1/23. Heterotopic pancreas in gastric antrum with macroscopic appearance of gastric polyp.Heterotopic pancreas is a relatively rare clinical diagnosis, not commonly involved in differential diagnostic considerations of GI symptoms. The authors report a case of heterotopic pancreas discovered endoscopically in the gastric antrum. A 60-year-old woman presented with epigastric pain. The patient took alendronate for osteoporosis. The endoscopic examination revealed helicobacter pylori positive antral atrophic gastropathy and a well delineated hemispherical polyp, 8 mm in diameter, in the antrum of the stomach. histology showed antral gastritis and the presence of heterotopic pancreas. After dietary measures and Helicobacter eradication, the patient was relieved of symptoms. According to the authors' opinion, the finding of heterotopic pancreas did not necessitate intervention, and was an incidental finding. The authors discuss the significance of heterotopic pancreas with the conclusion that the resection of the lesion is indicated only if consistent symptoms are present. Fig. 3, Ref. 28.)- - - - - - - - - - ranking = 1keywords = gastritis (Clic here for more details about this article) |
2/23. Gastric inverted hyperplastic polyp. Report of four cases and relation to gastritis cystica profunda.Gastric inverted hyperplastic polyp (IHP) is a rare type of gastric polyp, and is characterized by downward growth of the hyperplastic mucosal components into the submucosa. To the best ofour knowledge, 16 gastric IHP cases have been described in the English literature, but the pathogenesis has not been established. We report the clinical and pathological findings of four gastric IHP cases. The lesions were mainly composed of hyperplastic foveolar-type glands with focal cystic dilatation. Pyloric type glands, endocrine cells, acinic cell metaplasia, and smooth muscle bundles were also seen as components of the polyp. Two cases (cases 1 and 4) coexisted with multifocal gastritis cystica profunda (GCP) and gastric adenocarcinoma. Case 4 furthermore exhibited an intermediate form between IHP and GCP. We suggest that IHP may be GCP associated with exaggeratedly hyperplastic and metaplastic changes. In case 4, the coexisting gastric carcinoma was mainly located in the submucosa, whilst the mucosal component was minimal. Five out of twenty reported gastric IHP cases, including our cases, coexisted with gastric adenocarcinoma. These facts would lead us to further investigate the relation between gastric IHP and carcinoma.- - - - - - - - - - ranking = 5keywords = gastritis (Clic here for more details about this article) |
3/23. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: case report.BACKGROUND: Hyperplastic polyps are the most common polypoid lesions of the stomach. Rarely, they cause gastric outlet obstruction by prolapsing through the pyloric channel, when they arise in the prepyloric antrum. CASE PRESENTATION: A 62-year-old woman presented with intermittent nausea and vomiting of 4 months duration. Upper gastrointestinal endoscopy revealed a 30 mm prepyloric sessile polyp causing intermittent gastric outlet obstruction. Following submucosal injection of diluted adrenaline solution, the polyp was removed with a snare. Multiple biopsies were taken from the greater curvature of the antrum and the corpus. Rapid urease test for helicobacter pylori yielded a negative result. Histopathologic examination showed a hyperplastic polyp without any evidence of malignancy. Biopsies of the antrum and the corpus revealed gastritis with neither atrophic changes nor helicobacter pylori infection. Follow-up endoscopy after a 12-week course of proton pomp inhibitor therapy showed a complete healing without any remnant tissue at the polypectomy site. The patient has been symptom-free during 8 months of follow-up. CONCLUSIONS: Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy. Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment.- - - - - - - - - - ranking = 1keywords = gastritis (Clic here for more details about this article) |
4/23. Effect of helicobacter pylori eradication on gastric hyperplastic polyposis in Cowden's disease.A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas were identified. On endoscopy, multiple hyperplastic polyps were seen in the rectum and left-side colon. There were also esophageal glycogenic acanthosis and hyperplastic polyposis in the antrum accompanied by helicobacter pylori-related gastritis. Although gastric hyperplastic polyposis had by no means regressed with unsuccessful first-line eradication therapy for H pylori, following cure of the infection with salvage therapy consisting of rabeprazole, amoxicillin and metronidazole, the polyposis lesions almost disappeared. Follow-up gastroscopy 2 and 3 years after cessation of the second-line eradication therapy revealed almost complete regression of the polyposis lesions with no evidence of H pylori infection. We recommend eradication treatment for CD patients with gastric hyperplastic polyps and the infection, as the occurrence of gastric carcinoma among hyperplastic polyps has been described.- - - - - - - - - - ranking = 1keywords = gastritis (Clic here for more details about this article) |
