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A Case of Warthin’s Tumor Together with IgG4-Related Sialadenitis

Open Journal of Pathology 2024年第3期14卷 81-89页

作者： Ryogo Aoki risa ito Asuka Ohashi Riyoko Niwa Masashi Matsuyama Sachiko Oka Naomi Kawaguchi Toshimasa Sakakima Daichi Kodama Naoki Watanabe Daisuke Okamoto Takafumi Naiki Takuji Tanaka Department of Diagnostic Pathology (DDP) & Research Center of Diagnostic Pathology (RC-DiP) Gifu Municipal Hospital Gifu Japan Department of Central Clinical Laboratory Gifu Municipal Hospital Gifu Japan Department of Hematology Gifu Municipal Hospital Gifu Japan

Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland. The tumor contains the epithelial oncocyte cells with the presence of rich-mitochondria and their surrounding abundant lymphocytes. A relatively new disease entity of IgG4-related disease frequently occurs in the salivary gland. However, the coexistence of Warthin’s tumor and IgG4-related disease is scarcely observed. We have recently experienced a rare case of Warthin’s tumor with IgG4-related sialadenitis. A 51-year-old man presented to our hospital, complaining of a mass with right submandibular tenderness and spontaneous pain. A computed tomography scan of the cervical region revealed a suspicion of lymph node proliferative disease, including malignant lymphoma. Elevated serum levels of IL-2R: 1843 U/ml (reference value 122 - 496 U/ml), IgG: 3430 mg/dl (reference value 861 - 1747 mg/dl), and IgG4: 3140 mg/dl (reference value 11 - 121 mg/dl) were observed. Other laboratory data showed within normal ranges. The cervical tumor was diagnosed as Warthin’s tumor by the findings of fine-needle aspiration cytology and biopsy examination. Immunohistochemistry revealed numerous IgG4- and IgG-positive cells with fibrosis surrounding the epithelial component of Warthin’s tumor, suggesting IgG4-rerated sialadenitis. Finally, we diagnosed the cervical tumor as Warthin tumor with IgG4-related sialadenitis. This is the second report describing a case of Warthin’s tumor with possible involvement of IgG4-related sialadenitis.

关键词： Warthin’s Tumor Sialadenitis IgG4-Related Disease Immunohistochemistry

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Current perspectives of viral hepatitis

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World Journal of Gastroenterology 2024年第18期30卷 2402-2417页

作者： Daisuke Usuda Yuki Kaneoka Rikuo Ono Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Eri Nakajima Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi risa Katou Sakurako ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Viral hepatitis represents a major danger to public health,and is a globally leading cause of *** five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis E virus,each have their own unique epidemiology,structural biology,transmission,endemic patterns,risk of liver complications,and response to antiviral *** remain few options for treatment,in spite of the increasing prevalence of viral-hepatitiscaused liver ***,chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality,even though effective treatments are available that could reduce or prevent most patients’*** 2016,the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030,along with a discussion of current gaps and prospects for both regional and global eradication of viral ***,treatment is sufficiently able to prevent the disease from reaching advanced ***,future therapies must be extremely safe,and should ideally limit the period of treatment necessary.A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral *** review aims to summarize the current state of knowledge on each type of viral hepatitis,together with major innovations.

关键词： Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis D virus Hepatitis E virus Current perspectives

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Obligate aerobic, gram-positive, weak acid-fast, nonmotile bacilli, Tsukamurella tyrosinosolvens: Minireview of a rare opportunistic pathogen

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World Journal of Clinical Cases 2022年第24期10卷 8443-8449页

作者： Daisuke Usuda risa Tanaka Makoto Suzuki Shintaro Shimozawa Hayabusa Takano Yuta Hotchi Shungo Tokunaga Ippei Osugi risa Katou Sakurako ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Department of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

