1/15. Gastric adenocarcinomas in displaced mucosal glands.Although gastric carcinoma is one of the most common cancers worldwide, only a few histologic proximate precursors have been demonstrated. Several authors have found that foci of misplaced gastric mucosa with cystic dilatations (s.c. heterotopic mucosa) are often associated with gastric adenocarcinomas. However, adenocarcinomas originating within heterotopic gastric mucosa have never been reported. In present work, the review of 213 consecutive gastrectomy specimens in Japanese patients showed heterotopic gastric mucosa in 20.1% (n = 43). Up to 18 foci per gastrectomy were present. The heterotopic mucosa was surrounded by invaginations of the muscularis mucosae which showed strong positivity for smooth muscle actin. In 3 of the 213 specimens, an adenocarcinoma was found within a focus of heterotopic gastric mucosa. All 3 adenocarcinomas had cystic dilatations lined by neoplastic columnar epithelium with polymorphic nuclei, irregular nuclear membrane, large irregular nucleoli and pathological mitosis. The tumors had lateral bundles of smooth muscle (smooth muscle actin positive), regarded as invaginations of the muscularis mucosae. The p53 protein was strongly overexpressed in all 3 tumors. The heterotopic gastric mucosa may be one mucosal locus from which gastric adenocarcinomas may originate.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/15. Concomitant diagnosis of primary sjogren's syndrome and systemic AL amyloidosis.A 48 year old woman was referred to hospital for buccal discomfort. physical examination showed a macroglossia and features of xerostomia. She was diagnosed as having primary sjogren's syndrome according to the criteria proposed by the European Community study group in 1993. Furthermore, a lower lip salivary gland biopsy showed amyloid deposits that were also seen in the stomach and in the bone marrow. echocardiography was consistent with cardiac amyloidosis. serum immunofixation identified a monoclonal IgGlambda. As far as is known, this is the first report of systemic primary amyloidosis associated with sjogren's syndrome. The relation between these two disorders is discussed.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
3/15. adenocarcinoma arising in gastric heterotopic pancreas: clinicopathological and immunohistochemical study with genetic analysis of a case.Heterotopic pancreas in the stomach is a relatively common congenital condition, but the risk of malignant transformation is extremely low. In this study, we describe a case of adenocarcinoma arising from a gastric heterotopic pancreas and we consider its morphological and immunohistochemical features and genetic analysis, in order to examine its histogenesis. This unusual sequela was seen in a 57-year-old woman. Image studies showed a protruding lesion with a central ulcer located in the lesser curvature from the angle to the body of the stomach. A biopsy specimen confirmed this lesion as adenocarcinoma before total gastrectomy. The tumor showed mixed patterns of solid neoplastic-cell proliferation and moderately differentiated glandular structures, and also showed transitional lesions to obvious malignancy, that is, dysplasia, or adenocarcinoma in situ. Neoplastic cells had positive immunoreactivity for carbohydrate antigen (CA) 19-9, mucin (MUC) 1, and insulin, and the mutant allele-specific amplification method revealed a point mutation at K-ras codon 12 (GGT [Gly]-->GAT [Asp]), which is the most common mutational change observed in patients with pancreatic carcinoma. The features of the present case provide clear evidence that this tumor originated from heterotopic pancreatic tissue rather than from gastric epithelium.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
4/15. Heterotopic pancreatitis: gastric outlet obstruction due to an intramural pseudocyst and hamartoma.Heterotopic pancreas, usually a silent gastrointestinal malformation, may become clinically evident when complicated by chronic inflammation. We report a case of pancreatitis and extensive pseudocyst formation in the gastric antrum, which caused gastric outlet obstruction. The diagnosis was obscured by a history of emesis during pregnancy and a previously resected gastric polyp. The nature of the obstructive lesion was not diagnosed preoperatively in spite of endosonographic evaluation. Intraoperatively, a cystic tumor of the stomach wall was found, the lesion was excised, and a pyloroplasty was performed to close the excision site. histology revealed heterotopic pancreatic tissue with chronic inflammation, fibrosis and pseudocyst formation and adjacent to this lesion a myoglandular hamartoma. The patient is symptom-free two years after surgery and no recurrence was found. The nature of heterotopic pancreatic tissue, its diagnosis and management are discussed.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
5/15. A case report of localized gastric amyloidosis.AIM: To elucidate the clinical and laboratory features of localized gastric amyloidosis via a rare report along with a review of related literatures. methods: The clinical manifestations, laboratory results and surgical treatment of a female patient with localized gastric amyloidosis in our hospital were summarized. The relevant literatures were reviewed on the etiology, clinical features, diagnosis, treatment and prognosis of this disease. RESULTS: The patient was lack of specific clinical manifestations and positive laboratory results. Prior to the treatment, she was suspected to be of malignization from gastric ulcer by both gastroscopy and endoscopic ultrasonography, which was denied by the gastric biopsy. The patient was treated with subtotal gastrectomy and clearance of perigastric lymph nodes. The postoperative pathological diagnosis determined the lesion to be the deposition of amyloid materials in the gastric mucosa, submucosa and blood vessel walls with intestinal metaplasia and atrophy of the gastric glands, in which no malignant tumor was found. congo red staining with prior potassium permanganate incubation confirmed the AA type of amyloid in this case. Multiple biopsies from esophagus, remnant stomach, duodenum, colon and bone marrow in the follow-up survey showed no amyloidal deposition in these tissues and organs. Up to the present, no signs of recurrence have been found in this patient. CONCLUSION: Localized gastric amyloidosis, being rare in incidence, should be considered in the differentiation of gastric tumors, in which biopsy is the only means to confirm the diagnosis. Currently, surgical resection of pathological tissue and circumambient lymph nodes may be a preferable therapeutic strategy for the localized amyloidosis to prevent possible complications. Although with a benign prognosis, gastric amyloidosis possesses a recurrent tendency as suggested by the literatures.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
