Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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Diagnosis of follicular lymphoma of the gastrointestinal tract: A better initial diagnostic workup Reviewed

Masaya Iwamuro, Eisei Kondo, Katsuyoshi Takata, Tadashi Yoshino, Hiroyuki Okada

WORLD JOURNAL OF GASTROENTEROLOGY 22 ( 4 ) 1674 - 1683 2016.1

Language：English Publisher：BAISHIDENG PUBLISHING GROUP INC

Due to an increasing incidence and more frequent recognition by endoscopists, gastrointestinal follicular lymphoma has been established as a variant of follicular lymphoma. However, due to its rarity, there are no established guidelines on the optimal diagnostic strategy for patients with primary gastrointestinal follicular lymphoma or secondary gastrointestinal involvement of systemic follicular lymphoma. This review offers an overview and pitfalls to avoid during the initial diagnostic workup of this disease entity. Previously reported case reports, case series, and retrospective studies are reviewed and focus on the disease's endoscopic and histological features, the roles of computed tomography and positron emission tomography scanning, the clinical utility of the soluble interleukin-2 receptor, and the possible pathogenesis.

DOI： 10.3748/wjg.v22.i4.1674

Breast Cancer Metastasis to the Stomach That Was Diagnosed after Endoscopic Submucosal Dissection Reviewed International journal

Masahide Kita, Masashi Furukawa, Masaya Iwamuro, Keisuke Hori, Yoshiro Kawahara, Naruto Taira, Tomohiro Nogami, Tadahiko Shien, Takehiro Tanaka, Hiroyoshi Doihara, Hiroyuki Okada

Case Reports in Gastrointestinal Medicine 2016 1 - 2085452 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：Hindawi Publishing Corporation

A 52-year-old woman presented with stage IIB primary breast cancer (cT2N1M0), which was treated using neoadjuvant chemotherapy (epirubicin, cyclophosphamide, and paclitaxel). However, the tumor persisted in patchy areas; therefore, we performed modified radical mastectomy and axillary lymph node dissection. Routine endoscopy at 8 months revealed a depressed lesion on the gastric angle's greater curvature, and histology revealed signet ring cell proliferation. We performed endoscopic submucosal dissection for gastric cancer, although immunohistochemistry revealed that the tumor was positive for estrogen receptor, mammaglobin, and gross cystic disease fluid protein-15 (E-cadherin-negative). Therefore, we revised the diagnosis to gastric metastasis from the breast cancer.

DOI： 10.1155/2016/2085452

Magnifying Endoscopic Features of Follicular Lymphoma Involving the Stomach: A Report of Two Cases Reviewed

Masaya Iwamuro, Katsuyoshi Takata, Seiji Kawano, Nobuharu Fujii, Yoshiro Kawahara, Tadashi Yoshino, Hiroyuki Okada

Case Reports in Gastrointestinal Medicine 2016 1 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：Hindawi Publishing Corporation

A 70-year-old woman presented with follicular lymphoma involving the stomach, duodenum, jejunum, bone, and lymph nodes. Esophagogastroduodenoscopy revealed multiple depressed lesions in the stomach. Examination with magnifying endoscopy showed branched abnormal vessels along with gastric pits, which were irregularly shaped but were preserved. The second case was a 45-year-old man diagnosed with stage II 1 follicular lymphoma with duodenal, ileal, and colorectal involvement, as well as lymphadenopathy of the mesenteric lymph nodes. Esophagogastroduodenoscopy performed six years after the diagnosis revealed multiple erosions in the gastric body and angle. Magnifying endoscopic observation with narrow-band imaging showed that the gastric pits were only partially preserved and were destroyed in most of the stomach. Branched abnormal vessels were also seen. Pathological features were consistent with follicular lymphoma in both cases. The structural differences reported between the two cases appear to reflect distinct pathologies. Disappearance of gastric pits in the latter case seems to result from loss of epithelial cells, probably due to chronic inflammation. In both cases, branched abnormal vasculature was observed. These two cases suggest that magnified observations of abnormal branched microvasculature may facilitate endoscopic detection and recognition of the extent of gastric involvement in patients with follicular lymphoma.

