Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-seven Japanese patients with so-called primary non-Hodgkin's lymphoma of the central nervous system (CNS-NHL), unrelated to the acquired immunodeficiency syndrome (AIDS) or organ transplantation, were reviewed. The patients' ages ranged from 1 to 87 years (median: 58 years) with a male to female ratio of 1.77:1. The most frequent past histories were acute appendicitis (appendectomy), head injury, uveitis or iritis, and gastritis or gastric ulcer. These patients presented with symptoms suggesting an expanding intracranial lesion with no signs of extracranial lymphomatous disease. Combined computed tomographic scans, angiography, and findings at surgery or autopsy showed that the cerebrum was the commonest site of involvement, 87% of all cases, with the frontal to temporal region being the most commonly involved. Histologically, the diffuse large-cell type was most frequent and 26% of lymphomas were of high-grade malignancy as defined by the Working Formulation. The reported frequency of high-grade CNS-NHLs in AIDS patients in the United States is much higher (over 60%). Immunohistochemistry on paraffin-embedded sections revealed a B-cell nature of the present series of tumors. In 16% of the cases, large numbers of small lymphoid cells with a positive reaction predominantly for anti-T lymphocyte antibodies surrounded the tumors or aggregated around the capillaries. The tumors which were infiltrated by small lymphoid cells showed more favorable prognosis than those which were not, suggesting a host reaction to tumor growth in these patients.
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PMID:Malignant lymphoma of the central nervous system in Japan: histologic and immunohistologic studies. 232 40

The possible carcinogenic effects of antisecretory agents used in the treatment of gastric and duodenal ulcer were investigated in a population based cohort study of 16,739 patients who were prescribed the H2-antagonist cimetidine between 1977 and 1981. An excess risk for gastric cancer was observed, with a relative risk of about 10 in the first year after beginning use of the drug, which decreased thereafter. A similar pattern was seen for cancers of the colon, pancreas and gall bladder, and for non-Hodgkin's lymphoma. These increased risks probably represent cases in which a malignancy was misdiagnosed as a gastric ulcer. The excess risk for gastric cancer was unaffected by the method of diagnosis, the risk in those who had undergone an endoscopy being similar to those who had been diagnosed by an x-ray examination. A relative risk of 1.5-2.0 was observed for cancer of the respiratory organs, with no effect of latency, indicating that there are common risk factors for peptic ulcer and for lung cancer. Although the observed increases in cancer risk in persons receiving cimetidine is probably caused by factors other than a carcinogenic action of the drug itself, this possibility cannot be ruled out because of the short period of follow up.
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PMID:Cancer occurrence in a cohort of patients treated with cimetidine. 259 42

We report herein the case of a 65-year-old man who developed non-Hodgkin's lymphoma of the gastric stump 9 years after undergoing a distal gastrectomy for a gastric ulcer. The patient presented with epigastric discomfort, and an upper gastrointestinal series and gastroscopy revealed a lymphoma lesion located close to the site of his gastroduodenal anastomosis. A total gastrectomy was performed, followed by combination chemotherapy, comprised of vincristine, Endoxan, prednisone and Adriamycin (VEPA). Histologically, the resected specimen was diagnosed as non-Hodgkin's lymphoma. The patient has remained well without any signs of recurrence for 18 months since his operation. Although there have been a number of reports of adenocarcinoma developing in the gastric stump following surgery for peptic ulcers, the development of malignant lymphoma under such conditions is rare. Following the presentation of this case, we review the available literature and discuss the possibility of malignant lymphoma developing in the gastric stump.
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PMID:Non-Hodgkin's lymphoma of the gastric stump developing 9 years after a distal gastrectomy for a peptic ulcer: a case report and review of the literature. 786 58

Helicobacter pylori is a curvilinear motile gram-negative bacillus which is now recognized as the principal cause of type B gastritis, duodenal ulcer, gastric ulcer and MALT lymphoma. There is also a high degree of association between H. pylori gastritis and gastric carcinoma and non-Hodgkin's lymphoma of the stomach. H. pylori infection of the stomach is the most frequent chronic infection in the world. H. pylori is an extraordinary pathogen with virtually unrivaled versatility. The organism possesses the capacity to colonize and prosper in the hostile acidic gastric lumen, an environment in which other microorganisms cannot survive. H. pylori contains and expresses an assortment of proinflammatory biomolecules. H. pylori also stimulates host cells to release proinflammatory substances which participate in the initiation and perpetuation of inflammation and tissue injury. H. pylori elaborates a potent urease and a variety of other enzymes necessary for colonization and expression of the organism's pathogenicity. H. pylori is usually acquired in childhood, believed usually by fecal-oral transmission. The principal lesion induced by H. pylori is type B gastritis, which begins as acute inflammation involving the antrum. Type B gastritis then extends to the entire stomach with gradual progression to chronic gastritis and variable degrees of gastric mucosal atrophy. Much now is known but much more remains to be learned about H. pylori and the diseases which this extraordinary pathogen produces.
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PMID:Helicobacter pylori: the versatile pathogen. 890 15

