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1 47 10 mm PS S-100 Neuron Specific Enolase NSE (Granular ell umor) S-100 Neuron Specific Enolase(NSE) Granular ell umor 47 1)

5 31 175 cm 65 kg 130/88 mmhg strip biopsy 8 8 5 mm 10 mm WB 9940 /mm 3 LDH 347 IU/l RB 421 10 4 /mm 3 G 244 Hb 14.

2 cm 65 kg 130/88 mmhg strip biopsy mm 10 mm WB 9940 /mm 3 LDH 347 IU/l RB /mm 3 G 244 Hb 14.4 g/dl -hol 152 Plt /mm 3 BUN 10 P 7.1 g/dl r 0.5 -Bil 0.6 Na 143 meq/l GO 66 IU/l l 106 meq/l GP 53 IU/l K 4.0 meq/l

3 Granular ell umor 1 Granular ell yobla- stoma PS S-100 Neuron Specific Enolase NSE Nerve Growth actor Receptor NGR Schwann hromogranin S-100 Schwann myelin 5),6) S (39 ) (35 ) (32 ) NSE 1) 45 2),3),7)-10) ) 2) brikossoff 4) S 3

5 Granular ell umor 1 Granular ell umor Yamada Shimamoto Koike izuno Kawaura akeshige ita Hirano akeda akeda Nakata Natsuda kusawa Katada oshimori Ito Sugimoto Okubo Nagasaki kagi Yamada ihara Yatsumata Kobayashi Okina Utsunomiya Shimura Yamada Kataoka anishima Ono Ono Kawamura Yamada Urano akeshima akeshima Kaigi Sasahara Iwamoto Hamajima unakata Ryo akeyama Our case (mm) incomplete evacuation general fatigue anorexia lower diarrhea hematochezia abdominal disorder lower hematochezia diarrhea abdominal disorder abdominal defecation hematochezia constipation general fatigue abdominal disorder constipation diarrhea lower lower lower abdominal distention D S R R S D S R D,, R little finger tip size , , 10 8 S-100 NSE : cecum, : ascending colon, : transverse colon, D: descending colon, S: sigmoid colon, R: rectum, : not stated.

6 4 9.0 mm 2 mm 30 mm 3 7)-10) 2),13)-15) 1,, Granular cell 20 mm tumor ) , ,,,, 8mm, brikossoff Uber myoma ausgehend von 1 2 % der quergesteriften willkurkichen uskulatur. alignant Virchows rch [] 1926; 260: Granular ell umor, 12) Stefanson K, Wollmann RL: S-100 protein in >9 cm granular cell tumors. ancer 1982; 49:

7 Granular ell umor 1,,,, Hunter D Jr, Dewer JP alignant, 1 granular cell myoblastoma: report of a case and review of literature. m Surg 1960; 26: ,,, Rossi GB, de Bellis, arone P, De hiara, Losito S, empesta Granular,,,, cell tumors of the colon: report of a case and, Granular review of the literature. J lin Gastroenterol cell tumor 1. Gastroenterol 2000; 30: Endosc ,,,,,,, 1 1. Gastroenterol Endosc aediego G, Komorowski R, Dhar GJ:,, Granular cell tumor (myoblastoma) of the large 1. intestine removed by colonoscopy. Gastrointest Endosc 1980; 26: 108

8 Yamagata ed J ) Katsuyoshi Ishihama, Shuho Senba, Hiroaki akeda, asaru Harada, Shoichiro Hujishima, adahisa Hukui, Nanami Ito, omohiko Orii, Yuichi Nakazawa, itsunori Yamakawa, Sumio Kawata Second Department of Internal edicine, Yamagata University School of edicine, irst Department of Pathology, Yamagata University School of edicine, Yamagata , Japan BSR Granular cell tumors are uncommon, usually benign tumors that can be located anywhere in the body. hey commonly occur in the oral cavity, esophagus and subcutaneous tissue. In the gastrointestinal tract, granular cell tumors are quite rare in the colon. o date, forty-four Japanese patients with granular cell tumor have been reported in the literature. We describe the case of a 47-year-old Japanese man with granular cell tumor of the colon after screening colonoscopy. 10 mm-sized submucosal tumor was found in the cecum. Endoscopical examination revealed the submucosal tumor elastic-hard mass and endoscopic ultrasonography demonstrated a submucosal hypoecoic and well-circumscribed nodule, involving the mucosa, being difficult to distinguish the tumor from carcinoid tumor of the colorectum. Histologically, the tumor consisted of granular tumor cells that were positive for S-100 protein, neuron specific enolase (NSE), and PS stain. Since granular cell tumors are usually benign, we suggest a conservative approach for patients with this tumor of the colorectum by means of endoscopic resection and strict endoscopic follow-up. Key words Granular cell tumor, colon, S-100 protein, neuron specific enolase, endoscopic resection

BUN, CRP K mg/ cm, 49.6 kg, BMI /72 mmhg, 92/ Hb 6.7 g/dl PT-INR CT 1 MRI 2a, b T1 T2 T1 MRI

BUN, CRP K mg/ cm, 49.6 kg, BMI /72 mmhg, 92/ Hb 6.7 g/dl PT-INR CT 1 MRI 2a, b T1 T2 T1 MRI 20 2 2015 1 2 3 85 K CT Abstract A case of renal subcapsular hematoma resulting from trigger point injection under excessive effect of anticoagulant YAMANE Tateki, UMEDA Akira and SHIMAO Hitoshi An 85-year-old

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橡石浜.ec6