Résumé
Granular cell tumor is an uncommon submucosal neoplasm of uncertain etiology and histogenesis. Having been reported in virtually all other sites, granular cell tumors of the gastrointestinal tract are rare. Reported cases in the gastrointestinal tract account for 5~9% of all granular cell tumors, most commonly in the esophagus. Only one case of gastric granular cell tumor has been reported in Korea. We report a case of asymptomatic gastric granular cell tumor coexisting with gastric adenoma in 56-year-old male who had extramammary Paget's disease in the right scrotum, and it was successfully managed by endoscopic polypectomy.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Adénomes , Oesophage , Tube digestif , Tumeur à cellules granuleuses , Corée , Maladie de Paget extramammaire , Scrotum , EstomacRésumé
Patients with ulcerative colitis (UC) have the increased risk of colorectal cancer. The risk of colorectal cancer development in UC is associated with the extent of colitis and duration of disease. It is generally agreed that there is little or no increased risk associated with proctitis or proctosigmoiditis. A dysplasia-associated lesion or mass (DALM) is difficult to distinguish from sporadic adenoma. The DALM indicate a high association with colon cancer. The presence of DALM as a premalignant lesion has been considered as an indication for colectomy because of the high risk of progression to malignancy within a short period. We report a case of polyp with high grade dysplasia in a 27-year-old man of ulcerative colitis confined to rectum and sigmoid colon.
Sujets)
Adulte , Humains , Adénomes , Colectomie , Colite , Rectocolite hémorragique , Côlon sigmoïde , Tumeurs du côlon , Tumeurs colorectales , Polypes , Rectite , Rectocolite , Rectum , UlcèreRésumé
Henoch-Schonlein purpura is a form of systemic small-vessel vasculitis characterized by vascular purpura, predominantly occured on the lower limbs and articules with gastrointestinal and renal symptoms. The symptoms occur consecutively and purpura is the most common initial manifestation but if another symptoms prevails, the diagnosis often can be delayed. Any portion of the gastrointestinal tract distal to the esophagus may be involved, but most frequently affected sites are jejunum and ileum. Mucosal lesions found predominantly in the second portion of the duodenum seem to be characteristic of Henoch-Schonlein purpura and may assist the diagnosis in patients with atypical nonspecific symptoms. We report a case of Henoch-Schonlein purpura with the characteristic endoscopic finding in the second portion of duodenum, which helps to make the correct diagnosis and proper management of the patient.
Résumé
Pseudopolyp is a common association of ulcerative colitis but may also occur in Crohn's disease, ischemic colitis and infective colitis. Pseudopolyps are results of the repair process, representing islands of granulation tissue surrounded by mucosa with ulceation. When a pseudopolyp is larger than 1.5 cm, it is often called a "giant pseudopolyp". Such lesions of inflammatory origin are often confused with polypoid carcinoma or infiltrating submucosal malignancy. We report a case of asymptomatic Crohn's disease as giant pseudopolyposis mimicking malignancy on sigmoid colon, with a review of relevant literatures.
Sujets)
Colite , Colite ischémique , Rectocolite hémorragique , Côlon sigmoïde , Maladie de Crohn , Fistule , Tissu de granulation , Iles , MuqueuseRésumé
A 17-year-old man was referred to our hospital because of dizziness and mild dyspnea. He had a history of partial thyroidectomy due to benign mass when he was 10 year-old. His conjunctiva was anemic and acral keratosis was noted. He had a goiter and a previous surgical scar on the anterior neck just below the thyroid cartilage. Blood counts were as follows; Hb was 4.3 g/dL, WBC 5,500/mm3, PLT 366,000/ mm3. Esophagogastroduodenoscopy and colonoscopy showed esophageal acanthosis and numerous variable sized polyps in the stomach, duodenum and colon. The small bowel series showed numerous polypoid lesions in the entire small bowel. Gastric polyps revealed hamartoma and colon polyps revealed inflammatory polyp with lymphoid hyperplasia by pathologic examination. Thyroid ultrasonograph showed multiple nodules and cysts and I131 scintigraphy showed multiple cold and hot nodules in his remnant thyroid gland. We diagnosed the patient as Cowden's syndrome.