Tsukamurella species are obligate aerobic,gram-positive,weak acid-fast,nonmotile *** are found in various environments,such as soil,water,sludge,and petroleum reservoir wastewater,and belong to the order *** 2016,there was a reclassification of species within the genus Tsukamurella,merging the species Tsukamurella tyrosinosolvens(***)and Tsukamurella *** species are clinically considered to be a rare opportunistic pathogen,because most reported cases have been related to bacteremia and intravascular prosthetic devices and *** date,it has been isolated only from human specimens,and has always been associated with clinical disease;human infections are very *** infections have included pneumonia,brain abscesses,catheter-related bloodstream infections,ocular infections,bacteremia,and sepsis presenting with septic pulmonary emboli in patients who are *** date,there is no commercially available test for *** the other hand,sequence-based identification,including matrix-assisted laser desorption ionization time-of-flight mass spectrometry,is an alternative method for identifying clinical isolates that are either slow growers or difficult to identify through biochemical *** golden standards for diagnosis and optimal management still remain to be ***,newer molecular biological techniques can provide accurate identification,and contribute to the appropriate selection of definitive therapy for infections caused by this *** of several antimicrobial agents have been proposed for treatment,though the length of treatment for infections has yet to be determined,and should be individualized according to clinical *** patients often experience severe cases due to infection,and life-threatening *** events associated with dissemination and/or failure of source control have ***

关键词： Tsukamurella tyrosinosolvens Gram-positive bacilli Opportunistic infection Sequence-based identification Matrix-assisted laser desorption ionization time-of-flight mass spectrometry Combination antibiotic therapy

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Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9911-9920页

作者： Jiro Oba Daisuke Usuda Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Kenki Usami Shungo Tokunaga Ippei Osugi risa Katou Sakurako ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Faculty of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

BACKGROUND Esophageal submucosal hematoma is a rare *** the exact etiology remains uncertain,vessel fragility with external factors is believed to have led to submucosal bleeding and hematoma formation;the vessel was ruptured by a sudden increase in pressure due to nausea,and the hematoma was enlarged by antiplatelet or anticoagulant *** conditions are rare,with a better *** present the first known case of submucosal esophageal hematoma-subsequent hemorrhagic shock due to Mallory-Weiss *** SUMMARY A 73-year-old female underwent endovascular treatment for an unruptured cerebral *** patient received aspirin and clopidogrel before surgery and heparin during surgery,and was well during the *** hours after returning to the ICU,she complained of chest discomfort,vomited 500 m L of fresh blood,and entered hemorrhagic *** submucosal hematoma with Mallory-Weiss syndrome was diagnosed through an endoscopic examination and computed *** addition to a massive fluid and erythrocyte transfusion,we performed a temporary compression for hemostasis with a Sengstaken-Blakemore(S-B)***,she became hemodynamically *** postoperative day 1,we performed an upper gastrointestinal endoscopy and confirmed no expansion of the hematoma nor any recurring bleeding;therefore,we removed the S-B tube and clipped the gastric mucosal laceration at the esophagogastric *** started oral intake on postoperative day *** patient made steady progress,and was discharged on postoperative day *** We present the first known case of submucosal esophageal hematoma subsequent hemorrhagic shock due to Mallory-Weiss syndrome.

关键词： Esophageal submucosal hematoma Hemorrhagic shock Mallory-Weiss syndrome Antithrombotic therapy Anticoagulant therapy Case report

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Amebic liver abscess by Entamoeba histolytica

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World Journal of Clinical Cases 2022年第36期10卷 13157-13166页

作者： Daisuke Usuda Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Shungo Tokunaga Ippei Osugi risa Katou Sakurako ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Amebic liver abscesses(ALAs)are the most commonly encountered extraintestinal manifestation of human invasive amebiasis,which results from Entamoeba histolytica(***)spreading *** can be complicated by liver abscess in 9%of cases,and ALAs led to almost 50000 fatalities worldwide in *** there have been fewer and fewer cases in the past several years,ALAs remain an important public health problem in endemic *** causes both amebic colitis and liver abscess by breaching the host’s innate defenses and invading the intestinal *** often enter the circulatory system,where they are filtered in the liver and produce abscesses,and develop into severe invasive diseases such as *** clinical presentation can appear to be colitis,including upper-right abdominal pain accompanied by a fever in ALA *** diagnosis requires nonspecific liver imaging as well as detecting *** antibodies;however,these antibodies cannot be used to distinguish between a previous infection and an acute ***,diagnostics primarily aim to use PCR or enzyme-linked immunosorbent assay to detect *** can be treated medically,and percutaneous catheter drainage is only necessary in approximately 15%of *** indicated treatment is to administer an amebicidal drug(such as tinidazole or metronidazole)and paromomycin or other luminal cysticidal agent for clinical *** is good with almost universal *** which diagnostic methods are most efficacious will necessitate further analysis of similar clinical cases.

