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Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT. At reLDLT, a right liver lobe was donated from his spouse. Although steroid was effective for ACR, PTLD developed in the ileocecal area. The patient received rituximab for treatment of PTLD, and ileocecal resection for hemorrhage from ileocecal PTLD. The patient achieved complete response by rituximab and surgical resection for PTLD, but PSC recurred and hemophagocytic syndrome (HPS) developed with hyperbilirubinemia and elevated serum ferritin. The patient received steroid treatment for HPS, but thrombocytopenia and coagulopathy developed presumably due to thrombotic microangiopathy. Therefore, tacrolimus was switched to mycophenolate mofetil. Despite intensive treatment including plasmapheresis and platelet infusion, fungal infection of both lungs developed, and the patient died 22 months after reLDLT. Autopsy revealed complete response of PTLD, recurrence of PSC and persistance of HPS. [ABSTRACT FROM AUTHOR]

We present a case of nontraumatic intramural hematoma of the duodenum. A 77-year-old woman complained of nausea, vomiting, and abdominal pain during hospitalization. There was no traumatic episode. Laboratory data showed anemia (hemoglobin, 7.7 g/dl). The diagnosis was confirmed by computed tomography (CT), which showed a mixed hyperdense and hypodense mass obstructing the third portion of the duodenum. The cause was considered to be bleeding tendency caused by an antiplatelet drug. The patient was treated conservatively and the size of the hematoma was followed on CT. She was able to resume oral feeding 2 weeks after admission. [ABSTRACT FROM AUTHOR]

Metastatic tumors of the oral region are very rare, accounting for approximately 1% of intraoral malignant tumors. Caudal-related homeobox transcription factor (CDX2) regulates the development and differentiation of intestinal epithelial cells. We report herein a case of metastatic gingival tumor from rectal cancer after low anterior resection in which immunohistochemical analysis of CDX2 was useful for diagnosis of the origin. To the best of our knowledge, our case is the first report that immunohistochemical staining with CDX2 can contribute to diagnose metastatic gingival tumor from rectal cancer. [ABSTRACT FROM AUTHOR]