1/50. multiple myeloma involving the stomach with vitamin B12 deficiency.Involvement of the gastrointestinal tract by plasmocytoma is rare. In a 78-year-old man with IgA lambda multiple myeloma stage IIIB, the evaluation of a megaloblastic anaemia revealed a subnormal vitamin B12 level. Urinary excretion of isotope-labelled vitamin B12 was reduced. Tests for gastric parietal cell and intrinsic factor antibodies were negative. There were no clinical signs of an insufficient absorption in the ileum. biopsy specimens of the stomach showed a dense, diffuse infiltrate of malignant plasma cells in the lamina propria of fundus and corpus. A urease test for helicobacter pylori was positive. There was a minor haematological improvement when vitamin B12 was given parenterally. Several combinations of cytostatic drugs had no effect on the manifestations of the multiple myeloma. In our patient the vitamin B12 deficiency may be related to a displacement or destruction of parietal cells by malignant plasma cells.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
2/50. Relationship between pernicious anaemia and gastric neuroendocrine cell disorders.The incidence of gastric carcinoid tumours is increasing. This rise is probably due to the number of gastroscopies and improved histological techniques. The majority (65%) of these gastric tumours is associated with chronic atrophic gastritis and pernicious anaemia. In this article two patients are presented, one with pernicious anaemia and gastric neuroendocrine cell hyperplasia and one with pernicious anaemia and multiple gastric carcinoids. These neuroendocrine cell disorders have a relatively favourable prognosis. Therefore, a wait-and-see policy was preferred. The pathogenesis, clinical symptoms, diagnosis, prognosis and treatment of these different neuroendocrine cell manifestations are discussed. We recommend performing a gastroscopy at the time of diagnosis for young patients with pernicious anaemia, and whenever abdominal problems, unexplained weight loss or aggravation of the anaemia arise.- - - - - - - - - - ranking = 9keywords = anaemia (Clic here for more details about this article) |
3/50. Gastric neurofibroma in a patient with von Reklinghausen's disease: a cause of upper gastrointestinal hemorrhage.Gastric neurofibroma associated with von Reklinghausen's disease is a rare clinical entity. We report a case of gastric neurofibroma with gastrointestinal bleeding and severe anaemia. Surgical resection is the treatment of choice. The recommended follow-up is an annual complete cell blood count and stool testing for occult blood.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
4/50. Gastric metastasis from renal cell carcinoma fourteen years after radical nephrectomy.We report one case of solitary gastric metastasis from renal cell carcinoma following radical excision of the primary tumour 14 years previously. During evaluation for a severe anaemia with melaena, a patient underwent upper gastrointestinal endoscopy that evidenced the presence of a small polypoid lesion in the body of the stomach. Endoscopic biopsy revealed renal cell carcinoma. There was no evidence of further metastatic disease. A subtotal gastric resection with Roux-en-Y gastrojejunal reconstruction was performed. After 6 months follow-up, the patient was disease-free. This case confirms the potential of renal cell carcinoma for late and solitary metastasis with circumscribed local invasiveness and suggests that endoscopic resection may be feasible.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
5/50. Liver abscesses associated with stromal tumour of the stomach in a young woman.A 23-year-old Japanese woman was admitted to hospital because of pyrexia and anaemia. She was found to have liver abscesses and a gastric submucosal mass by computed tomography and ultrasonography. gastroscopy and a barium swallow revealed a round submucosal mass with a giant ulceration in the body of the stomach. The liver abscesses were successfully treated by percutaneous transhepatic drainage and intravenous administration of antibiotics. Cultures of the fluid from a liver abscess and gastric juice yielded alpha-haemolytic streptococci. Three weeks after the drainage, partial gastrectomy was performed. The tumour was diagnosed as a stromal tumour of the stomach (leiomyosarcoma) in the final histological report. The patient was discharged on postoperative day 17 without receiving adjuvant radio-chemotherapy. There have been no signs of recurrence two years after surgery. This is a rare case of a liver abscess associated with a stromal tumour of the stomach in a young patient. The bacteriological examinations suggested a possible association between these diseases.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
6/50. Management of enterochromaffin-like gastric carcinoid tumour metastasized to the liver.We report the rare case of a patient suffering from pernicious anaemia and a history of flushing and diarrhoea. The patient was found to have microcarcinoids with multiple gastric polyps and a solitary liver metastasis. He was successfully managed with subtotal gastrectomy, while the liver metastasis was cured by interferon-alpha and octreotide administration.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