The possibility of using [18F] FDG PET for assessment of tumor extension in primary gastric non-Hodgkin's lymphoma (NHL) was studied in 8 patients (6 high-grade and 2 low-grade, one of the MALT type) and in a control group of 7 patients (5 patients with NHL without clinical signs of gastric involvement, 1 patient with NHL and benign gastric ulcer and 1 patient with adenocarcinoma of the stomach). All patients with gastric NHL and the two with benign gastric ulcer and adenocarcinoma, respectively, underwent endoscopy including multiple biopsies for histopathological diagnosis. All patients with high-grade and one of the two with low-grade NHL and the patient with adenocarcinoma displayed high gastric uptake of [18F] FDG corresponding to the pathological findings at endoscopy and/or CT. No pathological tracer uptake was seen in the patient with low-grade gastric NHL of the MALT type. In 6/8 patients with gastric NHL, [18F] FDG PET demonstrated larger tumor extension in the stomach than was found at endoscopy, and there was high tracer uptake in the stomach in two patients who were evaluated as normal on CT. [18F] FDG PET correctly excluded gastric NHL in the patient with a benign gastric ulcer and in the patients with NHL without clinical signs of gastric involvement. Although the experience is as yet limited, [18F] FDG PET affords a novel possibility for evaluation of gastric NHL and would seem valuable as a complement to endoscopy and CT in selected patients, where the technique can yield additional information decisive for the choice of therapy.
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PMID:[18F] FDG PET in gastric non-Hodgkin's lymphoma. 940 47

Certain aspects of the use of CT, MR imaging and PET were evaluated in patients with non-Hodgkin's lymphoma (NHL) with the aim of determining whether these methods may provide practical guidance for improving the management of these patients. Subjective evaluation of the tumor pattern on CT images, and quantification of tracer uptake using 11C methionine (11C Met) and [18F] fluorodeoxyglucose (18FDG) PET in patients with NHL, were performed to determine their relations to malignancy grade. An inhomogeneous tumor pattern (I) was found on CT in 75% of high-grade tumors, whereas 68% of low-grade tumors were homogeneous (H). Sixteen (94%) of the 17 tumors with a severely inhomogeneous pattern (I) were high-grade NHL, while 22 (72%) of the 29 homogeneous tumors (H) were low-grade. All tumors were clearly visualized with both 11C Met and 18FDG PET. The uptake values for 18FDG were significantly-higher in high- than in low-grade tumors, while no significant differences between the prognostic groups were found for 11C Met. A subjective evaluation of the tumor pattern on CT and on MR images was performed. An inhomogeneity index (IH8) was also used in MR images to make a quantitative assessment of the degree of inhomogeneity to determine their relation to prognosis. Patients with localized NHL, treated with radiotherapy, had an excellent prognosis irrespective of the degree of inhomogeneity, while patients with generalized disease, treated with chemotherapy, had a poor prognosis if the tumors were heterogeneous. Among chemotherapy-treated patients, all 9 patients with high IH8 values (> 2.56) on MR images and 9 out of 11 patients with severe inhomogeneities on CT images died. All patients with gastric NHL except for one patient with low-grade NHL of the MALT type displayed high 18FDG uptake at PET corresponding to the pathological findings at endoscopy and/or CT. 18FDG correctly excluded gastric NHL in a patient with benign gastric ulcer, but was unable to discriminate between gastric NHL and gastric carcinoma. The results suggest that 18FDG PET may demonstrate the extension of NHL in the gastric wall more accurately than CT and endoscopy. The prognostic importance of the size of a residual mass after completion of chemotherapy, and of tumor regression rates during chemotherapy, was evaluated in patients with high-grade NHL. Neither a large tumor size before treatment nor a large residual tumor after treatment correlated with relapse. It appears, however, as if the response rate halfway through the therapy may predict the recurrence rate, although statistical significance was not reached.
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PMID:Computed tomography, magnetic resonance imaging and positron emission tomography in non-Hodgkin's lymphoma. 964 67

A 38-year-old woman with human immunodeficiency virus who was recently diagnosed with gastric ulcer presented to the hospital with nausea and vomiting of 1 month's duration. Work-up of patient led to a diagnosis of diffuse, large B-cell non-Hodgkin's lymphoma. The patient underwent six cycles of chemotherapy, and repeated endoscopy and biopsy failed to reveal malignancy. She remains in remission 23 months posttreatment. Management of patients with human immunodeficiency virus and concurrent malignancy remains a challenge. The primary care physician plays a central role by collaborating with infectious disease and oncologist specialists to formulate a management plan.
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PMID:Non-Hodgkin's lymphoma in a patient with human immunodeficiency virus. 1132 14

We report the case of a 77-year-old man who developed low grade B cell non-Hodgkin's lymphoma of the gastric stump 5 years after undergoing a distal gastrectomy for benign gastric ulcer. Lymphoma occurring in the post-operative stomach would appear to be very rare, with only 14 previously recorded cases. The median period of lymphoma onset after ulcer surgery is about 20 years (range 9-43 years) and gastric remnants of lymphoma are generally diagnosed in low stage, when surgery is possible and makes the prognosis good. The clinical case presented herein is quite different from the others. The patient developed lymphoma within 5 years of the ulcer surgery, thus, earlier than generally reported in literature; he presented with massive regional and extra-regional nodes involvement and liver metastases and he poorly responded to antiblastic chemotherapy. The pathogenetic role of Helicobacter pylori (HP) infection and the possibility of malignant lymphoma developing in the gastric stump are discussed.
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PMID:Gastric stump lymphoma five years after distal gastrectomy. 1268 60