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)

Fifteen endoscopic gastric biopsies (GBx) from 12 patients with small lymphocytic infiltrates morphologically raising a differential of indeterminate lymphocytic infiltrate versus mucosa-associated lymphoid tissue (MALT) lymphoma were analyzed genotypically after frozen-section identification of the abnormal lymphocytic infiltrate. Frozen-section immunoperoxidase immunophenotyping was equivocal in each case. All patients had abdominal pain attributable to superficial gastric ulceration, most often antral, without peripheral lymphadenopathy or hepatosplenomegaly. Rearrangement of the immunoglobulin heavy-chain gene (JH-R, seven patients) or kappa light-chain gene (JK-R, eight patients), was found in eight GBx from eight (seven stage IAE; one stage IBE) of 12 patients, establishing, in conjunction with the histologic features, a diagnosis of low-grade B-cell lymphoma. This diagnosis had not been tenable on multiple prior GBx, ranging from one to five per patient, over intervals of 1 month to 6.5 years (median 4.5 months). The T-cell receptor beta-chain gene retained germline configuration in all cases. Insufficient DNA for molecular studies was extracted from the GBx of two patients, one with JK-R (JH-G) on subsequent GBx and one without further GBx. One patient had two GBx, each demonstrating a single additional band in HindIII digests hybridized with the JH probe. No rearrangements were detected in either the BamHI or the EcoRI digests. Uninvolved tissue from this patient was not available for the exclusion of restriction fragment length polymorphism. Three GBx (two patients) showed germline JH genes (JH-G). One had a partial gastrectomy (histology: MALT lymphoma) in 1981 followed by GBx in 1983 (histologically benign) and in 1990 (JH-G), and negative esophagogastroduodenoscopy (EGD) in 1991 without biopsy. The other patient (two GBx with JH-G) had multiple subsequent abnormal EGD, but no biopsies since December 18, 1990. Adequate DNA for gene rearrangement studies can be extracted from GBx samples weighing as little as 20 mg. The two samples with insufficient DNA weighed 1 and 16 mg, respectively. Practically speaking, the remainder of a frozen block from a single GBx is adequate, thus allowing the screening of multiple endoscopic GBx by sequential frozen sections to determine which one contains the most extensive lymphocytic infiltrate for molecular study. Consistent results are obtained on samples weighing 40 to 60 mg. This method is a suitable alternative to kappa/lambda frozen-section immunoperoxidase immunostaining, which can be uninterpretable on endoscopic biopsies or small biopsies from other sites.
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PMID:Practicality of molecular studies to evaluate small lymphocytic proliferations in endoscopic gastric biopsies. 135 96

We describe a female aborigine from Taiwan with alpha-chain disease associated with multiple polypoid intestinal lymphocytic lymphoma and leukemic manifestation. Initially, the patient experienced intermittent diarrhea, abdominal pain, and leukemic manifestation. No evidence of bone marrow involvement was found. Alpha-chain protein was demonstrated in the serum. Gastroendoscopy and a series of radiographs of the small intestine revealed multiple polypoid tumors involving the entire length of the small intestine. Duodenal biopsy showed diffuse lymphocytic lymphoma. Immunohistochemical staining of tumor samples revealed features typical of alpha-chain disease. Cytogenetic analysis showed the same abnormal karyotypes of neoplastic clones in intestinal tumor cells and in circulating leukemic cells. The data suggest that alpha-chain disease can present initially with intestinal multiple polypoid lymphocytic lymphoma and leukemic manifestation without evidence of bone marrow involvement. The data also support the homing theory of lymphomas from mucosa-associated lymphoid tissue.
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PMID:Leukemic manifestation in a case of alpha-chain disease with multiple polypoid intestinal lymphocytic lymphoma. 141 95

This retrospective study evaluated 32 patients with primary gastrointestinal lymphoma managed at Belen Hospital, Trujillo, Peru, from 1966 to 1994 to determine their clinicopathologic findings and identify those prognostic factors that influenced in the 5-year survival. Median age was 44.2 years. The male to female ratio was 1.3:1 and seventh decade was the most involved. Abdominal pain, the predominant symptom, was present in gastric (100%) and intestinal (91%) lymphoma. Small intestine was involved in 62.5% cases, followed by stomach (28.1%). Most common stage was II1E (50%) and predominant histological was high grade-MALT type lymphoma (81.3%). Five year survival rate was 29% for those who received some kind of treatment (n = 30): It was 38% for whom underwent surgery plus chemotherapy and/or radiotherapy compared to those who only underwent surgery (23%) (p < 0.05). Factors as histological type (p < 0.005), stage (p < 0.005) and tumoral size (p < 0.05) were associated with long term survival. We conclude that early diagnosis is important to define management in these patients and post-operatory adjuvant treatment should be considered to obtain a longer survival.
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PMID:[Primary gastrointestinal lymphomas: clinical and pathological aspects and survival]. 766 17

