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Objective:To analyze the clinicopathological features of histological mixed-type early gastric cancer and to compare the endoscopic pathological features of dominant proportions.Methods:Clinical data of 43 patients with histological mixed-type early gastric cancer who underwent endoscopic submucosal dissection (ESD) at the Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2015 to December 2020 were retrospectively analyzed. The endoscopic characteristics, coincidence rate of preoperative diagnosis and postoperative pathology of the patients were analyzed. The endoscopic pathological findings of differentiation dominant group and undifferentiation dominant group were compared.Results:Histological mixed-type early gastric cancer was more common in patients over 60 years old (55.81%, 24/43) , male (65.12%, 28/43), and Helicobacter pylori ( HP) infection (69.77%, 30/43). Most lesions were found in atrophic background (79.07%, 34/43), and lower part of stomach (65.12%, 28/43). Redness or mixed redness was the main color (76.74%, 33/43), and 0-Ⅱc was the main type in lesion morphology (58.14%, 25/43). Characteristics of both differentiated and undifferentiated carcinoma could be observed under magnifying endoscopy. Only 16.28% (7/43) of the patients were diagnosed as having histological mixed-type carcinoma by biopsy. Postoperative pathology showed that there were 33 cases in differentiation dominant group and 10 cases in undifferentiation dominant group. There were 15 (34.88%) patients with deep submucosal infiltration, and 3 (6.98%) patients with positive lymphatic vessels. Differentiation dominant group had clearer demarcation line under endoscopy [78.79% (26/33) VS 4/10, χ2=7.753, P=0.012]. There was no significant difference between the two groups in gender, HP infection, background mucosa, lesion location, endoscopic morphology, lesion long diameter, color, or microscopic and microvascular manifestations under magnifying endoscopy ( P>0.05). Tub2+por was the most common pathological type in differentiation dominant group (78.79%, 26/33), and sig+tub2 was the dominant combination in undifferentiation dominant group (6/10). Endoscopic diagnosis of differentiated primary carcinoma was highly sensitive (93.94%, 31/33), and highly specific for undifferentiated primary carcinoma (94.28%, 33/35). Conclusion:Histological mixed-type early gastric cancer can be diagnosed qualitatively by endoscopy. It is difficult to accurately judge the differentiation advantage and the invasion depth before the operation, which is prone to postoperative pathological upgrading. Therefore, the indications should be strictly considered for ESD treatment for mixed-type early gastric cancer.
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Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.
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Objective:To verify the accuracy of the Kyoto classification score of gastritis for the endoscopic prediction of the Helicobacter pylori( H. pylori)infection in Chinese population. Methods:From June 2020 to January 2021, at the Digestive Endoscopy Center of the First Affiliated Hospital of Zhejiang Chinese Medical University, the clinical data of 489 patients who underwent gastroscopy examination were collected and the gastric mucosal manifestations under white light endoscopy (including atrophy, intestinal metaplasia, widening of gastric fold, nodularity, diffuse redness, white sticky mucus, etc.) were recorded according to the Kyoto classification of gastritis. H. pylori infection of the patients was determined according to 13C-urea breath test, histopathological examination and anti- H. pylori antibody test. The Kyoto classification score of gastritis of each patient was calculated. The sensitivity, specificity and odds ratio( OR)(95% confidence interval(95% CI)) of various endoscopic appearances in prediction of H. pylori infection were analyzed. Chi-square test was used for statistical analysis. Results:Among the 489 patients, 246 patients had H. pylori infection and 243 patients did not have H. pylori infection. There were 242 patients with Kyoto gastritis score ≥ 2, among them 215 cases had H. pylori infection and 27 cases did not have H. pylori infection. The accuracy of Kyoto classification score of gastritis in predition of H. pylori infection was 88.14% (431/489). Among the five indexes of the Kyoto classification score of gastritis, there was no significant difference in the incidence of intestinal metaplasia between patients with H. pylori infection and patients without H. pylori infection ( P>0.05). The incidence rates of atrophy, widening of gastric fold, nodularity and diffuse redness were higher in patients with H. pylori infection than those in patients without H. pylori infection (68.3%, 140/205 vs. 31.7%, 65/205; 95.2%, 99/104 vs.4.8%, 