RESUMO
A man was referred to our hospital because of malaise and abnormal liver function tests. He had had a kidney removed for early renal cell carcinoma. We performed ultrasonography, CT scan, and liver biopsy, all of which were normal. However, FDG-PET revealed abnormal, diffuse uptake in the bone. A bone biopsy showed abnormal clear cells resembling renal cell carcinoma. Because there was no other primary origin, this histopathological finding led to the diagnosis of bone metastasis of renal cell carcinoma, and the abnormal liver function test was thus inferred to be due to Stauffer syndrome.
Assuntos
Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Hepatopatias/diagnóstico por imagem , Biópsia , Carcinoma de Células Renais/diagnóstico por imagem , Evolução Fatal , Febre/etiologia , Fluordesoxiglucose F18 , Humanos , Inflamação/diagnóstico por imagem , Inflamação/etiologia , Neoplasias Renais/diagnóstico por imagem , Hepatopatias/etiologia , Hepatopatias/patologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de PósitronsAssuntos
Dissecação , Mucosa Gástrica/patologia , Gastroscopia/métodos , Movimentos da Cabeça , Cirurgia Vídeoassistida/métodos , Idoso , Desenho de Equipamento , Feminino , Mucosa Gástrica/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Interface Usuário-ComputadorRESUMO
This study aimed to assess the diagnostic usefulness of CT enterography (CTE) in Crohn's disease in Japanese patients. A total of 32 cases with bowel symptoms underwent CT enterography with polyethylene glycol electrolyte solution as oral contrast medium, among which 18 were clinically diagnosed as Crohn's disease and 14 were not: ulcerative colitis 1, Beçhet disease 1, simple ulcer 1, inflammatory bowel disease without definite diagnosis 5 and bowel symptoms of unknown origin 6. The incidence of bowel wall thickening, mural hyperenhancement, "the comb sign", mesenteric lymph nodes swelling, and stenosis were significantly higher in Crohn's disease than in other disease. Moreover, uneven bowel wall thickening and unilateral mural hyperenhancement on CTE were characteristic features of Crohn's disease, which our original quantitative evaluation with imaging analysis could support. Consequently, CTE is useful in Japanese patients with Crohn's disease.
Assuntos
Meios de Contraste , Doença de Crohn/diagnóstico por imagem , Polietilenoglicóis , Adolescente , Adulto , Idoso , Eletrólitos , Feminino , Humanos , Intestino Delgado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
A 50-year-old woman was admitted to our hospital because of abdominal pain and vomiting. Ileus with ulcerated jejunal tumor was diagnosed and biopsy revealed adenocarcinoma. Because her serum level of DUPAN-2 was high, she was examined by PET scan, which revealed that she had a left ovarian mass in addition to the jejunal tumor. Surgical resection was performed: both tumors were adenocarcinoma, but the ovarian tumor was considered to be metastatic clinically and histologically. Immunostaining for DUPAN-2 was positive in the both tumors. The serum level of DUPAN-2 returned to normal after the surgery, and has been within normal limits for about 3 years without any additional therapy. This case shows a possible relation between small bowel adenocarcinoma and DUPAN-2.