A 63 year old patient came to admission because of abdominal pain. A stone disease of the gallbladder was known. Gastroscopy showed active gastritis of the antral-mucosa with some erosive lesions. Histology revealed surprisingly a low grade MALT lymphoma. Helicobacter pylori colonization (H. pylori) was found in the mucosa. While additional lymphomas were not found, a therapy aiming at the eradication of H. pylori was started. A subsequent control biopsy showed only slight lymphoplasmacellular inflammatory infiltration of the mucosa but no evidence of lymphoma. Our case report shows, that regression of a gastric MALT lymphoma can be achieved by eradication of H. pylori only. So far we don't know for how long this regression will continue and if permanent healing is possible. Further studies will have to show whether eradication of H. pylori can be established as a new therapeutic concept of low-grade MALT lymphomas at early stages.
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PMID:[Low malignancy MALT lymphoma of the stomach: H. pyloric eradication as a therapeutic concept?]. 787 59

Small bowel lymphomas account for 20 to 40% of primary gut lymphomas in Western populations and are among the most common malignant tumours of the small bowel. We studied 119 cases of primary small bowel lymphoma presenting over 4 decades. Two thirds of the patients were men with a peak age incidence in the 7th decade. Common presenting features included abdominal pain, weight loss, small bowel obstruction, and acute abdomen. Tumours were classified using the Kiel European Association for Haematopathology Geneva Workshop scheme and phenotyped on paraffin sections; 66% were B cells, and 34% were T cell. In all cases, the antibodies L26 and polyclonal CD3 reliably distinguished between B- and T-cell tumours. Of the B-cell lymphomas, 62% were diffuse high grade, 20% were low-grade lymphomas of mucosa-associated lymphoid tissue, 11% had both low- and high-grade components, and 7% were other low-grade types. Of the T-cell lymphomas, 83% were high grade, and 49% were enteropathy associated. Most T-cell lymphomas were ulcerated plaques or strictures in the proximal small bowel; B-cell lymphomas tended to be annular or polypoid masses in the distal and terminal ileum. Survival data showed that low-grade B-cell lymphomas had the best outcome and T-cell lymphomas the worst. Adverse prognostic features included perforation, high-grade histology, multiple tumours and advanced stage.
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PMID:Primary lymphoma of the small intestine. A clinicopathological study of 119 cases. 847 Jul 58

A 79-year-old women with upper abdominal pain, vomiting and weight loss was found at endoscopy to have a large tumour mass in the gastric body. Histology of forceps biopsies revealed an adenocarcinoma of intestinal type. Gastrectomy was performed, but extensive lymph node metastasis precluded a curative surgical approach. Histopathological study of the specimen, however, revealed two distict malignancies, which arose in the setting of Helicobacter pylori-associated chronic gastritis with partial mucosal atrophy. One tumour was a gastric carcinoma, while the other was a primary B-cell lymphoma of the stomach (CD20-positive). The lymphoma comprised both a low-grade component (mucosa-associated lymphoid tissue- or MALT-type lymphoma), and a high-grade component (large cell lymphoma with CD30-positive giant cells). Infection with H. pylori was confirmed by the serological presence of IgG antibodies to H. pylori-antigens, including antibodies against the 128 kDa protein of the cytotoxin-associated gene (cagA gene) of H. pylori.
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PMID:Simultaneous gastric adenocarcinoma and MALT-type lymphoma in Helicobacter pylori infection. 854 31

Low-grade gastric B-cell lymphoma of mucosa-associated lymphoid tissue type (MALToma) is a recently recognized disease entity. We report the clinicopathologic features of 19 patients with MALToma in Taiwan. The 19 patients included eight men and 11 women, ranging in age from 26 to 77 years, with a mean age of 58.8 years. Most complained of abdominal pain or gastrointestinal bleeding. The endoscopic and gross features of the gastric lesions revealed erosion (flat type), ulceration (depressed type), cobblestone appearance or abnormal gastric folds (elevated type), mimicking chronic gastritis, ulcer or early gastric carcinoma. Typical histopathologic features included lymphoepithelial lesion and extensive mucosal infiltration of centrocyte-like cells in all cases. Clonality analysis of the variable-diversity-joining region of the immunoglobulin gene by semi-nested polymerase chain reaction demonstrated monoclonality in 72% of the cases. Helicobacter pylori bacilli (H. pylori) could be identified on histologic sections in 15 cases (78.9%); the serologic test for H. pylori was positive in 12 of 13 patients tested (92%). In six patients receiving triple therapy (amoxicillin, bismuth subcitrate and metronidazole), five showed significant histologic regression with eradication of H. pylori 4 to 6 months after the start of treatment; one patient showed persistent lesions and presence of H. pylori. However, persistence of residual lymphoid cells and monoclonality of the immunoglobulin gene, could still be demonstrated in four cases. Of nine patients treated with surgery or chemotherapy, two died: one due to concomitant gastric carcinoma and the other one due to sudden apnea. No recurrence was observed in the remaining seven patients. The remaining four patients were lost to follow-up. Our experience confirmed that gastric MALToma is a low-grade neoplastic process. The dramatic response of gastric MALToma to anti-H. pylori treatment suggests that H. pylori infection is closely related to the pathogenesis of low-grade gastric MALToma. However, long-term follow-up is mandatory due to the persistence of the monoclonality of the immunoglobulin gene in the residual lymphoid cells after treatment.
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PMID:Low-grade gastric B-cell lymphoma of mucosa-associated lymphoid tissue: clinicopathologic analysis of 19 cases. 899 Jul 74