DOI： 10.1155/2016/2082698

White Feces Caused by the Administration of a Somatostatin Analogue Reviewed

Masaya Iwamuro, Tomohiro Terasaka, Fumio Otsuka, Hiroyuki Okada

INTERNAL MEDICINE 55 ( 13 ) 1817 - 1817 2016

Xanthoma of the Duodenum Reviewed

Masaya Iwamuro, Takehiro Tanaka, Fumio Otsuka, Hiroyuki Okada

INTERNAL MEDICINE 55 ( 19 ) 2899 - 2900 2016

Endoscopic Resection of a Pedunculated Brunner's Gland Hamartoma of the Duodenum. Reviewed International journal

Masaya Iwamuro, Takehiro Tanaka, Satoko Ando, Tatsuhiro Gotoda, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Case reports in gastrointestinal medicine 2016 6707235 - 6707235 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：Hindawi Publishing Corporation

A 68-year-old Japanese woman presented with a solitary pedunculated polyp in the duodenum. Endoscopic ultrasonography showed multiple cystic structures in the polyp. The polyp was successfully resected by endoscopic snare polypectomy and pathologically diagnosed as Brunner's gland hamartoma. Because hamartomatous components were not identified in the stalk of the polyp, we speculate that the stalk developed from traction of the normal duodenal mucosa. When a solitary, pedunculated polyp with cystic structure within the submucosa is found in the duodenum, Brunner's gland hamartoma should be considered in the differential diagnosis, despite the rarity of the disease. This case underscores the usefulness of endoscopic ultrasonography for the diagnosis of duodenal subepithelial tumors.

DOI： 10.1155/2016/6707235

Magnified observation of spontaneous morphological changes of duodenal follicular lymphoma Reviewed

Iwamuro Masaya, Takata Katsuyoshi, Kawano Seiji, Kawahara Yoshiro, Yoshino Tadashi, Okada Hiroyuki

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 128 ( 2 ) 111 - 116 2016

Language：Japanese Publisher：Okayama Medical Association

A 63-year-old Japanese woman was diagnosed with duodenal follicular lymphoma. The initial esophagogastroduodenoscopic examination with magnifying observation revealed opaque white spots and enlarged whitish villi. Nine months later, esophagogastroduodenoscopy showed that the size of the lymphoma lesion decreased, and only opaque white spots were visible. The histological analysis of biopsy samples obtained during the initial endoscopy examination showed both neoplastic follicles and an inter-follicular infiltration of lymphoma cells, whereas the biopsy samples obtained at the endoscopy performed 9 months later showed only neoplastic follicle formation. These results suggest that the magnifying endoscopic features may reflect the underlying pathological mechanisms : enlarged whitish villi are probably due to lymphoma cell infiltration in the inter-follicular area, and opaque white spots are probably caused by neoplastic follicle formation.

DOI： 10.4044/joma.128.111

Colorectal Manifestation of Follicular Lymphoma Reviewed

Masaya Iwamuro, Hiroyuki Okada, Katsuyoshi Takata, Ryuta Takenaka, Tomoki Inaba, Motowo Mizuno, Haruhiko Kobashi, Shouichi Tanaka, Masao Yoshioka, Eisei Kondo, Tadashi Yoshino, Kazuhide Yamamoto

INTERNAL MEDICINE 55 ( 1 ) 1 - 8 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC INTERNAL MEDICINE

Objective Due to their rarity, the endoscopic features and clinical backgrounds of colorectal follicular lymphoma lesions have not yet been fully investigated. The aim of this study was to reveal the characteristics of this disease entity.
Methods A database search performed at the Department of Pathology of our institute identified 12 follicular lymphoma patients with involvement in the cecum, colon, and/or rectum. Data regarding the endoscopic, radiological, biological, and pathological examinations performed were retrospectively reviewed from their clinical records.
Results The mean age of the patients (5 men, 7 women) was 58.7 years. Five patients were classified as being Lugano system stage I, while the other seven patients were stage IV. In all of the patients, colorectal follicular lymphoma presented with papular (n=4), polypoid (n=4), and flat elevated lesions (n=4). No erosions or ulcers were seen in any of the lesions. The initial pathological diagnoses included extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (n=2) and colitis/proctitis with infiltration of inflammatory cells (n=3), in addition to the correct diagnosis of follicular lymphoma (n=7).
Conclusion Colorectal involvement of follicular lymphoma shows no erosions or ulcers. These lesions could be macroscopically observed as papular, polypoid and flat elevated lesions. Making a correct diagnosis of this disease based on the findings of biopsied samples is sometimes challenging. In such cases, multiple biopsies and/or endoscopic mucosal resection is required, in addition to appropriate consultation with pathologists.

