Proteinlosing gastropathy with gastric hypersecretion of acid (H+) and pepsin and hypergastrinemia. A case report.

A case with proteinlosing gastropathy with gastric hypersecretion of H+ and pepsin as well as hypergastrinemia is presented. Zollinger-Ellison syndrome was excluded by reduction in acid secretion and serum gastrin during the observation period as well as by the effect on gastric secretion and serum gastrin after injections of secretin and glucagon.     

Basophilic leukemia and the hypersecretion of gastric acid and pepsin

A 48-yr-old man with chronic myelogenous leukemia and basophilia developed a duodenal ulcer and hemorrhage. Gastric analysis revealed basal hyper-secretion of acid (33.1 mEq/h) and pepsin (44.5 x 10(-4) peptic units/h). Blood, serum, and urine histamine was elevated and serum gastrin was normal. Although acid output was markedly suppressed with ranitidine (50 mg i.v.), pepsin secretion was only inhibited 63% and had returned to basal levels by the sixth hour. Maximal acid output does not suggest a trophic effect of histamine in this patient. The previously reported cases of basophilic leukemia and gastric hypersecretion or duodenal ulcer disease are reviewed.     

Hyperplastic gastropathy with acid hypersecretion. A case report

The case of a 60-year-old male patient with hyperplastic hypersecretory gastropathy. The diagnosis was reached by means of the histologic study of a sample obtained by endoscopic macrobiopsy. Examination of the gastric secretions showed stimulate and basal hypersecretion; gastrinemia was normal and albumin levels were at the lower limit. Several observations are made concerning the acid secretion clinical aspects and treatment of this rare disorder.     

Epithelioid malignant peripheral nerve sheath tumor. A case report

Malignant peripheral nerve sheath tumors (MPNST) are exceptional and painful. The typical localization along a peripheral nerve is not always present. Prognosis is very poor. Diagnosis is particularly difficult because of the variable pathological presentation and unpredictable differentiation. We report an exceptional case of epithelioid differentiation in a 43-Year-old patient who complained of right thoracic pain for one and a half Years. Physical examination revealed weight loss and a paravertebral mass under the scapula. The chest x-ray showed a suprahilar opacity suggestive of parietal involvement and lysis of the sixth rib. Surgical biopsy of the parietal mass led to the diagnosis of epithelioid MPNST.     

Recurrent gastric carcinoma causing pseudoachalasia: case report

We report the case of a patient with a gastric remnant relapse of an antral carcinoma resected 5 years before and presenting with the clinical feature of a secondary achalasia (pseudoachalasia). In spite of the patient's 4-month history of dysphagia and weight loss that suggested a malignant lesion, barium swallow, repeated endoscopic biopsies and computed tomography (CT) scan of the upper abdomen did not reveal any abnormalities to indicate a recurrence. However, in the following months, because of worsening symptoms, a further CT scan was performed and revealed thickening of the cardia and gastric wall. The patient underwent an exploratory laparotomy that showed an unresectable lesion involving the gastric fundus, the diaphragm and penetrating into the mediastinum, and therefore a palliative jejunostomy was performed.     

Pituitary tumor cosecreting thyrotropin and prolactin causing hyperthyroidism--a case report

We report a case of a pituitary tumor cosecreting thyrotropin and prolactin with clinical manifestation of thyrotoxicosis, which is a very rare clinical disorder. Octreotide therapy is effective in suppressing the secretion of thyrotropin, prolactin, and thyroid hormones, and by this, renders relief of symptoms and complications of thyrotoxicosis.     

胃恶性黑色素瘤1例报道

众所周知,胃肠道恶性黑色素瘤是很罕见的。现报道1例我科确诊的胃恶性黑色素瘤,病理提示恶性黑色素瘤,经HMB-45、S-100蛋白免疫组化染色证实。     

Basal acid output and gastric acid hypersecretion in gastroesophageal reflux disease

The purpose of this study was to evaluate possible differences in basal gastric acid secretion with regard to severity of gastroesophageal reflux disease. Basal acid output was determined by nasogastric suction in 228 patients with gastroesophageal reflux disease who received upper gastrointestinal endoscopy and were diagnosed with either pyrosis alone (N = 98), erosive esophagitis with or without pyrosis (N = 87), or Barrett's esophagus (N = 43). Mean basal acid output for the 228 patients with gastroesophageal reflux disease was 6.5 ± 5.6 meq/hr, which was significantly different from 65 normal subjects with a mean basal acid output of 3.0 ± 2.7 meq/hr (P < 0.0001). Compared to normal subjects, mean basal acid outputs significantly differed for patients with pyrosis (P < 0.05), esophagitis (P < 0.01), and Barrett's esophagus (P < 0.01). There was also a significant difference in mean basal acid output between the patients with pyrosis and Barrett's esophagus (P < 0.01). Nineteen of the 98 patients with pyrosis (19%), 24 of the 87 patients with esophagitis (28%), and 15 of the 43 patients with Barrett's esophagus (35%) had gastric acid hypersecretion (basal acid output greater than 10.0 meq/hr). One hundred forty-six patients with gastroesophageal reflux disease were treated with ranitidine in doses that resulted in complete healing of esophagitis and disappearance of pyrosis. Ninety-three patients responded to ranitidine 300 mg/day; however, 53 patients required increased dose of ranitidine (mean 1205 mg/day, range 600–3000 mg/day). There was a significant correlation between basal acid output and daily ranitidine dose required for therapy for the 146 patients with gastroesophageal reflux disease (r = 0.53,P = 0.0001). Furthermore, a significant association was also found between the presence of gastric acid hypersecretion and the requirement for increased doses of ranitidine (greater than 300 mg/day) (P = 0.00001). These results indicate that there is a subset of patients with gastroesophageal reflux disease who do have idiopathic gastric acid hypersecretion. Moreover, these patients have an apparently higher requirement for medication dosage in order to achieve therapeutic efficacy.     

