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• 札幌医科大学   医学部　消化器内科学講座   助教  

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• Unique endoscopic features of primary biliary diffuse large B-cell lymphoma: A case report with literature review (with video).

  Tomoya Nakamura, Yoshiharu Masaki, Naohiro Kameyama, Yujiro Kawakami, Keisuke Ishigami, Yumemi Takada, Shuji Satoh, Taro Sugawara, Shintaro Sugita, Hiroshi Nakase

  DEN open   5 ( 1 ) e414  2025年04月  [国際誌]

  　概要を見る

  A 67-year-old man visited our hospital complaining of dark-colored urine and upper abdominal pain. Magnetic resonance cholangiopancreatography showed stricture of the distal bile duct, and contrast-enhanced computed tomography showed irregular thickening of the distal bile duct wall. However, no enlarged lymph nodes, pancreatic tumors, or other neoplastic lesions were apparent around the bile duct. Endoscopic ultrasonography and intraductal ultrasonography showed irregular thickening of the inner hypoechoic layer without the disappearance of the innermost thin hyperechoic layer. On the basis of these findings, we considered that the bile duct lesion was of non-epithelial origin. Thus, we repeatedly performed bile duct biopsies from the same site under fluoroscopy to obtain a sample of the submucosal tissue. The pathological diagnosis was diffuse large B-cell lymphoma, and the patient received systemic chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). After six courses of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, positron emission tomography-computed tomography showed the disappearance of 18-fluorodeoxyglucose uptake in the bile duct and endoscopic retrograde cholangiography showed improvement of the bile duct stricture. Endoscopic findings and repeated biopsies were useful in making the diagnosis of primary biliary diffuse large B-cell lymphoma.

  DOI PubMed

• Peroral cholangioscopy-guided biopsy with novel biopsy forceps in comprehensive cancer genomic profiling for cystic duct carcinoma.

  Yujiro Kawakami, Yoshiharu Masaki, Keisuke Ishigami, Takehiro Hirano, Ayako Murota, Shintaro Sugita, Hiroshi Nakase

  Endoscopy   56 ( S 01 ) E414-E415  2024年12月  [国際誌]

  DOI PubMed

• A rare case of delayed duodenal perforation due to an over-the-scope clip.

  Yujiro Kawakami, Shinji Yoshii, Masahiro Taniguchi, Yoshiharu Masaki, Taro Sugawara, Yasutoshi Kimura, Hiroshi Nakase

  Endoscopy   56 ( S 01 ) E331-E333  2024年12月  [国際誌]

  DOI PubMed

• Genomic analysis of an aggressive hepatic leiomyosarcoma case following treatment for hepatocellular carcinoma.

  Yuto Numata, Noriyuki Akutsu, Masashi Idogawa, Kohei Wagatsuma, Yasunao Numata, Keisuike Ishigami, Tomoya Nakamura, Takehiro Hirano, Yujiro Kawakami, Yoshiharu Masaki, Ayako Murota, Shigeru Sasaki, Hiroshi Nakase

  Hepatology research : the official journal of the Japan Society of Hepatology   54 ( 9 ) 859 - 865  2024年09月  [国際誌]

  　概要を見る

  A 70-year-old man undergoing treatment for immunoglobulin G4-related disease developed a liver mass on computed tomography during routine imaging examination. The tumor was located in the hepatic S1/4 region, was 38 mm in size, and showed arterial enhancement on dynamic contrast-enhanced computed tomography. We performed a liver biopsy and diagnosed moderately differentiated hepatocellular carcinoma. The patient underwent proton beam therapy. The tumor remained unchanged but enlarged after 4 years. The patient was diagnosed with hepatocellular carcinoma recurrence and received hepatic arterial chemoembolization. However, 1 year later, the patient developed jaundice, and the liver tumor grew in size. Unfortunately, the patient passed away. Autopsy revealed that the tumor consisted of spindle-shaped cells exhibiting nuclear atypia and a fission pattern and tested positive for α-smooth muscle actin and vimentin. No hepatocellular carcinoma components were observed, and the patient was pathologically diagnosed with hepatic leiomyosarcoma. Next-generation sequencing revealed somatic mutations in CACNA2D4, CTNNB1, DOCK5, IPO8, MTMR1, PABPC5, SEMA6D, and ZFP36L1. Based on the genetic mutation, sarcomatoid hepatocarcinoma was the most likely pathogenesis in this case. This mutation is indicative of the transition from sarcomatoid hepatocarcinoma to hepatic leiomyosarcoma.

