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)

Idiopathic granulomatous appendicitis has been categorized as primary Crohn's disease of the appendix based on its pathologic features, although the clinical course of this condition simulates acute appendicitis. In this study we report the clinical and pathologic features of 10 cases of idiopathic granulomatous appendicitis and compare the histopathology to 14 appendices inflamed by Crohn's disease. The patients comprised six women and four men with an age range of 15 to 48 years (mean, 29 years). Six patients had acute onset of right lower quadrant abdominal pain while in three patients the presentation was subacute; one patient was asymptomatic. Focal neutrophilic infiltration of crypts with crypt abscesses, mucosal erosion and ulceration, fissures, transmural lymphoid aggregates, and mural fibrosis were comparable in idiopathic granulomatous appendicitis and Crohn's disease affecting the appendix. Fistulization occurred more commonly in Crohn's disease. Idiopathic granulomatous appendicitis contained 19.7 granulomas per tissue section (range, 2.75 to 71.0) compared with 0.3 granulomas per tissue section (range, 0 to 3.0) for appendices affected by Crohn's disease. No patient with granulomatous appendicitis treated by simple appendectomy had recurrence of disease at mean follow-up of 4.5 years. Our morphologic data support the clinical contention that idiopathic granulomatous appendicitis is nosologically distinct from Crohn's disease. Ironically, the presence of numerous granulomas is the histopathologic feature distinguishing idiopathic granulomatous appendicitis from Crohn's disease.
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PMID:Idiopathic granulomatous appendicitis, or Crohn's disease of the appendix revisited. 850 37

A clinical syndrome of chronic colitis unique to the sigmoid colon harboring diverticular was recently reported; its histopathological appearance has not been fully elucidated. In this study, the authors analyzed the clinical and pathological features of 23 patients (age range, 38-87 years; median age, 72 years) with diverticular disease-associated chronic colitis. Nineteen presented with hematochezia; four had abdominal pain. Colonoscopic visualization of the mucosa showed patchy or confluent granularity and friability affecting the sigmoid colon encompassing diverticular ostia. Colonic mucosae proximal and distal to the sigmoid were endoscopically normal. Mucosal biopsy specimens showed features of idiopathic inflammatory bowel disease that included plasmacellular and eosinophilic expansion of the lamina propria (100%), neutrophilic cryptitis (100%) with crypt abscesses (61%), basal lymphoid aggregates (100%), distorted crypt architecture (87%), basal plasmacytosis (61%), surface epithelial sloughing (61%), focal Paneth cell metaplasia (48%), and granulomatous cryptitis (26%). Concomitant rectal biopsies obtained in five patients demonstrated histologically normal mucosa. Fourteen patients treated with high-fiber diet or antibiotics or both improved clinically, as did nine patients administered sulfasalazine or 5-aminosalicylic acid. Five patients underwent sigmoid colonic resection, three for stricture with obstruction and two for chronic blood loss anemia. Among a control population of 23 age- and gender-matched patients with diverticular disease without luminal surface mucosal abnormality, none required resection during the same follow-up period. By Fisher's exact test, a statistically significant difference in outcome for patients with and without colitis was detected (p = 0.049). In addition, three patients developed ulcerative proctosigmoiditis 6, 9, and 17 months after the onset of diverticular disease-associted colitis. The data indicate that diverticular disease-associated chronic sigmoid colitis expresses morphological features traditionally reserved for idiopathic inflammatory bowel disease. Its clinical and endoscopic profiles permit distinction from Crohn's disease and ulcerative colitis. Patients with chronic colitis in conjunction with diverticula are at increased risk for sigmoid colonic resection. Diverticular disease-associated chronic colitis may also precede the onset of conventional ulcerative proctosigmoiditis in some cases.
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PMID:Diverticular disease-associated chronic colitis. 854 Jun 14

The immunological and immunohistochemical characteristics of a patient with nodular lymphoid hyperplasia (NLH) of the terminal ileum were investigated pre- and post-operatively. The patient presented with diarrhea, lower abdominal pain, and weight loss, and an abdominal X-ray following barium enema revealed multiple small nodules in the terminal ileum which were subsequently confirmed to be NLH by histological examination. Preoperatively, although the serum immunoglobulin levels were normal, the T-cell responses in the peripheral blood, including the phytohemagglutinin (PHA)-blastogenesis and the T4/T8 ratio, were impaired. However, following an ileocecal resection, the PHA-blastogenesis became augmented and the T4/T8 ratio recovered to within the normal range. The immunohistochemical findings revealed a more marked accumulation of T cells in the interstitium around the hyperplastic follicles than in the interstitium of the normal intestine.
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PMID:Nodular lymphoid hyperplasia of the terminal ileum: report of a case and the findings of an immunological analysis. 878 2

