Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0740577 (acute abdominal pain)
 1,982 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

30-year-old woman admitted for acute abdominal pain with peritoneal signs was immediately operated with findings of hemorrhage in small pelvis. Laparotomy revealed hemorrhagic, friable mass 3 cm in maximum diammeter arising from the uterine horn. The neoplasm broadly invaded myometrium with no evidence of endometrial cavity involvement. Microscopically, the tumor displayed solid mosaic pattern and consisted of large epithelioid cells with ample eosinophilic, finely granular cytoplasm ongoing apparent clear cell change elsewhere. There was marked nuclear irregularity with numerous atypical mitotic figures and multiple bizarre giant elements dispersed throughout the lesion. Unusual complex phenotype included co-expression of vimentin, smooth muscle actin, desmin, HMB45, Melan A, CD10 and EMA. No obvious stigmata of tuberous sclerosis were found and a five months follow-up after chemotherapy indicated no progression of disease. With some uncertainty the tumor was finally rendered as pleomorphic leiomyosarcoma with peculiar melanocytic differentiation. PEComa as an alternative term was coined. Expressed are both difficulty in explaining the histogenesis and ambiguity of the existing terminology of the uterine tumors with mixed myoid and melanocytic phenotype. Reviewed is the literature and discussed is the differential diagnosis.
 ...
PMID:[Pleomorphic epithelioid/clear cell malignant tumor of the uterus exhibiting both myoid and melanocytic differentiation--leiomyosarcoma or PEComa? A case report and a review of the literature]. 1782 38

Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin) confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic) rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.
...
PMID:Spontaneous splenic rupture in melanoma. 2479 27

Meckel diverticulum is the most common congenital defect of the gastrointestinal tract. It can be asymptomatic or mimic appendicitis and may be complicated by bleeding, diverticulitis, obstruction, and, rarely, neoplasia. We report the first case of extranodal marginal zone lymphoma occupying a Meckel diverticulum. A 44-year-old man with history of colonic diverticulitis presented to the emergency department for evaluation of acute abdominal pain. Radiography showed enteric obstruction, prompting diagnostic laparoscopy. Above the level of mid-ileum an intact Meckel diverticulum was identified. Microscopy showed extensive infiltration of sheets of small lymphocytes with abundant cytoplasm (monocytoid B-cells) prominently in submucosa and focally transmural involving serosal adipose tissue with multiple reactive germinal centers. The immunostains showed positivity for CD20, BCL-2, and CD43 (weak) and negativity for CD3, CD5, BCL-1, CD10, and BCL-6 in monocytoid B-cells. Fluorescence in situ hybridization studies revealed API2-MALT1 fusion signals consistent with t(11;18)(q21;q21), which confirmed the diagnosis of extranodal marginal zone lymphoma, also known as mucosa associated lymphoid tissue lymphoma.
...
PMID:Extranodal Marginal Zone Lymphoma Presenting within the Meckel Diverticulum as Diverticulitis: A Case Report. 2486 77