关键词： Amebic liver abscess Entamoeba histolytica Polymerase chain reaction Enzyme-linked immunosorbent assay Percutaneous catheter drainage Amebicidal drug

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Diffuse large B cell lymphoma originating from the maxillary sinus with skin metastases:A case report and review of literature

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World Journal of Clinical Cases 2021年第23期9卷 6886-6899页

作者： Daisuke Usuda Toshihide Izumida Nao Terada Ryusho Sangen Toshihiro Higashikawa Sayumi Sekiguchi risa Tanaka Makoto Suzuki Yuta Hotchi Shintaro Shimozawa Shungo Tokunaga Ippei Osugi risa Katou Sakurako ito Suguru Asako Yoshie Takagi Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Yuji Kasamaki Department of General Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-0035Tokyo-toJapan Kanazawa Medical University Himi Municipal Hospital Himi-shi 935-8531Toyama-kenJapan

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is the most common type of malignant lymphoma(ML),accounting for 30%-40%of cases of non-Hodgkin’s lymphoma(NHL)in *** paranasal sinus lymphoma is a rare presentation of extranodal NHL that accounts for only 0.17%of all *** from the maxillary sinus(MS)is a particularly rare presentation,and is thus often difficult to *** have reported the first known case of DLBCL originating from the MS with rapidly occurrent multiple skin *** SUMMARY An 81-year-old Japanese man visited our hospital due to continuous pain for 12 d in the left maxillary nerve *** medical history included splenectomy due to a traffic injury,an old right cerebral infarction from when he was 74-years-old,hypertension,and type 2 diabetes mellitus.A plain head computed tomography(CT)scan revealed a 3 cm×3.1 cm×3 cm sized left *** day 25,left diplopia and ptosis occurred,and a follow-up CT on day 31 revealed the growth of the left MS *** on an MS biopsy on day 50,we established a definitive diagnosis of DLBCL,non-germinal center B-cell-like originating from the left *** patient was admitted on day 62 due to rapid deterioration of his condition,and a plain CT scan revealed the further growth of the left MS mass,as well as multiple systemic metastasis,including of the skin.A skin biopsy on day 70 was found to be the same as that of the left MS *** notified the patient and his family of the disease,and they opted for palliative care,considering on his condition and *** patient died on day *** This case suggests the need for careful,detailed examination,and for careful follow-up,when encountering patients presenting with a mass.

关键词： Diffuse large B cell lymphoma Non-germinal center B-cell-like lymphoma Malignant lymphoma Maxillary sinus Skin metastasis Case report

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High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report

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World Journal of Clinical Cases 2023年第16期11卷 3870-3876页

作者： Shintaro Shimozawa Daisuke Usuda Toru Sasaki Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Yuta Hotchi Shungo Tokunaga Ippei Osugi risa Katou Sakurako ito Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo-city 113-8421TokyoJapan

BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter *** has been a growing number of reported cases of toxicity in recent ***,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive *** presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her *** SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide *** patient had a history of drug abuse and multiple self-inflicted *** the time of admission,she exhibited symptoms of shock and altered ***,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal *** convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a *** lavage and activated charcoal were also administered after *** systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors *** patient regained consciousness and was *** patient was subsequently transferred to a psychiatric facility,as suicidal ideation *** We report the first case of shock caused by an overdose of dextromethorphan.

