scholarly journals Gastric Ganglioneuroblastoma in an Elder Man: A Case Report and Literature Review

2021 ◽  
Author(s):  
xuetong jiang ◽  
Jianqiang Wu ◽  
Feng Su ◽  
Hailong Huang ◽  
Yang Ding ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Submucosal Tumor ◽  
Gastrointestinal Surgery ◽  
Muscularis Propria ◽  
Laparoscopic Approach ◽  
Gastric Antrum ◽  
Arterial Phase ◽  
Tissue Mass ◽  
Abdomen Ct

Abstract Background: GNB is a moderate tumor of sympathetic origin, which is considered a disease of children with the majority of cases less than five years old and it rarely occurs in adults. There are no treatment guidelines for adults GNB. Here, we reported a rare case of adult gastric GNB, and was resected completely by laparoscopic approach.Case presentation:A 73-year-old man presented with dull pain in the upper abdomen along with abdominal distension for one month. Gastroscopy examination revealed chronic gastritis and submucosal tumor of gastric antrum. Endoscopic ultrasonography showed a hypoechoic mass in gastric antrum arising from the muscularis propria. Combined with the characteristics of gastroscope and ultrasound , the mass was suspected as gastrointestinal stromal tumor. Abdomen CT scan of revealed irregular soft tissue mass in gastric antrum with heterogeneous enhancement in arterial phase, and gastric cancer was suspected.The patient was addressed to the department of gastrointestinal surgery. The mass was completely resected in laparoscopic surgery. Histopathology reported that the mass contained differentiation neuroblasts, mature ganglion cells and ganglioneuromatisis component. Immunohistochemical staining revealed tumor cells were immunoreactive for CD56, Syn, S100 , while negative for CK, CD117, DOG-1, CgA. The pathological diagnosis was GNBi and the patient was staged as stage I. The patient received no adjuvant chemotherapy or radiotherapy.Until his one-year follow-up, the patient was doing well and without any signs of recurrence.Conclusion:Although the rarity of gastric GNB as a primary site of origin, it should be considered in the differential diagnosis of gastric masses in adult. Radical surgery is sufficient for the treatment of GNBi and long-term follow-up should be performed.

scholarly journals Gastric schwannoma: a case report

2016 ◽  
Vol 6 (4) ◽  
Author(s):  
Hayfa Romdhane ◽  
Myriam Cheikh ◽  
Zeineb Mzoughi ◽  
Sana Ben Slama ◽  
Rym Ennaifer ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Submucosal Tumor ◽  
Muscularis Propria ◽  
Partial Gastrectomy ◽  
Gastric Antrum ◽  
Submucosal Tumors ◽  
Gastric Schwannoma ◽  
One Year ◽  
Immunohistochemical Studies ◽  
Enhanced Computed Tomography

Schwannomas are generally benign, slow growing tumors. They are rarely observed in the gastrointestinal tract with the most common site being the stomach. These tumors are usually asymptomatic. The preoperative diagnosis <em>via</em> endoscopy is a challenging issue due to the difficulty of differentiation from other submucosal tumors. A 54-year-old woman presented with epigastric pain persisting for the last 10 months. Upper endoscopy revealed an elevated submucosal mass of the gastric antrum. The overlying mucosa was normal. Biopsy specimens yielded only unspecific signs of mild inactive chronic inflammation. Endoscopic ultrasound examination noted a hypoechoic homogeneous mass lesion located in the gastric antrum. The mass appeared to arise from the muscularis propria, and there was no perigastric lymphadenopathy. A contrast-enhanced computed tomography scan identified a homogeneous round mass and arising from the antrum of the stomach. Submucosal tumor was suspected and surgical intervention was recommended. The patient underwent an elective laparoscopic partial gastrectomy. The histopathologic features and immunohistochemical-staining pattern were consistent with a benign gastric schwannoma. Our patient shows no recurrence with a follow-up of one year. The definitive diagnosis of gastric schwannomas requires immunohistochemical studies. Complete margin negative surgical resection, as in this case, is the curative treatment of choice. The clinical course is generally benign.

scholarly journals Sclerosing Angiomatoid Nodular Transformation of the Spleen: Analysis of Clinical and Pathological Features in Five Cases

2021 ◽  
Vol 7 ◽  
Author(s):  
Huijiang Shao ◽  
Baochun Lu ◽  
Zhihong Shen ◽  
Fang Liu
Keyword(s):  
Laparoscopic Approach ◽  
Ct Scans ◽  
Arterial Phase ◽  
Pathological Features ◽  
Sclerosing Angiomatoid Nodular Transformation ◽  
Mild Abdominal Pain ◽  
Central Calcification ◽  
Peripheral Enhancement ◽  
Clinical And Pathological Features

