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7. Long-term outcomes of patients with primary intestinal follicular lymphoma managed with watch-and-wait strategy

Author

Iwamuro, Masaya, Tanaka, Takehiro, Ennishi, Daisuke, Matsueda, Kazuhiro, Yoshioka, Masao, Miyahara, Koji, Sakaguchi, Chihiro, Nishimura, Mamoru, Nagahara, Teruya, Mannami, Tomohiko, Takenaka, Ryuta, Oka, Shohei, Inoue, Masafumi, Takimoto, Hidetaka, Inaba, Tomoki, Kobayashi, Sayo, Toyokawa, Tatsuya, Tsugeno, Hirofumi, Suzuki, Seiyuu, Sawada, Sachiko, Tanaka, Shouichi, Tsuzuki, Takao, and Okada, Hiroyuki

Published
2023
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13. Recent updates on treatment options for primary follicular lymphoma of the gastrointestinal tract.

Author

Iwamuro, Masaya, Tanaka, Takehiro, Ennishi, Daisuke, and Otsuka, Motoyuki

Subjects
FOLLICULAR lymphoma, BOWEL obstructions, GASTROINTESTINAL system, INTESTINAL tumors, LYMPHOMAS
Abstract

Background: Primary gastrointestinal follicular lymphoma is a subtype of follicular lymphoma that originates directly from the gastrointestinal tract. Pathologically, it exhibits substantial similarities with the secondary gastrointestinal involvement observed in nodal follicular lymphoma. However, primary gastrointestinal follicular lymphoma presents clinically distinct features, necessitating divergent considerations in treatment selection compared with nodal follicular lymphoma. Areas covered: This narrative review focused on recent articles (2018–2023) regarding the long-term prognosis and treatment options for gastrointestinal follicular lymphoma. In addition, a brief overview of gastrointestinal follicular lymphomas is provided. Expert opinion: Patients with primary gastrointestinal follicular lymphoma often present with a low tumor burden. Lymphoma lesions typically remain asymptomatic for several years or may undergo spontaneous regression without immediate treatment. Therefore, a 'watch and wait' approach is justified. Conversely, when large tumor masses are identified in the gastrointestinal tract, the potential for tumor bleeding or intestinal obstruction requires timely therapeutic interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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16. A Prospective Observational Study on Gastric Endoscopic Submucosal Dissection under Continuous Administration of Antithrombotic Agents.

Author

Kawai, Daisuke, Iwamuro, Masaya, Takenaka, Ryuta, Obata, Taisuke, Yamamoto, Takashi, Hirata, Shoichiro, Miura, Ko, Takemoto, Koji, Tsugeno, Hirofumi, and Fujiki, Shigeatsu

Subjects
*FIBRINOLYTIC agents, *LONGITUDINAL method, *SCIENTIFIC observation, *DISSECTION, *ENDOSCOPIC hemostasis, *DUODENAL tumors, *INTESTINAL perforation
Abstract

Background: This study aimed to assess the completion rate and postoperative bleeding incidence of endoscopic submucosal dissection (ESD) for gastric tumors under continuous antithrombotic therapy. Methods: A prospective observational study was conducted including 88 patients with 100 gastric lesions who underwent gastric endoscopic submucosal dissection (ESD) and received continuous antithrombotic therapy. Additionally, retrospective data on gastric ESD in 479 patients with 534 lesions who did not receive antithrombotic therapy were collected for comparison. Results: The en bloc resection rates (100% in the continuous antithrombotic therapy group vs. 100% in the non-antithrombotic therapy group) and complete resection rates (97.0% vs. 96.3%, respectively) were high and comparable between the groups. No significant differences were found in the specimen size or procedure time. Perforation rates were low (0% vs. 2.3%, respectively) and were not significantly different between the groups. However, postoperative bleeding occurred significantly more frequently in the continuous antithrombotic therapy group (10.2% vs. 4.2%, respectively) than in the non-antithrombotic therapy group. The subgroup analysis revealed a higher incidence of postoperative bleeding in patients receiving thienopyridine derivatives. Conclusions: Continuous administration of antithrombotic agents, especially thienopyridines, increased the risk of postprocedural hemorrhage following gastric ESD. These findings support the need for careful consideration of pharamcological management before ESD, aligning with the current guidelines. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Results of the interim analysis of a prospective, multicenter, observational study of small subepithelial lesions in the stomach.

