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Wakabayashi, Hideyuki,Matsutani, Takeshi,Fujita, Itsurou,Kanazawa, Yoshikazu,Nomura, Tsutomu,Hagiwara, Nobutoshi,Hosone, Masaru,Katayama, Hironori,Uchida, Eiji The Korean Gastric Cancer Association 2014 Journal of gastric cancer Vol.14 No.1
We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy, and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristics of 56 cases of gastric squamous cell carcinoma reported in Japan.
Kazuyuki Matsumoto,Hironari Kato,Shigeru Horiguchi,Takeshi Tomoda,Akihiro Matsumi,Yuki Ishihara,Yosuke Saragai,Saimon Takada,Shinichiro Muro,Daisuke Uchida,Hiroyuki Okada 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.5
Background/Aims: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA; EUS-FNA) allows for diagnostic tissue specimens from various regions to be analyzed. However, diagnosing recurrent pancreaticobiliary cancer after surgery is sometimes difficult. We evaluated the efficacy of EUS-FNA in the diagnosis of local recurrence of pancreaticobiliary cancer and analyzed the factors associated with falsenegative results. Methods: Fifty-one consecutive patients who underwent EUS-FNA due to suspected recurrence of pancreaticobiliary cancer after surgery in an academic center were retrospectively analyzed. The criteria for EUS-FNA were a resected margin or remnant pancreas mass, round swollen lymph node (≥10 mm in diameter), and soft-tissue enhancement around a major artery. Patients with suspected liver metastasis or malignant ascites were excluded. Results: Thirty-nine of the 51 patients had pancreatic cancer; the remaining 12 had biliary cancer. The target sites for EUS-FNA were the soft tissue around a major artery (n=22, 43%), the resected margin or remnant pancreas (n=12, 24%), and the lymph nodes (n=17, 33%). The median size of the suspected recurrent lesions was 15 mm (range, 8 to 40 mm). The overall sensitivity, specificity and accuracy of EUS-FNA for the diagnosis of recurrence was 84% (32/38), 100% (13/13), and 88% (45/51), respectively. FNA of the soft tissue around major arteries (odds ratio, 8.23; 95% confidence interval, 1.2 to 166.7; p=0.033) was significantly associated with a falsenegative diagnosis in the multivariate analysis. Conclusions: EUS-FNA is useful for diagnosing recurrent cancer, even after pancreaticobiliary surgery. The diagnoses of recurrence at soft-tissue sites should be interpreted with caution.
Ryo Harada,Hironari Kato,Soichiro Fushimi,Hirofumi Inoue,Daisuke Uchida,Yutaka Akimoto,Takeshi Tomoda,Kazuyuki Matsumoto,Yasuhiro Noma,Naoki Yamamoto,Shigeru Horiguchi,Koichiro Tsutsumi,Hiroyuki Okada 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.4
Background/Aims: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy ofspecimen sampling using endosonography. We conducted this study to evaluate the effcacy of the BLS in sampling of specimens byendoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses. Methods: This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on grossvisual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence inthe first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium wasevaluated by a cytopathologist who was blinded to any clinical information. Results: A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) withthe BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement wasobserved both with and without BLS (kappa score 0.40 and 0.29, respectively). Conclusions: The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacyusing gross visual inspection.
Yuki Fujii,Kazuyuki Matsumoto,Hironari Kato,Yosuke Saragai,Saimon Takada,Sho Mizukawa,Shinichiro Muro,Daisuke Uchida,Takeshi Tomoda,Shigeru Horiguchi,Noriyuki Tanaka,Hiroyuki Okada 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.5
Background/Aims: This study aimed to examine the diagnostic ability of endoscopic ultrasonography (EUS) for major vascularinvasion in pancreatic cancer and to evaluate the relationship between EUS findings and pathological distance. Methods: In total, 57 consecutive patients who underwent EUS for pancreatic cancer before surgery were retrospectively reviewed. EUSimage findings were divided into four types according to the relationship between the tumor and major vessel (types 1 and 2: invasion,types 3 and 4: non-invasion). We also compared the EUS findings and pathologically measured distances between the tumors andevaluated vessels. Results: The sensitivity, specificity, and accuracy of EUS diagnosis for vascular invasion were 89%, 92%, and 91%, respectively, in theveins and 83%, 94%, and 93%, respectively, in the arteries. The pathologically evaluated distances of cases with type 2 EUS findings weresignificantly shorter than those of cases with type 3 EUS findings in both the major veins (median [interquartile range], 96 [0–742] µmvs. 2,833 [1,076–5,694] µm, p=0.012) and arteries (623 [0–854] µm vs. 3,097 [1,396–6,000] µm, p=0.0061). All cases with a distance of≥1,000 µm between the tumors and main vessels were correctly diagnosed. Conclusions: Tumors at a distance ≥1,000 µm from the main vessels were correctly diagnosed by EUS.
Hideyuki Wakabayashi,Itsurou Fujita,Yoshikazu Kanazawa,Tsutomu Nomura,Nobutoshi Hagiwara,,Masaru Hosone,Hironori Katayama,Eiji Uchida,Takeshi Matsutani 대한위암학회 2014 Journal of gastric cancer Vol.14 No.1
We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy,and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristicsof 56 cases of gastric squamous cell carcinoma reported in Japan.