ABSTRACT
Gastrointestinal involvement has been reported to occur in about 5 to l0% of patients with lymphoma. The most common gastrointestinal site for a lymphoma is the stomach, followed by the small intestine and ileocecal region. When lymphoma is found in the esap us, generally it is with contiguous involvement of the gastric fundus, the cervical node, secondary to mediastinal lymph node compression, or a late manifestation of advanced desease. Such cases cannot be labeled as primary esophageal lymphoma. A search of the literature reveals that there have been about 20 or more published cases classified as esophageal lymphoma. However, more than ten cases are indistingishable from the case of distal esophageal involvement by gastric lymphoma. In 1935, Chiolero described a case of midesophageal stricture, which at autopsy was consistent with Hodgkin's disease for the first time. Berman reported an authentic case of primary histiocytic lymphoma confined to the lower esophagus. Only six or more cases were reported in literature until the present time. Here, a 30-year-old man with substernal discomfort was shown to have a mass lesion on the esophagus. The mass was proved to be malignant lymphoma on the histologic examination. This may be the first report dealing with spontaneous regression of maligant lymphoma of the esophagus possibly associated with the use of cimetidine.
Subject(s)
Adult , Humans , Autopsy , Cimetidine , Constriction, Pathologic , Esophagus , Gastric Fundus , Hodgkin Disease , Intestine, Small , Lymph Nodes , Lymphoma , Lymphoma, Large B-Cell, Diffuse , StomachABSTRACT
Herpetic esophagitis is a rare disease occuring mostly ie immunocompromised and cancer patient. It is also documented as self-limiting esopbagitis in young healthy adults. We report here a 30- year-old immunocompetent male patient with esophageal ulceration. Heryetic esophagitis was diagnosed by characteristic endoscopic and microscopic findings. And the diagnosis was confirmed by electron microscopic appearance. This immunocompetent patient recovered spontaneously with symptomatic treatment only. And repeat endoscopy and histology confirmed absence of herpes infection.
Subject(s)
Adult , Humans , Male , Diagnosis , Endoscopy , Esophagitis , Rare Diseases , UlcerABSTRACT
The ischemic coitis proximal to obstructive colon cancer was firstly reported by MacCallum and Kaisch in 1947. Nowsdays, its clinical importance and the study of pathogenesis is reported frequently. Because of the rare inciedence of this complicated condition this lesion could be overlooked which then could result anastomotic leakage, fecal fistula and peritonitis. Recently, we have examined a 61 year-old Korean male patient who had the complaints of acute abdominal pain and bloody diarrhea. The diagnosis of gangrenous ischemic colitis associated with obstucting rectal cancer was confirmed on the basis of sigmoidoscopic and operative and associated histopathological findings. After prompt surgical intervention, the patient was discharged with good improvement. The literatures are reviewed here with the case presentation.
Subject(s)
Humans , Male , Middle Aged , Abdominal Pain , Anastomotic Leak , Colitis, Ischemic , Colonic Neoplasms , Diagnosis , Diarrhea , Fistula , Peritonitis , Rectal NeoplasmsABSTRACT
Percutaneous transhepatic biliary drainge (PTBD) is a widely accepted technique for the decotnn of biliary obstruction. However, PTBD is most frequently performed in patients whose prognosis is poor becauase of unresectable malignancy, sepsis, or advanced age. And this technique has disadvantages which inclusdes loss of biliary fluids, fat malabsorption, discomfort and psychologic problem for many patients. A 68-year-old man admitted to the hospital because of obstructive jaundice. He had received cholectystectomy two yeas ageo due to the perforation of gallbladder caused by adenocarcinoma of cystic duct. An external PTBD was placed. But because of the chronic bile loss, a percutaneous endoscopic gastrostomy (PEG) was inserted and drainge of bile into the stomach through an extracoporeal circuit utilizing the PTBD as an exit and PEG as an entrance was achieved.
Subject(s)
Aged , Humans , Adenocarcinoma , Bile , Cystic Duct , Drainage , Gallbladder , Gastrostomy , Jaundice, Obstructive , Prognosis , Sepsis , StomachABSTRACT
To determine the effect of verapamil on experimental duodenal ulcer, pathologic assessment and secretory study were performed in the rats with ulcerogenic dose of cysteamine. The cysteamine increased gastric acid secretion and produced double duodenal ulcers at the proximal protion of the duodenum. Intramuscular injection of verapamil, 3 hours later, produced a significant decreased in gastric acid secretion which lasted at least 4 hours (cysteamine vs. cysteamine+ verapamil; 63.5 +/- 18.4 muEq vs. 25.5 +/- 9.0 muEq during the 1st hour after verapamil administration, 83.1 +/- 24.2 muEq vs. 27.8 +/- 12.3 muEq during the 2nd hour, 110.9 +/- 14.4 muEq vs. 38.5 +/- 25.9 muEq during the 3rd hour, 116.4 +/- 12.1 muEq vs. 40.7 +/- 29.6 muEq during the 4th hour, p less than 0.001). However, cysteamine-induced duodenal ulcers were not alleviated by two doses of intramuscular verapamil administration (4 mg/kg x 2). It is presumed that suppression of gastric acid secretion may not be sufficient to reduce cysteamine-induced duodenal ulcer formation or that verapamil itself may have aggresive effects against duodenum. To illucidate the exact role of verapamil in cysteamine-induced duodenal ulcer, further studies would be needed.