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Lin ZX, Weiss A, Lee KI, Heering G, Chang L, Pais S. Metastatic Squamous Cell Carcinoma of the Lung Disclosed From Constipation Workup. ACG Case Rep J 2023; 10:e01133. [PMID: 37654618 PMCID: PMC10468112 DOI: 10.14309/crj.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
A palpable rectal mass associated with gastrointestinal (GI) symptoms immediately raises concern for colorectal cancer, but rarely can represent distant metastatic disease. The incidence of symptomatic colorectal metastasis from a primary lung cancer without any pulmonary symptom is extremely rare. We report a rare case of constipation as the presenting symptom in a patient ultimately found to have metastatic squamous cell carcinoma of the lung. A rectal mass was readily palpable on examination, illustrating the importance of digital rectal examination. In addition, GI clinicians should maintain a high index of suspicion when evaluating patients at risk of non-GI malignancies.
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Affiliation(s)
- Zilan X. Lin
- Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, Valhalla, NY
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Aaron Weiss
- Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, Valhalla, NY
| | - Kyu-In Lee
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Gabriel Heering
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Lillian Chang
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Shireen Pais
- Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, Valhalla, NY
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2
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Lung sarcomatoid carcinoma metastasizing to the colonic hepatic flexure, the mesentery and adrenal glands: A case report. Asian J Surg 2023; 46:636-637. [PMID: 35864043 DOI: 10.1016/j.asjsur.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 12/15/2022] Open
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3
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Intestinal obstruction caused by colonic metastasis of lung squamous carcinoma. Asian J Surg 2022; 46:1850-1851. [PMID: 36328846 DOI: 10.1016/j.asjsur.2022.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 10/20/2022] [Indexed: 11/23/2022] Open
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4
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Kikuchi Y, Shimada H, Isobe K, Shimizu R, Wakabayashi M, Yamaguchi K, Igarashi Y. Clinicopathological characteristics of colorectal metastases from lung cancer: systematic review of the case reports in the Japanese literature. Int Cancer Conf J 2021; 10:266-273. [PMID: 34567936 PMCID: PMC8421478 DOI: 10.1007/s13691-021-00502-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022] Open
Abstract
Since colorectal metastases from primary lung cancer are rare, the location of metastatic lesion and prognostic factors have not been well evaluated. Therefore, we carried out a systematic review and meta-analysis to assess the clinicopathological characteristics and prognostic factors of Japanese patients with colorectal metastasis from lung cancer. We searched the Ichushi-Web database from January 1964 to December 2020. We found 59 colorectal metastases in 52 cases for this meta-analysis. Small cell carcinoma was shown to have significantly more metastases to the appendix than non-small cell carcinoma. However, there was no significant correlation between location and histology when classified into right and left colons (P = 0.247). The median overall survival after diagnosis was 6 months. Univariate analysis showed that adenocarcinoma (Hazard Ratio (HR) 0.383, P = 0.024), simultaneous metastasis (HR 0.325, P = 0.046), and chemotherapy group (HR 0.482, P = 0.044) were good prognostic factors. Multivariate analysis confirmed that chemotherapy (HR 0.38, P = 0.02) was an independent good prognostic factor for overall survival. In conclusion, although there was no statistical difference, right colon metastases were more frequent than left colon metastases. Chemotherapy may be effective for colorectal metastases from lung cancer.
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Affiliation(s)
- Yoshinori Kikuchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
| | - Hideaki Shimada
- Department of Gastroenterological Surgery and Clinical Oncology, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Kazutoshi Isobe
- Division of Respiratory Medicine, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Ryo Shimizu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
| | - Munehiro Wakabayashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
| | - Kazuhisa Yamaguchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
| | - Yoshinori Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
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Bhutta SI, Ahmed Y, Zahid T, Rehman HU, Nur MM, Mahmood T, Calvert P. Colonic Metastasis of Primary Lung Cancer. Case Rep Oncol 2021; 14:901-905. [PMID: 34267636 PMCID: PMC8261258 DOI: 10.1159/000516795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 12/18/2022] Open
Abstract
The colon is an uncommon secondary site for metastasis of lung adenocarcinoma. Distinguishing primary colonic carcinoma from metastatic spread of lung carcinoma can be difficult. We present a case of a patient with lung adenocarcinoma who, on abdominal computed tomography scan examination, was found to have a sigmoid tumor that was thought to represent a synchronous primary colorectal adenocarcinoma. Histological examination of endoscopic sigmoid tumor biopsies confirmed this to be metastasis from the lung adenocarcinoma. The patient subsequently developed major rectal bleeding and deteriorated significantly. This case also illustrates the poor prognosis association with colorectal metastasis of lung cancer.
