Background: Liver abscess due to gastrointestinal perforation by foreign bodies is rare. Furthermore, there are few case reports of liver abscess via the portal vein caused by perforation of the lower gastrointestinal tract by a foreign body. Case presentation: A 54-year-old man visited our hospital because of a fever that had lasted for 1 month. There were no physical findings except for the fever. Laboratory tests showed only elevated inflammatory markers. Abdominal contrast-enhanced computed tomography revealed an abscess in the right lobe of the liver and a highdensity object in the small intestine. We diagnosed him with liver abscess secondary to intestinal perforation by a foreign body. The patient underwent drainage of the liver abscess and laparoscopic surgery for perforation of the small intestine. A fish bone had perforated the top of Meckel's diverticulum, which had been covered by the ileal mesentery. We successfully performed diverticulectomy and removed the fish bone. The patient was discharged without complications on the 13th postoperative day. Conclusions: Liver abscess caused by foreign bodies requires multidisciplinary treatment, so we must detect and remove the cause of the abscess earlier. Liver abscess can form via the portal vein secondary to lower gastrointestinal perforation, as in this case. When exploring the cause of liver abscess, we should investigate the whole body, including the lower gastrointestinal tract.
Tumor‐resident memory T (T
RM
) cells in primary tumors are reportedly associated with a favorable prognosis in several malignancies. However, the behaviors and functions of T
RM
cells in regional lymph nodes (LNs) of esophageal cancer remain poorly understood. The aim of this study was to elucidate the effects of T
RM
cells in regional LNs of esophageal cancer on clinicopathological findings and prognosis. Specimens of esophageal cancer and primary metastatic LNs (recurrent nerve LNs) were obtained from 84 patients who underwent radical esophagectomy between 2011 and 2017. We performed immunohistochemistry to enumerate and analyze T
RM
cells, and used flow cytometry to investigate the function of T
RM
cells. T
RM
cells were observed in both metastatic LNs and primary tumors. T
RM
cell‐rich specimens exhibited reduced lymphatic invasion and LN metastasis and prolonged survival compared with T
RM
cell‐poor specimens. T
RM
cells in metastatic LNs were more significantly associated with enhanced survival than T
RM
cells in primary tumors. T
RM
cells expressed high levels of granzyme B as a cytotoxicity marker. Our results suggested that high T
RM
cell infiltration in metastatic LNs improves survival even though LN metastasis is commonly associated with poor prognosis. T
RM
cells possibly contribute to antitumor immunity in regional LNs.
Esophageal cancer has high frequency of lymph node (LN) metastasis and poor prognosis, and often relapse early even after radical esophagectomy. Extensive LN dissection has made it possible to grasp the detailed metastatic status and the relationship between LN metastasis and prognosis. It is necessary to study more about metastatic style and prognostic factors for minimalization of surgical invasion and individualization of treatment.
We analyzed about metastatic location, prognosis and recurrence for esophageal cancer cases with a few LN metastasis. We study 168 stageII, III esophageal cancer cases that underwent radical esophageal resection with regional LN dissection (D2 or more) from January 2015 to December 2017. Those cases included 37 or 29 cases with one or two LN metastasis.
The number of cases on each tumor location (Ce/Ut/Mt/Lt/Ae) were 4/19/80/55/10 cases. On LN dissection, D2 were 68 cases and D3 were 100 cases. In a comparison of survival rate, age (<65/≧65), lymphatic invasion, the number of metastatic lymph node have significant difference. The 5-years overall survival rate of esophageal cancer with one or two metastatic LNs was each 82.9% or 65%. Most of a few LN metastasis cases have first group LN metastasis (11th Japanese Classification of Esophageal Cancer), for example No.106rec or abdominal LNs, but we didn’t sometimes detect them prior to surgery.
Esophageal cancer with a few metastatic lymph nodes had relatively good prognosis, and metastasis was likely to stay nearby the primary lesion. However, it is difficult to detect metastasis precisely prior to surgery, so developing the further technique of diagnosis and individualized treatment are expected in the future.
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