We report a case of Mediterranean lymphoma treated with antibiotics. A 74-year-old woman visited the hospital due to abdominal pain. Endoscopic examination showed erosions and ulcerations on duodenal mucosa. Biopsy specimens histologically revealed massive infiltration of small-sized lymphocytes and plasma cells in subepithelial mucosa. Immunoperoxidase staining showed that the infiltrating cells were positively stained with anti-alpha heavy chain. Serum IgA concentration was elevated and immunoelectrophoresis of the serum demonstrated monoclonal protein composed of alpha heavy chain. During the antibiotic treatment her symptoms disappeared and serum IgA concentration was normalized. Endoscopic examination also showed healing of the duodenal ulceration. The similarities between Mediterranean lymphoma and gastric mucosa-associated lymphoid tissue (MALT) type lymphoma, both of which may be related to bacterial infection and can be treated with antibiotics, are discussed in this report.
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PMID:"Mediterranean lymphoma" treated with antibiotics. 903 Sep 84

Lymphoid polyps of the rectum are rare lesions. We report on an 8 1/2-year-old boy, who presented with hematochezia and abdominal pain. Flexible endoscopy revealed large sessile polyps of the rectum and lymphonodular hyperplasia of the duodenum, terminal ileum und descending colon. One rectal polyp was excised in toto, microscopically it revealed the typical features of a lymphoid polyp. Based on the distinct follicular architecture, the cytomorphology and the immunohistochemical findings of the lymphatic infiltrate we were able to distinguish this lesion from malignant lymphoma. The coincidence of lymphoid polyps and gastrointestinal lymphonodular hyperplasia gives evidence that both entities are different variations of the same benign lymphoproliferative process. Lymphoid polyps of the rectum should be treated by local excision for diagnostic purposes. Immunohistochemical staining of fresh, nonfixed tissue is a useful ancillary technique in distinguishing these benign lesions from lymphoma of mucosa associated lymphoid tissue (MALT-lymphoma).
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PMID:Gastrointestinal lymphonodular hyperplasia and lymphoid polyps of the rectum--a rare coincidence. 916 91

The publication of the National Institutes of Health Consensus Development Conference guidelines on management of Helicobacter pylori infection in 1994 set a precedence. At present, at least eight European countries have produced national guidelines, and, more recently, the European Helicobacter pylori Study Group also outlined guidelines based on the strength of available evidence. It is generally agreed that H. pylori should be eradicated in peptic ulcer disease. In nonsteroidal anti-inflammatory drug (NSAID)-related ulcers, most countries that considered the issue suggested discontinuing NSAIDs when possible and eradicating H. pylori. The prophylactic eradication of H. pylori was not recommended. A number of panels felt that there was not enough evidence available to recommend eradication of H. pylori in functional dyspepsia, whereas other groups felt that nonulcer dyspepsia, particularly after investigation and with severe or recurrent symptoms, was an indication for eradication therapy. Other conditions (i.e., gastroesophageal reflux disease [GERD] and mucosa-associated lymphoid tissue [MALT] lymphoma) have emerged in this short time as possible indications for H. pylori eradication. There is no evidence that H. pylori infection has a role in the pathogenesis of GERD, but there is evidence suggesting that patients with H. pylori infection who require long-term acid suppression may be at risk of developing atrophic gastritis. The European Helicobacter pylori Study Group has suggested that eradication therapy should be offered to infected family members of patients with gastric cancer. It also recommended that eradication therapy was "strongly recommended" on the basis of "supportive" evidence in gastritis with severe abnormalities and after early resection of early gastric cancer. An "uncertain" recommendation with "equivocal" evidence was given for asymptomatic subjects, extra-alimentary tract disease, the prevention of gastric cancer in the absence of risk factors, and in pediatric patients with recurrent abdominal pain. Despite considerable advances, further research studies are needed to provide definite direction for the treatment of many conditions.
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PMID:Who should be treated for Helicobacter pylori infection? A review of consensus conferences and guidelines. 939 69


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