Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007095 (carcinoid)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report two cases of gastric carcinoid that presented as benign-appearing polyps. One presented with multiple, benign-appearing polyps--a particularly unusual presentation for an uncommon tumor. The second patient had a single polypoid gastric carcinoid and atropic gastritis with pernicious anemia. These atypical presentations and uncommon association of gastric carcinoid are discussed.
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PMID:Gastric carcinoid: two unusual presentations. 685 10

A man with long-standing pernicious anaemia developed multiple gastric carcinoid tumours with a background of diffuse enterochromaffin-like cell hyperplasia. There is evidence that enterochromaffin-like cells synthesis and store histamine and that their proliferation is stimulated by high serum gastrin levels. Gastric carcinoid tumours can be difficult to differentiate from the more common adenocarcinomas and may be a more frequent complication of pernicious anaemia than is currently recognised.
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PMID:Diffuse enterochromaffin-like (ECL) cell hyperplasia and multiple gastric carcinoids: a complication of pernicious anaemia. 722 60

Hypergastrinemia induces argyrophil cell hyperplasia in oxyntic mucosa (FACH) in patients with non-antral atrophic gastritis, with or without pernicious anemia. This proliferation favours the development of carcinoid tumours. In order to determine the most usual appropriate method to document FACH, we have studied 29 consecutive fundic biopsies from 26 patients with fundic chronic gastritis. The study encompassed gastrinemia levels, standard histology permitting the classification of chronic gastritis, demonstration of FACH by Grimelius stain, immunohistochemical studies using NSE, chromogranin A and by electron microscopy. The FACH was classified for each stain as slight, moderate or severe. The study displayed a relationship between the grade of gastritis and the density of argyrophil endocrine cells in oxyntic mucosa assessed by Grimelius stain (p < 0.0001) and chromogranin A (P < 0.01). There was also a relationship between the serum gastrin level and the density of argyrophil endocrine cells detected by these two stains (p < 0.001). A highly significant correlation was observed between Grimelius stain and chromogranin A (p < 0.0001). On the other hand, no significant correlation was noted with either NSE or electron microscopy. We conclude that Grimelius stain and immunohistochemical studies against chromogranin A were the best methods for the demonstration of FACH in atrophic gastritis. One of these two techniques is sufficient in current practice for defining the patients at risk for subsequent surveillance.
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PMID:Fundic argyrophil cell hyperplasia in atrophic gastritis: a search for a sensitive diagnostic method. 768 75

The etiology, prognosis, and optimal management of primary gastric carcinoids remain controversial. Records of 36 consecutive patients with gastric carcinoid (15 men) were reviewed retrospectively between 1975 and 1990. Follow-up was complete in 97% of cases. Mean age at diagnosis was 58.4 years (range 24-82 years). The clinical presentations included anemia (72%), pain (69%), and carcinoid syndrome (11%). Associated autoimmune and endocrine abnormalities were common and included atrophic gastritis (67%), pernicious anemia (58%), hypothyroidism (39%), diabetes (19%), Addison's disease (6%), and hyperparathyroidism (6%). Lesions were nonantral in 78%, involving only the corpus in 42%, the fundus in 28%, and only the antrum in 8%; 42% were multiple. Urinary 5-hydroxyindoleacetic acid (5-HIAA) and serum gastrin levels were elevated in 17% and 50% of those tested, respectively. Histologic examination revealed that 28% of lesions were > or = 2 cm, and 33% had liver metastases on presentation or developed them during follow-up. Eight patients (22%) died of tumor with a median survival of 39 months. The presence of metastases, atypical histology, serosal involvement, and size > 2 cm were adverse prognostic factors. In patients without hypergastrinemia (n = 6), 66% developed metastases, 60% had elevated 5-HIAA, and 50% died of carcinoid tumor. In sharp contrast, those patients with hypergastrinemia and "typical" gastric carcinoids (n = 15), metastases and death did not occur (p < 0.003 and p < 0.005, respectively, compared with eugastrinemic patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diverse clinical and pathologic features of gastric carcinoid and the relevance of hypergastrinemia. 772 31