Author

Iwamuro, Masaya, Mitsuhashi, Toshiharu, Inaba, Tomoki, Matsueda, Kazuhiro, Nagahara, Teruya, Takeuchi, Yoji, Doyama, Hisashi, Mizuno, Masakatsu, Yada, Tomoyuki, Kawai, Yoshinari, Nakamura, Jun, Matsubara, Minoru, Nebiki, Hiroko, Niimi, Keiko, Toyokawa, Tatsuya, Takenaka, Ryuta, Takeda, Sho, Tanaka, Shouichi, Nishimura, Mamoru, and Tsuzuki, Takao

Subjects
*SCIENTIFIC observation, *STOMACH, *NATURAL history, *GASTROINTESTINAL stromal tumors, TUMOR surgery
Abstract

Objectives: Long‐term outcomes of gastric subepithelial lesions have not been elucidated. To reveal the natural history, we initiated a prospective, 10‐year follow‐up of patients with small (≤20 mm) gastric subepithelial lesions in September 2014. Here, we report the results of an interim analysis of a prospective observational study. Methods: In total, 567 patients with 610 lesions were prospectively registered between September 2014 and August 2016. The location, size, morphology, and number of subepithelial lesions were recorded on a web‐based case report form. This study has been conducted as an Academic Committee Working Group of the Japan Gastroenterological Endoscopy Society. Results: The endoscopic follow‐up period was 4.60 ± 1.73 years (mean ± standard deviation), and survival data were investigated for 5.28 ± 1.68 years. This interim analysis revealed that the estimated cumulative incidence of a size increase ≥5 mm, after accounting for patients' death and resection of the tumor as competing risk events, was 4.5% at 5 years. In addition, the estimated cumulative incidence of lesion size increase ≥5 mm or resection of lesions was 7.9% at 5 years, and that of size increase ≥10 mm or resection of lesions was 4.5% at 5 years. Conclusion: These results indicate that approximately one in 13 patients with small (≤20 mm) gastric subepithelial lesions may require resection or further investigation for increased tumor size (≥5 mm) within 5 years. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Differential Diagnoses and Management Approaches for Gastric Polyposis.

Author

Iwamuro, Masaya, Kawano, Seiji, and Otsuka, Motoyuki

Subjects
*ADENOMATOUS polyposis coli, *PEUTZ-Jeghers syndrome, *COWDEN syndrome, *ENDOSCOPY, *PROTON pump inhibitors
Abstract

Multiple gastric polyps are observed in various polyposis syndromes and conditions associated with polypoid lesion development in the stomach. Polyposis syndromes often occur concurrently with specific malignant tumors and can manifest at any point in an individual's lifespan, thus explaining the diversity in surveillance methods. Furthermore, genetic counseling and surveillance are essential not only for the patients themselves but also for their blood relatives. Therefore, the accurate diagnosis and appropriate surveillance of multiple gastric polyps are crucial for improving patient outcomes. This review aims to provide essential information on such lesions along with representative endoscopic images of familial adenomatous polyposis, Peutz-Jeghers syndrome, Cowden syndrome, Cronkhite-Canada syndrome, juvenile polyposis syndrome, gastric adenocarcinoma and proximal polyposis of the stomach, neuroendocrine tumors in autoimmune gastritis, proton pump inhibitor-related gastric mucosal changes, and multiple submucosal heterotopic glands. We wish for this review to serve as a valuable resource for endoscopists seeking to deepen their comprehension of gastric polyposis. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Scattered Tiny Whitish Protrusions in the Stomach Are a Clue to the Diagnosis of Autoimmune Gastritis

Author

Iwamuro, Masaya, Tanaka, Takehiro, Hamada, Kenta, Kono, Yoshiyasu, Kanzaki, Hiromitsu, Kawano, Seiji, Kawahara, Yoshiro, and Okada, Hiroyuki

Subjects
small white protrusions, mucosal lesions, esophagogastroduodenoscopy, scattered lesions, autoimmune gastritis
Abstract

Herein, we report two patients with autoimmune gastritis who had undergone multiple esophagogastroduodenoscopy procedures for 17 and 9 years, respectively, before their diagnosis. Instead, they had been diagnosed with and treated for Helicobacter pylori-associated gastritis. The correct diagnosis was made when scatterings of tiny whitish protrusions in the gastric mucosa were detected on esophagogastroduodenoscopy. Our findings suggest that scattered tiny whitish bumps may be a clue to the diagnosis of autoimmune gastritis.