Objective: We aimed to summarize the clinical and pathological features of sclerosing angiomatoid nodular transformation (SANT) in spleen among five cases.Methods: Five cases (male: 3; female: 2; mean age: 47.6 years) with SANT confirmed by pathological analysis between July 2010 and November 2019 in our hospital were included in this study. The clinical, imaging, and pathological data were analyzed retrospectively.Results: Three patients presented with mild abdominal pain or discomfort, while the other two were symptom free. Two patients received ultrasonography (US), and all patients underwent a computerized tomography (CT) scan in our hospital. The typical “spoke wheel” pattern was seen in two cases, and central calcification was detected in one case on the CT scans. All patients indicated peripheral enhancement around the SANT lesion during the arterial phase. Open or laparoscopic splenectomy was performed for treatment. No patient showed recurrence in the follow-up. The pathological characteristics of our cases were in line with those of previous literatures.Conclusions: Peripheral enhancement around the SANT lesion during the arterial phase should be taken into consideration for the diagnosis of SANT as an imaging sign on CT scans. Special attention should be paid to the splenic integrality during the laparoscopic approach, due to the probability of malignancy and the fragility of the spleen.

Two Cases of Plexiform Angiomyxoid Myofibroblastic Tumor (PAMT) of Gastrointestinal (GI) Tract: One With 8-Year Follow-up, One in Distal Jejunum

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S56-S56
Author(s):  
Mustafa Erdem Arslan ◽  
Timothy Jennings ◽  
Hua Li ◽  
Edward Lee ◽  
Ankesh Nigam ◽  
...  
Keyword(s):  
Small Bowel ◽  
Imaging Finding ◽  
Disease Patient ◽  
Outlet Obstruction ◽  
Muscularis Propria ◽  
Gastric Antrum ◽  
Proximal Jejunum ◽  
Spindle Cell Neoplasm ◽  
Distal Jejunum

Abstract Objectives PAMT is an exceedingly rare mesenchymal tumor of the gastric antrum that was first described in 2007. Although likely benign, long-term follow-up is limited due to its recent description and rarity. In small bowel, only four cases of PAMT have been reported, two in duodenum and two in proximal jejunum. Methods (A) A 16-year-old female presented with GI bleeding and gastric outlet obstruction. Imaging studies suggested a gastrointestinal stromal tumor (GIST) arising in duodenum. An open biopsy revealed a bland spindle cell neoplasm. Resection of the tumor was performed. (B) A 68-year-old male presented with an incidental mesenteric mass on imaging during hematuria workup. He underwent surgical resection of the mass to exclude a GIST. Results Case A was a 15.0-cm mass arising in gastric antrum, and case B was an 8.0-cm mass arising in antimesenteric side of distal jejunum. Both tumors showed multinodular plexiform growth pattern and foci of cystic changes, with a proliferation of bland spindle cells in a prominent myxoid matrix. Numerous vascular structures were noted without tumor necrosis, nuclear atypia, or mitotic activity. The lesional cells were positive for actin and negative for desmin. The lesional cells were negative for other markers including cytokeratin, CD34, CD117, DOG-1, S-100, and PDGFRA (case B). Both masses were based in the subserosa with focal extension to the muscularis propria in case A. Patient A was followed up for 8 years with no evidence of disease. Patient B was lost to follow-up. Conclusion While clinical presentation and imaging finding of PAMT overlap with GIST, PAMT appears to be more indolent. PAMT of distal jejunum has not been previously reported. Small bowel PAMT is much less common than gastric PAMT but can involve variable segments. PAMT may be underdiagnosed.

scholarly journals Recurrence after ESD curative resection for early gastric cancer

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ayako Kamiya ◽  
Hitoshi Katai ◽  
Kenichi Ishizu ◽  
Takeyuki Wada ◽  
Tsutomu Hayashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Curative Resection ◽  
Treatment Guidelines ◽  
Submucosal Tumor ◽  
Pathological Examination ◽  
Node Metastasis