5/104; 89.7%, 35/39, vs.10.3%, 4/39; 85.0%, 227/267 vs.15.0%, 40/267), and the differences were statistically significant ( χ2=45.68, 106.46, 26.37 and 283.48, all P<0.01). The sensitivity, specificity and OR (95% CI) of atrophy, widening of gastric fold, nodularity and diffuse redness in prediction of H. pylori infection were 56.91%, 73.25%, and 3.62 (2.47 to 5.29); 40.24%, 97.94% and 32.06 (12.76 to 80.57); 14.23%, 98.35%, 9.91 (3.47 to 28.35); and 92.28%, 83.54% and 60.63 (34.02 to 108.08), respectively. The sensitivity and specificity of atrophy in prediction of H. pylori infection were low, and the diagnostic efficacy was general. The incidence rates of white sticky mucus and spotty redness of the gastric fundus and body were higher in patients with H. pylori infection than those in patients without H. pylori infection (86.5%, 32/37 vs. 13.5%, 5/37; 86.9%, 146/168, vs. 13.1%, 22/168), and the differences were statistically significant ( χ2=20.96 and 137.12, both P<0.01). The sensitivity, specificity, and OR (95% CI) of the two indicators in prediction of H. pylori infection were 13.01%, 97.94% and 7.12 (2.72 to 18.60), and 59.35%, 90.95%and 14.67(8.84 to 24.34), respectively, and the diagnostic efficacy was ideal. Conclusions:The Kyoto classification score of gastritis used for the endoscopic prediction of H. pylori infection is suitable for Chinese population. However, from the perspective of individual indicator, the diagnostic efficiency of atrophy and intestinal metaplasia is unsatisfactory. At the same time, attention should be paid to whether there is sticky mucus or spotty redness of the gastric fundus and body.
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Helicobacter pylori (Hp) resides in the epithelium of gastric mucosa and can cause chronic inflammation. Under the conventional white light endoscopy, normal gastric mucosa, current Hp-infected gastric mucosa and past Hp-infected gastric mucosa have different endoscopic features. High-resolution white light endoscopy and various new image-enhanced endoscopy are helpful to accurately diagnose the infection of Hp, and thereby improving the detection rate of early gastric cancer by identifying the high-risk endoscopic manifestations related to gastric cancer. This article reviewed the endoscopic diagnosis of Hp infection and its clinical value.
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ABSTRACT Objective: To analyze the main endoscopic findings in patients under 40 years of age and the main indications for colonoscopy in these patients. Methods: A retrospective study with 362 reports of patients under 40 years of age who underwent colonoscopy from January 2014 to June 2017 at the colonoscopy service of the General Hospital Roberto Santos. Colon preparation was performed with mannitol and the patients underwent sedation as the anesthetist criteria. Results: Of the 362 patients analyzed, 192 (53%) were female. The mean age was 25 years (25.58 ± 11.95). The most frequent indications were inflammatory bowel disease in 24.3% (88) of the patients, bleeding in the lower digestive tract in 24% (87), and chronic diarrhea in 20.2% (73). The main colonoscopic findings were polyposis in 21.3% (77) of the patients and inflammatory alterations in 20.7% (75). Conclusion: With the analysis of the data provided by the colonoscopies, it was possible to conclude that, when the investigation is adequate and the examination is well indicated, even under the age of 40, colonoscopy can help in the diagnostic and treatment of several pathologies, including those that may increase the risk of colorectal cancer.
RESUMO Objetivo: Analisar os principais achados endoscópicos nos pacientes com idade inferior a 40 anos e as principais indicações para realização das colonoscopias. Métodos: Estudo retrospectivo, com análise de 362 laudos de pacientes com idade inferior a 40 anos submetidos à colonoscopia, no período de Janeiro de 2014 até Junho de 2017 no serviço de coloproctologia do Hospital Geral Roberto Santos. Foi realizado preparo de cólon com manitol e os pacientes foram submetidos à sedação á critério do anestesista. Resultados: Dos 362 pacientes analisados, 192 (53%) eram do sexo feminino. Em relação à idade: média de 25 anos (25,58 ± 11,95). As indicações mais frequentes foram doença inflamatória intestinal em 24,3% (88) dos pacientes, sangramento digestivo baixo em 24% (87); e diarreia crônica 20,2% (73). Os principais achados colonoscópios foram polipose em 21,3 (77) dos pacientes e alterações inflamatórias em 20,7% (75). Conclusão: Com análise dos dados fornecidos pelos exames colonoscópios e suas indicações foi possível concluir que quando a investigação é adequada e o exame é bem indicado, mesmo abaixo dos 40 anos, a colonoscopia pode auxiliar no diagnóstico e tratamento de diversas patologias, inclusive as que podem aumentar o risco de câncer colorretal.
