1/722. Molecular relationships of helicobacter pylori strains in a family with gastroduodenal disease.OBJECTIVE: Few studies have examined the genetic relationships of helicobacter pylori strains affecting family members. Our aim was to do so. methods: We characterized H. pylori isolates obtained from members of a single family presenting with various gastroduodenal diseases to examine H. pylori bacterial genetic similarity. Endoscopic evaluation with gastric mapping was performed on each individual to establish clinical and histological disease. Genomic dna extracted from each H. pylori isolate was used to generate dna fingerprints for each strain by REP-PCR. vacA genotypes and cagA presence were established by PCR. RESULTS: gastrointestinal diseases among the five members of this family included gastric adenocarcinoma in a 52-yr-old man (index patient), gastric MALT-lymphoma in the 73-yr-old mother; intestinal metaplasia (IV) and atrophic gastritis in the 48-yr-old brother; intestinal metaplasia (I-III) in the 47-yr-old brother, and a duodenal ulcer scar in the 42-yr-old sister. REP-PCR dna fingerprints of H. pylori isolates from the index patient, his mother, and both of his brothers were identical or highly similar. By contrast, the H. pylori dna fingerprint from the sister was markedly different from the H. pylori dna fingerprints from the other family members. All isolates had the genotype cagA-positive and vacA slb/ml mosaic genotype. CONCLUSIONS: The dna fingerprints of H. pylori strains obtained from members of this family with malignancy or premalignant histological disease were identical or highly similar and markedly different from the H. pylori dna fingerprint from the sibling with duodenal ulcer disease. All H. pylori isolates within the family possessed genetic markers of enhanced virulence (presence of the cagA gene and vacA sl/ml mosaicism). In addition to host genetics and environmental factors, these findings suggest that infection with genetically similar H. pylori strains is a significant factor in determining the clinical outcome of an infection with H. pylori.- - - - - - - - - - ranking = 1keywords = adenocarcinoma (Clic here for more details about this article) |
2/722. Anti-epiligrin cicatricial pemphigoid: a case associated with gastric carcinoma and features resembling epidermolysis bullosa acquisita.A 48-year-old woman with anti-epiligrin cicatricial pemphigoid (CP) who showed clinical features resembling epidermolysis bullosa acquisita was found to have adenocarcinoma of the stomach. Histological examination of lesional skin demonstrated a subepidermal blister. Direct immunofluorescence microscopy of perilesional skin revealed linear deposits of IgG and C3 at the basement membrane zone. The patient's serum contained IgG autoantibodies that bound to the dermal side of 1 mol/L NaCl-split normal human skin as determined by indirect immunofluorescence microscopy, and the lamina lucida as determined by indirect immunoelectron microscopy. The patient's serum immunoprecipitated laminin-5 from extracts and media of biosynthetically radiolabelled human keratinocytes. Immunoblot studies showed that the patient's autoantibodies specifically bound the alpha3 subunit of this laminin isoform. Fragility of the skin and bullous lesions disappeared after total gastrectomy, but soon reappeared possibly in association with metastatic disease in a lymph node. The possibility that anti-epiligrin CP may develop paraneoplastically in some patients is discussed.- - - - - - - - - - ranking = 1keywords = adenocarcinoma (Clic here for more details about this article) |
3/722. Synchronous adenocarcinoma and MALT lymphoma of stomach.We describe a patient in whom adenocarcinoma and lymphoma occurred simultaneously in the stomach. She presented with pain and lump in the epigastrium with history of hematemesis. endoscopy revealed a growth involving the lesser curvature, and biopsy showed poorly differentiated carcinoma. Histological examination of the gastrectomy specimen showed synchronous diffuse adenocarcinoma with primary lymphoma of MALT type. The latter entity is known to be associated with helicobacter pylori infection.- - - - - - - - - - ranking = 6keywords = adenocarcinoma (Clic here for more details about this article) |
4/722. Malignant pseudoachalasia.During the course of a laparoscopic Heller myotomy, a patient thought to have primary achalasia was found instead to have an adenocarcinoma of the gastroesophageal junction. Aspects of this patient's clinical course, which are exemplary of malignant pseudoachalasia, are discussed, as are ways in which this not uncommon error in diagnosis can be avoided.- - - - - - - - - - ranking = 1keywords = adenocarcinoma (Clic here for more details about this article) |
5/722. Synchronous and metachronous gastric adenocarcinoma: case report and literature review.Whilst synchronous adenocarcinoma of the stomach is well documented, metachronous primary disease is exceedingly rare. We report a man with a family history of colonic and gastric cancer, who underwent a resection of a Duke's C adenocarcinoma of the rectum, aged 56 years, and a proximal partial gastrectomy for synchronous stage 1 gastric adenocarcinomas of the lesser curve, aged 61 years. Nine years later, a metachronous gastric primary was discovered in the gastric remnant, necessitating total gastrectomy. Total gastrectomy is the operation of choice for synchronous gastric primaries as it ensures clearance and prevents metachronous growth. However, it may not be appropriate for all gastric cancer as operative morbidity and mortality are increased, and because synchronicity and metachronicity of gastric cancer are uncommon. Moreover, there are no consistent data to demonstrate a survival advantage for total compared with partial gastrectomy for operable gastric cancer. If, after partial gastrectomy, synchronous disease is detected in the resected specimen (as in this reported case), endoscopic surveillance for metachronous disease is advised, since this may be amenable to surgical cure.- - - - - - - - - - ranking = 7keywords = adenocarcinoma (Clic here for more details about this article) |
