National Cancer Institute®
Last Modified: July 1, 2002
UI - 11976826
AU - Tsuchiyama J; Yoshino T; Imajo K; Kondou E; Hamada E; Tomiyama Y; Toba
TI - K; Furukawa T; Fuse I; Aizawa Y; Harada M; Tsubota T Lymphomatous polyp of mantle cell type in the duodenum complicated by gastric cancer: a case of trisomy 3 and t(11;14)(q13;q32).
SO - Ann Hematol 2002 Apr;81(4):224-7
AD - First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi 1-754, 951, Japan. email@example.com
We experienced a rare case of a lymphomatous polyp of mantle cell type forming a polypoid mass lesion in the duodenum bulbous together with advanced gastric cancer. A total gastrectomy was performed, and the specimen revealed atypical small- to medium-sized lymphoid cells with indented nuclei, which infiltrated the Peyer's patch and formed a nodular mass in the lamina propria and submucosa of the duodenum. The lymphoma cells also infiltrated the lymphoid follicle of the gastric mucosa, spleen, and regional lymph node with a typical mantle zone pattern. Flow cytometric analysis of the single cells of the lymph node and immunohistochemistry of a paraffin-embedded specimen revealed that the lymphoma cells expressed surface CD5, CD19, CD20, and nuclear cyclin D1. Chromosomal analysis of this single cell suspension revealed that these lymphoma cells have trisomy 3 in conjunction with t(11;14)(q13;q32), which is frequently seen in mucosa-associated lymphoid tissue lymphomas (MALToma) in the stomach and is also reported in mantle cell lymphoma as a secondary genetic alteration. Our report suggests that trisomy 3 may be a common chromosomal abnormality in lymphomatous polyps of mantle cell type.
UI - 12064872
AU - Jiao YF; Nakamura S; Sugai T; Habano W; Uesugi N; Oikawa M; Sato T
TI - p53 gene mutation and MDM2 overexpression in a case of primary malignant fibrous histiocytoma of the jejunum.
SO - APMIS 2002 Feb;110(2):165-71
AD - Division of Pathology, Central Clinical Laboratory, School of Medicine, Iwate Medical University, Uchimaru, Morioka, Japan.
Primary malignant fibrous histiocytoma of the gastrointestinal tract is extremely rare. To date, only 10 cases of primary malignant fibrous histiocytoma arising in the small intestine have been reported in the English literature. We describe here the genetic alterations and morphologic features of a primary malignant fibrous histiocytoma arising in the jejunum. Immunohistochemically, the tumor cells expressed vimentin, CD68 and alpha-1-antitrypsin, but were negative for other markers. Ultrastructurally, they showed features of fibroblasts and histiocytes. Immunohistochemical overexpression of p53 and MDM2 was observed. Mutation analysis of the p53 gene detected a missense mutation in codon 158 of exon 5. Our results suggest that p53 gene mutations and MDM2 overexpression may play an important role in the tumorigenesis. To our knowledge, the present report is the first genetic study of this rare lesion.
UI - 12010890
AU - Phillips RK; Wallace MH; Lynch PM; Hawk E; Gordon GB; Saunders BP;
TI - Wakabayashi N; Shen Y; Zimmerman S; Godio L; Rodrigues-Bigas M; Su LK; Sherman J; Kelloff G; Levin B; Steinbach G; FAP Study Group A randomised, double blind, placebo controlled study of celecoxib, a selective cyclooxygenase 2 inhibitor, on duodenal polyposis in familial adenomatous polyposis.
SO - Gut 2002 Jun;50(6):857-60
AD - Colorectal Cancer Unit, Imperial Cancer Research Fund, London, UK.