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Affiliation(s)
- Salman Idrees Bhutta
- Division of Oncology, Department of Medicine, University Hospital Waterford, Waterford, Ireland
| | - Yasar Ahmed
- Division of Oncology, Department of Medicine, University Hospital Waterford, Waterford, Ireland
| | - Talal Zahid
- Department of Medicine, District Headquarters Hospital, Faisalabad, Pakistan
| | - Habib Ur Rehman
- Department of Medicine, District Headquarters Hospital, Faisalabad, Pakistan
| | - Mutaz M Nur
- Division of Pathology, Department of Medicine, University Hospital Waterford, Waterford, Ireland
| | - Tariq Mahmood
- Department of Medicine, Consultant Physician, District Headquarters Hosiptal, Jhang, Pakistan
| | - Paula Calvert
- Department of Medicine, Consultant Oncologist, University Hospital Waterford, Waterford, Ireland
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Tanriverdi O, Alkan A, Ozseker B, Solak-Ozseker H, Kilinc RM. Synchronous duodenum and descending colon metastasis from primary lung neuroendocrine small-cell carcinoma: A case report and review of the literature. J Oncol Pharm Pract 2020; 26:1524-1529. [PMID: 32063106 DOI: 10.1177/1078155220904133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Metastasis to the gastrointestinal tract from lung cancer is very uncommon and is often asymptomatic. Although small bowel metastasis may commonly occur, metastases to the stomach and colon are uncommon. CASE REPORT In this paper, we present a previously healthy 57-year-old male patient, a 60-packet per year smoker, who was taken to the emergency room with complaints of increasing abdominal pain, rectal bleeding, weight loss, and dyspnea for the last three months. Endoscopic examination revealed polypoid lesions in the duodenum and the descending colon. We diagnosed neuroendocrine small-cell lung cancer based on histopathological and immunohistochemical staining.Management and outcome: A cisplatin (d1, 60 mg/m2/day)-etoposide (d1 to d3, 120 mg/m2/day) regimen was given every three weeks as palliative chemotherapy. After the three course of chemotherapy, the lung radiograph showed a decline in hilar expansion and there was no pleural effusion. Then, he died of acute respiratory failure two weeks after radiotherapy of brain. DISCUSSION Gastrointestinal tract metastasis of lung cancer is recognized synchronously with or rarely before diagnosis. It is generally recognized after the diagnosis of lung cancer. These patients often have other concurrent body metastases. Prognosis is poor, and survival expectation is short. The most common metastases to the gastrointestinal tract are squamous and large cell lung cancer metastases. Our aim is to emphasize the importance of immunohistochemical examination for masses in the gastrointestinal tract and to present this rare case of synchronous duodenal and colonic metastases of small-cell lung cancer.
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Affiliation(s)
- Ozgur Tanriverdi
- Department of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Burak Ozseker
- Department of Gastroenterology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Havva Solak-Ozseker
- Department of Medical Pathology, Mugla Sitki Kocman University Education and Research Hospital, Mugla, Turkey
| | - Rabia Mihriban Kilinc
- Department of Radiodiagnostics, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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Greenberg S, Inman JC, Yung E, Choo EB. Colon mass: a rare site of metastasis for squamous cell cancer of the head and neck. J Surg Case Rep 2020; 2020:rjz391. [PMID: 32064074 PMCID: PMC7015074 DOI: 10.1093/jscr/rjz391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/06/2019] [Accepted: 12/18/2019] [Indexed: 11/14/2022] Open
Abstract
A 61-year-old man with a past medical history significant for heavy alcohol consumption and an extensive smoking history presented with a left neck mass which was diagnosed as a pT3N2bM0 squamous cell carcinoma (SCC) of the submandibular gland. The patient was later found to have recurrence with mediastinal metastasis despite adjuvant chemoradiation. He subsequently developed abdominal distention with computed tomography revealing an ascending colon mass and findings concerning for perforation. The patient underwent an exploratory laparotomy with right hemicolectomy. Surgical pathology was consistent with metastatic SCC.