Published
2023

24. Association of screening tool scores with overall survival in older patients with unresectable gastrointestinal or biliary pancreatic cancer: A retrospective study

Author

Inoo, Shoko, Kono, Yoshiyasu, Kanzaki, Hiromitsu, Horiguchi, Shigeru, Kato, Hironari, Yamasaki, Yasushi, Hirata, Shoichiro, Kuraoka, Sakiko, Matsueda, Katsunori, Okanoue, Shotaro, Satomi, Takuya, Hamada, Kenta, Iwamuro, Masaya, Kawano, Seiji, Kawahara, Yoshiro, Okada, Hiroyuki, and Otsuka, Motoyuki

Published
2024
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25. Clinical significance of gastrointestinal bleeding history in patients who undergo left atrial appendage closure.

Author

Kikuchi, Tatsuya, Kono, Yoshiyasu, Nakagawa, Koji, Okada, Hiroyuki, Miyamoto, Masakazu, Takaya, Yoichi, Hirata, Shoichiro, Inoo, Shoko, Kuraoka, Sakiko, Okanoue, Shotaro, Matsueda, Katsunori, Satomi, Takuya, Hamada, Kenta, Iwamuro, Masaya, Kawano, Seiji, and Kawahara, Yoshiro

Subjects
LEFT atrial appendage closure, GASTROINTESTINAL hemorrhage
Abstract

Background and Aim: Anticoagulant users with nonvalvular atrial fibrillation (NVAF) sometimes suffer from gastrointestinal bleeding (GIB) and have difficulty continuing the medication. Left atrial appendage closure (LAAC) has been developed for such situations. We aimed to clarify the clinical significance of a history of GIB in comparison to other factors in patients who had undergone LAAC. Methods: From October 2019 to September 2023, patients with NVAF who underwent LAAC at our hospital were enrolled. We investigated the percentage of patients with a history of GIB who underwent LAAC and compared the incidence of post‐LAAC bleeding in these patients compared to those with other factors. Results: A total of 45 patients were included. There were 19 patients (42%) with a history of GIB who underwent LAAC. In a Kaplan–Meier analysis, the cumulative incidence of bleeding complications after LAAC was significantly higher in patients with a history of GIB in comparison to patients with other factors. There were eight cases of post‐LAAC bleeding in total, and seven cases had GIB. Conclusions: We need to recognize that GIB is a significant complication in patients who undergo LAAC. The management of GIB by gastroenterologists is essential to the success of LAAC. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Optimal Bowel Preparation Method to Visualize the Distal Ileum via Small Bowel Capsule Endoscopy.

Author

Kametaka, Daisuke, Ito, Mamoru, Kawano, Seiji, Ishiyama, Shuhei, Fujiwara, Akiko, Nasu, Junichirou, Yoshioka, Masao, Shiode, Junji, Yamamoto, Kazuhide, Iwamuro, Masaya, Kawahara, Yoshiro, Okada, Hiroyuki, and Otsuka, Motoyuki

Subjects
SMALL intestine, CAPSULE endoscopy, ILEUM, GASTROINTESTINAL contents, INTESTINAL mucosa
Abstract

Small bowel capsule endoscopy (SBCE) is a convenient and minimally invasive method widely used to evaluate the small intestine. However, especially in the distal ileum, visualization of the intestinal mucosa is frequently hampered by the remaining intestinal contents, making it difficult to detect critical lesions. Although several studies have reported on the efficacy of bowel preparation before SBCE, no standardized protocol has been established. Herein, we determined the optimal preparation method for better visualization of the distal ileum using SBCE. We retrospectively analyzed 259 consecutive patients who had undergone SBCE between July 2009 and December 2019, divided into three groups: Group A (no preparation except overnight fasting), Group B (ingestion of 1–2 L polyethylene glycol 4 h before colonoscopy after overnight fasting and performing SBCE immediately after colonoscopy), and Group C (ingestion of 0.9 L magnesium citrate [MC] before SBCE after overnight fasting). The visibility of the intestinal mucosa in the first 10 min and at the last 10 min during the period of observation of the distal ileum was examined using a scoring system and compared. The visibility of the images captured by SBCE was assessed based on the scoring of the degree of bile/chyme staining, residual fluid and debris, brightness, bubble reduction, and visualized mucosa. The status of intestinal collapse was also assessed. In the first 10 min of observation of the distal ileum, no significant differences were detected among the groups. In the last 10 min, significantly better images were acquired in Group C in terms of bile/chyme staining, brightness, bubble reduction, and visualized mucosa. Bowel preparation using a low-dose MC solution 2 h before SBCE provided significantly higher-quality images of the distal ileum. Further optimization, such as the timing of initiating the preparation, is necessary to determine the optimal regimen for bowel preparation prior to SBCE. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users

