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2.
Intern Med ; 59(4): 513-518, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31708540

RESUMO

A 72-year-old man was followed as an outpatient at our hospital for 6 years after surgery for small cell carcinoma of left adrenal gland origin. Follow-up abdominal computed tomography showed a 6-cm mass in the left lower mesentery. The patient underwent open laparotomy. The histological diagnosis was sclerosing mesenteritis. The previous specimens of the left adrenal mass were then re-examined with a microscope, and panniculitis was found around the small cell carcinoma. Both lesions were histologically similar to IgG4-related disease (RD), but they did not completely meet the diagnostic criteria of IgG4-RD clinically or histologically.


Assuntos
Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/fisiopatologia , Doença Relacionada a Imunoglobulina G4/cirurgia , Mesentério/fisiopatologia , Mesentério/cirurgia , Paniculite Peritoneal/diagnóstico , Paniculite Peritoneal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diagnóstico Diferencial , Feminino , Humanos , Laparotomia/métodos , Masculino , Pessoa de Meia-Idade , Mimetismo Molecular , Paniculite Peritoneal/patologia , Tomografia Computadorizada por Raios X/métodos
3.
Pathol Int ; 68(12): 706-711, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30511782

RESUMO

A fundic gland polyp (FGP) is a common gastric polyp. Intraepithelial neoplasia in FGPs, referred to as FGP with dysplasia, is often seen in patients with familial adenomatous polyposis (FAP). In sporadic FGPs, low-grade dysplasia (LGD) is rare, and high-grade dysplasia (HGD) or carcinoma arising from sporadic FGPs is extremely rare. Because of this rarity, the prognosis and appropriate management of these lesions have not been clarified. In the present case, a sporadic FGP with LGD did not develop into invasive carcinoma, but contained foci of HGD 14 years after diagnosis. The biopsy specimen of the polyp taken at the first esophagogastroduodenoscopy 15 years earlier was diagnosed as FGP without dysplasia. At the second histological examination, LGD was found. Because the polyp increased in size during proton pump inhibitor therapy for 14 years, endoscopic mucosal resection was performed. The pathological diagnosis of the resected specimen was FGP with HGD mixed in LGD, with no invasive carcinoma. Dysplasia in FGPs might have less malignant potential regardless of dysplasia or size.


Assuntos
Pólipos/patologia , Inibidores da Bomba de Prótons/uso terapêutico , Neoplasias Gástricas/patologia , Esofagite Péptica/tratamento farmacológico , Feminino , Humanos , Hiperplasia/patologia , Pessoa de Meia-Idade
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