Neuroendocrine tumor of the gallbladder

Neuroendocrine tumors [NET] arise from neuroendocrine cells and are an exceedingly rare malignancy in the gallbladder. In this case report, a 52-year-old woman with complaints of episodic abdominal pain for two months prior was admitted to our hospital. She had no other signs and symptoms and her laboratory tests were within normal limits. Ultrasonography showed a broad-necked mass [26 x 12 mm] in the gallbladder for which she underwent laparoscopic cholecystectomy. The final pathological diagnosis was a high grade neuroendocrine carcinoma of the gallbladder with involvement of the lymph nodes and omentum. The patient received the chemotherapy regimens of gemcitabine plus cisplatin, followed by docetaxel plus sunitinib for her metastatic liver lesions. She also underwent radiofrequency ablation. Serial CT-scans revealed metastatic liver lesions that had decreased in size, with no significant improvement. The patient refused additional treatment and at 46 months, she was doing well with no complaints of any pain, disease recurrence, or metastatic progression

Clinical, high resolution computed tomography and pulmonary function in sulphur mustard victims

We aimed to evaluate clinical, high resolution computed tomography [HRCT] and pulmonary function test [PFT] findings after 18-23 years of exposure in veterans of sulphur mustard [SM] exposure. We performed a cross-sectional study of 106 patients. Inclusion criteria were 1: documented exposure to SM as confirmed by toxicological analysis of their urine and vesicular fluid after exposure 2: single exposure to SM that cause skin blisters and subsequent transient or permanent sequel. Cigarette smoking and pre-exposure lung diseases were of exclusion criteria. After taking history and thorough respiratory examination, patients underwent high resolution computed tomography and spirometry. Clinical diagnoses were made considering the findings. More than 85% of the patients were complaining of dyspnea and cough. Obstructive pattern [56.6%] was main finding in spirometry followed by restrictive and normal patterns. HRCT revealed air trapping [65.09%] and mosaic parenchymal attenuation patterns [58.49%] as most common results. Established diagnoses mainly were chronic obstructive pulmonary disease [COPD] [54.71%], bronchiolitis obliterans [27.35%] and asthmatic bronchitis [8.49%]. There were not any significant association between the clinical findings and results of PFT and HRCT imaging and also between PFT and HRCT findings [P-values were more than 0.05]. Considering debilitating and progressive nature of the respiratory complications of SM exposure, attempts are needed for appropriate diagnosis and treatment.

[DNA microsatellite instability and mismatch repair germ line mutation in Iranian patients with hereditary non-polyposis colorectal cancer]

HNPCC [hereditary non-polyposis colorectal cancer] is the most common type of hereditary colorectal cancers. Germ line mutations in different DNA mismatch repair genes [MMR] and microsatellite instability [MSI] are associated with HNPCC. But still there has not been any report from Iran. The purpose of this study is to evaluate MSI and MMR gene mutation among a group of Iranian patients with the clinical diagnosis of HNPCC. In this cross-sectional study 94 patients [m/f=1.41] who fulfilled at least on of the Bethesda criteria were assessed. MSI analysis was performed in all cases. SSCP was used as screening test in all cases to select highly probable MMR mutation for DNA sequencing. Information analyzed by Chi2, Fisher exact, independent t-test with SPSS16 and EPI6 soft wares. MSI analysis shows 41.5% MSI-H, 17% MSI-L, and 41.5% MSS in this study. There were 18 [19.1%] band shift in SSCP results, which was include 8 mutations after DNA sequencing. The pattern of MMR mutations in Iranian patients differs from the reports of other countries. The evaluation of the histopathology and clinical features of colorectal cancer burdens in Iran and also the frequency additional HNPCC genes remain as a point of concern

Gastritis cystica polyposa in an unoperated stomach, treated by endoscopic polypectomy

Gastritis cystic polyposa is a rare and peculiar polypoid lesion arising at a gas-troenterostomy site, and almost always on the gastric side. It is characterized by elongation of the gastric foveolae along with hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. Esophagogastroduodenoscopy in a 47-year-old woman without any history of gastric operation revealed a pedunculated polyp approximately 2 cm in diameter, in a background of erythematous gastric folds along the anterior wall of the fundus. Polypectomy was performed, with endoscopic impression of hyperplastic or fundic gland polyp, without any complications. Histopathological findings were consistent within gastritis cystic polyposa[GCP]. A mild Helicobacter pylori colonization in gastric pits was seen. GCP could occur in an unoperated stomach and treated by endoscopic polypectomy. However, removal and histopathologic confirmation of these lesions are necessary