Russell bodies are globular and eosinophilic inclusion bodies in the cytoplasm of mature plasma cells.Plasma cells whose cytoplasm is filled with Russell bodies are designated as Mott cells.Russell body duodenitis(RBD) is a unique form of chronic duodenitis that is characterized by infiltration of numerous Mott cells.RBD is very rare;only two cases have been reported to date.In this paper,we report a case of RBD in a patient with retroperitoneal metastasis of ureteral cancer.A 77-year-old man was admitted to our hospital complaining of appetite loss,vomiting,and upper abdominal distension.He had undergone left nephroureterectomy for ureteral cancer 4 years earlier.Upper digestive tract endoscopy revealed edema,stenosis,and punctate redness of the mucosa of the duodenum,and a biopsy was performed.Histological analysis showed that numerous Mott cells had infiltrated the lamina propria mucosae,and the condition was diagnosed as RBD.A mass lesion in the retroperitoneum adjacent to the duodenum was detected by abdominal computed tomography,and was diagnosed as metastatic urothelial carcinoma by biopsy.It is possible that chemokines produced by tumor cells caused RBD in this case.
The patient was a 58-year-old male with symptomatic alcoholic chronic pancreatitis.Since a 10 mm calculus was observed in the pancreatic body and abdominal pain occurred due to congestion of pancreatic juice,endoscopic retrograde cholangiopancreatography was conducted for assessment of the pancreatic duct and treatment of pancreatic calculus.Pancreatogram was slightly and insuff iciently obtained by injecting the contrast media via the common channel of the duodenal main papilla.We tried to cannulate selectively into the pancreatic duct for a clear image.However,the selective cannulation of the pancreatic duct was difficult because of instability of the papilla.On the other hand,selective cannulation of the bile duct was relatively easily achieved.Therefore,after the imaging of the bile duct,a guidewire was retained in the bile duct to immobilize the duodenal papilla and cannulation of the pancreatic duct was attempted.As a result,selective pancreatic duct cannulation became possible.It is considered that the bile duct guidewire-indwelling method may serve as one of the useful techniques for cases whose selective pancreatic duct cannulation is diff icult('selective pancreatic duct diff icult cannulation case').
AIM:To evaluate the safety and clinical application of high-intensity focused ultrasound(HIFU)therapy for unresectable pancreatic cancer(PC).METHODS:Thirty PC patients(16 cases in stage III and 14 cases in stage IV)with visualized pancreatic tumors were admitted for HIFU therapy as an optional local therapy in addition to systemic chemotherapy or chemoradiotherapy.Informed consent was obtained.This study began at the end of 2008 and was approved by the ethics committee of our hospital[Institutional Review Board(IRB):890].The HIFU device used was the FEP-BY02(Yuande Bio-Medical Engineering,Beijing,China).RESULTS:The mean tumor size after HIFU therapy changed to 30.9±1.7 mm from 31.7±1.7 mm at pre-therapy.There were no significant changes in tumor size,mean number of treatment sessions(2.7±0.1 mm),or mean total treatment time(2.4±0.1 h).The rate of symptom relief effect was 66.7%.The effectiveness of primary lesion treatment was as follows:complete response,0;partial response,4;stable disease,22;progressive disease,4.Treatment after HIFU therapy included 2 operations,24 chemotherapy treatments,and 4 best supportive care treatments.Adverse events occurred in 10%of cases,namely pseudocyst formation in 2 cases and mild pancreatitis development in 1.However,no severe adverse events occurred in this study.CONCLUSION:We suggest that HIFU therapy is safe and has the potential to be a new method of combination therapy for PC.