BACKGROUND: Non-selective cyclooxygenase (COX) inhibitors (non-steroidal anti-inflammatory drugs) inhibit large bowel carcinogenesis in patients with familial adenomatous polyposis (FAP). Their role in the duodenum of these patients is less certain. The disease modifying activity of specific COX-2 inhibitors has not been explored in humans. Patients and methods: This was a randomised, double blind, placebo controlled study of celecoxib (100 mg twice daily (n=34) or 400 mg twice daily (n=32)) versus placebo (n=17), given orally twice daily for six months to patients with FAP. Efficacy was assessed qualitatively by blinded review of shuffled endoscopy videotapes comparing the extent of duodenal polyposis at entry and at six months and quantitatively by measurement of the percentage change in duodenal area covered by discrete and plaque-like adenomas from photographs of high and low density polyposis. RESULTS: Shuffled and blinded video review showed a statistically significant effect of 400 mg twice daily celecoxib compared with placebo treatment (p=0.033) with all five independent observers scoring a beneficial effect. Overall, patients taking celecoxib 400 mg twice daily showed a 14.5% reduction in involved areas compared with a 1.4% for placebo (p=0.436). However, patients with clinically significant disease at baseline (greater than 5% covered by polyps) showed a 31% reduction in involved areas with celecoxib 400 mg twice daily compared with 8% on placebo (p=0.049). CONCLUSIONS: A panel of five endoscopists found a significant reduction in duodenal polyposis after six months of treatment with celecoxib 400 mg twice daily. COX-2 inhibition may help this otherwise untreatable condition.
UI - 11824886
AU - Brown RS; Yassin J; Colville DH; Harland SJ; Payne HA
TI - First report of an isolated jejunal seminoma: presentation with melaena and iron deficiency anaemia.
SO - Clin Oncol (R Coll Radiol) 2001;13(6):455-7
AD - Middlesex Hospital, London, UK.
We present the case history of a man with isolated seminoma in the jejunum and abnormal testes but no provable malignant testicular disease. Treatment with cisplatin-based chemotherapy led to complete resolution of the jejunal seminoma. The rarity of seminoma involving the small bowel is highlighted. A literature search did not reveal other similar cases of isolated seminoma affecting the jejunum. The possible origins of this tumour are discussed.
UI - 12010304
AU - Cakirer S; Sirvanci M; Duran C
TI - Jejunojejunal intussusception secondary to lipoma in an adult.
SO - Acta Radiol 2002 Mar;43(2):196-7
AD - Department of Radiology, Istanbul Sisli Etfal Hospital and Kadir Has University, Turkey.
Lipoma is a rare cause of adult intussusception. We present the CT findings of an adult patient with jejunojejunal intussusception secondary to submucosal lipoma as the lead point in this case report.
UI - 11510613
AU - Kobayashi K; Narita H; Morimoto K; Hato M; Ito A; Sugiyama K
TI - Primary malignant fibrous histiocytoma of the ileum: report of a case.
SO - Surg Today 2001;31(8):727-31
AD - Department of Surgery, Kakegawa Municipal Hospital, Sugiya, Japan.
We report herein a case of primary malignant fibrous histiocytoma (MFH) of the ileum. A 71-year-old Japanese man was admitted to our hospital with symptoms of abdominal pain and anorexia. Computed tomography, magnetic resonance imaging, a follow-through study of the small intestine, and angiography all demonstrated a tumor of the ileum suggestive of a primary malignancy. A partial resection of the ileum was performed. It was histopathologically and immunohistochemically diagnosed to be a storiform-type primary MFH of the ileum with peritoneal dissemination. There have been a total of 25 cases of primary small bowel MFH documented in the Japanese or Western literature including our case. The malignant potential of such tumors is high, and the prognosis tends to be very poor. Unfortunately, we could not conclude whether the poor outcome was due to a delayed diagnosis or instead to its biological malignant behavior, since the number of such reported cases is still too small to make any definitive conclusions.
UI - 11702164
AU - Schneider G; Seidel R; Altmeyer K; Remberger K; Pistorius G; Kramann B;
TI - Uder M Lymphangioma of the pancreas and the duodenal wall: MR imaging findings.
SO - Eur Radiol 2001;11(11):2232-5
AD - Department of Diagnostic Radiology, University Hospital, 66421 Homburg/Saar, Germany. firstname.lastname@example.org
Pancreatic lymphangiomas are rare benign tumours with a histogenesis not yet completely understood. Predominantly the cystic aspect of this lesion can complicate the differentiation from other neoplastic and non-neoplastic cystic tumours of the pancreas. We present a case of a middle-aged woman with a lymphangioma involving the duodenal wall and the pancreatic head. With special regard to MR imaging findings differential diagnosis is discussed.
UI - 11922580
AU - Avendano-Garcia M; Mercado U; Marin ME
TI - A case of Peutz-Jeghers syndrome associated with duodenal carcinoma and sickle cell anemia.
SO - Am J Gastroenterol 2002 Mar;97(3):762-3
UI - 11901452
AU - Gerber T; Bontikous S; Smolka G; Vestring T; Schmidt D; Gickler W
TI - [Cystic lymphangioma with endosalpingiosis as a rare cause of gastrointestinal bleeding]
SO - Z Gastroenterol 2002 Mar;40(3):183-8
AD - Medizinische Klinik II, Klinikum Osnabruck.