5/23. Treatment of solitary gastric carcinoid tumor by endoscopic polypectomy in a patient with pernicious anemia.Type I gastric carcinoid tumors result from hypergastrinemia in 1%-7% of patients with pernicious anemia. We diagnosed pernicious anemia in a 48-year-old female patient with complaint of fatigue for three months. She had no gastrointestinal symptoms. Endoscopic examination ot the upper gastrointestinal tract revealed atrophic gastritis and a polypoid lesion in the corpus of 3-4 mm in size. Endoscopic polypectomy was performed. Histopathological examination of the specimen revealed positive chromogranin a and synaptophysin stainings compatible with the diagnosis of a carcinoid tumor. serum gastrin level was increased, urinary 5-hydroxyindoleacetic acid was within the normal range. There was no other symptom, sign, or laboratory finding of a carcinoid syndrome in the patient. No metastasis was found with indium-111 octreotide scan, computed tomographies of abdomen and thorax. Type I gastric carcinoid tumors are only rarely solitary and patients with tumors < 1 cm in size may benefit from endoscopic polypectomy.- - - - - - - - - - ranking = 1keywords = gastritis (Clic here for more details about this article) |
6/23. The topographic distribution of lymphocytic gastritis in gastrectomy specimens.Forty-eight entire gastrectomy specimens received consecutively at this Department were cut into blocks for histologic examination. Focal or more extended areas of chronic gastritis (i.e. superficial or atrophic with or without intestinal metaplasia) were present in all 48 specimens. In addition, two of the 48 specimens had a large number of lymphocytes in the surface and foveolar epithelium of the mucosa. In the literature the latter is regarded as "lymphocytic gastritis". Lymphocytic gastritis was found in all 156 sections obtained from the two specimens. This lympho-epithelial phenomenon was present even in areas lacking chronic inflammation in the subjacent lamina propria mucosae. From our results it would appear that while chronic gastritis has a focal or a regional topographic distribution, lymphocytic gastritis includes the entire surface-foveolar epithelium of the gastric mucosa.- - - - - - - - - - ranking = 9keywords = gastritis (Clic here for more details about this article) |
7/23. Hyperplastic gastric polyps associated with persistent helicobacter pylori infection and active gastritis.We report two cases of patients with 3-yr histories of upper gastrointestinal symptoms, hyperplastic gastric polyps, and active chronic gastritis. Biopsies retrospectively stained with Giemsa revealed the persistent presence of helicobacter pylori (HP) in gastric biopsies of both patients throughout the 3 yr. After treatment with amoxicillin and bismuth subsalicylate, both became asymptomatic, one demonstrating disappearance and recurrence of the gastric polyps in conjunction with the HP. These cases demonstrate 3 yr of hyperplastic gastric polyps associated with HP and active gastritis.- - - - - - - - - - ranking = 6keywords = gastritis (Clic here for more details about this article) |
8/23. Gastric xanthelasma in hyperplastic gastric polyposis.Hyperplastic polyps of the stomach are uncommon, while xanthelasma of the gastric mucosa has a variable reported frequency. The frequency of both lesions appear increased in association with chronic gastritis and previous gastrointestinal anastomosis. The present article consists of a case report that documents for the first time (to our knowledge) the coexistence of these two lesions in a patient with a history of erosive gastritis.- - - - - - - - - - ranking = 2keywords = gastritis (Clic here for more details about this article) |
9/23. Composite carcinoid-adenocarcinoma of the stomach associated with multiple gastric carcinoids and nonantral gastric atrophy.A case of multiple gastric carcinoids and nonantral atrophic gastritis in which the larger tumor was a composite carcinoid-adenocarcinoma is presented. The two components of the composite tumor immunohistochemically showed clear-cut diverging functional differentiations although the available evidence supported a common histogenesis from the metaplastic intestinal epithelium of the gastric mucosa. The carcinoid tissue of the composite tumor, which showed "atypical" features, also differed from the other, pure carcinoids, in which the histologic appearance was "typical." Total gastrectomy performed 1 month after the original gastric resection with antrectomy disclosed regressive changes in the endocrine cell proliferations of the gastric stump consistent with the withdrawal of a stimulating effect of the antral gastrin.- - - - - - - - - - ranking = 1keywords = gastritis (Clic here for more details about this article) |
10/23. Menetrier's disease. A trivalent gastropathy.Current conceptions of Menetrier's disease only obliquely resemble those originally described. Bona-fide cases are so uncommon that, of 125 cases diagnosed as Menetier's disease, hypertrophic gastritis, or protein-losing gastropathy treated at the massachusetts General Hospital during the 26-year period of 1962-1987, only six cases merited an unequivocal anatomic diagnosis. Two other cases previously described proved on review to be nondiagnostic in one instance and campylobacter pylori gastritis in the other. Because abnormalities in the secretion of gastric acid and in the loss of protein from the stomach may coexist, a representation of each case in semiquantitative terms can be described on triaxial coordinates. Three patients had a hypercoagulable state, one in association with gastric carcinoma. One other case of gastric carcinoma and one of esophageal carcinoma coexistant with Menetrier's disease were identified. Administration of subcutaneous heparin during the perioperative period to patients with Menetrier's disease is appropriate regardless of whether or not hypercoagulation or carcinoma is manifest. If treatment with anticholinergic drugs and inhibitors of gastric acid secretion fails, total gastrectomy is the best solution, because it stops protein loss, eliminates hyperchlorhydria, prevents development of gastric carcinoma, and permits anastomotic reconstruction between normal esophagus and normal small bowel.- - - - - - - - - - ranking = 2keywords = gastritis (Clic here for more details about this article) |
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