Chronological changes in the ultrasonic findings of gallbladder metastasis from renal cell carcinoma: a case report and review.

The present case involves a gallbladder metastasis from renal cell carcinoma (GBMRCC). During 11 months of ultrasound follow-up examinations, the mass, covered with a highly echoic surface layer, exhibited the following changes: the wide base became constricted, the tumor surface became irregular, and the mass increased in diameter. A histopathological examination confirmed that the tumor cells were mainly present in the subepithelial layer, the gallbladder epithelium had ruptured, and necrotic debris covered the tumor surface.

KIR3DL1-HLA-Bw4 combination and IL28B polymorphism predict response to Peg-IFN and ribavirin with and without telaprevir in chronic hepatitis C.

Natural killer cells play a key role in the immune control of viral infections. Killer immunoglobulin-like receptors (KIRs) regulate natural killer cell activation and inhibition through the recognition of their cognate HLA class I ligands. We assessed the predictive factors of a sustained virological response (SVR) in 200 Japanese patients with chronic genotype 1b hepatitis C who were treated with telaprevir (TVR), pegylated-interferon-α2b (PEG-IFN), and ribavirin (RBV) triple therapy (92 patients) or PEG-IFN/RBV therapy alone (108 patients).

Endoscopic ultrasound-guided antegrade stone removal in a patient with pancreatic stones and anastomotic stricture after end-to-side pancreaticojejunostomy.

Pancreaticoenteric anastomotic stricture can occur as a late complication of pancreatic head resection and is difficult to manage. The surgically altered anatomies of patients that have undergone pancreatic head resection make it difficult to perform pancreatic duct drainage using conventional endoscopes, and it is especially difficult to endoscopically identify stenotic pancreaticojejunal anastomoses. A 40-year-old woman was referred to our department for the treatment of symptomatic multiple pancreatic stones and anastomotic stricture after end-to-side pancreaticojejunostomy.

Impact of changing our cannulation method on the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis after pancreatic guidewire placement.

Aim: To clarify whether the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) after pancreatic guidewire placement (PGW) can be reduced by using a different cannulation method.

Methods: Between April 2001 and October 2009, PGW was performed in 142 patients with native papilla to overcome difficult biliary cannulation. Our cannulation method for ERCP was changed from contrast injection (CI) using a single-lumen catheter (April 2001-May 2008) to wire-guided cannulation (WGC) using a double-lumen catheter (June 2008-October 2009).

Obstructive jaundice caused by a portal cavernoma.

A 69-year-old Japanese man was admitted to our hospital because of acute cholangitis with biliary obstruction. The cause of obstruction was either compression by a portal cavernoma or cavernous transformation. Multidetector row computed tomography (MDCT) and abdominal ultrasonography (US) revealed a portal cavernoma around the common bile duct.

Mucinous cystadenoma of the pancreas with huge mural hematoma.

A 60-year-old woman was referred for evaluation of a cystic mass in the pancreatic body that extended to the tail. Transabdominal ultrasonography demonstrated an oval cystic mass 24 cm in diameter, filled with debris. On the cyst wall there was a wide-based, smooth-surfaced, heterogeneous high-echoic protrusion that was 5 cm in diameter.

Growth process of small pancreatic carcinoma: a case report with imaging observation for 22 months.

This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions. IDC was demonstrated as an extremely low-echoic mass resembling a cyst with an unclear margin on the initial endoscopic ultrasonography.

Intraductal carcinoma with complex fusion of tubular glands without macroscopic mucus in main pancreatic duct: dilemma in classification.

An 84-year-old man, who was being followed up after lobectomy for lung carcinoma, was referred for evaluation of a dilated main pancreatic duct (MPD) from the body to the tail. Endoscopic ultrasonography demonstrated a low-echo mass occupying the MPD from the body to the tail. Endoscopic retrograde pancreatography showed an occlusion of the MPD in the body, and brush cytology indicated malignant cells.