Yoshio Deguchi

Natural Killer-Like T Cell Lymphoma of the Small Intestine : Report of a Case

We report the case of a 77-year-old Japanese man with natural killer (NK)-like T cell lymphoma of the small intestine diagnosed after an emergency laparotomy for perforated peritonitis. Immunohistochemical staining of the tumor showed that the patient had CD3+ CD8+ CD30− CD56+ CD68− CD79a− UCHL-1+ EMA− LMP-1 NK-like T cell lymphoma. The patient had a history of hepatocellular carcinoma (HCC) and was also diagnosed with T cell non-Hodgkins lymphoma associated with T cell receptor (TCR) reconstruction in the Jγ chain. Intestinal T cell lymphoma is uncommon and very few cases of CD56+ T cell lymphoma, otherwise known as NK-like T cell lymphoma, have been reported. The patient did not have a history of gluten-sensitive enteropathy (celiac disease). Multiple lesions appeared within months after the initial operation and his condition deteriorated rapidly. We think that this patient probably had NK-type granular lymphocyte-proliferative disorder (NK-GLPD) because the percentage of CD16+ CD56+ cells among peripheral blood mononuclear cells was elevated, at 21%. We report this case to help elucidate the relationship between underlying digestive organ disease and the development of intestinal NK-like T cell lymphoma. An accumulation of other such cases is needed to determine the etiology of this disease.

Single-incision cholecystectomy in a patient with situs inversus totalis presenting with cholelithiasis: A case report.

Laparoscopic cholecystectomy has become the gold standard for the treatment of cholelithiasis, and many reports of single‐incision laparoscopic cholecystectomy have been published in the past few years. Situs inversus totalis is a very rare condition, but the variant anatomy should not preclude a minimally invasive approach to surgery. We report a case of successful single‐port laparoscopic cholecystectomy in a patient with situs inversus totalis, describe the technical advantages, and review the literature.