We report on a 31-year-old woman with an iron-deficiency anemia and positive Guaiac test, existing for more than 2 years. Despite an extensive gastrointestinal examination a bleeding source could not be found. Also angiography of the abdominal arteries with injection of heparin as provocative protocol was normal. Enteroclysis showed a remarkable finding which led to laparotomy. A cystic lymphangioma with endolymphatic endosalpingiosis as the bleeding source was identified and removed.Lymphangioma is a rare benign soft tissue tumor which usually appears during the first 2 years of life. Only in some cases the lymphangioma is intraabdominal and there can be different, no specific symptoms. Endosalpingiosis is also a rare benign disease, it consists of scattered epithelium of the Fallopian tube. It is the first case to our knowledge, in which the appearance of the endosalpingiosis in a lymphangioma is described.
UI - 11901454
AU - Laukhuf F; Tischer KH; Strobel K; Wietholtz H
TI - [Crohn's disease and stromal sarcoma of the small bowel--a rare coincidence]
SO - Z Gastroenterol 2002 Mar;40(3):193-6
AD - Klinikum Darmstadt, Medizinische Klinik II, Germany.
We report the case of a 29-year-old female who suffers for more than 13 years from Crohn's disease. A small bowel resection had to be performed because of a complicated and insufficiently controlled course of the disease with beginning subileus.At laparotomy a leiomyosarcoma was found. This case represents the forth case in the literature of an association between chronic inflammatory bowel disease and malign mesenchymal tumors. Tumors of epithelial and lymphoreticular origin are known as a much more common complication in Crohn's disease and especially ulcerative colitis. An exact histological characterization of these sarcomas is important to define the prognosis of the disease. If recurrent subileus is poorly controlled in Crohn's disease stromal tumors with their frequent intraluminal growth have to be considered as part of the differential diagnosis.
UI - 12079162
AU - Lee KF; Lin PY; Cheung YC
TI - Leiomyomatosis of mesenteric lymph nodes associated with duodenal adenocarcinoma.
SO - Chang Gung Med J 2002 Apr;25(4):271-4
AD - Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Leiomyomatosis of lymph nodes is an extremely rare disease. Only a few cases have previously been reported in pelvic lymph nodes. They were related to a benign uterine leiomyoma, a metastasizing uterine leiomyoma, an endometrial adenocarcinoma, and an ovarian endometrioid carcinoma. We report on a case of leiomyomatosis of the mesenteric lymph nodes associated with a duodenal adenocarcinoma with no history of uterine leiomyoma or any gynecological malignancy. The patient, a 56-year-old woman, was found to have an adenocarcinoma of the duodenum. All mesenteric lymph nodes removed showed leiomyomatosis, which was verified by immunohistochemical study showing positive immunostaining for smooth muscle actin, desmin, and vimentin, but negative staining for HMB-45. It is necessary to make a differential diagnosis from other examples of spindle cell proliferation involving lymph nodes such as a hemorrhagic spindle cell tumor with amianthoid fibers (palisade myofibroblastoma), angiomyolipoma, lymphangiomyomatosis, inflammatory pseudotumor, and Kaposi's sarcoma.
UI - 12082685
AU - Allal AS; Bischof S; Nouet P
TI - Impact of the "belly board" device on treatment reproducibility in preoperative radiotherapy for rectal cancer.