Sujets)
Adolescent , Enfant , Humains , Cicatrice , Côlon , Coloscopie , Conjonctive , Sensation vertigineuse , Duodénum , Dyspnée , Endoscopie digestive , Goitre , Hamartomes , Syndrome des hamartomes multiples , Hyperplasie , Kératose , Cou , Polypes , Scintigraphie , Estomac , Cartilage thyroïde , Glande thyroide , Nodule thyroïdien , ThyroïdectomieRésumé
So called Brunner's gland hyperplasia is characterized by a nodular proliferation of histologically normal Brunner's gland, accompanied by ducts and scattered stromal element. The clinical presentation vary from vague epigastric disomfort to obstruction and gastrointestinal bleeding. We experienced a case of huge Brunner's gland hyperplasia presented as a huge duodenal polyp. A 28-year-old woman was refered to our hospital because of suspicious ampulla of Vater cancer or duodenal cancer in abdominal CT scan. The patient complained of dizziness and intermittent melena. The side view duodenoscopic examination revealed a huge pedunculated mass originated from the posterior wall of the duodenal bulb. The head of the polyp was placed on the ampulla of Vater with several erosions suggesting recent bleeding. Resection of duodenal polyp was performed by laparoscopic duodenotomy and Brunner's gland hyperplasia was revealed on pathologic examination.
Sujets)
Adulte , Femelle , Humains , Ampoule hépatopancréatique , Sensation vertigineuse , Tumeurs du duodénum , Tête , Hémorragie , Hyperplasie , Méléna , Polypes , TomodensitométrieRésumé
Chronic neutrophilic leukemia is a rare myeloproliferative disorder. We have experienced a typical case of chronic neutrophilic leukemia in a 76-year-old man who complained abdominal distension due to hepatosplenomegaly. White blood cell count of peripheral blood was 50,500/nL with 90% segmented neutrophils. The underlying disease for a leukemoid reaction had not been detected. Leukocyte alkaline phosphatase score and the serum levels of vitamin B12 and uric acid were elevated. Chromosome study showed a normal karyotype without Philadelphia chromosome or bcr/abl rearrangement. Phorbol myristate acetate-activated respiratory burst activity of neutrophils measured with chemiluminescence showed increased activity.
Sujets)
Sujet âgé , Humains , Phosphatase alcaline , Caryotype , Leucémie chronique à neutrophiles , Réaction leucémoïde , Numération des leucocytes , Leucocytes , Luminescence , Syndromes myéloprolifératifs , Acide myristique , Granulocytes neutrophiles , Chromosome Philadelphie , Stimulation du métabolisme oxydatif , Acide urique , Vitamine B12Résumé
The incidence of deep neck infection has been reduced by modern antibiotic therapy. Life-threatening deep neck infection of odontogenic or upper airway origin may extend to the thorax. Early diagnosis, administration of the potent antibiotics, and complete debridement and drainage are essential to improve the chances for survival in these very ill patients. We report two cases of deep neck infection which were complicated by thoracic infection such as mediastinitis, pericarditis, and empyema as a result of descending infection.
Sujets)
Humains , Antibactériens , Débridement , Drainage , Diagnostic précoce , Empyème , Incidence , Médiastinite , Cou , Péricardite , ThoraxRésumé
The bronchopulmonary sequestration is a region of lung parenchyma that has an incomplete or no connection with the airways and is supplied by an aberrant artery arising from the aorta or one of its branches. The anatomy of supplied artery is very important during operation. We present a case of pulmonary sequestration supplied with left gastric artery. The patient was 61 years old male and had hemoptysis. The left lower lung was cystic bronchiectasis and a few air-fluid level on chest CT. Also, in aortogram, arterial supply was from left gastric artery of abdominal aorta branches. Left lower lobectomy and abnormal arterial ligation was done.