胃窦部平滑肌增生肥大误诊为恶性肿瘤1例

本文报告了1例内镜下显示胃窦部环状隆起型占位，形成假幽门，内镜考虑为恶性肿瘤，经活检病理组织形态学证实为黏膜固有层内平滑肌增生肥大所致，避免了患者的过度治疗。     

Subperiosteal inflammatory pseudotumor mimicking primary malignant bone tumor: A case report

We report a case of IgG4-positive inflammatory pseudotumor mimicking malignant bone tumor. Biopsy revealed no tumor cells. Surgical excision was performed and an abscess developing beneath the periosteum was observed with Streptococcus constellatus. Preoperative serum IgG4 value of 120 mg/dl normalized postoperatively to 80.6 mg/dl. It was difficult to distinguish inflammatory pseudotumor from sarcoma because it developed under the periosteum. In such cases, it is important to measure blood IgG4 values and perform tissue staining and culturing.     

Synchronous occurrence of a primary colon adenocarcinoma and a gastric stromal tumor. A case report

Gastrointestinal stromal tumors are currently the object of a great clinical and experimental interest. We are presenting the case of a 69-year-old patient, who was presented with lower gastrointestinal bleeding and dyspeptic symptoms over the last six months. The colonoscopy showed a large tumor of the sigmoid and the gastroscopy a large gastric tumor of the antrum, which were histologically diagnosed as colonic adenocarcinoma and gastric stromal tumor respectively. The patient underwent a sigmoidectomy and a partial gastrectomy. Six months after surgery were the clinical condition, abdominal CT, gastroscopy and colonoscopy without pathological findings. To our best knowledge, this is the second report of a synchronous gastric stromal tumor and a colonic adenocarcinoma in medical literature.     

Primary malignant liver mesenchymal tumor: a case report

Primary malignant liver mesenchymal tumor is a rare condition defined as a tumor with vascular, fibrous, adi-pose, and other mesenchymal tissue differentiation. We report a case of primary malignant liver mesenchymal tumor in a 51-year-old male with anemia, weight loss and hepatomegaly. Finally unconventional liver biopsy and histological manifestation led to the definitive diag-nosis.     

Primary gastric actinomycosis: A case report.

Gastric actinomycosis is an extremely rare disease. To date, about 20 cases have been reported in the literature. In most cases, diagnosis was made by histopathologic evaluation of an operative specimen. We report here a 68-year-old man with primary gastric actinomycosis who was admitted to the hospital with upper gastrointestinal bleeding and diagnosed as actinomycosis by microscopic examination of biopsy specimens obtained by endoscopy. This case is reported because of the rarity of endoscopically diagnosed primary gastric actinomycosis.     

Ovarian tumor and Peutz-Jeghers syndrome. A case report

A case of Peutz-Jeghers syndrome associated with ovarian mucinous cystadenoma and ovarian sex cord tumor with annular tubules is presented. The sec cord tumor with annular tubules was described in 1970 by Scully, who recognized its striking association with the Peutz-Jeghers syndrome. This tumor is an almost constant finding in patients' ovaries with this disorder. Three cases of ovarian mucinous cystadenoma and sex cord tumor with annular tubules associated with Peutz-Jeghers syndrome were found in the literature. Our observation confirms that gynecologic abnormalities are an important manifestation of the syndrome and require careful surveillance.     

A case report of early gastric cancer with Paneth-like tumor cells]

A 55-year-old man was given a diagnosis of grade 0IIc type gastric cancer of the midgastric posterior wall following endoscopy of the upper digestive tract, and subsequently underwent distal gastrectomy. Tumor cells resembling Paneth cells were occasionally observed in differentiated adenocarcinoma that had invaded the submucosal layer, the tumor was CD10-positive, and showed differentiation to complete intestinal metaplasia. In addition, p53-positive cells were also occasionally observed. Although complete intestinal metaplasia is associated with a low incidence of malignant transformation, this case was considered to be different from complete intestinal metaplasia, on which a mutation of the gene of p53 is involved in the early period of carcinogenesis.