1/9. Evolution of acute cytomegalovirus gastritis to chronic gastrointestinal dysmotility in a nonimmunocompromised adult.A 30-year-old nonimmunocompromised woman developed chronic gastrointestinal dysmotility as a consequence of acute cytomegalovirus infection. The acute nature of the infection was documented by high immunoglobulin m antibody titer to cytomegalovirus (CMV); the chronicity of the infection was shown by persistence of CMV in biopsy specimens of her gastrointestinal tract over a 21/2-year period. Gastrointestinal dysmotility was confirmed by delayed emptying on gastric nuclear scintigraphy, by retrograde propagation of migrating myoelectric complexes on small intestinal manometry, and by presence of tachygastria on cutaneous electrogastrography. The patient's nausea, vomiting, abdominal pain, and early satiety resolved after a short course of treatment with leuprolide acetate but returned after medication was discontinued. Her symptoms persisted despite clearance of CMV from the gastrointestinal tract after a course of treatment with ganciclovir. These observations show that acute CMV infection can cause gastrointestinal dysmotility in nonimmunocompromised individuals and that the disturbance in gastrointestinal motor function may persist for years after viral infection of the gastrointestinal tract has been eradicated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/9. Phlegmonous gastritis following coronary bypass surgery.Phlegmonous gastritis is a rare, rapidly progressive and potentially fatal gastric bacterial infection. A case of phlegmonous gastritis following a coronary bypass surgery is described. This condition was not diagnosed premortem due to the nonspecific nature of the gastrointestinal symptoms. Upper gastrointestinal endoscopy may be of value in establishing the diagnosis in emergencies with culture of gastric aspirate and biopsy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/9. Gastric adenocarcinoma associated with granulomatous gastritis. Case report and review of the literature.AIMS: We describe the fourth reported case of granulomatous gastritis associated with gastric adenocarcinoma, with a review of the literature and considerations about the prognostic implications of this association. RESULTS: A 48-year-old woman who had been suffering from gastritis for ten years was admitted to our institute for increasing left epigastric pain associated with vomiting. After an endoscopic biopsy had revealed an ulcerated signet ring cell carcinoma, the patient was submitted to subtotal gastrectomy with regional lymph node dissection. Pathological examination of the resected specimen revealed a superficial signet ring cell carcinoma (early cancer) associated with multiple granulomas. The granulomas, which were observed within the mucosa and the submucosa at the periphery of the carcinoma, were composed of CD68-positive, CD15-negative epithelioid and giant cells of the Langhans type, confirming their true histiocytic nature, and were also extensively found within the dissected lymph nodes. Since no ocular, skin, pulmonary or other gastrointestinal lesions were found and the granulomas were negative for acid-fast and fungal stain, a diagnosis of granulomatous gastritis was made. CONCLUSIONS: To the best of our knowledge this is the fourth example of gastric adenocarcinoma and granulomatous gastritis. These cases suggest an association between granulomatous gastritis and early gastric cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/9. An unusual presentation of helicobacter pylori infection: so-called "Russell body gastritis".helicobacter pylori (H. pylori) is a "slow" bacterial pathogen, which induces several gastroduodenal diseases. Varying degrees of inflammation can be present in the gastric mucosa of patients infected with H. pylori. The case presented here is a male patient suffering from dyspepsia and nausea. His upper gastrointestinal endoscopy revealed pan gastritis. Histological examination of multiple gastric biopsies taken from the body and antrum showed a rare morphological expression of H. pylori gastritis characterized by diffuse plasma cell infiltration with extensive Russell body formation. Diffuse infiltration of plasma cells with Russell bodies in gastric mucosa can cause difficulties in differentiation from neoplastic processes. However, immunohistochemically, the infiltrating cells in the gastric mucosa stained negatively with cytokeratins while they expressed both kappa and lambda light chains showing their polyclonal nature. The presence of diffuse plasma cells with Russell bodies in the gastric mucosa may represent a different presentation of H. pylori gastritis. There are only two case reports of similar presentation and both have been called "Russell body gastritis".- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/9. The natural history of hypertrophic gastrophy (Menetrier's disease). Report of a case with 16 year follow-up and review of 120 cases from the literature.We describe a 33 year old man who presented with epigastric pain, weight loss and hematemesis. Roentgenograms of the upper gastrointestinal tract and endoscopy demonstrated giant rugal folds, and the diagnosis of hypertrophic gastropathy was confirmed by operative biopsy. This patient's symptoms and abnormalities noted on the roentgenograms persisted until his death 16 years later. Postmortem examination confirmed the persistence of hypertrophic gastropathy and revealed, in addition, a hepatocellular carcinoma metastatic to the stomach and regional lymph nodes. A review of 120 previously reported cases of hypertrophic gastropathy with special attention to its natural history indicates that the chronic nature of this patient's illness is typical. In addition, the chance of gastric carcinoma developing in these patients is appreciable. Since the reported long-term results of operative therapy appear favorable, patients with persistent and sufficiently distressing symptoms should be considered for gastric resection.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/9. Hyalinoid giant cell gastritis. A unique gastric lesion associated with eosinophilic hyalinoid degeneration of smooth muscle.A rare case of degenerative and inflammatory lesion of the stomach occurring in a 34-year-old woman is reported. Clinically, the lesion simulated gastric carcinoma because of the extensive involvement of the mucosa and submucosa by the process. Histologically, it was characterized by eosinophilic hyalinoid degeneration of smooth muscles in the muscularis mucosae as well as mucosal and submucosal blood vessels accompanied with foreign body giant cells and other inflammatory cells. The lesion occurred in association with chronic peptic ulcers, and a small submucosal nodule histologically compatible with inflammatory fibroid polyp coexisted within the area of this lesion. The patient has had no systemic disease and has been well for 4.5 years postoperatively. These clinical features suggest a localized nature of the lesion limited to the stomach. The term "hyalinoid giant cell gastritis" is proposed to describe this distinctive form of gastritis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/9. Mediastinal parathyroid cyst.Computed tomography (CT) accurately demonstrated the cystic nature of a superior mediastinal mass, which was confirmed at thoracotomy to be a parathyroid cyst. To our knowledge this is the only case of a mediastinal parathyroid cyst characterized preoperatively by CT.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/9. Benign hypertrophic gastropathy: menetrier's disease in childhood and adolescence.Menetrier's disease (hypertrophic gastropathy) in patients under the age of 20 years is rare. A case is described and the features of the condition found in 11 young patients are discussed. The patients, when seen, are usually in acute abdominal pain and vomiting or edema due to hypoproteinemia is present. Eosinophila was found in half of the recorded cases and the cause in these cases may be due to hypersensitivity. anemia is common and hypoproteinemia usually found. There is a distinct male predominance and patients are usually Caucasians. Our patient is the second black male youth recorded with this disease. The distinction from adult Menetrier's disease is its benign nature in this age group and complete clinical recovery is the rule. The term benign hypertrophic gastropathy is suggested.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/9. Eosinophilic gastritis. Radiologic-pathologic correlation (RPC) from the Armed Forces Institute of pathology (AFIP).Eosinophilic gastroenteritis may involve the gastrointestinal tract locally ofr diffusely. When localized to the stomach, the preferred terminology is "eosinophilic gastritis". Pathologically, this entity is characterized by a high eosinophil count (which closely follows the symptomatology) and diffuse infiltration of the antral wall by eosinophils. Typical roentgenographic manifestations include gastric antral rigidity, thickened folds, and mucosal nodules. The differential diagnosis is discussed. Correct diagnosis is vital because of the benign nature of the disease and good response to conservative therapy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |