[ case report: intestinal T-Cell lymphoma]

In this study a 31 y/o woman who was housewife, came from Mazandaran and lived in Behshahr is presented. Patient's complaints were diarrhea, bloating, abdominal pain and weight loss. Abdominal radiography showed loop dilatation. In primary Para clinic assessments she had Alb: 2.8, Ca: 6.4, P: 2.3 and PTH: 201. Considering malabsorption in early evaluation, upper endoscopy was done. Intestinal folds were disappeared in second and third part of duodenum in endoscopic view and duodenal biopsy was done. Then pathological assessment revealed a large accumulation of intraepithelial lymphocytes and obvious villus atrophy that was accordant to celiac sprue. She was advised to be on gluten free diet. After about 1 month, She was referred because of sever lower extremities edema. Serum albumin was checked that was 2. Enlarged mesenteric lymph nodes were detected in sonography. Considering non- responding treatment, IHC staining of intestinal biopsy was performed with celiac sprue complication suspicion. Therefore the patient was referred to chemotherapy center with the diagnosis of T-cell lymphoma following celiac sprue. She was spent 6 course chemotherapy with CHOP regimen and radiotherapy

Demonstration acidic mucin production in non-goblet metaplastic columnar cells of lower esophagus as an early sign of Barrett esophagus inpatients with gestroesophageal reflux disease

The aim of this study was to demonstrate changes in nature of mucin and production of acidic forms using PAS-Alcian blue stain at PH=2.5. Appearance of non-goblet metaplastic columnar cells of lower esophagus is considered as an early sign of Barrett'esophagus,"simultaneous in conjunction or before the appearance of goblet cells in patients with gastroesophageal reflux disease. Material and Forty four biopsy samples where taken from the squamo-columnar junction of patients with reflux associated columnar metaplasia of lower esophagus who referred to Shariati Hospital during 1378. All specimens were stained by Alcian blue-PAS at PH=2.5 to search for acidic mucin production in non-goblet metaplastic columnar cells of lower esophagus. Colonic mucosa specimen and the goblet cells from 9 case with overt intestinal metaplasia were used as external and internal positive controls and cardiac type columnar cells were considered as negative control for acidic mucin production. Eight out of 44 biopsy samples taken at squamo-columnar junction of patients with reflux associated columnar metaplasia in lower esophagus showed acidic mucin production in non-goblet metaplastic columnar cells. Alcian blue-PAS stain at PH=2.5 can demonstrate changes in nature of mucin content and reveals acidic mucin production in non-goblet metaplastic columnar cells of lower esophagus in some patients with gastroesophageal reflux disease. This finding can be considered as an early sign of "Barretts esophagus" before the appearance of goblet cells and can help in early detection of this premalignant lesion and as a result, better surveillance and follow up of the affected patients