorsi muscle flap with skin graft. The pathological examination revealed well-differentiated SCC surrounded by numerous synthetic hair grafts inducing inflammatory cell infiltration and severe cicatrizing fibrous changes. The postoperative course was uneventful, and no recurrence or metastasis was observed at 9 months postoperatively