6/722. A case report of gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation.We report herein an unusual gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation in a 63-year-old Japanese male. The tumor was a pedunculated large polypoid tumor (7 x 6.5 x 3.5 cm) located in the pylorus. Histologically, it invaded to the subserosa and was composed of both adenocarcinomatous and sarcomatous components. Adenocarcinomatous foci generally showed tubular to solid patterns and occupied the parts facing the gastric lumen, while the sarcomatous components showed a generally irregular and solid arrangement. There were transitions between the sarcomatous and carcinoma elements. In addition, carcinoma cells with a cord-like or trabecular arrangement similar to that seen in endocrine carcinoma expressed chromogranin a, and were mainly observed in an intermediate area between the adenocarcinomatous and sarcomatous foci. The sarcomatous areas were mainly composed of spindle cells and occasionally contained a sarcomatous component showing rhabdomyosarcomatous differentiation. This is an interesting case to consider how the variety of cell type appeared in such a type of tumor in the stomach.- - - - - - - - - - ranking = 2keywords = adenocarcinoma (Clic here for more details about this article) |
7/722. acanthosis nigricans and wart-like lesions associated with metastatic carcinoma of the stomach.A 63-year-old white man developed malignant acanthosis nigricans one year after a hemigastrectomy for adenocarcinoma of the stomach. Multiple "wart-like" lesions involving the dorsa of the hands, arms and trunk were also present. The malignant acanthosis nigricans in the patient appears to have paralledled the course of the metastatic gastric adenocarcinoma. Discrete verrucous lesions can occur in malignant acanthosis nigricans which histopathologically may show either squamous or basal cell hyperplasia.- - - - - - - - - - ranking = 2keywords = adenocarcinoma (Clic here for more details about this article) |
8/722. Simultaneous MALT-type lymphoma and early adenocarcinoma of the stomach associated with helicobacter pylori gastritis.We report about two cases of combined gastric lymphoma and gastric carcinoma with one of them representing a case of early gastric high grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) with co-existing early gastric adenocarcinoma. In contrast to most previously reported similar cases, in both of our cases the definitive diagnosis of gastric lymphoma and carcinoma was obtained preoperatively. This, however, seems to be in future times an essential prerequisite for employing minimal invasive methods such as eradication therapy in the case of diagnosed early lymphoma and endoscopic treatment for early gastric carcinomas. These methods have been proven to be an effective and beneficial alternative treatment especially with regard to the life quality of the patients.- - - - - - - - - - ranking = 5keywords = adenocarcinoma (Clic here for more details about this article) |
9/722. cardiac tamponade originating from primary gastric signet ring cell carcinoma.A 45-year-old man with dry cough and dyspnea was referred by a medical practitioner for evaluation of heart failure on February 10, 1996. Chest X-ray revealed increased cardiothoracic ratio, and ultrasonographic echocardiography disclosed massive pericardial effusion with right ventricular collapse. cardiac tamponade was diagnosed and pericardiocentesis was performed. Ten days after admission, the pleural effusion had become more pronounced, and thoracocentesis was performed. carcinoembryonic antigen level was elevated in both the pericardial and pleural effusion, and cytology implicated adenocarcinoma, which suggested malignant effusion. Endoscopic study disclosed gastric cancer in the posterior wall of the upper body, and the histopathological diagnosis was signet-ring cell carcinoma. The patient died of respiratory failure on May 2, 1996, and autopsy was performed. The final diagnosis was gastric cancer with pulmonary lymphangitis, pericarditis, and pleuritis carcinomatosa, accompanied by enlargement of mediastinal and paraaortic lymph nodes. Interestingly, the primary signet-ring cell carcinoma of the stomach was situated mostly in the mucosa. Deep in the submucosal region, there was prominent invasion of the intralymphatic vessels, without direct destruction of the mucosa muscularis.- - - - - - - - - - ranking = 1keywords = adenocarcinoma (Clic here for more details about this article) |
10/722. Combined yolk sac tumor and adenocarcinoma in a gastric stump: molecular evidence of clonality.BACKGROUND: Extragonadal yolk sac tumors of the gastrointestinal tract are extremely rare neoplasms. Their greater rarity compared with other extragonadal yolk sac tumors suggests that different pathogenetic mechanisms could be involved according to the site of origin. This report describes a case of a combined yolk sac tumor and adenocarcinoma that arose in a gastric stump in a man age 61 years 43 years after he underwent distal gastric resection and gastrojejunostomy (Billroth II operation) for a benign duodenal ulcer. The coexistence of an adenocarcinomatous component with the yolk sac component suggests that the two histologic patterns may represent distinct phenotypes arising from a common mucosal epithelial cell. methods: Immunohistochemical and molecular techniques were used to define the mutation pattern of p53 in both components of the tumor. RESULTS: Single-strand conformation polymorphism and sequencing analyses demonstrated the same pattern of p53 mutation in the adenocarcinomatous and yolk sac tumor components. CONCLUSIONS: This finding suggests that the two tumors could have been derived from the same cellular clone and supports the hypothesis that the two components represented a heterogeneous differentiation of the same tumor.- - - - - - - - - - ranking = 7keywords = adenocarcinoma (Clic here for more details about this article) |
| | Next -> |