Abstract Background Endoscopic submucosal dissection (ESD) is gaining ground as a minimally invasive treatment for early gastric cancer (EGC) that has a negligible risk of lymph node metastasis. According to the 5th edition of Japanese gastric cancer treatment guidelines, annual or biannual follow-up with endoscopy is recommended, but follow-up with abdominal ultrasonography or computed tomography (CT) for surveillance of metastases is not recommended after the eCuraA resection. However, we experienced a case of lymph node recurrence following ESD resulting in eCuraA. Case presentation A 76-year-old female received ESD for EGC in a previous hospital 4 years ago. Pathological findings were tub1, 30 mm, T1a (M), UL0, Ly0, V0, pHM-, pVM- (eCuraA) according to the 15th edition of Japanese Classification of Gastric Carcinoma. Follow-up esophagogastroduodenoscopy revealed submucosal tumor, which was suspected as a swollen lymph node by CT and endoscopic ultrasound fine-needle aspiration revealed the recurrence of gastric cancer. We performed total gastrectomy with D2 lymph node dissection. Postoperative pathological examination revealed no local recurrent tumor at the ESD site in the stomach. Swollen lymph node was diagnosed as metastasis and lymph node metastasis was limited near the cardia. Conclusion This case provides valuable information about tumor with a minimum poorly differentiated adenocarcinoma component may develop lymph node metastasis even satisfying the guidelines criteria for curative resection.

Fibroadenoma of Ectopic Breast Tissue in the Groin – A Rare Disease Entity

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S47-S48
Author(s):  
D Emechebe ◽  
M Alshal ◽  
T Rana ◽  
M Agaronov
Keyword(s):  
Breast Tissue ◽  
Tissue Mass ◽  
Ectopic Breast Tissue ◽  
The Common ◽  
Painless Mass ◽  
The Right ◽  
Ectopic Breast ◽  
Urogenital Anomalies ◽  
Superficial Soft Tissue

Abstract Introduction/Objective Ectopic breast tissue (EBT) is a well-documented anomaly of the breast and commonly presents along the embryonic milk line extending between the axilla and groin. Reported incidence of accessory breast is 0.4–6% in females. Pathologies developing in an EBT are reported as a rare entity in the literature. Carcinoma is reported as the common pathology followed by inflammation and fibroadenoma Methods We present a case of 43-year- old female who presented with a painless mass in her right groin for the past year which gradually increased in size. CT abdomen pelvis with contrast showed a 2.2 x 3.0 x 4.4 cm superficial soft tissue mass in the right groin which was suspected to be a lymph node. Further investigation and histopathological report of biopsy showed ectopic breast tissue with admixed chronic inflammation and reactive changes.However, excision of the mass three months later showed showed proloferation of both glandular and stromal elements. Results The tissue from the biopsy was positive for GATA 3, mammoglobin, GCDFP and CD 10 and the histological features on excision was confirmatory of fibroadenoma. Conclusion In conclusion, when tumors or nodules are found along the mammary line, the presence of breast tissue should be considered during the investigation. It is clinically wise to evaluate and screen carefully cases of supernumerary breast for any pathology and for any associated urogenital anomalies such as supernumerary kidneys, polycystic kidneys and renal cell adenocaricnoma. In our case, patient had no associated urogenital anomalies and she is on follow up.

scholarly journals The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016667 ◽  
Author(s):  
Herng-Ching Lin ◽  
Sudha Xirasagar ◽  
Cha-Ze Lee ◽  
Chung-Chien Huang ◽  
Chao-Hung Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Reflux Disease ◽  
Treatment Guidelines ◽  
Population Based ◽  
Oesophageal Reflux ◽  
Study Patient ◽  
Oesophageal Reflux Disease ◽  
Increased Risk

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.

Relationship between mean follow-up intraocular pressure, rates of visual field progression and current target intraocular pressure guidelines

2020 ◽  
pp. bjophthalmol-2020-317406
Author(s):  
Bruna Melchior ◽  
Carlos Gustavo De Moraes ◽  
Jayter S Paula ◽  
George A Cioffi ◽  
Christopher A Girkin ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Treatment Guidelines ◽  
Evaluation Study ◽  
Mean Deviation ◽  
Racial Groups ◽  
Current Guideline ◽  
Registration Number ◽  
The Mean

AimsTo investigate if eyes presenting intraocular pressure (IOP) within the limits of current guideline-driven target IOP indeed experience slow rates of glaucomatous visual field (VF) progression.MethodsA total of 8598 24-2 VF tests from 603 eyes from the African Descent and Glaucoma Evaluation Study with manifest glaucoma were included. The sample was split into three groups based on baseline VF mean deviation (MD): G1 (better than −5.0 dB), G2 (−5.0 to −10 dB) and G3 (worse than −10 dB). We investigated the relationship between existing target IOP guidelines and rates of MD progression in these groups.ResultsFor stable eyes, the medians and IQR of the mean follow-up IOP were G1=15.0 mmHg (IQR: 13.1 to 17.7), G2=13.2 mmHg (IQR: 11.6 to 14.3) and G3=11.9 mmHg (IQR: 10.1 to 13.8) (p<0.01). When considering the mean follow-up IOP within the limits proposed by current guidelines, the median MD slopes were: −0.20 dB/y (IQR: −0.43 to −0.02) for G1<21 mmHg, −0.19 dB/y (IQR: −0.51 to −0.01) for G2<18 mmHg and −0.15 dB/y (IQR: −0.47 to 0.05) for G3<15 mmHg (p=0.63). There were no significant differences between racial groups.ConclusionIn a sample of patients with manifest glaucoma, despite substantial variability between eyes, adherence to treatment guidelines helped slow the rates of global VF progression at various stages of disease.Trial registration numberclinicaltrials.gov Identifier: NCT00221923.

