scholarly journals A Misdiagnosed Case of Hypertrophic Gastropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Sushma Thapa ◽  
Arnab Ghosh ◽  
Gita Pun ◽  
Dilasma Ghartimagar ◽  
O. P. Talwar
Keyword(s):  
Gastric Mucosa ◽  
Transforming Growth Factor ◽  
Epigastric Pain ◽  
Partial Gastrectomy ◽  
Gastric Fundus ◽  
The Body ◽  
Upper Gastrointestinal Endoscopy ◽  
Childhood Form ◽  
Factor Alpha ◽  
Hypertrophic Gastropathy

Hypertrophic gastropathy is a rare idiopathic hyperproliferative disorder which may present as Menetrier’s disease (MD) characterized by foveolar hyperplasia in the gastric fundus and body. It is often accompanied by a severe loss of plasma proteins (including albumin) from the altered gastric mucosa. The disease occurs in two forms, a childhood form due to cytomegalovirus infection and an adult form attributed to overexpression of transforming growth factor-alpha (TGF-α). The most common symptoms include epigastric pain with fullness and vomiting and generalized peripheral edema with hypoalbuminemia. We present a case of 75-year-old female presenting with epigastric pain and vomiting. Upper gastrointestinal endoscopy and computed tomography scan revealed an irregular mucosal fold at the body and antrum and thickening of the stomach wall, respectively. Though the endoscopic gastric mucosal biopsy was nonspecific, the patient underwent partial gastrectomy due to clinicoradiological suspicion of carcinoma. On histopathology, the case was reported as hypertrophic gastropathy, consistent with MD. Though there is a strong clinical and radiological suspicion of malignancy in the hypertrophied gastric mucosa, MD should be one of the important differential diagnoses.

scholarly journals miR-191 is involved in renal dysfunction in arsenic-exposed populations by regulating inflammatory response caused by arsenic from burning arsenic-contaminated coal

2019 ◽  
Vol 39 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Y Xu ◽  
Z Zou ◽  
Y Liu ◽  
Q Wang ◽  
B Sun ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Renal Dysfunction ◽  
Transforming Growth Factor Beta ◽  
Transforming Growth Factor ◽  
Scientific Basis ◽  
The Body ◽  
Targeted Prevention ◽  
Necrosis Factor Alpha ◽  
Multiple Organs ◽  
Factor Alpha

Chronic exposure to arsenic may result in the manifestation of damage in multiple organs or systems of the body. Arsenic-induced renal dysfunction has been determined, but their pathogenesis has not been fully examined. In this study, we measured the expression levels of miR-191 in plasma, the contents of pro-inflammatory (interleukin (IL)-6 and tumor necrosis factor alpha) and anti-inflammatory (IL-2 and transforming growth factor beta) cytokines, and renal dysfunction indicators (blood urea nitrogen, blood creatinine, uric acid, and cystatin C) in serum from control and arsenic poisoning populations and analyzed the relationship between the miR-191, cytokines, and renal dysfunction indicators. The results clearly show the alteration of miR-191 expression was significantly associated with arsenic-induced renal dysfunction. Overall, the association of miR-191, inflammatory response and renal dysfunction, is clearly supported by the current findings. In other words, miR-191 is involved in renal dysfunction in exposed populations by regulating inflammatory response caused by coal-burning arsenic. The study provides a scientific basis for further studies of the causes of the arsenic-induced renal dysfunction, the biological role of miR-191, and targeted prevention strategies.

scholarly journals Temporal observation of endoscopic and histological findings of gastritis after administration of an immune checkpoint inhibitor: a case report

2022 ◽  
Author(s):  
Keita Saito ◽  
Daiki Ozono ◽  
Hironobu Nagumo ◽  
Masayo Yoshimura ◽  
Yoko Masuzawa
Keyword(s):  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Epigastric Pain ◽  
Lymphocytic Infiltration ◽  
The Body ◽  
Gastric Antrum ◽  
Upper Gastrointestinal Endoscopy ◽  
Drug Induced ◽  
Old Japanese ◽  
Greater Curvature