  DOI PubMed

• Predictors of occult metastases in potentially Resectable pancreatic ductal adenocarcinoma.

  Takeshi Murakami, Yasutoshi Kimura, Masafumi Imamura, Minoru Nagayama, Toru Kato, Kazuharu Kukita, Makoto Yoshida, Yoshiharu Masaki, Hiroshi Nakase, Ichiro Takemasa

  Surgery open science   20   222 - 229  2024年08月  [国際誌]

  　概要を見る

  BACKGROUND: Patients with resectable (R) or borderline resectable (BR) pancreatic ductal adenocarcinoma (PDAC) sometimes show unexpected liver, peritoneal, and para-aortic lymph node metastases intraoperatively. Despite radical pancreatectomy, a nonnegligible number of patients relapse within 6 months after surgery. The aim of this study was to identify the preoperative predictors of occult metastases (OM), defined as intraoperative distant metastases or within 6 months after pancreatectomy. MATERIALS AND METHODS: This study included patients with R and BR PDAC who underwent curative-intent pancreatectomy or staging laparoscopy between 2006 and 2021. Multivariate logistic regression and Cox hazard analyses were performed to identify the preoperative predictors of OM and to assess the impact of these factors on prognosis after pancreatectomy. RESULTS: Of the 279 patients, OM was observed intraoperatively in 47 and postoperatively in 34. In the OM group, there were no differences in prognosis between patients who had intraoperative metastases and recurrence within 6 months (median survival time [MST], 18.1 vs. 12.9 months), and between patients who underwent pancreatectomy and those who did not (MST, 13.9 vs. 18.1 months). Preoperative tumor size ≥22 mm (odds ratio [OR], 2.03; 95 % confidence interval [CI], 1.16-3.53; p = 0.013) and preoperative CA19-9 level ≥ 118.8 U/mL (OR, 2.64; 95 % CI, 1.22-5.73; p = 0.014) were significant predictors of OM. Additionally, positive OM predictors were strong independent prognostic factors for overall survival after pancreatectomy (hazard ratio, 2.47; 95 % CI, 1.54-3.98; p < 0.001). CONCLUSION: Multidisciplinary treatment strategies should be considered for patients with predictors of OM to avoid inappropriate surgical interventions.

  DOI PubMed

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• 自己免疫性膵炎診療の現状と課題 自己免疫性膵炎診療における消化管精査の意義

  川上 裕次郎, 柾木 喜晴, 仲瀬 裕志

  Gastroenterological Endoscopy ( (一社)日本消化器内視鏡学会 )  66 ( Suppl.2 ) 2158 - 2158  2024年10月

• 切除不能または再発胆道癌に対するゲムシタビン/シスプラチン/S-1(GCS)療法とゲムシタビン/シスプラチン/デュルバルマブ(GCD)療法との比較検討

  吉田 真誠, 村松 丈児, 石川 和真, 高田 弘一, 村瀬 和幸, 大沼 啓之, 柾木 喜晴, 永島 裕之, 宮西 浩嗣

  胆道 ( (一社)日本胆道学会 )  38 ( 3 ) 421 - 421  2024年09月

• 新規デバイスデリバリーシステムEndoSheatherを用いた経乳頭的胆嚢生検

  川上 裕次郎, 柾木 喜晴, 大沼 法永, 中村 友哉, 石上 敬介, 室田 文子, 仲瀬 裕志

  胆道 ( (一社)日本胆道学会 )  38 ( 3 ) 476 - 476  2024年09月

• 若年発症自己免疫性肝炎に対する部分的脾動脈塞栓術後に肝機能改善を認めた1例

  沼田 泰尚, 阿久津 典之, 我妻 康平, 川上 裕次郎, 石上 敬介, 柾木 喜晴, 室田 文子, 齊藤 正人, 仲瀬 裕志

  日本臨床免疫学会総会プログラム・抄録集 ( (一社)日本臨床免疫学会 )  52回   113 - 113  2024年08月

• 術後膵液瘻に対する超音波内視鏡下ドレナージ法の比較検討

  吉田 真誠, 斉藤 聖也, 村松 丈児, 石川 和真, 高田 弘一, 柾木 喜晴, 池田 裕貴, 宮西 浩嗣

  膵臓 ( (一社)日本膵臓学会 )  39 ( 3 ) A440 - A440  2024年07月

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