Internal medicine
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Background The etiology of liver cancer is changing to metabolic dysfunction-associated steatotic liver disease, and ultrasound elastography is useful for identifying high-risk patients. However, these regional differences remain unclear. We aimed to investigate regional differences in the prevalence of liver cancer and the use of ultrasound elastography in Japan using the National Database of Health Insurance Claims (NDB). ⋯ Conclusion The morbidity of liver cancer and diabetes-related diseases is higher in Western Japan. However, ultrasound elastography is not widely used in Japan. There is an urgent need to promote awareness of ultrasound elastography to screen patients at high risk for liver cancer, particularly in Western Japan.
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Currently, immune checkpoint inhibitors (ICIs) are the standard treatment for malignant pleural mesothelioma (MPM). The characteristic responses to ICI treatment include pseudoprogression (PP) and hyperprogressive disease (HPD), which require attention. ⋯ This was initially judged as HPD but was subsequently diagnosed as PP owing to a marked reduction in tumor size. This case highlights the importance and difficulty of differentiating between PP and true progression, including HPD, during treatment of MPM with ICIs.
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This is the first report of therapy-related mixed-phenotype acute leukemia (MPAL) characterized by B-cell, T-cell, and myeloid lineage phenotypes. A 68-year-old man, who was in complete remission after chemoradiotherapy for recurrent esophageal cancer, developed bacterial pneumonia with increasing blasts in the peripheral blood, and a subsequent bone marrow biopsy revealed 85.2% blasts. ⋯ After the initiation of venetoclax and azacitidine, the patient achieved complete remission, and cord blood transplantation was performed. This case provides novel insights into the therapeutic options for therapy-related trilineage MPAL treatment.
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Cancer cachexia, which is characterized by weight loss and muscle weakness, is common in patients with pancreatic cancer. Anamorelin, a ghrelin receptor agonist, has shown potential for the management of cachexia in various cancers. ⋯ Cachexia's complex metabolic changes make treatment difficult; however, anamorelin's appetite and weight gain effects highlight its possible role in managing cachexia in pancreatic cancer. Therefore, further research is required in this regard.
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Idiopathic multicentric Castleman disease (iMCD) accompanied by thrombocytopenia, anasarca, fever, reticulin myelofibrosis/renal insufficiency, and organomegaly (TAFRO) frequently develops into prolonged severe thrombocytopenia and multiorgan dysfunction, which is associated with a high mortality rate. We herein describe three cases of iMCD-TAFRO in which serum soluble interleukin-2 receptor (sIL-2R) levels varied in relation to disease activity following the initiation of treatment. Thrombocytopenia persisted for several weeks to months after the normalization of the patients' C-reactive protein levels, whereas their sIL-2R levels normalized 10-47 days prior to platelet recovery (≥100×109/L). The serum sIL-2R measurement may therefore be an effective method for evaluating the disease activity in iMCD-TAFRO patients with prolonged thrombocytopenia.