Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty of 81 consecutive HIV antibody positive patients referred with non-cryptosporidial diarrhoea had no potential infectious cause; most had AIDS related complex rather than the full blown syndrome. Opportunistic infections with cytomegalovirus (CMV), mycobacterium avium-intracellulare (MAI), and herpes simplex virus (HSV), which allowed a diagnosis of AIDS to be made, were found in 19 patients and were the presenting features of AIDS in five. Other potential pathogenic species included entamoeba, giardia, campylobacter, and salmonella (without septicaemia). Cytomegalovirus infection was often accompanied by abdominal pain. Severe weight loss (greater than 10 kg) at presentation was found in patients with CMV infection and MAI. Bloody diarrhoea was confined to the group with HSV procitis. Malignant causes of diarrhoea were rare. Two patients developed a squamous carcinoma of the anorectal margin and one a non-Hodgkin's lymphoma. In only two of 12 patients who had Kaposi's sarcoma was this considered as a cause of diarrhoea. Rigid sigmoidoscopy showed macroscopic abnormalities in over a third (32) of the 81 patients with non-cryptosporidial diarrhoea. Most commonly this was severe inflammation (17) or discrete ulceration (four) [three of whom had CMV colitis]. Kaposi's sarcoma was identified in 11 patients. Non-specific inflammation was seen histologically in 40 of the 60 patients with no sigmoidoscopic inflammatory changes. Barium enema only revealed an abnormality in a minority of the patients and a colonoscopy only revealed information additional to rigid sigmoidoscopy in two patients--one with CMV ulcers in the transverse colon and the other with evidence of Kaposi's sarcoma not seen in the rectum. Ten patients had a rectal biopsy examined by electron microscopy as no infective cause of diarrhoea was uncovered. In four of these microtubular structures which are commonly seen in viral infections were found and two had prelymphomatous changes and in one of these frank lymphoma has developed. We recommend multiple stool analysis, sigmoidoscopy and rectal biopsy as the initial investigations in these patients reserving tests of malabsorption, colonoscopy, and barium enema for the small number of more difficult cases.
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PMID:Non-cryptosporidial diarrhoea in human immunodeficiency virus (HIV) infected patients. 253 10

In a series of 320 patients with lymphoid neoplasms treated with polychemotherapy, three patients with non-Hodgkin's lymphoma and one with myeloma were diagnosed as having neutropenic enterocolitis (NEC). All patients were adult, all had received multiple chemotherapeutic drugs and, during neutropenia, they had clinically presented with fever and abdominal pain, generally in the right lower quadrant. The diagnosis was clinical in all cases, and the imaging techniques provided only the suspicion of retro-cecal abscess in one of them. Two patients were operated on because of the development of features of peritoneal involvement, another because of septic shock and another because of retro-cecal abscess. Surgery and pathological study confirmed the diagnosis. The fundamental findings were ileocecal wall edema, mucosa ulceration, local necrosis, hemorrhage and thrombosis, and clusters of bacterial colonies without evidence of granulocytic or tumoral infiltration. NEC can develop with varying types of morphological involvement resulting in a highly variable clinical severity spectrum ranging from nonspecific abdominal symptoms to acute abdomen. Thus, diagnosis is very difficult and is only possible with a high suspicion index. It should rely on clinical data, which are unique, to assess the evolution and to indicate medical or surgical therapy. These therapeutic modalities should be individualized in each patient. All physicians treating neutropenic patients should be familiar with this condition and consider it in the differential diagnosis of abdominal pain.
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PMID:[Neutropenic enterocolitis during treatment of lymphoproliferative neoplasms]. 261 46

