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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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• 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    2024年12月

  DOI

• 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    2024年12月

  DOI

• A rare case of resection of a mucinous cystic neoplasm originating from the extrahepatic bile duct with cholangioscopic imaging.

  Yoshiharu Masaki, Yujiro Kawakami, Keisuke Ishigami, Ayako Murota, Masahiro Shitani, Kazuharu Kukita, Yasutoshi Kimura, Keiko Segawa, Tadashi Hasegawa, Hiroshi Nakase

  DEN open   4 ( 1 ) e349  2024年04月  [国際誌]

  　概要を見る

  A 29-year-old woman was admitted to our hospital for examination of obstructive jaundice and an extrahepatic bile duct lesion. Contrast-enhanced computed tomography revealed a 20 mm cystic lesion with a thin external capsule in the common hepatic duct. Cholangioscopy revealed translucent oval masses with capillary vessels attached to the bile duct walls. The surface was mostly smooth yet partially irregular with redness, suggesting that the masses were epithelial neoplasms. Histological findings of cholangioscopy-guided targeted biopsies of the mass showed subepithelial spindle cell proliferation with no atypical epithelium. The patient underwent an extrahepatic bile duct resection to confirm the pathological diagnosis. Immunohistochemistry of surgical specimens revealed that the spindle cells were positive for estrogen and progesterone receptors. Finally, the cystic lesion with ovarian-like stroma was diagnosed as a mucinous cystic neoplasm with low-grade intraepithelial neoplasia. This is the first report of cholangioscopic imaging of a biliary mucinous cyctic neoplasm. Cholangioscopic imaging can be helpful in the differential diagnosis of biliary neoplasms and in the determination of treatment strategies.

  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    2024年03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

• Invisible pancreatic cancer: the cuff sign.

  Ken Nagahata, Yujiro Kawakami, Hiroshi Nakase

  QJM : monthly journal of the Association of Physicians    2024年03月  [国際誌]

  DOI PubMed

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