1/14. 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 = 1keywords = nature (Clic here for more details about this article) |
2/14. 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 = 0.5keywords = nature (Clic here for more details about this article) |
3/14. Gastric Castleman's disease with a lupus-like circulating anticoagulant.We report the case of a 13-yr-old patient with retarded growth and a 2-yr background of asthenia, anorexia, and fever, whose laboratory data revealed anemia, thrombocytosis, an elevated erythrocyte sedimentation rate, ferropenia, hyperglobulinemia, hyperfibrinogenemia, and presence of a lupus-like circulating anticoagulant. Clinical studies revealed a tumor-like overgrowth in the gastric wall, and surgery confirmed its subserosal localization in the gastric fundus. After total removal of the mass, the systemic manifestations disappeared. The pathological study revealed the existence of the hyaline-vascular variety of Castleman's disease. Having reviewed the medical literature, we have not found a single unquestionable case of gastric Castleman's disease, although three other cases have been described as gastric pseudolymphoma which, when analyzed, could correspond to typical cases of Castleman's disease. Likewise, this is the second case associated with a circulating anticoagulant of lupoid characteristics. We conclude that Castleman's disease should be included in the differential diagnosis of gastric lesions of lymphoid nature and in the series of processes associated with lupus anticoagulant.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
4/14. Gastric pseudolymphoma and its relationship to malignant gastric lymphoma.Gastric pseudolymphoma is generally considered a benign, reactive condition to chronic inflammation. We report a patient who, although initially diagnosed as having a gastric pseudolymphoma, was found to have a malignant gastric lymphoma 5 yr later. A review of the literature revealed 12 previously reported cases in which gastric pseudolymphoma was associated with a malignant gastric lymphoma. The premalignant nature of gastric pseudolymphoma is discussed, and frequent endoscopic surveillance to exclude transition to malignant lymphoma is recommended.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
5/14. Transient gastroparesis associated with cutaneous herpes zoster.We report a patient who developed delayed gastric emptying with vomiting and weight loss simultaneously with herpes zoster in the sixth right thoracic dermatome. Sequential radionuclide solid egg meal gastric emptying studies were used to document gastroparesis, the response to metoclopramide and its transient nature. We present a possible explanation for this phenomenon within the context of the known pathophysiology of varicella-zoster infection.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
6/14. A case of amyloid tumor of the stomach.A 68-year-old female was admitted to hospital with a 5 month history of epigastric distress. Radiological and gastrofiberscopic examinations revealed a tumor of the stomach which was strongly suggestive of gastric carcinoma. Microscopic examination of the removed stomach, however, revealed no tumors in the stomach, but instead, there a localized amyloidosis was found in the antrum, the patient died of hepatic failure 10 months after the operation. autopsy demonstrated no evidence of systemic deposit of amyloid substance. The amyloid tumor of the stomach is rare, and the present case is believed to be the fifth of the reported cases of this lesion and, at the same time, the first case in which the solitary nature of amyloidosis was verified at autopsy.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
7/14. Plasma cell granuloma of the stomach. A report of a case associated with gastric cancer.Plasma cell granuloma arose multifocally in the stomach combined with gastric cancer (adenocarcinoma). The immunohistochemical study demonstrated the polyclonal nature of the plasma cells in the former lesion, and confirmed the diagnosis of plasma cell granuloma.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
8/14. Postsplenectomy gastric deformity.Mass- or polyplike defects of the gastric fundus were found on upper gastrointestinal examination in five patients, representing 7% of those who had undergone splenectomy. In four cases, the splenectomies were performed 1--5 months earlier, and, in one, the splenectomy was performed 10 years before. Dense adhesions were the cause of the defects in two patients. Plication deformity was thought to be a possible cause in the others. Recognition of the nonneoplastic nature of such defects is important in preventing unnecessary surgery. Computed tomography and endoscopy may be helpful in confirming the diagnosis.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
9/14. Endoscopic biopsy for improved accuracy in upper gastrointestinal tract diagnosis.Esophagogastroduodenoscopy has become the most accurate diagnostic method for identifying lesions of the upper gastrointestinal (GI) tract. It permits thorough inspection and a direct biopsy yielding a tissue diagnosis of surface lesions from the upper part of the esophagus to the second portion of the duodenum. The surgeon responsible for patients with upper GI tract disease should perform the endoscopic examination to gain first-hand information on the nature, extent, and location of the patient's problem. The surgeon-endoscopist gains an extra advantage, since the size and proximity of a lesion to the cardia, pylorus, or ampulla will determine surgical options available for the patient's problem. In patients with upper GI tract hemorrhage, the surgeon can determine immediately whether the bleeding is due to esophageal varices, Mallory-Weiss tear, gastric erosions, or an ulcer or tumor of the esophagus, stomach, or duodenum.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
10/14. Eosinophilic infiltration of the stomach.An unusual case of eosinophilic infiltration of the proximal stomach with direct extension into the left hemidiaphragm, liver, and transverse colon is described. Because the lesion was unresectable, a trial of steroid therapy was begun, with an initially good clinical response. Subsequent extensive tumor necrosis and accompanying diaphragmatic perforation, autolysis of the left lower lung, and a chronic gastropleurocutaneous fistula led to death. This case underscores the aggressive nature which this "histologically benign" neoplasm can pursue.- - - - - - - - - - ranking = 0.5keywords = nature (Clic here for more details about this article) |
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