An immunohistochemical study of a rare initial manifestation of non-Hodgkin's lymphoma (NHL) in the ovaries is presented. There have been very few reports to date on immunohistochemical studies of lymphoma involving the ovaries. A 53-year-old woman suffering from lower abdominal pain and abnormal genital bleeding was diagnosed as having a tumor in her left ovary by ultrasonic echograms and CT scanning. The patient underwent a simple total hysterectomy and bilateral salpingo-oophorectomies. The tumor, measuring 14 x 10 x 10 cm, was located in the left ovary and extended to the major omentum, mesocolon and left ureter. The histology of the tumor was that of NHL showing diffuse proliferation of small cleaved cells. Immunohistochemical studies of the ovarian tumor showed that the tumor cells were of a B-cell lymphoma nature with LCA+, MB-1+, lambda+, keratin-, IgG-, IgM-, IgA-, kappa-, and MT-1-. Although the main lesion involved the ovary, the case could not be identified definitely as primary lymphoma of the ovary.
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PMID:Ovarian involvement as an initial manifestation of malignant lymphoma. 273 70

Between January 1977 and January 1988, 19 patients with non-Hodgkin's lymphoma (NHL) involving the ileocaecal region were cared for by the CRC Wessex Medical Oncology Unit. Fifteen of these patients had primary ileocaecal NHL (stages IE or IIE) and four had secondary involvement of this region (stage IV). The commonest clinical presentation was with abdominal pain and a palpable mass in the right iliac fossa. Bulky (greater than 10 cm) disease was a particularly common feature, and complete surgical removal was possible in only seven patients. All patients had intermediate (18) or high grade (one) NHL using the Working Formulation. The commonest histological subtype was diffuse large cell. Seventeen patients received postoperative therapy, comprising local radiotherapy in one and combination chemotherapy in the remaining 16. Eleven of the 19 patients remain disease-free 6-60 months from diagnosis. Because of the high incidence of bulky disease at this site, postoperative therapy may be indicated, even for patients with apparently completely excised stage I disease.
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PMID:Involvement of the ileocaecal region by non-Hodgkin's lymphoma in adults: clinical features and results of treatment. 278 43

From 1972 to 1985, a total of 35 children with histological diagnosis of non-Hodgkin's lymphoma were treated. A previously undiagnosed abdominal non-Hodgkin's lymphoma produced intussusception in three of these children between 5 and 10 years of age. Our experience indicates that any child around 6 years of age with abdominal pain, bloody stools and a palpable mass plus radiographic evidence of intussusception should be considered to have an intestinal wall lymphoma until proven otherwise. Inadequate surgical treatment may result from failure to recognize relationship between intussusception and lymphoma in older child.
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PMID:[Non-Hodgkin's lymphoma as a cause of intussusception in children]. 344 99

A series of 50 patients with malignant lymphoma, proven by biopsy, was retrospectively studied. 39 were non-Hodgkin's lymphoma and 11 Hodgkin's disease. 45 (90%) had been misdiagnosed because of lack of initial specific symptoms. It is suggested that for patients with a painless progressively enlarging superficial lymph node without adhering to its surrounding tissues and irresponsive to general management, having irregular fever, bloody stool, abdominal pain or mass, complication of partial intestinal obstruction, sharp vigilance be kept for the possibility of malignant lymphoma.
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PMID:[Misdiagnosis of malignant lymphoma--report of 45 patients]. 345 41

This study reports 43 patients (male: n = 17, female: n = 26) with non-Hodgkin's lymphoma of the stomach, who underwent surgery between 1. January 1977 and 31. December 1986. The main clinical symptoms were abdominal pain, weight loss and vomiting. Symptoms preceded diagnosis by 13 weeks. Barium meal and endoscopy were useful diagnostic procedures. The biopsy specimens indicated malignancy in 80% of cases. Operations performed were: total gastrectomy (n = 18), distal resection (B I: n = 4, B II: n = 14), partial duodenopancreatectomy (n = 3), proximal gastric resection (n = 1), local excision (n = 1) and explorative laparotomy (n = 2). Perioperative mortality was 0%. Peritonitis occurred in 1 patient due to leakage of the duodenal stump. According to the Ann-Arbor system we found stage I in 19, stage II in 10 and stage III in 14 cases. The histological type according to the Working Formulation showed low grade of malignancy in 15 and high grade of malignancy in 28 patients. All patients underwent postoperative chemotherapy and/or radiotherapy with respect to tumour staging and morphology. 24 patients are alive without relapse, 16 patients died intercurrently. The data were collected retrospectively and analysed by means of Kaplan-Meier survival functions. For comparisons we used the Breslow and the Mantel test. We investigated the prognostic significance of: sex, clinical symptoms, localisation of the tumour, type and radicality of operation, lymphadenectomy, splenectomy, splenic infiltration, tumour size and depth of infiltration, staging and grading. The 2-year survival rate was 82%, the 5-year rate was 55%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Non-Hodgkin's lymphoma of the stomach: surgical therapy and prognosis]. 361 72