Toxoplasma Appendicitis: A Once-in-a-Lifetime Diagnosis!

2017 ◽  
Vol 26 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Anisha M. Fernandes ◽  
Maheshkumar M. Lakhe ◽  
Sanjay A. Pai
Keyword(s):  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Muscularis Propria ◽  
Immunocompromised Patients ◽  
Lymphoid Follicles ◽  
Negative Results ◽  
Immunosuppressed Patients ◽  
Life Threatening

Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were reactive lymphoid follicles with histiocytes in the submucosa and tachyzoites in the muscularis propria. Immunohistochemistry confirmed the diagnosis of toxoplasma appendicitis. Serological evaluation yielded negative results. Retrospective review of the history revealed that the patient was on long-term immunosuppressive therapy with methotrexate. The patient was treated with sulfamethoxazole-trimethoprim and is asymptomatic at 7-month follow-up. Toxoplasma appendicitis must be considered in the differential diagnosis of appendicitis in immunosuppressed patients.

MO663THE UTILITY OF SMART SCALES TO MONITOR BODY COMPOSITION IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Lucia Cordero ◽  
Marta Rivero Martínez ◽  
Paula Jara Caro Espada ◽  
Elena Gutiérrez ◽  
Evangelina Mérida ◽  
...  
Keyword(s):  
Body Composition ◽  
Fat Tissue ◽  
Lean Tissue ◽  
Tissue Mass ◽  
Composition Data ◽  
The Mean ◽  
Good Concordance ◽  
Urea Distribution Volume ◽  
Assess Body Composition

Abstract Background and Aims Overhydration (OH) is an independent predictor of mortality on hemodialysis (HD). The gold standard to assess OH is BCM monitor from Fresenius®, however BCM is a hospital hold device limiting its use. New smart scales have emerged as household devices reporting daily body composition data. Objective To determine if Renpho ES-CS20M® could be useful on a 52 HD patient to estimate body composition data. Method 72 body composition assessments (BCA) during mid-week HD session were performed. Each BCA included: (1) Predialysis Renpho measurement, (2) Predialysis BCM monitor measurement, (3) Postdialysis Renpho measurement. To track the fluid balance during the HD session: (1) we recorded ultrafiltration, (2) food or fluid intake was not allowed, and (3) none of the HD patients urinated during the HD session. If any intravenous fluids were needed during the HD session, we subtracted them off from UF. Results Data from 52 HD patients were studied (age 58.8 ± 16.8 years, 56.9 % males, 14.7% diabetics), with a mean pre-HD weight of 70.0 ± 13. 4 Kg, overhydration of 1.7 ± 1.5 L and urea distribution volume of 31.7 ± 5.7 L. The mean ultrafiltration during HD session was -1.8 ± 0.9 L. Renpho estimated a Pre – HD hydration of 34.25 ± 6.02 Kg vs 33.4 ± 5.7 Kg by BCM, showing a good concordance between methods (ICC 0.788 [0.67-0.86], B -0.58, p &lt;0.01). Renpho poorly estimated pre – HD lean tissue mass at 45.4 ± 6.9 Kg compared with 33.8 ± 8.0 Kg by BCM. Although Renpho was able to provide a moderate concordant estimation of fat tissue mass (33.8 ± 8.0 % with Renpho vs 34.7 ± 9.6%), the bias proportion was unacceptable. Post- HD hydration by Renpho was not able to reproduce the ultrafiltracion achieved during the HD session (pre-HD 34.25 ± 6.02 Kg vs post-HD 34.08 ± 6.00 Kg). Conclusion Renpho has a proportional bias estimating predialysis hydration compared with BCM monitor, but is not able to assess changes produced with ultrafiltration or other parameters of body composition (as lean or fat tissue mass). Although smart scales are unacurate to assess body composition on HD patients, they could be useful on the follow up of them changing the accuracy for frequency.

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