[A case of gastric follicular lymphoma with rapid deterioration and transformation]

A 79-year-old male patient underwent esophagogastroduodenoscopy, which revealed a reddish lesion, 10mm in diameter, presenting as a surface recess in the angular incisure. He was diagnosed with gastric follicular lymphoma. Positron emission tomography-computed tomography revealed metastasis to the mediastinal lymph node, although the tumor size was small. Hence, we did not administer any treatment and continued following up. After 8 months, multiple enlarged lymphoma lesions in the stomach and a mass with ulceration on the oral side of the duodenal papilla were observed. The tumor had transformed into diffuse large B-cell lymphoma; therefore, chemotherapy was initiated. The patient has remained recurrence-free for 55 months after treatment.

Folinic Acid, Fluorouracil, and Oxaliplatin Therapy for Recurrent Esophageal Cancer with Syndrome of Inadequate Antidiuretic Hormone Secretion (SIADH) After Preoperative Cisplatin/5-Fluorouracil Therapy

Patient: Male, 77-year-old

Final Diagnosis: Syndrome of inadequate antidiuretic hormone secretion (SIADH)

Symptoms: Lightheadedness • diaphoresis • nausea • became unconscious

Medication: —

Clinical Procedure: —

Specialty: Oncology

[A case of anaplastic pancreatic carcinoma with tumor infiltration into the main pancreatic duct]

A 57-year-old man with fatigue was admitted to our hospital. Abdominal contrast computed tomography indicated the presence of a 35mm tumor in the pancreatic head and dilation of the main pancreatic duct from its body to the tail. Endoscopic ultrasonography revealed that the tumor had infiltrated and occupied the main pancreatic duct, and endoscopic retrograde pancreatography confirmed that the tumor was present in the main pancreatic duct. Tumor biopsy via endoscopic retrograde cholangiopancreatography demonstrated the proliferation of spindle and pleomorphic cells. Therefore, the patient was diagnosed with anaplastic pancreatic carcinoma and underwent subtotal stomach-preserving pancreaticoduodenectomy. Histological analysis showed the prevalence of adenocarcinoma and anaplastic carcinoma cells in the pancreatic parenchyma and main pancreatic duct, respectively. Anaplastic carcinoma cells showed a decrease in E-cadherin staining. In conclusion, tumor cell proliferation and lack of cell adhesion may have caused the infiltration into the main pancreatic duct.

Successful Treatment of Bouveret Syndrome by Electrohydraulic Lithotripsy and Double Balloon Endoscopy

Patient: Female, 84

Final Diagnosis: Bouveret syndrome

Symptoms: Abdominal and/or epigastric pain vomitting

Medication: —

Clinical Procedure: Electrohydraulic lithotripsy

Specialty: Gastroenterology and Hepatology

Acute Pancreatitis Caused by Ampullary Duodenum Adenoma in a Patient with Adenomatous Polyposis Coli with Billroth II Reconstruction After Distal Gastrectomy

Patient: Male, 73

Final Diagnosis: Pancreatitis

Symptoms: Upper abdominal pain

Medication: —

Clinical Procedure:—

Specialty: Gastroenterology and Hepatology

[A case of intracholecystic papillary neoplasm of the gallbladder (ICPN) examined using contrast-enhanced endoscopic ultrasonography]

A 78-year-old woman was found to have gallbladder wall thickening on ultrasonography during a routine health check-up and was referred to our clinic. On contrast-enhanced endoscopic ultrasonography, a papillary lesion measuring 14mm was detected in the fundus, which showed a heterogeneous enhancement at the early phase. She underwent cholecystectomy and gallbladder bed resection. Histological examination revealed that the tumor consisted of mucinous atypical cells, regularly arranged in a high-papillary architecture with delicate fibrovascular cores, which led to the diagnosis of intracholecystic papillary neoplasm of the gallbladder.