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Adulto Joven , Neoplasias Colorrectales , Enfermedades Inflamatorias del Intestino , Colonoscopía , Cirugía ColorrectalRESUMEN
Endoscopy may be used for early screening of various cancers, such as nasopharyngeal cancer, esophageal adenocarcinoma, gastric cancer, colorectal cancer, and bladder cancer, and performing minimal invasive surgical procedures, such as laparoscopy surgery. During this procedure, an endoscope is used; it is a long, thin, rigid, or flexible tube having a light source and a camera at the tip, which facilitates visualization inside the affected organs on a screen and helps doctors in diagnosis.
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Humanos , Artefactos , Detección Precoz del Cáncer/métodos , Endoscopía/métodos , Redes Neurales de la ComputaciónRESUMEN
BACKGROUND/AIMS: This study examined the accuracy of endoscopic evaluation for determining the Helicobacter pylori infection status in patients with mild atrophy who might not exhibit characteristic endoscopic findings. METHODS: Forty endoscopists determined the H. pylori infection status of 50 randomly presented H. pylori-positive and H. pylori-negative cases on the basis of a list of established findings. RESULTS: The median clinical endoscopy experience was 7 years (range, 1–35 years), including 22 board-certified endoscopists (55%) of the Japan Gastroenterological Endoscopy Society. The mean accuracy rate of endoscopic diagnosis was 67% and was unrelated to experience status (experienced vs. trainee: 69% vs. 65%, p=0.089) and total years of experience (R 2 =0.022). The most frequently selected endoscopic findings were regular arrangement of collecting venules (59%), atrophy (45%), and red streak (22%), which had fair accuracy rates of 67%, 65%, and 73%, respectively. By contrast, the accuracy rates of nodularity (89%) and mucosal swelling (77%) were highest. The 20 endoscopists who more frequently identified these findings diagnosed H. pylori infection significantly more accurately than did the other endoscopists (71% vs. 64%, p=0.008). CONCLUSIONS: Careful attention to nodularity and mucosal swelling in patients with mild atrophy may enhance diagnosis, enable prompt treatment, and avoid possible long-term carcinogenesis.
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Humanos , Atrofia , Carcinogénesis , Diagnóstico , Endoscopía , Gastritis Atrófica , Helicobacter pylori , Helicobacter , Japón , VénulasRESUMEN
BACKGROUND: Endoscopic diagnosis of atrophic gastritis can contribute to risk stratification and thereby tailored screening for gastric cancer. We aimed to evaluate the effect of training on inter-observer agreement in diagnosis and grading of endoscopic atrophic gastritis (EAG) according to the level of endoscopists' experience. METHODS: Twelve endoscopists (six less-experienced and six experienced) participated in this prospective study. The training session consisted of 1) four interventions with two-week intervals, and 2) a follow-up period (two follow-up assessments without feedback). EAG was categorized as C1 to O3 according to the Kimura-Takemoto classification. Kappa statistics were used to calculate inter-observer agreement. RESULTS: At baseline, kappa indexes were 0.18 in the less-experienced group and 0.32 in the experienced group, respectively. After four interventions with feedback, the kappa index improved in both groups and was sustained during the follow-up period. Overall diagnostic yields of EAG were 43.1% ± 10.7% in pre-intervention and 46.8% ± 5.9% in post-intervention. Variability in the rate of diagnosis of EAG significantly decreased in the less-experienced group (r = 0.04, P = 0.003). CONCLUSION: Irrespective of experience level, inter-observer agreement for diagnosis and grading of EAG improved after training and remained stable after intervention.