AbstractA 71-year-old Japanese man was treated with 200 mg of pembrolizumab for lung adenocarcinoma with multiple bone metastases at the Department of Respiratory Medicine of Kameda General Hospital. After 19 treatment courses, he complained of epigastric pain before meals. Upper gastrointestinal endoscopy showed multiple erosions in the gastric antrum, and antacids were administered at follow-up. After 27 treatment courses, the patient underwent another endoscopy because of anorexia. The erosions were enlarged and had increased from the gastric antrum to the greater curvature of the body. Histological biopsy showed lymphocytic infiltration with a predominance of CD8-positive T cells. The patient had previously been treated for Helicobacter pylori infection, and we suspected drug-induced gastritis due to the administration of immune checkpoint inhibitors in the course of the disease. Pembrolizumab was discontinued, and the patient’s symptoms gradually improved. Endoscopic examinations were performed 2, 5, and 9 months after discontinuation of pembrolizumab, and improvement in mucosal findings and decreased lymphocyte infiltration were confirmed each time. The patient has remained without any relapse of symptoms for more than 1 year after discontinuing treatment.

Is Endoscopic Resection of Gastric Gastrointestinal Stromal Tumors Safe?

2008 ◽  
Vol 74 (12) ◽  
pp. 1186-1189 ◽  
Author(s):  
Alyson L. Waterman ◽  
Stephen R. Grobmyer ◽  
William G. Cance ◽  
Steven N. Hochwald
Keyword(s):  
Endoscopic Resection ◽  
Gastrointestinal Stromal Tumors ◽  
Incidental Finding ◽  
Pelvic Mass ◽  
Partial Gastrectomy ◽  
Gastric Fundus ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Gist ◽  
Stromal Tumors ◽  
Single Mass

Gastric gastrointestinal stromal tumors (GIST) commonly present as an incidental finding on upper gastrointestinal endoscopy. Advances in endoscopic technology have allowed some to perform attempted excision of these lesions endoscopically. The oncologic implications of such an approach remain unclear. A-74-year-old man initially presented with an incidental finding of a 1.6 x 1.8-cm c-kit-positive gastrointestinal stromal tumor with low mitotic activity in the gastric fundus. The patient underwent an attempted endoscopic resection of this mass resulting in incomplete excision and gastric perforation. There was immediate conversion to a celiotomy and the patient underwent partial gastrectomy; there was no evidence of metastatic GIST. Three years later, the patient was noted to have an asymptomatic large pelvic mass (4 x 7 cm) on CT scan and was referred for evaluation. Subsequent surgical exploration revealed a single mass adherent to the pelvic sidewall that was resected. Subsequent pathology demonstrated a c-kit-positive GIST consistent with metastatic disease. Eighteen months later, the patient remains free of disease. Complications from endoscopic resection of gastric GIST may be associated with peritoneal dissemination of disease. This should be considered when formulating a strategy for management of gastric GIST. Complete transperitoneal excision (either open or laparoscopic) with clear margins and without tumor rupture remains the gold standard for management of gastric GIST.

scholarly journals Eosinophil granuloma due to parasite treated by laparoscopic and endoscopic cooperative surgery: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Toshikatsu Tsuji ◽  
Noriyuki Inaki
Keyword(s):  
Malignant Disease ◽  
Histopathological Examination ◽  
Epigastric Pain ◽  
Submucosal Tumor ◽  
Eosinophilic Granuloma ◽  
Parasitic Infection ◽  
Partial Gastrectomy ◽  
Gastric Body ◽  
Upper Gastrointestinal Endoscopy ◽  
Undifferentiated Cancer

Abstract Background Gastric eosinophilic granuloma caused by parasitic infection is rare. It is often suspected to be a malignant disease and it is difficult to diagnose. We successfully diagnosed and removed a gastric eosinophilic granuloma using laparoscopic and endoscopic cooperative surgery (LECS). Case presentation A 35-year-old woman visited our hospital because of epigastric pain. Upper gastrointestinal endoscopy revealed a 15 mm submucosal tumor (SMT) with changes in the folds, such as enlargement and convergence, located in the greater curvature of the lower gastric body. Computed tomography (CT) showed a dense, nonenhanced area of 15 mm at the same site. SMT was suspected, but undifferentiated cancer could not be excluded. We performed laparoscopic partial gastrectomy using LECS for resection biopsy. Histopathological examination showed an SMT 8 × 8 × 5 mm in size with an unclear boundary and necrosed insects at the core of the tumor. There was marked eosinophilic infiltration around the area. The diagnosis was gastric granuloma caused by parasitic infection. Conclusions It is difficult to differentiate gastric eosinophilic granuloma caused by parasitic infection from malignant disease. In this case, LECS is considered a minimally invasive and useful procedure.