A clinicopathologic analysis of nine patients with B-immunoblastic sarcoma (B-IBS) presenting as a bulky lymph node-based retroperitoneal mass is reported. The histologic and immunologic findings, similar to those reported in B-IBS presenting in various other nodal and extranodal sites, support the recognition of this aggressive large cell non-Hodgkin's lymphoma (NHL) as a distinct pathologic entity. The patients, with a mean age of 60.5 years, presented for evaluation of abdominal pain and a palpable abdominal mass. Four patients were Stage II or IIE, one Stage III, and four Stage IV; eight of nine had B symptoms. Chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin [CHOP-B] or cyclophosphamide, doxorubicin, vincristine, methotrexate with leucovorin rescue, cytarabine [ACOMLA]) yielded significant palliation in five patients (mean survival, 12.3 months); three untreated patients and one receiving radiation treatment (XRT) died within 1 month from diagnosis. There was a striking predilection for pleuropulmonary involvement in disseminating disease. The initial blood lymphocyte count correlated significantly with survival (correlation coefficient, 0.84). The one durable complete remission (CR) was obtained in a patient who received substantial surgical debulking before chemotherapy.
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PMID:Retroperitoneal mass presentations of B-immunoblastic sarcoma. 387 94

Bone marrow necrosis occurred in two patients with non-Hodgkin's lymphoma. One had a four-year history of lymphoma for which he received combination chemotherapy. Severe bone pain, abdominal pain and fever occurred during the terminal part of his illness. The other patient presented initially with symptoms of bone pain and lymphadenopathy. At bone marrow examinations, both had anatomically extensive bone marrow necrosis with associated evidence of involvement by lymphoma. The previously recognized clinical features of bone marrow necrosis and its complications occurred in one or both of these illustrative cases, with the exception that bone tenderness was absent in both. Attempts were made to correlate the technetium-99m sulphur colloid scans with sites of disease as determined by the bone marrow examinations.
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PMID:Bone marrow necrosis diagnosed during life: clinical and laboratory features of extensive involvement. 694 43

We describe one case with rheumatoid arthritis who developed non-Hodgkin's lymphoma during treatment with low dose weekly methotrexate. A 73 year-old man had seropositive RA since 1974. He had been treated with several medications, including nonsteroidal antiinflammatory drugs, gold sodium thiomalate (from January, 1987), and bucillamine (from January, 1988). He presented to this hospital in April 1988, at a time when his rheumatoid arthritis worsened. Methotrexate was administered at a weekly dose of 7.5 mg orally, together with a daily dose of 5 mg of prednisone. He had had no joint-related pain and no side effects until December 1991 (total dose 1290 mg) when severe abdominal pain was started abruptly. The chest X-ray showed an abdominal free air and a diagnosis of acute panperitonitis was made. An emergency operation was carried out. There was a soft-tissue mass in the terminal of ileum which was ruptured with massive ascites. Histologic examination of the mass revealed a diffuse large cell lymphoma. The oncogenic potential of MTX and rheumatoid arthritis is reviewed.
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PMID:[A case of rheumatoid arthritis with malignant lymphoma taking methotrexate]. 748 65


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