Author

Kono, Yoshiyasu, Matsubara, Minoru, Toyokawa, Tatsuya, Takenaka, Ryuta, Suzuki, Seiyu, Nasu, Junichirou, Yoshioka, Masao, Nakagawa, Masahiro, Mizuno, Motowo, Sakae, Hiroyuki, Abe, Makoto, Gotoda, Tatsuhiro, Miura, Ko, Kanzaki, Hiromitsu, Iwamuro, Masaya, Hori, Keisuke, Tsuzuki, Takao, Kita, Masahide, Kawano, Seiji, Kawahara, Yoshiro, and Okada, Hiroyuki

Published
2017
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30. Four types of duodenal white lesions (follicular lymphoma, lymphoid hyperplasia, lymphangiectasia, and lymphangioma) : A case report

Author

Iwamuro, Masaya, Tanaka, Takehiro, and Okada, Hiroyuki

Subjects
十二指腸濾胞性リンパ腫（duodenal-type follicular lymphoma）, リンパ管腫（lymphangioma）, リンパ濾胞過形成（lymphoid hyperplasia）, リンパ管拡張（lymphangiectasia）
Abstract

A 70-year-old Japanese man underwent esophagogastroduodenoscopy that revealed multiple whitish duodenal granules. The histopathological analysis of the biopsied specimen led to the diagnosis of duodenal-type follicular lymphoma. The lesion showed spontaneous improvement ; however, 14 months later a few small whitish granules were observed by esophagogastroduodenoscopy. Observation under magnification revealed slightly elevated opaque white spots and whitish granular protrusions of roughly the same size that were uniformly distributed in the duodenal bulb. The duodenal bulb lesions were histopathologically diagnosed as lymphoid hyperplasia. The patient also exhibited lymphangiectasia (which presented as scattered white spots) and lymphangioma (which presented as a soft submucosal tumor with white spots on the surface) in the second portion of the duodenum. This patient presented with four white lesions in the duodenum : duodenal-type follicular lymphoma, lymphoid hyperplasia, lymphangiectasia, and lymphangioma. Careful endoscopic evaluation enabled a prompt diagnosis in this case.

Published
2021

38. Promising therapeutic efficacy of a novel reduced expression in immortalized cells/dickkopf‐3 expressing adenoviral vector for hepatocellular carcinoma

Author

Sawahara, Hiroaki, Shiraha, Hidenori, Uchida, Daisuke, Kato, Hironari, Kato, Ryo, Oyama, Atsushi, Nagahara, Teruya, Iwamuro, Masaya, Horiguchi, Shigeru, Tsutsumi, Koichiro, Mandai, Mari, Mimura, Tetsushige, Wada, Nozomu, Takeuchi, Yasuto, Kuwaki, Kenji, Onishi, Hideki, Nakamura, Shinichiro, Watanabe, Masami, Sakaguchi, Masakiyo, Takaki, Akinobu, Nouso, Kazuhiro, Yagi, Takahito, Nasu, Yasutomo, Kumon, Hiromi, and Okada, Hiroyuki

Published
2017
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40. Zinc Acetate Dihydrate Tablet-Associated Gastritis Occurring in a Post-Hematopoietic Stem Cell Transplant Recipient

Author

Iwamuro, Masaya, Tanaka, Takehiro, Matsumura, Akifumi, Kawano, Seiji, Kawahara, Yoshiro, and Okada, Hiroyuki

Subjects
Article Subject
Abstract

A 65-year-old Japanese woman underwent umbilical cord blood transplantation for acute myeloid leukemia. Zinc acetate dihydrate tablets were administered for hypozincemia after transplantation, and vomiting and appetite loss occurred soon thereafter. Esophagogastroduodenoscopy revealed mucosal redness, erosion, white coat adhesion, and ulcers. Although graft-versus-host disease, intestinal transplant-associated microangiopathy, and cytomegalovirus infection were considered as possible causes, we diagnosed the patient with zinc acetate dihydrate tablet-associated gastric mucosal alterations based on the endoscopic features. This case reinforces the notion that medication-associated gastric lesions should be suspected in patients taking zinc acetate dihydrate tablets.

Published
2022
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41. SIGNIFICANCE OF EUS IN THE FOLLOW-UP OF SMALL SUBEPITHELIAL LESIONS IN THE STOMACH: A PROSPECTIVE, MULTICENTER, OBSERVATIONAL STUDY.