6/15. bronchogenic cyst of the stomach masquerading as benign stromal tumor.Gastric bronchogenic cyst is an extremely rare lesion. A 62-year-old Korean woman presented with an incidentally found perigastric nodule. An abdominal ultrasonogram and computed tomography showed a 1.5 cm solid, homogeneous, low-density nodule in the hepatogastric ligament near the gastric lesser curvature. At the time of surgery, a soft 1.7 cm nodule was found in the lesser curvature side just below the gastroesophageal junction, and a gelatinous mass was protruded from the nodule during the resection. Microscopically, the gastric subserosa showed cystic structures lined by pseudostratified ciliated columnar epithelium, seromucinous gland, connective tissue and complete layers of smooth muscle bundles. Neither cartilage nor gastrointestinal epithelium was identified. A mucocele was found near the cyst and foamy cells and faintly bluish mucinous substances were found near the cystic structures. All the mucinous substances were stained by alcian blue at pH 2.5 with varying degrees of staining intensity. The present case is the smallest reported cyst among the gastric bronchogenic cysts, and these lesions are unusually located at the lesser curvature side of the stomach. Although these lesions are very rare, gastric bronchogenic cyst should be included in the differential diagnosis of gastric wall mass.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
7/15. Cardiac glands hyperplastic polyp of the stomach.Reported herein is a very rare polyp in the gastric cardia of a 49-year-old man. He was referred because of a polyp detected by upper gastrointestinal examination in an affiliated hospital. Endoscopic examination revealed a polyp-like submucosal tumor. Endoscopic ultrasonography revealed minute cystic dilatations and thickening of the submucosal layer. Accordingly, a preliminary diagnosis of cardiac gland hyperplasia was made. The lesion was removed successfully by snare polypectomy. Observed macroscopically, the polyp was 30 mm in diameter and covered with normal gastric mucosa. Examined histologically, the polyp comprised a hyperplastic submucosal cardiac gland.- - - - - - - - - - ranking = 1.5keywords = gland (Clic here for more details about this article) |
8/15. Pyloric obstruction following the ingestion of corrosive acid.Pyloric obstruction is a well documented end result of ingestion of corrosive acid. Whereas the oesophageal mucosa is resistant to damage, the pyloric spasm and the resultant pooling of acid in the pre-pyloric region, causes injury to this area. The fibrosis of the gastric wall with motility disturbances, and the diminution of acid and pepsin production from damage to the glandular elements, would weigh against the addition of a vagotomy to the drainage procedure. A case of ingestion of concentrated sulphuric acid and the management of its late sequelae, are discussed.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
9/15. Achalasia sicca--juvenile sjogren's syndrome with achalasia and gastric hyposecretion.sjogren's syndrome (SS) in its classical form, which includes keratoconjunctivitis sicca, xerostomia and recurrent enlargement of the salivary glands, is associated with a connective tissue disease in at least half the patients. According to the present study of three patients with SS, achalasia and gastric hyposecretion seem to be either further manifestations of SS, or separate phenomena associated with SS. The gastric hyposecretion involves both the hydrochloric acid and the total volume of the secretion, but the gastric mucosa has a normal appearance on microscopy. Because of the simultaneous presence of achalasia, gastric hyposecretion and reduced salivation, we have called the combination "achalasia sicca". The reduction in the secretions of the upper gastrointestinal tract might have a pathogenic association with achalasia.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
10/15. poisoning by the red alga 'ogonori' (gracilaria verrucosa) on the Nojima Coast, Yokohama, Kanagawa Prefecture, japan.A food poisoning case due to the ingestion of 'ogonori', an edible red alga, occurred at Yokohama, Kanagawa Prefecture, japan, in late October 1993, resulting in two victims, including one death (female). No causative agent present in the ogonori was found from a routine bioassay for marine toxins. From the production of increased amounts of prostaglandins (PGs), mainly PGE2, by the alga on stimulation by cutting or soaking in fresh water, and further increase of PGE2 by addition of arachidonic acid, it appeared that an enzyme, probably fatty acid cyclooxygenase, in the ogonori and the body of the victim, was acting on the highly unsaturated fatty acids in the oil of the ingested seafood and in the blood hemorrhaged from the stomach of the victim. This resulted in the production of over 30 mg of PGE2 and small amounts of other PGs in a comparatively short time. With this dosage the victim suffered from nausea, vomiting, and hypotension, and died of hypotensive shock. PGE2 seems to work more selectively on females. This type of poisoning is very unusual, and differs from the more familiar forms of poisoning occurring after ingestion of marine organisms.- - - - - - - - - - ranking = 0.25keywords = gland (Clic here for more details about this article) |
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