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Objective The aim of this study was to investigate the application and clinical value of ultra-fine nasal endos-copy in the diagnosis and treatment of digestive tract stenosis. Methods A retrospectively investigation of 160 cases of nasogastricos-copy in esophageal,gastroduodenal and colorectal stenosis lesions,the detection rate of lesions under the stenosis and endoscopic treat-ment were analyzed from January 1,2016 to December 31,2017. Results In 102 cases of diagnostic examination,the passing rates of nasogastricoscopy in esophageal,gastroduodenum and colorectal stenosis were 76. 92% ,50. 00% and 88. 00% ,respectively. In the ca-ses which the endoscope could successfully pass the stenotic lesions, the detection rates of new lesions below the stenosis were 8. 89% ,0 and 27. 78% ,respectively,in esophageal,gastroduodenum and colorectal stenosis. A total of 58 cases of digestive tract ste-nosis were treated with endoscopic gastroscopy. Among them,46 cases had stenosis and the pass rate was 79. 31% . Conclusion Ultra-fine nasal endoscopy can significantly improve the completeness and accuracy of endoscopic diagnosis in patients with digestive tract stenosis that cannot be passed by standard gastrointestinal endoscopy. It can also be used for endoscopic treatment of digestive tract stenosis.
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Gastric cancer is a leading cause of cancer death worldwide. It is well known that Japan is the world leader in endoscopic diagnosis and treatment of early gastric cancer (EGC),thus the current status and executive standard in this area in Japan is worthy of studying. This paper reviewed numerous researches,reviews and epidemiological data, summarized the basic principles,standardized protocols,and the diagnostic algorithm and criteria and progress on endoscopic screening and diagnosis of EGC in Japan. Finally,the differences in endoscopic strategies for EGC existed between Japan and China were compared.
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Se realizó un estudio descriptivo y retrospectivo de 989 pacientes con diagnóstico endoscópico de gastritis crónica, cuyas biopsias habían sido procesadas en el Departamento de Anatomía Patológica del municipio de Palma Soriano, en Santiago de Cuba, durante el período 2008-2014, con el objetivo de determinar la incidencia de la infección por Helicobacter pylori, para lo cual además se consideraron las variables: edad, sexo, tipos de gastritis, presencia del microorganismo y su asociación con neoplasias malignas. En la serie predominaron el grupo etario de 40-49 años (26,7 %) y el sexo femenino (69,0 %); asimismo, resultó más frecuente la gastritis superficial (57,8 %) y se halló la bacteria en 70,5 % de la muestra, donde solo 0,5 se asoció a neoplasias malignas
A descriptive and retrospective study of 989 patients with endoscopic diagnosis of chronic gastritis whose biopsies had been processed in the Pathology Department of Palma Soriano in Santiago de Cuba, was carried out during 2008-2014, aimed at determining the incidence of the infection due to Helicobacter pylori, for which the variables: age, sex, gastritis types, presence of the organism and its association with malignancies were also considered. In the series the 40-49 years age group (26,7 %) and female sex (69,0 %) prevailed; also, the superficial gastritis was more frequent (57,8 %) and the bacteria was found in 70,5 % of the sample, where only 0,5 was associated to malignancies
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Endoscopía Gastrointestinal , Helicobacter pylori , Gastritis/diagnóstico , AdenocarcinomaRESUMEN
La mucosa gástrica heterotópica en esófago cervical (MGHEC) es una condición probablemente subdiagnosticada. La gran mayoría de los pacientes son asintomáticos y su detección es un hallazgo incidental. En los pacientes sintomáticos, las manifestaciones se asocian con cambios no neoplásicos o neoplásicos, que permiten categorizarlos en cinco tipos. A la categoría tipo III corresponde el caso presentado del paciente, con disfagia y globus faríngeo por MGHEC de compromiso circunferencial con estenosis franqueable. Al momento de esta publicación, solo se encontraron siete casos similares en la literatura mundial. La detección de MGHEC (apoyada en nuevas tecnologías de imagen como la cromoendoscopia) puede ser un indicador de calidad en el desempeño endoscópico, similar a la detección de adenomas en colonoscopia.
Heterotopic gastric mucosa in the cervical esophagus is a condition that is probably underdiagnosed. The vast majority of patients are asymptomatic, and detection is an incidental finding. In symptomatic patients, manifestations are associated with non-neoplastic or neoplastic changes that allow categorization into five types. The case presented here is a patient who had Type III with dysphagia and pharyngeal globus due to heterotopic gastric mucosa in the cervical esophagus with circumferential presentation with stenosis. At the time of publication, only seven similar cases could be found in the literature. Detection, supported by new imaging technologies such as chromoendoscopy, may be an indicator of the quality of endoscopic performance in a manner that is similar to detection of adenomas in colonoscopy.