SO - Strahlenther Onkol 2002 May;178(5):259-62
AD - Radiation Oncology Division, University Hospital of Geneva, Geneva, Switzerland. Abdelkarim.Allal@hcuge.ch
BACKGROUND: The use of the belly board device (BBD) in the prone position has gained acceptance to spare small bowel in rectal cancer patients irradiated postoperatively, but there are few data in the preoperative setting, and the advantages of the BBD regarding normal tissue sparing may be counteracted by problems of patient positioning. This study was undertaken to investigate prospectively the influence of the BBD on treatment reproducibility in patients irradiated preoperatively in the prone position. PATIENTS AND METHODS: 23 patients with rectal carcinoma in clinical stages II/III were included in this study. Axis displacement was evaluated in 14 patients treated without the BBD and nine with. The BBD is a commercial device (Belly Board, Radiation Products Design, Albertville, MN) made of a 17-cm thick hard sponge with an opening of 42 x 42 cm2. No specific patient immobilization devices were used. During radiotherapy, twelve patients had four control films, while eleven patients had three. The mean treatment position deviation was calculated for the medio-lateral, cranio-caudal and antero-posterior directions. RESULTS: When comparing the first control film to the corresponding simulation film for patients without the BBD and with the BBD, the mean lateral displacements were 1.5 mm and 3.2 mm (p = 0.26), the mean cranio-caudal displacements were 1.55 mm and 4.2 mm (p = 0.13), and the mean antero-posterior displacements were 1.8 mm and 4.5 mm (p = 0.04), respectively. When considering all control films, for the three directions, the amplitudes of the displacements were greater when using the BBD, particularly for the antero-posterior direction where the difference was highly significant (p = 0.0006). CONCLUSIONS: Our data show that, in patients treated prone for rectal cancer, the use of the BBD in the preoperative setting without immobilization devices was associated with problems of patient position reproducibility, particularly for the antero-posterior direction. Thus, the use of patient immobilization devices and/or individual custom-made BBD may be recommended if a decision to treat the patient with a BBD is taken.
UI - 12044697
AU - Tunaci M
TI - Carcinoma of stomach and duodenum: radiologic diagnosis and staging.
SO - Eur J Radiol 2002 Jun;42(3):181-92
AD - Department of Radiology, Istanbul Faculty of Medicine, 34390 Capa, Istanbul, Turkey. email@example.com
Gastric carcinoma is one of the leading causes of cancer mortality worldwide. Accurate preoperative staging of gastric cancer is important in planning the most effective therapy toward cure or palliation. This article reviews the radiologic diagnosis and staging of gastric cancer.
UI - 12044698
AU - Korman MU
TI - Radiologic evaluation and staging of small intestine neoplasms.
SO - Eur J Radiol 2002 Jun;42(3):193-205
AD - Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300 Kocamustafapasa, Istanbul, Turkey.
The small intestine is an uncommon location for neoplasms in either clinical or radiological practice. Because of its anatomic location and morphology, diagnosis of the diseases that affect small intestine pose difficulties. Symptoms are nonspecific and endoscopy is commonly unsatisfactory. Since early and definite diagnosis is crucial for prompt therapy, radiological imaging plays an essential role. Enteroclysis is the primary and effective radiologic modality in the evaluation of small bowel neoplasms. On the other hand, computed tomography should be the complementary radiologic method as well as for staging. In this review, the most common neoplasms of the small intestine and their common radiologic findings have been discussed.
UI - 11827193
AU - Takahashi M; Minabe D; Kotani A; Kito F; Koganei K; Fukushima T
TI - Successful resection of ampullary carcinoma in a father and adenoma in a daughter with familial adenomatous polyposis following detection by surveillance: report of two cases.
SO - Surg Today 2001;31(12):1100-3
AD - Division of Surgery, Yokohama Municipal Citizen's Hospital, Japan.
This report describes the successful resection of ampullary carcinoma in a 58-year-old man and an adenoma in his 28-year-old daughter after they had undergone proctocolectomy for familial adenomatous polyposis (FAP). Both patients had been monitored by surveillance endoscopy once a year since their proctocolectomy. The father was found to have an ampullary adenoma 26 years after proctocolectomy, and ampullary carcinoma was detected 2 years later, for which pancreatoduodenectomy was performed. Histological examination of the specimen revealed an ampullary carcinoma, 2.5 x 1.7 cm, that had invaded the submucosal layer, but no lymph node metastasis was found. The patient's daughter underwent endoscopy, which showed an ampullary polyp 6 years after total colectomy. Endoscopic mucosal resection of the periampullary lesion was performed, and histological examination revealed a dysplastic tubular adenoma 0.6 x 0.4 cm in diameter. This report reinforces the importance of long-term periodic surveillance of patients with FAP by gastroduodenal endoscopy.
UI - 11824067
AU - Di Cataldo A; Greco S; Caldarella P; Lanteri R; Li Destri G; Licata A
TI - Carcinoid of the ileocaecal valve: a case report.
SO - Chir Ital 2001 Nov-Dec;53(6):879-82
AD - Cattedra di Chirurgia dell'Apparato Digerente, Policlinico Universitario, Universita degli Studi di Catania.