DOI： 10.2169/internalmedicine.55.5393

An Energy Dispersive X-ray Spectroscopy Analysis of Elemental Changes of a Persimmon Phytobezoar Dissolved in Coca-Cola Reviewed

Masaya Iwamuro, Haruo Urata, Reiji Higashi, Masahiro Nakagawa, Shin Ishikawa, Hidenori Shiraha, Hiroyuki Okada

INTERNAL MEDICINE 55 ( 18 ) 2611 - 2615 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC INTERNAL MEDICINE

To investigate the mechanism of phytobezoar dissolution by Coca-Cola (R), persimmon phytobezoar pieces removed from a 60-year-old Japanese woman were analyzed by energy dispersive X-ray spectroscopy. The amount of calcium significantly decreased after dissolution treatment using Coca-Cola (R), suggesting a potential contribution of calcium to dissolution mechanisms. Moreover, immersion in Coca-Cola (R) for 120 hours on the exterior surface revealed that Coca-Cola (R) did not permeate persimmon phytobezoars. This is the first study to investigate the mechanisms of persimmon phytobezoar permeability and dissolution induced by Coca-Cola (R).

DOI： 10.2169/internalmedicine.55.6985

Reactivation of Human Herpes Virus-6 in the Renal Tissue of a Patient with Drug-induced Hypersensitivity Syndrome/Drug Rash with Eosinophilia and Systemic Symptoms (DIHS/DRESS) Reviewed

Hideharu Hagiya, Masaya Iwamuro, Takehiro Tanaka, Kou Hasegawa, Yoshihisa Hanayama, Maya Kimura, Fumio Otsuka

INTERNAL MEDICINE 55 ( 13 ) 1769 - 1774 2016

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC INTERNAL MEDICINE

A 74-year-old man who had been administered trimethoprim-sulfamethoxazole for three weeks suffered from drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS). In the early stage of the clinical course, he developed renal dysfunction. A renal biopsy showed granulomatous tubulointerstitial nephritis accompanying the proliferation of human herpes virus ( HHV)-6 in tubular epithelial cells. With corticosteroid therapy, the systemic rash and renal function gradually improved. The present patient is the second case of DIHS/DRESS demonstrating a possible reactivation of HHV-6 in the renal tissue. The clinical role of viral reactivation in DIHS/DRESS must be further elucidated.

DOI： 10.2169/internalmedicine.55.6287

Actual Status of Involvement of Helicobacter pylori Infection That Developed Gastric Cancer from Group A of ABC (D) Stratification - Study of Early Gastric Cancer Cases That Underwent Endoscopic Submucosal Dissection. Reviewed International journal

Ko Miura, Hiroyuki Okada, Yoshiyasu Kouno, Hiromitsu Kanzaki, Masaya Iwamuro, Keisuke Hori, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai

Digestion 94 ( 1 ) 17 - 23 2016

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/AIMS: Patients who are Helicobacter pylori antibody negative and have normal pepsinogen (PG) levels (group A of ABC (D) stratification) are considered unlikely to develop gastric cancer. This study aimed to clarify the involvement (uninfection, present infection or previous infection) of H. pylori in group A patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) by examining their background gastric mucosa endoscopically and histologically. METHODS: This study included 166 patients with gastric cancer who were treated by ESD. Patients were classified according to PG levels and H. pylori antibody titers. Three biopsies (greater curvature of the antrum, lesser curvature of the middle corpus and greater curvature of the middle corpus) from group A were histologically analyzed and compared with those of groups B, C, D and after eradication). RESULTS: In group A (34 patients), 32 patients had endoscopic atrophy (group A'). Histological neutrophil activity, chronic inflammation and atrophy scores were lower in group A' than in other groups. Group A' scores were similar to those of the after eradication group. CONCLUSION: Most of the group A patients with early gastric cancer were not uninfected with H. pylori, but had previous infections, thus carrying carcinogenic risk.

DOI： 10.1159/000446771

Long-term survival of two patients with esophageal neuroendocrine carcinoma who underwent multidisciplinary therapy

Gotoda Tatsuhiro, Kawano Seiji, Kono Yoshiyasu, Miura Kou, Kanzaki Hiromitsu, Iwamuro Masaya, Kawahara Yoshiro, Tanaka Takehiro, Yoshino Tadashi, Shirakawad Yasuhiro, Tabata Masahiro, Tanimoto Mitsune, Okada Hiroyuki

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 128 ( 3 ) 207 - 212 2016

Language：Japanese Publisher：Okayama Medical Association

Esophageal neuroendocrine carcinoma (ECC) is rare and has a poor prognosis when presenting with vascular invasion and distant metastasis from an early stage. Multidisciplinary therapy with surgery, chemotherapy, and radiation therapy may prolong survival in patients with advanced ECC, but there is as yet no standard therapy for advanced ECC. We treated two patients who have achieved long-term survival (> 4 years) who underwent multidisciplinary therapy, including chemotherapy, for ECC. Our experience with these two cases suggests that multidisciplinary therapy, including chemotherapy, may be effective for treating ECC at an advanced stage.

