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Gastric linitis plastica with autoimmune pancreatitis diagnosed by an endoscopic ultrasonography-guided fine-needle biopsy: A case report

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World Journal of Clinical Cases 2022年第31期10卷 11607-11616页

作者： Ryosuke Sato Kazuyuki Matsumoto Hiromitsu Kanzaki Akihiro Matsumi Kazuya Miyamoto Kosaku Morimoto Hiroyuki Terasawa Yuki Fujii tatsuhiro yamazaki Daisuke Uchida Koichiro Tsutsumi Shigeru Horiguchi Hironari Kato Gastroenterology and Hepatology Okayama University HospitalOkayama 700-8558Japan

BACKGROUND Gastric linitis plastica(GLP)is a subset of gastric cancer with a poor prognosis.It is difficult to obtain a definitive diagnosis by endoscopic mucosal biopsies,and the usefulness of an endoscopic ultrasonography-guided fine-needle biopsy(EUSFNB)for GLP has been recently reported.Meanwhile,autoimmune diseases are occasionally known to coexist with malignant tumors as paraneoplastic syndrome.We herein report the usefulness of an EUS-FNB for detecting GLP and the possibility of paraneoplastic syndrome coexisting with GLP.CASE SUMMARY An 81-year-old man was admitted to our hospital for a 1-mo history of epigastric pain that increased after eating.His laboratory data revealed high levels of serum carbohydrate antigen 19-9 and immunoglobulin-G4.Endoscopic examinations showed giant gastric folds and reddish mucosa;however,no epithelial changes were observed.The gastric lumen was not distensible by air inflation,suggesting GLP.Computed tomography showed the thickened gastric wall,the diffuse enlargement of the pancreas,and the peripancreatic rim,which suggested autoimmune pancreatitis(AIP)coexisting with GLP.Because the pathological findings of the endoscopic biopsy showed no malignancy,he underwent an EUSFNB and was diagnosed with GLP.He received chemotherapy for unresectable gastric cancer due to peritoneal metastasis,after which both the gastric wall thickening and diffuse enlargement of the pancreas were improved.CONCLUSION An EUS-FNB for GLP with a negative endoscopic biopsy is useful,and AIP may develop as a paraneoplastic syndrome.

关键词： Endoscopic ultrasound-guided fine needle aspiration Linitis plastica Autoimmune pancreatitis Paraneoplastic syndromes Case report

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Crosstalk between angiogenesis, cytokeratin-18, and insulin resistance in the progression of non-alcoholic steatohepatitis

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World Journal of Gastroenterology 2009年第41期15卷 5193-5199页

作者： Mitsuteru Kitade Hitoshi Yoshiji Ryuichi Noguchi Yasuhide Ikenaka Kosuke Kaji Yusaku Shirai Masaharu yamazaki Masahito Uemura Junichi Yamao Masao Fujimoto Akira Mitoro Masahisa Toyohara Masayoshi Sawai Motoyuki Yoshida Chie Morioka tatsuhiro Tsujimoto Hideto Kawaratani Hiroshi Fukui Third Department of Internal Medicine Nara Medical University

AIM: To elucidate the possible crosstalk between angiogenesis, cytokeratin-18 (CK-18), and insulin resistance (IR) especially in patients with non-alcoholic steatohepatitis (NASH).METHODS: Twenty-eight patients with NASH and 11 with simple fatty liver disease (FL) were enrolled in this study and underwent clinicopathological examination. The measures of angiogenesis, CK-18, and IR employed were CD34-immunopositive vessels, CK-18immunopositive cells, and homeostasis model assessment of IR (HOMA-IR), respectively. The correlations of these factors with NASH were elucidated.RESULTS: Significant development of hepatic neovascularization was observed only in NASH, whereas almost no neovascularization could be observed in FL and healthy liver. The degree of angiogenesis was almost parallel to liver fibrosis development, and both parameters were positively correlated. Similarly, CK-18expression and HOMA-R were signifi cantly increased in NASH as compared with FL and healthy liver. Furthermore, CK-18 and HOMA-IR were also positively correlated with the degree of neovascularization. CONCLUSION: These results indicate that the crosstalk between angiogenesis, CK-18, and IR may play an important role in the onset and progression of NASH.

关键词：胰岛素抵抗血管生成细胞角蛋白脂肪肝酒精性串扰肝炎佛罗里达州

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