The authors present a case of carcinoid of the ileocaecal valve. The patient complained for over one year of mild pain in the right lower quadrant of the abdomen. Colonoscopy had shown hyperaemia on the colic side of the ileocaecal valve which appeared substenotic and biopsy revealed micronodules formed by chromogranin-A-positive neuroendocrine cells. Roentgenography of the small bowel and barium enema revealed a specular filling defect in the caecum and in the terminal ileum near the ileocaecal valve. Right hemicolectomy was performed and the definitive diagnosis was carcinoid of the ileocaecal valve. The tumour had spread to all layers of the intestinal wall and 4/19 lymph nodes were metastatic. The patient refused an oncological examination; however, three years after surgery there are no signs of recurrence. Carcinoids have been included in the APUD system and usually present endocrine activity. The 5-year survival of patients with gastrointestinal carcinoids is 80% when located in the appendix and rectum as against 50% in the stomach, jejunum and colon, because the localisation in the appendix and rectum is marked by clinical signs of appendicitis and rectal bleeding, which suggest diagnostic examinations useful for an early diagnosis. Radical operations according to the rules of oncologically correct surgery are the treatment of choice, while complementary treatments have yet to be codified.
UI - 11818987
AU - Celis J; Ruiz E; Berrospi F; Payet E
TI - [Mechanical versus manual suture in the jejunal esophageal anastomosis after total gastrectomy in gastric cancer]
SO - Rev Gastroenterol Peru 2001 Oct-Dec;21(4):271-5
AD - Departamento de Abdomen, Instituto de Enfermedades Neoplasicas, Lima, Peru.
AIM: To compare the leakage rate of esophagojejunal anastomosis performed with stapler or hand sutures. MATERIAL AND METHODS: We studied a series of 367 patients who underwent total gastrectomy for gastric cancer at the Instituto de Enfermedades Neoplasicas (Lima-Peru) from 1986 to 1999. RESULTS: In 197 patients esophagojejunal anastomosis was performed with stapler and in 170 with manual sutures. There were no differences between both groups with regard to age, TNM stage, operating time and hospital stay. There were 8 anastomotic leakage (4.1%) in the stapler group and 4 (2.4%) in the hand sutures group (p> 0.05). Of these 12 cases, 2 patients (16%) died of causes directly related to the leak of the esophagojejunal anastomosis. CONCLUSION: There were no statistical differences in the rate of leakage of the esophagojejunal anastomosis performed with stapler or hand sutures, thus both techniques should be accepted as standard procedures.
UI - 11957383
AU - Konsten JL; Kazemier G; Dees J; van Eijck CH
TI - [Pancreas-preserving total duodenectomy due to familial adenomatous polyposis in 4 patients]
SO - Ned Tijdschr Geneeskd 2002 Mar 30;146(13):621-4
AD - Academisch Ziekenhuis Rotterdam-Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam.
In 4 patients with familial adenomatous polyposis (FAP) and multiple severe dysplastic adenomas in the duodenum (a 42-year-old woman and 3 men aged 44, 53 and 33 years, respectively), pancreas-preserving total duodenectomy (PPTD) was carried out. In 2 of the patients, serious early post-operative complications arose (leakage and haemorrhage of the gastrojejunostomy, respectively), and 1 patient developed a late complication (attacks of pancreatitis). During the 1-5-year follow-up period, small villous adenomas were seen in the jejunum (neoduodenum) of 1 of the patients. PPTD is a technically possible procedure which allows targeted treatment to be carried out if duodenum polyps are found upon endoscopic examination.
UI - 12077832
AU - Shoikhet IaN; Moskvitina LN; Slukhai EIu; Mar'ian AV; Smirnov AK
TI - [Surgical treatment of malignant tumors in the biliopancreatoduodenal zone]
SO - Khirurgiia (Mosk) 2002;(5):30-3
Results of surgical treatment of 381 patients with cancer of biliopancreatoduodenal zone associated with obstructive jaundice were analyzed. Mean level of bilirubinemia was 182 +/- 12 mcmol/l. Cholecystoanastomosis was created in the majority of cases (51.4%). Radical surgery was carried out in 31 patients. Postoperative complications were seen in 155 (41%) patients. Renal-hepatic failure (28.1%) and purulent-septic complications (25.2%) were dominant. Lethality after radical operations was 12.9%, after palliative--15.7%. Inhibiting effect of autoplasma on phagocytosis and decrease of phagocytosis indexes 1.5-2 times are the risk factors of postoperative purulent-septic complications development. Discrete plasmapheresis reduces of postoperative purulent-septic complications rate.
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