Internal medicine
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Case Reports
Localized Gastric Amyloidosis that Displayed Morphological Changes over 10 Years of Observation.
We herein report an extremely rare case of localized gastric amyloidosis (LGA) with morphological changes during the follow-up. A 71-year-old woman who had a depressed lesion with central elevation in the gastric lower body was diagnosed with LGA. ⋯ The final pathological diagnosis was amyloid light-chain (AL)-type LGA. This case may provide useful information regarding the natural history of AL-type LGA.
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Case Reports
Obstructive Jaundice Due to Duodenal Ulcer Induced by Lenvatinib Therapy for Hepatocellular Carcinoma.
An 82-year-old man with hepatocellular carcinoma presented with upper abdominal pain, vomiting, and jaundice. He had been taking a standard lenvatinib dose for three months. Although acute cholangitis was suggested, imaging studies failed to detect the biliary obstruction site. ⋯ Endoscopic biliary drainage and antibiotics improved concomitant Enterobacter cloacae bacteremia. Ulcer healing was confirmed after rabeprazole was replaced with vonoprazan and misoprostol. Our case shows that lenvatinib can induce duodenal ulcers resulting in obstructive jaundice.
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Case Reports
A Case of Late-onset Hereditary ATTR Amyloidosis with a Novel p.P63S (P43S) Transthyretin Variant.
The patient was an 82-year-old Japanese man with no family history suggestive of amyloidosis. He developed bilateral leg edema and shortness of breath and was referred to our hospital. An electrocardiogram showed atrial fibrillation with right bundle branch block. ⋯ In silico analyses predicted that this variant only modestly altered the structure and function of the TTR protein. The p. P63S variant might be associated with an elderly-onset cardiac-dominant ATTRv phenotype.
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Case Reports
A Case of Pulmonary Sparganosis: Tunnel Sign and Migrating Sign on Computed Tomography.
A 77-year-old woman presented at our hospital to undergo a close examination of an abnormal shadow which was observed on a chest radiograph. Contrast-enhanced computed tomography (CT) images in the lung window revealed a tortuous tunnel structure (tunnel sign), which was suspected to be the migration path of a parasite. Furthermore, CT images in the mediastinal window showed a linear filling defect from the right inferior pulmonary vein to the venous ostium in the left atrium (migrating sign), which was suspected to be a migrating parasite in the pulmonary vein. Tunnel and migrating signs on chest CT images were helpful in diagnosing pulmonary sparganosis.