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Affiliation(s)
- Shannon Greenberg
- Department of General Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Jared C Inman
- Department of Ear, Nose, and Throat Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Esther Yung
- Department of General Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Evelyn B Choo
- Department of Pathology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
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Metastatic Cutaneous Squamous Cell Carcinoma of the Colon Presenting as Transfusion-Dependent Hematochezia. ACG Case Rep J 2020; 7:e00303. [PMID: 32309497 PMCID: PMC7145165 DOI: 10.14309/crj.0000000000000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/07/2019] [Indexed: 11/17/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the colon is an exceedingly rare clinical diagnosis with few cases reported in the literature. We report a case of a 61-year-old man with a medical history of cutaneous SCC of the penis who presented with hematochezia and was found to have metastatic SCC to the distal transverse colon. To our knowledge, this is the first case of colonic SCC presenting as a metastatic disease from a primary penile site.
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Parker NA, McBride C, Forge J, Lalich D. Bowel obstruction caused by colonic metastasis of lung adenocarcinoma: a case report and literature review. World J Surg Oncol 2019; 17:63. [PMID: 30961608 PMCID: PMC6454752 DOI: 10.1186/s12957-019-1611-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/29/2019] [Indexed: 01/07/2023] Open
Abstract
Introduction Lung cancer is the most common cause of cancer-related deaths globally. Metastatic disease is often found at the time of initial diagnosis in the majority of lung cancer patients. However, colonic metastases are rare. This report describes an uncommon case of colonic metastasis from lung adenocarcinoma. Case presentation A 64-year-old female presented to her gastroenterologist for progressively worsening abdominal pain and constipation. Exploratory colonoscopy revealed a large rectosigmoid mass resulting in near total rectal occlusion. Her specialist recommended she immediately go to her regional hospital for further workup. On admission, she complained of continued abdominal pain and constipation. Notably, she had a past medical history of non-small cell lung cancer (T1bN3M0 stage IIIB), diagnosed 1 year prior. She was thought to be in remission following radiation and immunotherapy with pembrolizumab. Upon hospital admission, she underwent an urgent colostomy, ileocecectomy and anastomosis, and rectosigmoid mass resection with tissue sampling. Pathology confirmed the diagnosis of colonic metastasis from primary lung adenocarcinoma. Treatment was with systemic chemotherapy followed by localized radiation to the pelvic region was started. She did not respond well to these therapies. Subsequent imaging showed refractory tumor growth in the pelvic region. Treatment could not be completed due to the patient experiencing a debilitating stroke, and she was transitioned to hospice care. Conclusions Clinicians should have a low threshold for intestinal investigation and considerations for colonic metastasis when patients with a history of primary lung cancer have abdominal symptoms.
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Affiliation(s)
- N A Parker
- Department of Internal Medicine, University of Kansas School of Medicine, 2817 N Tallgrass St, Wichita, KS, 67226, USA.