Gastric carcinoid tumors were previously believed to be rare lesions, representing less than 2% of all carcinoid tumors and less than 1% of all stomach neoplasms. More recent studies have demonstrated that they may constitute as much as 10-30% of carcinoid tumors. Patients with conditions associated with hypergastrinemia, such as chronic atrophic gastritis, Zollinger-Ellison syndrome with multiple endocrine neoplasia type 1 (ZES-MEN-1), and pernicious anemia, display a markedly elevated incidence of gastric carcinoid tumor formation. A classification system distinguishing three types of gastric carcinoid tumor has been proposed: 1) tumors associated with chronic atrophic gastritis, 2) tumors associated with Zollinger-Ellison syndrome, and 3) sporadic lesions. Tumors that develop in association with hypergastrinemia are usually composed of enterochromaffin-like (ECL) cells, in contrast to sporadic lesions that contain a variety of endocrine cell types (enterochromaffin, ECL, X). In both intact animal models such as the rat and Praomys (mastomys) natalensis and in isolated purified ECL cell preparations, gastrin has been demonstrated to exert a powerful trophic effect on ECL cells, in addition to stimulating histamine secretion. It is apparent that hypergastrinemia-associated gastric carcinoids display relatively benign biological behavior. Sporadic lesions require aggressive surgical management on diagnosis. Type I and type II (hypergastrinemia-associated) lesions can be managed initially by endoscopic excision of accessible tumors, followed by endoscopic surveillance. If tumors recur, antrectomy and local excision may be used to remove the source gastrin, resulting in cure in the vast majority of patients.
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PMID:Gastric carcinoid tumors: the biology and therapy of an enigmatic and controversial lesion. 787 69

The stomach is an uncommon site for carcinoid tumors, the incidence of which is about 2% of all carcinoids. During a five-year period, from 1988 to 1992, three patients with gastric carcinoid tumors were diagnosed at the Tan Tock Seng Hospital, Singapore. Their ages ranged from 59 to 68 years, and all were male. Two patients were referred for investigation of anemia, and one patient presented with massive hematemesis and an advanced ulcerated tumor requiring emergency total gastrectomy. Of the other two patients, one had pernicious anemia with multiple carcinoid polyps, and the other had sessile carcinoid nodules. None of the patients had carcinoid syndrome. Two patients underwent gastrectomy, while the patient with polyps had an endoscopic polypectomy. Follow-up ranged from one to three years. Two patients remained well, but the patient who presented with an advanced tumor with serosal invasion and nodal involvement had hepatic recurrence and died two years after the diagnosis of recurrence.
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PMID:Gastric carcinoid: a rare form of gastrointestinal carcinoids. A report on three cases. 795 59

A 21-year-old female with autoimmune polyglandular failure (APG) manifested by insulin-dependent diabetes mellitus (IDDM), hypothyroidism and pernicious anaemia developed severe malabsorption due to exocrine pancreatic insufficiency. Supplemental pancreatic enzymes resulted in marked improvement of steatorrhea. There was also an incidental finding of gastric carcinoid tumour. We identified only 13 other patients in our institution with either type 2 or 3 APG, one of which had significant steatorrhoea. Another patient with IDDM, hypothyroidism and pernicious anaemia had an asymptomatic gastric carcinoid tumour. The possible mechanisms for malabsorption in APG are discussed.
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PMID:Autoimmune polyglandular failure associated with malabsorption and gastric carcinoid tumour. 825 57

To assess the value of gastroscopic cancer surveillance of patients with pernicious anaemia, 56 patients were re-endoscoped and biopsied after three years. In addition, changes in the density of fundic mucosal endocrine cells were evaluated morphometrically. Two cases (3.6%) of early gastric cancer and two cases of small gastric carcinoid tumours (3.6%) were detected in addition to the five carcinoids that had been found at the initial endoscopic screening. Nodular argyrophil cell hyperplasia and morphometric density of argyrophil cells were not stable phenomena: nodular hyperplasias regressed in five patients, remained similar in six, and progressed to a small carcinoid tumour in one. Serum gastrin concentrations did not correlate well with changes in the endocrine cell density. Regular endoscopic surveillance for gastric cancer may be beneficial and realistic in young patients with pernicious anaemia while the importance of fundic endocrine cell hyperplasia and that of small gastric carcinoids need further study.
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PMID:Gastroscopic follow up of pernicious anaemia patients. 843 47

Carcinoids of the stomach are rare but have gained importance since the introduction of acid secretion inhibitors. The most important type is the tumor occurring in patients with chronic atrophic gastritis with and without pernicious anemia. The tumors are benign and can be treated by local endoscopic or surgical methods. Antrectomy reduces hypergastrinemia and may cause regression of the tumor. Sporadic carcinoids of the gastric antrum are malignant, however, and require radical surgical treatment.
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PMID:[Therapy of carcinoids of the stomach]. 871 70

Gastric carcinoid tumors are being recognized increasingly in patients with pernicious anemia. Such tumors occur in the presence of achlorhydria, chronic atrophic gastritis involving the fundus and body of the stomach, hypergastrinemia, and enterochromaffin-like cell hyperplasia-dysplasia. A 74-yr-old man with a 6-yr history of pernicious anemia who developed a solitary gastric carcinoid tumor of the corpus is described. The patient presented with hematemesis and was treated endoscopically. A total of 136 patients with pernicious anemia-associated gastric carcinoids have been described in the literature. Their clinical characteristics are also reviewed.
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PMID:Pernicious anemia and gastric carcinoid tumor: case report and review. 926 Aug 13


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