DOI： 10.4044/joma.128.207

Ectopic sebaceous glands in the esophagus that became evident over a three-year span

Iwamuro Masaya, Okada Hiroyuki, Harada Keita, Kanzaki Hiromitsu, Hori Keisuke, Kita Masahide, Kawano Seiji, Kawahara Yoshiro, Tanaka Takehiro, Yamamoto Kazuhide

Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 128 ( 3 ) 201 - 205 2016

Language：Japanese Publisher：Okayama Medical Association

A 43-year-old Japanese woman was diagnosed with ectopic sebaceous glands in the esophagus by esophagogastroduodenoscopy and biopsy. At the age of 46, typical ectopic sebaceous glands were recognized in the upper esophagus, whereas yellowish white granules were faintly observed in the lower esophagus. Esophagogastroduodenoscopy examinations were repeated when she was 47 and again at 50 years old, and the lesions in the lower esophagus had become more evident over the ensuing 3 years. Esophageal ectopic sebaceous glands are relatively infrequent, and there have been few case reports describing the progression of the endoscopic features. We also report the clinical and endoscopic features of the five similar cases with pathologically proven ectopic sebaceous glands in the esophagus.

DOI： 10.4044/joma.128.201

Clinical Features of Intestinal Behçet's Disease Associated with Myelodysplastic Syndrome and Trisomy 8. Reviewed

Kawano S, Hiraoka S, Okada H, Akita M, Iwamuro M, Yamamoto K

Acta medica Okayama 69 ( 6 ) 365 - 369 2015.12

Serrated polyp of the duodenum Reviewed

Masaya Iwamuro, Keisuke Hori, Takehiro Tanaka, Hiroyuki Okada

GASTROINTESTINAL ENDOSCOPY 82 ( 5 ) 966 - 967 2015.11

Cytomegalovirus as an Insidious Pathogen Causing Duodenitis Reviewed

Hideharu Hagiya, Masaya Iwamuro, Takehiro Tanaka, Yoshihisa Hanayama, Fumio Otsuka

ACTA MEDICA OKAYAMA 69 ( 5 ) 319 - 323 2015.10

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion; however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.

DOI： 10.18926/AMO/53679

内視鏡的治療を行った消化管異物37件の検討

岩室雅也, 甲斐華恵, 宮部欽生, 河合良成, 大塚文男

日本病院総合診療医学会雑誌 9 ( 1 ) 17 - 22 2015.10

Language：Japanese Publisher：(一社)日本病院総合診療医学会

尾道市立市民病院で内視鏡治療を行った消化管異物33例(男性12例、女性21例、平均年齢74.6歳)、のべ37件について検討した。異物の内訳は、魚骨(8件)、プレス・スルー・パッケージ(PTP)(7件)、残渣塊(7件)、義歯・歯科治療材料(4件)、肉片(4件)、その他(7件)であった。存在部位は食道(25件)、胃(7件)、喉頭(4件)、大腸(1件)であり、自覚症状はつかえ感(10件)、疼痛(10件)が多かった。基礎疾患としては消化管手術の既往を7例に、消化管悪性疾患の併存を3例に認めた。37件全例で消化管異物に対して内視鏡的治療が実施され、36件で内視鏡的治療が成功した。18件で軽度の粘膜傷害や出血がみられたが、いずれも保存的治療で軽快した。他の重篤な偶発症は認めず、外科手術を要した症例はなかった。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J05937&link_issn=&doc_id=20160609410003&doc_link_id=%2Ffg3byoin%2F2015%2F000901%2F003%2F0017-0022%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg3byoin%2F2015%2F000901%2F003%2F0017-0022%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Hepatic stellate cells promote upregulation of epithelial cell adhesion molecule and epithelial-mesenchymal transition in hepatic cancer cells. Reviewed International journal

Teruya Nagahara, Hidenori Shiraha, Hiroaki Sawahara, Daisuke Uchida, Yasuto Takeuchi, Masaya Iwamuro, Junro Kataoka, Shigeru Horiguchi, Takeshi Kuwaki, Hideki Onishi, Shinichiro Nakamura, Akinobu Takaki, Kazuhiro Nouso, Kazuhide Yamamoto