Ectopic Pancreas Imitating Gastrointestinal Stromal Tumor (GIST) In The Stomach

2015 ◽  
Vol 87 (5) ◽  
Author(s):  
Justyna Zińczuk ◽  
Roman Bandurski ◽  
Anna Pryczynicz ◽  
Emilia Konarzewska-Duchnowska ◽  
Andrzej Kemona ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Histopathological Examination ◽  
Epigastric Pain ◽  
Incidental Finding ◽  
Proximal Part ◽  
Pancreatic Tissue ◽  
The Body ◽  
Stromal Tumor ◽  
Ectopic Pancreas ◽  
Upper Gastrointestinal Endoscopy

AbstractEctopic pancreas is a rare congenital disorder defined as pancreatic tissue lacking vascular or anatomic communication with the normal body of the pancreas. Most cases of ectopic pancreas are asymptomatic, but it may become clinically evident depending on the size, location and the pathological changes similar to those observed in case of the normal pancreas. It is often an incidental finding and can be located at different sites in the gastrointestinal tract. The most common locations are: the stomach, duodenum or the proximal part of small intestine. The risk of malignancy, bleeding and occlusion are the most serious complications. Despite the development in diagnostics, it still remains a challenge for the clinician to differentiate it from neoplasm.In this report, we described a case of 28-years old woman who presented recurrent epigastric pain. The upper gastrointestinal endoscopy revealed gastrointestinal stromal tumor on the border of the body and antrum of the back wall of great curvature of the stomach. The histopathological examination after surgery showed heterotopic pancreatic tissue. Ectopic pancreas should be considered in the differential diagnosis of gastric mass lesions.

Transforming growth factor alpha disrupts the normal program of cellular differentiation in the gastric mucosa of transgenic mice

Development ◽  
1995 ◽  
Vol 121 (1) ◽  
pp. 149-161
Author(s):  
R. Sharp ◽  
M.W. Babyatsky ◽  
H. Takagi ◽  
S. Tagerud ◽  
T.C. Wang ◽  
...  
Keyword(s):  
Growth Factor ◽  
Gastric Mucosa ◽  
Transforming Growth Factor ◽  
Expression Patterns ◽  
Brdu Incorporation ◽  
Transforming Growth Factor Alpha ◽  
Cell Renewal ◽  
Chief Cells ◽  
Mouse Tissues ◽  
Factor Alpha

Transforming growth factor alpha (TGF alpha) evokes diverse responses in transgenic mouse tissues in which it is over-expressed, including the gastric mucosa, which experiences aberrant growth and a coincident repression of hydrochloric acid production. Here we show that ectopically expressed TGF alpha induces an age-dependent cellular reorganization of the transgenic stomach, in which the surface mucous cell population in the gastric pit is greatly expanded at the expense of cells in the glandular base. Immunohistochemical analysis of BrdU incorporation into DNA demonstrated that although mature surface mucous cells were not proliferating, DNA synthesis was enhanced by approximately 67% in the glandular base and isthmus, where progenitor cells reside. RNA blot and in situ hybridization were employed to determine temporal and spatial expression patterns of specific markers representing a variety of exocrine and endocrine gastric cell types. Mature parietal and chief cells were specifically depleted from the glandular mucosa, as judged by a 6- to 7-fold decrease in the expression of genes encoding H+,K(+)-ATPase, which is required for acid secretion, and pepsinogen C, respectively. The reduction of these markers coincided in time with the activation of TGF alpha transgene expression in the neonatal stomach. The rate of cell death in the glandular region was not overtly different. Significantly, the loss of parietal and chief cells occurred without a concomitant loss of their respective cellular precursors. In contrast to exocrine cells, D and G endocrine cells were much less severely affected, based on analysis of somatostatin and gastrin expression. Analysis of these dynamic changes indicates that TGF alpha can induce selective alterations in terminal differentiation and proliferation in the gastric mucosa, and suggests that TGF alpha plays an important physiological role in the normal regulation of epithelial cell renewal.

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