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Humanos , Femenino , Persona de Mediana Edad , Esófago , Mucosa GástricaRESUMEN
Recently, several new endoscopic imaging techniques have been developed, including endoscopic ultrasonography, narrow band imaging, autofluorescence imaging, and confocal laser endomicroscopy. Preliminary studies have reported promising results in diagnosing gastric cancer with these new endoscopic imaging techniques. For wider clinical application, however, more evidence is required to show the clinical efficacy of these advanced endoscopic techniques in the diagnosis of gastric cancer. For the treatment of early gastric cancer, endoscopic submucosal dissection methods have recently been developed. Endoscopic submucosal dissection enables en bloc resection of large lesions and lesions with accompanying ulcerations, as the lesion is directly dissected along the submucosal layer using a high-frequency electrosurgical knife. With the development of the endoscopic submucosal dissection technique and the accumulation of long-term outcome data, the applications for endoscopic resection for early gastric cancer are expanding.
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Diagnóstico , Endosonografía , Imagen de Banda Estrecha , Imagen Óptica , Neoplasias Gástricas , ÚlceraRESUMEN
Recently, several new endoscopic imaging techniques have been developed, including endoscopic ultrasonography, narrow band imaging, autofluorescence imaging, and confocal laser endomicroscopy. Preliminary studies have reported promising results in diagnosing gastric cancer with these new endoscopic imaging techniques. For wider clinical application, however, more evidence is required to show the clinical efficacy of these advanced endoscopic techniques in the diagnosis of gastric cancer. For the treatment of early gastric cancer, endoscopic submucosal dissection methods have recently been developed. Endoscopic submucosal dissection enables en bloc resection of large lesions and lesions with accompanying ulcerations, as the lesion is directly dissected along the submucosal layer using a high-frequency electrosurgical knife. With the development of the endoscopic submucosal dissection technique and the accumulation of long-term outcome data, the applications for endoscopic resection for early gastric cancer are expanding.
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Diagnóstico , Endosonografía , Imagen de Banda Estrecha , Imagen Óptica , Neoplasias Gástricas , ÚlceraRESUMEN
Introduction Helicobacter pylori infection is associated with gastro-duodenal diseases. Genes related to pathogenicity have been described for H. pylori and some of them appear to be associated with more severe clinical outcomes of the infection. The present study investigates the role of cagE as a pathogenicity biomarker of H. pylori compare it to cagA, vacA, iceA and babA2 genes and correlate with endoscopic diagnoses. Methods Were collected biopsy samples of 144 dyspeptic patients at the Hospital of the Federal University of Rio Grande, Rio Grande do Sul, Brazil. After collection, the samples were sent for histological examination, DNA extraction and detection of all putative pathogenicity genes by PCR. Results Of the 144 patients undergoing endoscopy, 57 (39.6%) presented H. pylori by histological examination and PCR by detection of the ureA gene. Based on the endoscopic diagnoses, 45.6% (26/57) of the patients had erosive gastritis, while 54.4% (31/57) had enanthematous gastritis. The genes cagA, cagE, vacAs1/m1, vacAs1/m2 and iceA1 were related to erosive gastritis, while the genes vacAs2/m2, iceA2 and babA2 were associated to enanthematous gastritis. We found a statistically significant association between the presence of cagE and the endoscopic diagnosis. However, we detect no statistically significant association between the endoscopic diagnosis and the presence of cagA, vacA, iceA and babA2, although a biological association has been suggested. Conclusions Thus, cagE could be a risk biomarker for gastric lesions and may contribute to a better evaluation of the H. pylori pathogenic potential and to the prognosis of infection evolution in the gastric mucosa. .
