scholarly journals A Retrospective Analysis to Validate the Alarm Signs Used in the CEDAP-Plus Study

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Hou-De Zhang ◽  
Mu-Xian Lin ◽  
Qu Zhang

Background and Study Aim. This study aimed to validate the alarm signs used in the 2007 German CEDAP-Plus study for indicating capsule endoscopy in patients who have idiopathic chronic abdominal pain. Patients and Methods. We retrospectively reviewed the cases of all patients who underwent capsule endoscopy at our institution between August 2007 and August 2009 for chronic hitherto undiagnosed abdominal pain, despite previous investigations. The demographic data, indications, findings, and diagnoses were recorded, as were the alarm signs (i.e., 10% loss of weight within 3 months, suspected small intestinal bleed or chronic anemia, and laboratory indications of inflammation). Results. Alarm signs were found in only 4 of the 62 included patients. Capsule endoscopy revealed findings that led to diagnoses of Crohn's disease (), tuberculosis (), gastrointestinal stromal tumors (), and hookworm (); these diagnoses included 100% (4/4) of the patients with alarm signs, but only 8.6% (5/58) of patients without them. However, 55.6% (5/9) of patients with clinically capsule endoscopy findings reported no alarm signs. Conclusions. Although selecting patients based on the alarm signs may increase the yield of capsule endoscopy, the alarm sign criteria appear to have low sensitivity.

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Makoto Tomatsu ◽  
Jun Isogaki ◽  
Takahiro Watanabe ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
...  

Gastrointestinal stromal tumors (GISTs) are relatively common in neurofibromatosis type 1 (NF 1) patients. Approximately 90% of GISTs associated with NF 1 are located in the small intestine, while sporadic GISTs are most commonly located in the stomach. Here we report an extremely rare case of an NF 1 patient with multiple gastric GITs (90 or more) but without multiple small intestinal tumors. A 63-year-old female patient who had a history of NF 1 underwent surgery for a gastric neuroendocrine tumor and gastric submucosal tumor (SMT). During the operation, multiple small nodules were identified on the serosal surface of the upper stomach. SMT and multiple nodules on the serosal surface were diagnosed as GISTs consisting of spindle cells positive for KIT, CD34, and DOG-1. Both GIST and the normal gastric mucosa showed no mutations not only in the c-kitgene (exons 8, 9, 11, 13, and 17) but also in thePDGFRAgene (exons 12, 14, and 18). This patient is being followed up without the administration of a tyrosine kinase inhibitor.


2017 ◽  
Vol 56 (12) ◽  
pp. 1453-1457 ◽  
Author(s):  
Makoto Nakano ◽  
Shiro Oka ◽  
Shinji Tanaka ◽  
Atushi Igawa ◽  
Sayoko Kunihara ◽  
...  

2015 ◽  
Vol 81 (1) ◽  
pp. 186-193 ◽  
Author(s):  
Meng Xue ◽  
Xueqin Chen ◽  
Liuhong Shi ◽  
Jianmin Si ◽  
Liangjing Wang ◽  
...  

2006 ◽  
Vol 130 (10) ◽  
pp. 1466-1478 ◽  
Author(s):  
Markku Miettinen ◽  
Jerzy Lasota

Abstract Context.—Gastrointestinal stromal tumors (GISTs) are specific, generally Kit (CD117)-positive, mesenchymal tumors of the gastrointestinal tract encompassing a majority of tumors previously considered gastrointestinal smooth muscle tumors. They are believed to originate from interstitial cells of Cajal or related stem cells. Objective.—To review current clinicopathologically relevant information on GIST. Data Sources.—Literature in Medline and authors' own experience. Conclusions.—GISTs usually occur in older adults (median age 55–60 years) and rarely in children in the second decade (<1%) throughout the gastrointestinal tract: 60% in stomach, 35% in small intestine, and less than 5% in rectum, esophagus, omentum, and mesentery; most GISTs in the latter 2 sites are metastatic. Five percent of GISTs occur in patients with neurofibromatosis type 1 syndrome (multiple small intestinal tumors) and in Carney triad (gastric epithelioid GISTs in young females). Familial GISTs occur in patients with inheritable germline Kit or platelet-derived growth factor receptor alpha (PDGFRA) mutations. Histologically GISTs vary from spindle cell tumors to epithelioid and pleomorphic tumors. Most GISTs (95%) express Kit (CD117), CD34 (70%), and heavy caldesmon (80%), whereas 25% are positive for smooth muscle actin and less than 5% for desmin. Tumor size and mitotic activity are best predictive prognostic features; small intestinal tumors behave more aggressively than gastric tumors with similar parameters. Mutually exclusive gain-of-function Kit or PDGFRA mutations occur in a majority of GISTs representing in-frame deletions, point mutations, duplications and insertions. Mutations in Kit juxtamembrane domain (exon 11) are the most common in GISTs of all sites, whereas rare Kit extracellular domain (exon 9) Ala502-Tyr503 duplication is specific for intestinal GISTs. Mutations in PDGFRA have been identified in juxtamembrane (exon 12) and tyrosine kinase domains (exons 14 and 18), nearly exclusively in gastric GISTs, mostly in epithelioid variants. Some Kit and PDGFRA mutations have a prognostic value. Kit/PDGFRA tyrosine kinase inhibitor imatinib has been successfully used in the treatment of metastatic GISTs for more than 5 years. However, primary and acquired secondary resistance linked to certain types of Kit and PDGFRA mutations is limiting long-term success necessitating the use of alternative treatments.


2021 ◽  
pp. 12-13
Author(s):  
Shivangi Singh ◽  
Munesh Munesh ◽  
Sweta Sweta

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours of alimentary tract comprising 0.2% of gastrointestinal tumors and only 0.04% of small intestinal tumours. Jejunal GISTs are one of the rarest subtypes. GISTs display various morphological forms like spindle and epitheloid cells in a variety of patterns and can be submucosal, intramuscular or subserosal in location. Grossly they are solid and cyst with variable hemorrhage and necrosis. Most of the gastrointestinal stromal tumors have mutations in either KIT (CD117) or PDGFRα gene. DOG 1 is a sensitive and specic marker of GIST independent of CD117 or PGDFRα expression. Here we present a case of malignant jejunal GIST with missed diagnosis on CECT abdomen.


Medicine ◽  
2018 ◽  
Vol 97 (8) ◽  
pp. e0025 ◽  
Author(s):  
Libin Huang ◽  
Zhiyin Huang ◽  
Yang Tai ◽  
Pu Wang ◽  
Bing Hu ◽  
...  

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