Oncology reports 34 ( 3 ) 1169 - 77 2015.9

Language：English Publishing type：Research paper (scientific journal)

Microenvironment plays an important role in epithelial-mesenchymal transition (EMT) and stemness of cells in hepatocellular carcinoma (HCC). Epithelial cell adhesion molecule (EpCAM) is known as a tumor stemness marker of HCC. To investigate the relationship between microenvironment and stemness, we performed an in vitro co-culture assay. Four HCC cell lines (HepG2, Hep3B, HuH-7 and PLC/PRF/5) were co-cultured with the TWNT-1 immortalized hepatic stellate cells (HSCs), which create a microenvironment with HCC. Cell proliferation ability was analyzed by flow cytometry (FCM) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, while migration ability was assessed by a wound healing assay. Expression of EpCAM was analyzed by immunoblotting and FCM. HCC cell lines were co-cultured with TWNT-1 treated with small interfering RNA (siRNA) for TGF-β and HB-EGF; we then analyzed proliferation, migration ability and protein expression using the methods described above. Proliferation ability was unchanged in HCC cell lines co-cultured with TWNT-1. Migration ability was increased in HCC cell lines (HepG2, Hep3B, HuH-7 and PLC/PRF/5) directly (216.2±67.0, 61.0±22.0, 124.0±66.2 and 51.5±40.3%) and indirectly (102.5±22.0, 84.6±30.9, 86.1±25.7 and 73.9±29.7%) co-cultured with TWNT-1 compared with the HCC uni-culture. Immunoblot analysis revealed increased EpCAM expression in the HCC cell lines co-cultured with TWNT-1. Flow cytometry revealed that the population of E-cadherin-/N-cadherin+ and EpCAM-positive cells increased and accordingly, EMT and stemness in the HCC cell line were activated. These results were similar in the directly and indirectly co-cultured samples, indicating that humoral factors were at play. Conversely, HCC cell lines co-cultured with siRNA‑treated TWNT-1 showed decreased migration ability, a decreased population of EpCAM-positive and E-cadherin-/N-cadherin+ cells. Taken together, humoral factors secreted from TWNT-1 promote upregulation of EpCAM and EMT in hepatic cancer cells.

DOI： 10.3892/or.2015.4126

Serum anti-p53 antibody as a tumour marker for colorectal cancer screening Reviewed

Masaya Iwamuro, Yoshinari Kawai, Tomoko Matsumoto, Masashi Uda, Hiroyuki Okada

ecancermedicalscience 9 2015.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Cancer Intelligence

A 60-year-old Japanese man presented to our hospital for further investigation of an elevated serum anti-p53 antibody level. He was diagnosed with colon cancer and the tumour was surgically resected. Histological diagnosis of advanced colon cancer without lymph node involvement or distant metastasis was made. It was noteworthy that both serum carcinoembryonic antigen (CEA) and a fecal occult blood test that were performed preoperatively were non-diagnostic. This case highlights the potential usefulness of serum anti-p53 antibody tests for detection of colorectal cancers. Moreover, sequential changes in the anti-p53 antibody levels after curative resection were observed.

DOI： 10.3332/ecancer.2015.560

Gastric bezoar treatment by endoscopic fragmentation in combination with Pepsi-Cola® administration Reviewed

Masaya Iwamuro, Naoko Yunoki, Jun Tomoda, Kazuhiro Nakamura, Hiroyuki Okada, Kazuhide Yamamoto

American Journal of Case Reports 16 445 - 448 2015.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Medical Science International

Objective: Unusual setting of medical care Background: Although bezoar dissolution by Coca-Cola® has been described in case reports and case series, to the best of our knowledge, the usefulness of other cola products such as Pepsi-Cola® has never been reported in the English literature. Case Report: An 86-year-old Taiwanese man was diagnosed with a gastric bezoar. Endoscopic fragmentation with a polypectomy snare was attempted twice but failed to remove the bezoar. Subsequently, 500 mL of Pepsi NEX Zero® was administered daily for 4 days via nasogastric tube. The bezoar was softened and successfully fragmented by the polypectomy snare and needle-knife devices on the third attempt. Conclusions: This report presents the first case of a gastric bezoar successfully treated by endoscopic fragmentation in combination with Pepsi-Cola® administration, suggesting the possible utility of cola beverages in bezoar treatment, regardless of product brands.

DOI： 10.12659/AJCR.893786

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