Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An 89-year-old woman was seen for indigestion, light chest pain, and melanotic stools. Endoscopic examination revealed 2 submucosal gastric masses. A subtotal gastrectomy showed 2 submucosal masses in the stomach: one infiltrating through the muscularis propria into the serosa, the second one, a well-circumscribed submucosal nodule. Histologic examination showed large tumor cells infiltrating diffusely through the muscularis propria into the subserosa. On higher magnification, numerous signet ring cells were present against a myxoid stroma, in addition to large vacuolated epithelioid cells. There was no evidence of invasion, necrosis, nuclear pleomorphism, or mitotic activity. Initial diagnostic considerations based on the histology included signet ring cell carcinoma, malignant melanoma, and a myxoid mesenchymal tumor, including gastrointestinal stromal tumor. A panel of immunohistochemical stains showed diffuse strong positivity for S-100 protein and negative reaction for CD117, bcl-2, cytokeratin AE1/AE3, Melan-A, HMB45, smooth muscle antigen, and other differentiation markers. Electron microscopic examination revealed elongated, complex, and interdigitating cell processes covered by a thin layer of continuous basement membrane material characteristic of peripheral nerve sheath differentiation. The presentation of this tumor was significant in that it was multifocal and infiltrative, mimicking a malignant neoplasm. The extensive myxoid/signet ring cell change represents a heretofore-unreported histologic variant of gastric schwannoma.
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PMID:Signet ring cell gastric schwannoma: report of a new distinctive morphological variant. 1832 78

Desmoplastic spindle cell tumor of the liver is a recently described and extremely unusual neoplasm that affects children and young adults. We report 1 case in a 33-year-old man. The patient had abdominal pain and dyspepsia. Abdominal examination showed that the liver was enlarged and palpable until umbilical region. Laboratory studies demonstrated positive serologic markers to hepatitis B virus. All other analytical studies were irrelevant. Computed tomography revealed a large tumor mass in left hepatic lobe showing heterogeneous densities, with hyperdense peripheral areas, as multiple nodular calcifications of less than 1 cm. In the central part of the mass, a big hypodense area was observed. There was no evidence of extrahepatic disease. Grossly, the tumor was well circumscribed with multiple nodular calcifications. The tumor was characterized by the presence of cohesive nests of bland spindle cells arranged in short fascicles and surrounded by desmoplastic stroma, intermixed with epithelioid cells. Mitotic activity was very low. Extensive osteoid formation was seen inside the cell nests. The tumor cells showed cytoplasmic reactivity for vimentin and pan-cytokeratin. The cells of desmoplastic stroma were immunoreactive for actin. The biologic behavior is still uncertain with only 5 published cases, but current information suggests that they are low-grade tumors with an indolent course. The clinical and morphologic features of this tumor are very similar to those of tumors previously reported as "nested stromal-epithelial tumor of liver" and "ossifying stromal-epithelial tumor of liver." We describe the histologic, immunohistochemical, and molecular genetic features of a case of desmoplastic spindle cell tumor of the liver and review the literature.
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PMID:Desmoplastic nested spindle cell tumor of the liver in an adult. 2012 57

A 72-year-old female presented with dyspepsia for 2 years and an incidental mass in the head of the pancreas on abdominal computed tomography (CT) scan. Patient had multiple negative endoscopic ultrasound guided biopsies. She was followed up for 3 years with serial imaging until an abdominal CT scan showed an increase in size of the pancreatic mass. Physical examination was unremarkable. Laboratory tests including tumor markers were normal. Given the enlarging size of the mass and its impingement on the portal vein, the consensus was to proceed with surgery. Histology revealed a 3.5 cm mass showing a spindle cell neoplasm with mild atypia. The lesion was well defined and nerve tissue was noted at the periphery. On immuno-stains, the spindle cells were positive for S-100 protein and negative for pan-cytokeratin, CD-34, CD-117, smooth muscle actin and Melan A, consistent with the diagnosis of a pancreatic schwannoma.
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PMID:Enlarging Pancreatic Schwannoma: A Case Report and Review of the Literature. 2691 99

Pseudomyxoma peritonei (PMP) is a rare disease that usually originates from mucinous neoplasms of the appendix and, less commonly, from extra-appendiceal tumors, but it may also be caused by synchronous primary mucinous tumors of the ovary and appendix. The current study discusses the case of a 73-year-old female who presented with progressively worsening indigestion and abdominal distension. Magnetic resonance imaging of the pelvis revealed a large cystic mass with a thin enhancing septa arising from the right ovary and ascites with scalloping of the liver surface. On laparotomy, the patient was observed to have a large ruptured mass on the right ovary and a partially amputed distended appendix filled with mucin. The subsequent pathology report confirmed a borderline mucinous tumor of the right ovary and a low-grade appendiceal mucinous neoplasm associated with PMP. Immunohistochemical examination demonstrated the ovarian tumor stained strongly positive for cytokeratin (CK)-7, and negatively for CK-20 and homeobox protein CDX-2 (CDX2), whereas the appendiceal tumor stained negative for CK-7 and positive for CK-20 and CDX2. This study presents a rare case of PMP caused by synchronous primary mucinous tumors of the ovary and appendix in a postmenopausal female.
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PMID:An unusual case of pseudomyxoma peritonei associated with synchronous primary mucinous tumors of the ovary and appendix: A case report. 2859 82