| | - C McBride
- Department of Internal Medicine, University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - J Forge
- Department of Internal Medicine, University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - D Lalich
- Department of Anatomical and Clinical Pathology, Wesley Medical Center, 550 N. Hillside St, Wichita, KS, 67214, USA
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Isolated colonic metastasis two years after resection of stage IA primary adenocarcinoma of the lung: A case report. Respir Med Case Rep 2018; 25:86-88. [PMID: 30094153 PMCID: PMC6076219 DOI: 10.1016/j.rmcr.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/10/2018] [Accepted: 07/10/2018] [Indexed: 02/07/2023] Open
Abstract
Colonic metastasis from lung cancer is rare, generally asymptomatic and usually develop at advanced cancer stages. Here, we report a case with a resected stage IA lung adenocarcinoma in a 51yo male patient that presented two years later with mild abdominal pain due to intestinal obstruction caused by a metastatic colon tumor. The patient underwent colonoscopy followed by surgical resection and the pathologic report was adenocarcinoma which was the same as that from a lung nodule that was excised two years earlier. Immunohistochemistry was cytokeratin 7 (CK7) positive, thyroid transcription factor 1 (TTF1) focally positive and cytokeratin 20 (CK20), caudal-related homeobox transcription factor 2 (CDX2) negative on both lung biopsy and colon surgical specimens. Interestingly there was no obvious lung cancer recurrence both at the time of metastasis and one year following chemotherapy.
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11
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Schwartz B, Schwartz M. Metastatic Cutaneous Squamous Cell Carcinoma with Gastrointestinal Involvement: A Case Report. Case Rep Oncol 2016; 9:869-873. [PMID: 28203180 PMCID: PMC5260607 DOI: 10.1159/000454760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 11/28/2016] [Indexed: 01/29/2023] Open
Abstract
Metastatic squamous cell carcinoma (SCC) involving the gastrointestinal tract as the sole site of metastatic disease is exceedingly rare. We report a patient with known cutaneous SCC that metastasized to regional lymph nodes who, after therapy, appeared to be disease free until a small metastatic lesion was identified on colonoscopy within a diverticular orifice. He was subsequently noted to have more diffuse gastrointestinal involvement, including a small bowel lesion not previously identified on imaging. The presence of a gastrointestinal metastatic lesion in this setting should prompt consideration to exclude other synchronous lesions and the need for possible additional systemic therapy.
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Asayama N, Oka S, Tanaka S, Hirano D, Sumimoto K, Ninomiya Y, Tamaru Y, Shigita K, Hayashi N, Shimamoto F, Arihiro K, Chayama K. Pedunculated-type T1 colorectal carcinoma with lung carcinoma metastasis at the deepest invasive portion. Clin J Gastroenterol 2016; 9:208-14. [PMID: 27259703 DOI: 10.1007/s12328-016-0659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/24/2016] [Indexed: 11/30/2022]
Abstract
We present a rare case of colorectal T1 carcinoma with metastasis of previous lung carcinoma found at the deepest invasive portion. A 61-year-old man presented with cervical lymphadenopathy 18 years after undergoing surgery for right lung carcinoma [poorly differentiated adenocarcinoma stage IIb (T3N0M0)]. Contrast-enhanced computed tomography showed enlarged lymph nodes (LNs) in the neck and mediastinal regions. Combined hybrid-F-fluorodeoxyglucose positron emission-computerized tomography showed increased radionuclide uptake in multiple cervical LNs and mediastinal LNs. LN biopsy revealed a poorly differentiated adenocarcinoma, suspected to be a metastatic tumor of the lung. Subsequent colonoscopy revealed a pedunculated-type lesion with a depressed area in the ascending colon. We performed polypectomy as total excisional biopsy; this tumor was composed mainly of moderately differentiated adenocarcinoma, partially mixed with mucinous adenocarcinoma. The pathological findings of the invasive front of the colorectal carcinoma showed poorly differentiated adenocarcinoma with a morphological pattern similar to that of the previous lung carcinoma. Furthermore, immunohistochemical results for the histological type of the deepest invasive portion of the tissue specimen were positive for thyroid transcription factor-1 but negative for Caudal-type homeobox 2. From these morphological and immunohistochemical findings, the final diagnosis was moderately differentiated lung carcinoma, pTX N3 M1b (LN, colon) Stage IV.
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Affiliation(s)
- Naoki Asayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Shiro Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Daiki Hirano
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kyoku Sumimoto
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Ninomiya
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuzuru Tamaru
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenjiro Shigita
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nana Hayashi
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Fumio Shimamoto
- Department of Health Science, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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