Author

Nebiki, Hiroko, Iwamuro, Masaya, Inaba, Tomoki, Matsueda, Kazuhiro, Takeuchi, Yoji, Nagahara, Teruya, Doyama, Hisashi, Mizuno, Masakatsu, Yada, Tomoyuki, Kawai, Yoshinari, Nakamura, Jun, Matubara, Minoru, Toyokawa, Tatsuya, Takenaka, Ryuta, Takeda, Sho, Tanaka, Shouichi, Nishimura, Mamoru, Tsuzuki, Takao, Akahoshi, Kazuya, and Fujishiro, Mitsuhiro

Published
2024
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43. A Granulation Polyp in the Colon Masquerading as Metastatic Cancer

Author

Iwamuro, Masaya, Takahara, Masahiro, Yamazaki, Tatsuhiro, Tanaka, Takehiro, Kondo, Yoshitaka, Hiraoka, Sakiko, and Okada, Hiroyuki

Subjects
colonoscopy, colonic neoplasms, granulation polyp, digestive system diseases
Abstract

A 60-year-old Caucasian male was diagnosed with lung adenocarcinoma and multiple metastases to the bone, spleen, and brain. He underwent radiotherapy for the brain and lumbar spine metastases, plus chemotherapy (cisplatin and pemetrexed). The chemotherapy was discontinued due to vomiting and hyponatremia, and nivolumab was then administered. Eight months later, 18F-fluorodeoxyglucose positron emission tomography showed tracer uptake in the colon. Colonoscopy revealed a reddish multinodular polyp in the sigmoid colon. The polyp showed irregular microvessels. No colonic mucosal surface structures were observed. Colonic metastasis of the lung carcinoma was highly suspected; the polyp was therefore surgically removed. The histological analysis revealed granulation tissue and suppurative inflammation without neoplastic changes. We diagnosed the lesion as a granulation polyp. Despite the difficulty in diagnosing these lesions due to their rarity and similarity to metastatic colon tumors, we suggest that recognizing the endoscopic features of the polyp surface may allow a preoperative diagnosis.

Published
2019

44. Erratum to: Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users

Author

Kono, Yoshiyasu, Matsubara, Minoru, Toyokawa, Tatsuya, Takenaka, Ryuta, Suzuki, Seiyu, Nasu, Junichirou, Yoshioka, Masao, Nakagawa, Masahiro, Mizuno, Motowo, Sakae, Hiroyuki, Abe, Makoto, Gotoda, Tatsuhiro, Miura, Ko, Kanzaki, Hiromitsu, Iwamuro, Masaya, Hori, Keisuke, Tsuzuki, Takao, Kita, Masahide, Kawano, Seiji, Kawahara, Yoshiro, and Okada, Hiroyuki

Published
2017
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45. A multicenter survey of enteroscopy for the diagnosis of intestinal follicular lymphoma

Author

IWAMURO, MASAYA, OKADA, HIROYUKI, KAWANO, SEIJI, SHIODE, JUNJI, TAKENAKA, RYUTA, IMAGAWA, ATSUSHI, INABA, TOMOKI, SUZUKI, SEIYU, NISHIMURA, MAMORU, MIZUNO, MOTOWO, ARAKI, MASASHI, MANNAMI, TOMOHIKO, UEKI, TORU, KOBASHI, HARUHIKO, FUKATSU, HARUKA, TANAKA, SHOUICHI, OMOTO, AKIYOSHI, KAWAI, YOSHINARI, KITAGAWA, TAKASHI, TOYOKAWA, TATSUYA, TAKATA, KATSUYOSHI, YOSHINO, TADASHI, TAKAKI, AKINOBU, and YAMAMOTO, KAZUHIDE

Published
2015
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46. A Case of Myoepithelial Hamartoma: Morphological Variation Supported by OCT4 Expression

Author

Tanaka, Takehiro, Nishida, Kenji, Iwamuro, Masaya, Kikuchi, Satoru, and Yoshino, Tadashi

Subjects
Article Subject
Abstract

In this report, we describe a patient with myoepithelial hamartoma, which is regarded as synonymous with adenomyosis and heterotopic pancreas. Endoscopy revealed a submucosal tumor in the antrum of the stomach. Subsequently, distal gastrectomy with Roux-en-Y reconstruction was performed. Histological findings of adenomyomatous lesion and heterotopic pancreatic tissue were observed in this lesion. The distribution of OCT4, which is a pluripotency marker, varied in each part.

Published
2021
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