Leucopenia as presentation of sarcoidosis

A 20-year-old male Saudi national presented initially with leucopenia and splenomegaly. The absence of other signs of disease, progressive pancytopenia and normal bone marrow examination posed a diagnostic dilemma as to the cause of hypersplenism. Subsequently, the patient had splenectomy the histopathological appearance of which was non-caseating granuloma. A high level of angiotension converting enzyme [ACE] was found in this patient. Sarcoidosis is a recognized cause of hypersplenism, and though the disease is not yet widely described in this part of the world. It is the most probable diagnosis in this patient

Gastric cancer: a Clinicopathological analysis of 54 cases seen at Asir central hospital, Abha, Saudi Arabia

To study the clinicopathological patterns and outcome of treatment of gastric cancer as seen at Asir Central Hospital and compare them with other studies in other regions. Retrospective analysis of patients' data, as collected from their files, over a 4-year period [June 1989-June 1993]. Asir Central Hospital, Abha, Saudi Arabia. Patients with gastric malignancy. Fifty-four patients were considered for this study. The male:female ratio was 2.2:1, and the age range was 25-85 years [mean =63 years]. The most common symptoms were epigastric pain [81%], weight loss [70%] and vomiting [61%]; while epigastric tenderness [50%] was the most common sign. Tumours were located in the antrum in 41% and in the fundocardiac region in 30% of cases. Adenocarcinoma constituted 80% of malignancies, of which, the intestinal type was the commonest lesion [93%]. Ninety-eight per cent of patients had advanced disease and, therefore, had palliative treatment. Twenty-eight [51.9%] patients had subtotal gastrectomy, 20 [37%] had total gastrectomy, three [6%] had laparotomy and bypass procedures and three [6%] had only laparotomy and biopsy. The hospital mortality was 15% i.e. eight patients; four [20%] had total gastrectomy, one [3.6%] had subtotal gastrectomy, and the remaining three died after laparotomy and bypass or biopsy operations. The clinicopathological pattern of gastric cancer in our patients is not significantly different from that of other regions of the Kingdom. Judging from the infra-hospital mortality rate, it seems that subtotal gastrectomy would be the preferred therapeutic option unless the whole stomach is involved with the tumour