A case of Crohn's disease in an extremely elderly man (92-years-old) is reported. He was admitted for abdominal pain and was operated on under a diagnosis of ischemic colitis. At the mucosal surface, many linear and irregularly shaped shallow ulcers were found on the mesenteric side. Microscopically, transmural inflammatory cell infiltration, bead-like lymphoid aggregates around the propriate muscle, small epithelioid cell granulomas, fissure, and volcano-like streamers of inflammatory cells were found. Nerve fibers in Meissner's and Auerbach's plexi seemed to be increased in number, and some were hyperplastic. There was no feature of ischemic colitis or Yersinia enteritis. Serially sectioned tissue specimens did not show dysplastic mucosal change. Many cases of Crohn's disease in the elderly have been reported but an extremely elderly patient such as the present one is very rare, especially in Japan. Characteristics of elderly patients with Crohn's disease are discussed.
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PMID:Crohn's disease in a 92-year-old male. 880 39

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 the case of a middle-aged man who presented de novo with abdominal pain and hepatomegaly and was found to have positive serology for hepatitis C and subsequently a primary hepatic lymphoma. An increased incidence of primary hepatocellular cancer is well characterized in both cirrhotic and non-cirrhotic cases of chronic hepatitis C. The relationship between chronic hepatitis C and primary hepatic lymphoma remains obscure. It has been established that hepatitis C can sustain the clonal B-cell expansion that occurs in associated cryoglobulinaemia, and hepatitis C RNA has been detected within extrahepatic lymphoma tissue. Viral aetiologies for lymphoma are well characterized, such as Epstein-Barr virus (EBV) and human T-cell leukaemia virus (HTLV) I and II. Existing models of chronic infection causing lymphoma within the gastrointestinal tract include that of Helicobacter pylori and mucosa-associated lymphoid tumour of the stomach. Given the relatively low frequency of occurrence it may be prudent to perform a retrospective analysis on past cases of primary hepatic lymphoma in order to determine whether or not hepatitis C was present.
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PMID:Primary hepatic lymphoma in a man with chronic hepatitis C. 903 6

Enlarged anorectal lymph nodes can cause colic in young horses by obstructing the caudal aspect of the rectum. Dyschezia and clinical signs consistent with abdominal pain were the predominant reasons for evaluation of the 5 young (3 to 15 month old) horses of this report. Digital transrectal palpation revealed a firm mass obstructing the caudal aspect of the rectum in each horse. Results of cytologic evaluation of the masses revealed a lymphoid population of cells in 4 of 5 horses. These nodes regressed over time or became abscesses and drained into the rectum. In 1 horse, detection of a mature abscess and concomitant dysuria necessitated immediate surgical drainage of the mass; however, the other 4 horses were successfully managed medically, thereby avoiding risks associated with surgery of the perirectal area. Anorectal lymphadenopathy should be considered as a differential diagnosis in young horses with colic.
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PMID:Anorectal lymphadenopathy causing colic, perirectal abscesses, or both in five young horses. 907 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

Juvenile ankylosing spondylitis (JAS) is a chronic inflammatory arthritis of the peripheral and axial skeleton, frequently accompanied by enthesitis. About four percent of patients with JAS have ulcerative colitis or Crohn's disease. Crohn's disease is the more common of the two and is diagnosed in 26 percent of patients with chronic spondyloarthropathy. In this paper, a 14-year-old male patient is presented as a typical case of juvenile ankylosing spondylitis and Crohn's disease with low back pain, morning stiffness, limited motion in anterior and lateral flexion and extension, left sacroiliitis, ankylosis in the apophyseal joints of the lumbar vertebrae, abdominal pain, bloody diarrhea, characteristic histopathologic changes of colonic involvement such as lymphoid follicles, fissures, submucosal polymorphonuclear cell infiltration and definite ganglion cells. The current therapy with mesalazin, having fewer side effects than sulfosalazin, and its applicability in combination with naproxen sodium is also discussed.
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PMID:A case of juvenile ankylosing spondylitis and Crohn's disease. 922 28

A 63-year-old woman with a 1-year history of abdominal pain and intrahepatic cholestasis developed anorexia, weight loss, lassitude and diarrhoea. Studies led to a diagnosis of primary intestinal T-cell lymphoma involving especially the proximal small intestine and infiltrating the mesenteric lymph nodes, bone marrow and skin. An associated severe hypoalbuminaemia (1.3 g dL-1) was most probably the result of protein-losing enteropathy. Liver biopsy demonstrated concentric fibrosis of the bile ducts ('onion skin' lesions, with an inflammatory cell infiltrate and lymphoid aggregates) and was considered almost pathognomonic of primary sclerosing cholangitis. Sudden death due to pulmonary embolism occurred and a limited autopsy confirmed the diagnosis. Other associated diseases such as coeliac disease or inflammatory bowel disease were not found. This first report of the simultaneous occurrence of two rare diseases - primary sclerosing cholangitis and intestinal T-cell lymphoma - may indicate an intriguing association, possibly mediated by the effect of cytokines released by the infiltrating T-cells into the portal circulation.
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PMID:Primary intestinal T-cell lymphoma and sclerosing cholangitis: a cytokine-mediated association? 989 8


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