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Proteínas Bacterianas/genética , Gastritis/microbiología , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Helicobacter pylori/patogenicidad , ADN Viral/análisis , Marcadores Genéticos , Reacción en Cadena de la Polimerasa , Pronóstico , Factores de RiesgoRESUMEN
Objective To summarize the endoscopic characteristics of Primary Gastrointestinal Malignant Lymphoma (PGIML) and increase the diagnostic accuracy of this method to aid the clinical treatment.Methods The clinical data of 67cases with PGIML from 2004 to 2009 were studied retrospectively.ResultsPGIML lacked specific clinical symptoms.The main clinical symptoms were abdominal pain, melena and abdominal mass.In our study, most PGIML(37/67,55.8%)were detected in stomach.Nodular appearance of mucosal surface was the most common endoscopic finding.The positive rate of endoscopic biopsy for the diagnosis of PGIML was 68.7 % (46/67 biopsy cases).All cases had Non-Hogkin Lymphoma (NHL).The most common immunophenotype was B-cell majority (50/67).Thirty cases had MALT.ConclusionIt is hard to diagnose PGIML at early stage,combination of various diagnosis tests should be considered to solve this problem.The effectiveness of surgery on PGIML should be further confirmed by prospective randomized clinical trials.
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The diagnosis of hilar cholangiocarcinoma (CCA) is usually accomplished through a combination of imaging modalities and endoscopic examination including tissue sampling. Although high quality cross-sectional imagings provide evidences for hilar obstruction and a malignancy arising from the bile duct, a definitive diagnosis and staging often obtained through the use of endoscopic procedures. It can provide complementary information for accurate tumor extension and tissue acquisition for histologic confirmation. These informations are important in determining therapeutic options. However, despite the various available techniques, the diagnosis and accurate staging of hilar CCA is often still challenging. Newly developed adjunctive diagnostic endoscopic techniques including intraductal ultrasound and cholangioscopy improve the accuracy of endoscopic diagnosis of this lesion. Multiple endoscopic modalities can be tried to obtain accurate assessment of the tumor. Therefore, endoscopy will continue to occupy an important position in assessment of the hilar CCA.
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Conductos Biliares , Colangiocarcinoma , EndoscopíaRESUMEN
Barrett's esophagus is a metaplastic change of the esophageal mucosa, such that the normal squamous epithelium is replaced by specialized columnar epithelium. During the last decades, there has been a significant change in the definition, endoscopic diagnosis, pathologic diagnosis, surveillance and management of Barrett's esophagus. Because of the rising prevalence of gastroesophgeal reflux disease in Korea, problems related to Barrett's esophagus are expected to be much more common in the near future. In this review, methods of endoscopic diagnosis of Barrett's esophagus are discussed in detail. Management strategies in the context of Korean epidemiology are also suggested.
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Esófago de Barrett , Epitelio , Corea (Geográfico) , Membrana Mucosa , PrevalenciaRESUMEN
Objective To study the clinical and pathologic features,and endoscopic diagnosis as well as therapy and prognosis of the primary gastrointrestinal lymphoma(PGIL), and to improve its diagnosis and therapy efficiency. Methods The clinical data in 29 cases of PGIL were retrospectively reviewed. Results In these cases, the tumor was mainly located at stomach (n=21), colon(n=6) and small intestine(n=2). The type of pathology was mucosa associated lymphoid tissue lymphoma(n=8), diffuse large B-cell lymphoma(n=18), T-cell lymphoma(n=3). The commom manifestation include abdominal pain, anaemia, abdominal distention, melena or hemafecia, loss of weigh etc. The tumor appeared infilitrative in 11 cases, ulcerative in 10 cases, protruding in 6 cases, 9 cases were diagnosed by firstly routine biopsy endoscopiccally. 10 cases were treated by operation and chemotherapy, 19 cases were treated by chemotherapy. Up to now, 6 cases survival in operation group, 13 cases survival in chemotherapy group, the difference was not statistically significant . Conclusions PGIL was mainly located at stomach, which was not specific clinical manifestation; The type of pathology was mainly diffuse large B-cell lymphoma; the diagnositic rate of routine endoscopic biopsy was low. chemotherapy was the first treatment of PGIL.
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Phlegmonous gastritis is a rare disorder caused by suppurative bacterial infection of the gastric wall. The mortality rate remains extremely high and the gastrectomy has been thought to be an effective form of treatment. We report a case of acute phlegmonous gastritis developed in a patient with advanced alcoholic liver cirrhosis, and recovered with early endoscopic diagnosis and antibiotics alone.