关键词： Dextromethorphan Drug overdose Shock Symptom Treatment Case report

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Secondary pulmonary infection by Fusarium solani and Aspergillus niger during systemic steroid treatment for COVID-19:A case report

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世界临床病例杂志 2023年第26期11卷 6280-6288页

作者： Daisuke Usuda Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi risa Katou Sakurako ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 *** addition,Fusarium *** a rare cause of opportunistic life-threatening fungal *** Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting *** our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(***)and Aspergillus niger(***)during systemic steroid treatment for *** SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and *** established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal *** was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous *** condition improved,and we finished the vasopressor on the fifth hospital *** administered dexamethasone for ten days,and finished the course of *** the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the *** changed antibiotics to meropenem plus *** addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of ***,the pneumonia worsened,and the patient died on the seventeenth day of ***,*** and *** were identified from sputum collected on the twelfth *** was believed that he developed a cell-mediated immune defic

关键词： Fusarium solani Aspergillus niger Pulmonary infection Cell-mediated immune deficiency Coronavirus disease 2019 Case report

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Penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive man: A case report

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世界临床病例杂志 2023年第24期11卷 5811-5816页

作者： Daisuke Usuda Nobuyoshi Kaminishi Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi risa Katou Sakurako ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period,and a variety of metallic and non-metallic objects are *** the other hand,penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term *** goal of treating penile incarceration is to remove the foreign object as soon as *** the other hand,removal can be very challenging,and often requires resourcefulness and a multidisciplinary *** SUMMARY A 47-year-old man who has sex with men was transferred to our hospital for persistent phallodynia and scrotal pain,accompanying swelling due to strangulation by stainless steel *** medical history included acquired immunodeficiency *** day prior,he had put three stainless steel rings on his penis and scrotum before sexual *** sexual intercourse,he was unable to remove them,due to swelling of his penis and *** swelling persisted,and he felt pain in the affected area the next day,then he was transferred to our hospital by *** emergency department found that his penis and scrotum were markedly engorged and *** established a diagnosis of penile and scrotal strangulation by stainless steel *** unsuccessfully attempted to cut the rings using a cutter,then requested a rescue team via emergency medical *** cut through each ring in two places,using an electric-powered angle grinder,and successfully removed all of the ***,he was discharged and went *** We report the first case of penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive person.

关键词： Penile strangulation Stainless steel ring Human immunodeficiency virus Urologic emergency Management Case report

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Exophiala dermatitidis

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World Journal of Clinical Cases 2021年第27期9卷 7963-7972页

作者： Daisuke Usuda Toshihiro Higashikawa Yuta Hotchi Kenki Usami Shintaro Shimozawa Shungo Tokunaga Ippei Osugi risa Katou Sakurako ito Toshihiko Yoshizawa Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Department of Geriatric Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531Toyama-kenJapan

Exophiala is a genus comprising several species of opportunistic black yeasts,which belongs to *** is a rare cause of fungal ***,infections are often chronic and recalcitrant,and while the number of cases is steadily increasing in both immunocompromised and immunocompetent people,detailed knowledge remains scarce regarding infection mechanisms,virulence factors,specific predisposing factors,risk factors,and host *** most common manifestations of Exophiala infection are skin infections,and the most frequent type of deep infection is pulmonary infection due to *** invasive disease ranges from cutaneous or subcutaneous infection to systemic dissemination to internal *** final identification of the causative organism should be achieved through a combination of several methods,including the newly introduced diagnostic analysis,matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry,together with sequencing of the ribosomal ribonucleic acid internal transcribed spacer region of the fungi,and histological and culture *** treatment,because anti-infective agents and natural compounds exhibited poor antibiofilm activity,few treatments have ultimately been found to be effective for specific antifungal therapy,so the optimal antifungal therapy and duration of therapy for these infections remain ***,most forms of disease caused by Exophiala dermatitidis require aggressive combination therapies:Both surgical intervention and aggressive antifungal therapy with novel compounds and azoles are necessary for effective treatment.

关键词： Exophiala dermatitidis Black yeast Immunocompromised host Matrixassisted laser desorption/ionization-time-of-flight mass spectrometry Ribosomal ribonucleic acid Antifungal drugs

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