7/50. Gastric carcinoma presenting with cellulitis-like cutaneous metastasis.INTRODUCTION: A case of carcinoma of the stomach presenting with cellulitis-like cutaneous metastasis is reported. CLINICAL PICTURE: This patient was diagnosed to have early stage carcinoma of the prostate (T1bN0M0), which was treated with radiotherapy and hormonal therapy. He presented with an erythematous area of induration over the right neck a few weeks after the completion of radical radiotherapy. The CT scan of the neck showed features suggestive of cellulitis of the right cervical region. Due to the lack of response to intravenous antibiotics, a fine needle aspiration biopsy of the indurated area was done. This confirmed the presence of adenocarcinoma. Due to the presence of iron-deficiency anaemia and the positive occult blood test in the stool, an upper gastrointestinal endoscopy was done. This confirmed the presence of adenocarcinoma of the stomach of the signet-ring cell type. OUTCOME: He had a rapid downhill course after the diagnosis and died four weeks after the diagnosis was made. CONCLUSION: Carcinoma of the stomach can rarely present with cutaneous metastasis as a cellulitis-like picture.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
8/50. dyskeratosis congenita associated with three malignancies.dyskeratosis congenita is a rare inheritable disorder characterized by abnormalities of the skin, nails and oral mucosa. Aplastic anaemia resulting from bone marrow hypoplasia is a frequent cause of death. Squamous cell carcinoma developing from leukoplakia and visceral malignancies are other complications of the disease. We report here a case of dyskeratosis congenita in a man who developed three neoplasias of different systems over a period of many years. Squamous cell carcinoma and gastric adenocarcinoma manifested 17 years after the man was diagnosed with Hodgkin's disease.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
9/50. Hyperplastic gastric polyposis, hypergastrinaemia and colorectal neoplasia: a description of four cases.BACKGROUND AND AIMS: Previous reports have suggested a possible association between hyperplastic polyposis and colorectal neoplasms. Increased gastrin may be the link between these two conditions insofar as gastrin has been reported to be a growth-promoting tumoural agent. This report describes gastric polyposis, hypergastrinaemia and colorectal neoplasms in four elderly patients. methods: Four male patients with no family history of cancer, who were found to have multiple gastric hyperplastic polyps, hypergastrinaemia and colorectal cancers or an adenomatous polyp, were evaluated. Assessment included clinical evaluation, biochemical and haematological profiles, fasting gastrin levels, helicobacter pylori serology, cobalamin, parietal cell antibodies, gastroscopy with biopsies of polyps and gastric mucosa, urease tests, and colonoscopy with biopsies of colorectal neoplasms. immunohistochemistry of specimens from gastric polyps and colonic carcinomas was performed for chromogranin a, synaptophysin, Leu 7, neuron-specific enolase and gastrin. RESULTS: The mean age at diagnosis of gastric polyps was 71.2 years and at removal of colorectal neoplasm was 70.0 years. In two patients, the gastric lesion was diagnosed before the colonic lesion and conversely in the two remaining patients. Gastrin was very high (1604 pg/ml; normal level, < 115 pg/ml) in one patient with pernicious anaemia, and the mean level for the other three was 324 pg/ml. H. pylori were found in two patients. immunohistochemistry failed to identify neuroendocrine cells in the hyperplastic gastric polyps and three of the colonic carcinomas. CONCLUSIONS: Occurrence of sporadic colorectal neoplastic lesion in patients with diffuse hyperplastic gastric polyposis and hypergastrinaemia may represent a new syndrome. Gastrin is not secreted by the gastric polyps or colonic carcinomas and may be related to gastric mucosal changes and H. pylori colonization. In patients with hyperplastic gastric polyposis and hypergastrinaemia, colorectal neoplasms should be ruled out.- - - - - - - - - - ranking = 1keywords = anaemia (Clic here for more details about this article) |
10/50. Phlegmonous gastritis associated with Kaposi sarcoma: a case report and review of the literature.We report a case of phlegmonous gastritis associated with Kaposi sarcoma in a 37-year-old, human immunodeficiency virus (hiv)-positive man who presented with an acute abdomen. Computed tomographic scan revealed free fluid in the abdominal cavity and a thickened gastric wall. A partial gastrectomy was performed. The resected portion of stomach had a hemorrhagic, necrotic thickened wall and showed extensive, acute suppurative inflammation, especially in the submucosa, with focal transmural involvement. Beneath an area of healing ulceration, a focus of Kaposi sarcoma was present. Group A beta-hemolytic streptococcus was grown from peritoneal fluid, and treatment with numerous antibiotics was initiated. After a difficult postoperative course that responded to 8 weeks of antibiotic therapy, the patient was medically stable and discharged from the hospital on antiretroviral therapy for hiv. Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the gastric wall. Kaposi sarcoma is one of the most common malignancies in hiv-positive patients, and gastric involvement is relatively common in those patients with systemic Kaposi sarcoma. To our knowledge, this is the first reported case of phlegmonous gastritis associated with Kaposi sarcoma, and it represents a rare survival following surgical and antibiotic therapy.- - - - - - - - - - ranking = 0.58395136582635keywords = hemolytic (Clic here for more details about this article) |
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