Three Cases of Gastric Anisakiasis Mimicking Submucosal Tumor / 대한소화기내시경학회지

Gastric anisakiasis is a parasitic infestation that occurs after eating raw marine fish that contain Anisakis larvae. The diagnosis is usually confirmed by endoscopy, which often reveals the presence of the larvae itself, mucosal edema, erosion, ulceration, and hemorrhage. However, gastric anisakiasis mimicking submucosal tumor is extremely rare. To date, six cases have been reported in Korea. We report three additional cases of gastrtic anisakiasis mimicking submucosal tumor. An asymptomatic 56-year-old man and a 40-year-old woman underwent endoscopis examination during a physical checkup, and a 63-year-old woman visited our hospital complaining of epigastric discomfort.The endoscopic findings indicated submucosal tumors in all cases. Endoscopic ultrasonography revealed inhomogeneous, hypoechoic lesions in submucosal layer (1 case) and muscle layer (2 cases). A laparoscopic and endoscopic resection was carried out for definite diagnosis and treatment. The pathologic findings of the resected specimens were eosinophilic granuloma caused by Anisakis.

Three Cases of Gastric Anisakiasis Mimicking Submucosal Tumor / 대한소화기내시경학회지

Gastric anisakiasis is a parasitic infestation that occurs after eating raw marine fish that contain Anisakis larvae. The diagnosis is usually confirmed by endoscopy, which often reveals the presence of the larvae itself, mucosal edema, erosion, ulceration, and hemorrhage. However, gastric anisakiasis mimicking submucosal tumor is extremely rare. To date, six cases have been reported in Korea. We report three additional cases of gastrtic anisakiasis mimicking submucosal tumor. An asymptomatic 56-year-old man and a 40-year-old woman underwent endoscopis examination during a physical checkup, and a 63-year-old woman visited our hospital complaining of epigastric discomfort.The endoscopic findings indicated submucosal tumors in all cases. Endoscopic ultrasonography revealed inhomogeneous, hypoechoic lesions in submucosal layer (1 case) and muscle layer (2 cases). A laparoscopic and endoscopic resection was carried out for definite diagnosis and treatment. The pathologic findings of the resected specimens were eosinophilic granuloma caused by Anisakis.

A Case of Primary Pure Squamous Cell Carcinoma of the Stomach / 대한소화기내시경학회지

Primary pure squamous cell carcinoma of the stomach is extremely rare. To date, five cases have been reported in Korea. We report an additional case of a 71-year-old male with pure squamous cell carcinoma of the stomach. Upper gastrointestinal endoscopy showed a large ulceroinfiltrating mass with irregular margin in the body of the stomach. Histologic examination of biopsy specimen confirmed moderately differentiated squamous cell carcinoma. Abdominal computed tomography showed metastatic mass in the left hepatic lobe, pancreatic body and tail. Despite the combination chemotherapy with docetaxel, cisplatin and 5-fluorouracil, the patient died from wide spread metastasis.

A Case of Duodenal Gastrointestinal Stromal Tumor Presenting with Gastrointestinal Bleeding / 대한소화기내시경학회지

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial tumor of the gastrointestinal tract. GISTs are most common in the stomach, followed by small intestine, colon and rectum, and esophagus. We report a case of duodenal GIST presenting with gastrointestinal bleeding in a 53-year-old male. Upper gastrointestinal endoscopy revealed a protruded mass with central ulceration on the second portion of the duodenum. Spontaneous spurting blood was encountered from the central ulcer of the mass. Abdominal computed tomography scan and celiac angiography revealed hypervascular tumor, located in the second portion of the duodenum. Laparotomy with wedge resection was performed. Histological and immunohistochemical studies on resected specimen revealed a duodenal GIST of a combined smooth muscle and neural type.

A case of non-Hodgkin's lymphoma presented only as unilateral pleural effusion / 대한내과학회지

We experienced a case of non-Hodgkin's lymphoma presented only as right side pleural effusion, that is primary effusion lymphoma (PEL), in a 75 year-old male patient in Korea where is the endemic area of tuberculosis. He visited our hospital complaining of exertional dyspnea. He did not have B symptoms. The breathing sound was decreased on the right side chest, but we could not find external lymphadenopathy or hepatosplenomegaly on physical examination. Simple chest radiograph showed right side pleural effusion. The cells of pleural fluid were lymphocyte-predominant and the pH, protein, lactate dehydrogenase, adenosine deaminase of the fluid was 7.31, 38 g/L, 381 U/L, 31 U/L, respectively. The biopsy specimen of the parietal pleura was diagnosed as non-Hodgkin's lymphoma of small lymphocytic type. Computed tomograph of the chest, abdomen and pelvis, and the biopsy of bone marrow were negative for disease. We tried up to 3 cycles of chemotherapy with adriamycin, vincristine, cyclophosphamide and prednisolone and there was a marked decrease in the amount of the pleural effusion.

A case of abdominal actinomycosis simulating Dieulafoy's ulcer / 대한내과학회지

Actinomycosis is a chronic suppurative and granulomatous disease caused by Actinomyces species and characterized by sulfur granule formation. Depending on the site of primary infection, it is generally classified as cervicofacial, thoracic and abdominal type. Abdominal actinomycosis is often difficult to diagnose before operation because of low frequency and no characteristic clinical features of the disease. As it progresses chronically, it can be misdiagnosed such as cancer, inflammatory bowel disease or other abscess. The diagnosis is usually based on histologic demonstration of sulfur granules in pus or surgically resected specimen. In vast majority of cases, treatment has consisted of long-term antibiotic therapy coupled with surgical resection. We experienced a case of colonic actinomycosis initially diagnosed as Dieulafoy's ulcer and confirmed by colonoscopic biopsy. Treatment with intravenous penicillin for 4 weeks was successful independently, and we report this case with a brief review of literatures.

The Clinical Effects of Tranilast on Restenosis after Percutaneous Transluminal Coronary Angioplasty

BACKGROUND AND OBJECTIVES: Tranilast is an anti-allergic drug that suppresses the release of cytokines, such as platelet-derived growth factor, transforming growth factor-beta and interleukin-1beta. It has recently become known to be effective in the prevention of restenosis following PTCA (percutaneous transluminal coronary angioplasty). SUBJECTS AND METHODS: One hundred forty two consecutive patients with angina who underwent PTCA between Jan 1999 and Jul 2000 at Chonnam National University Hospital were analyzed prospectively. Thirty patients (Tranilast group:60.8+/-7.7 years, M:F=22:8, 41 lesions) out of 48 who received 300 mg tranilast for 3 months following PTCA and who underwent follow-up CAG (coronary angiogram), were compared with 61 patients (Control group:58.1+/-11.0 years, M:F=52:9, 82 lesions) out of 94, 94 who did not receive tranilast but did undergo follow-up CAG. RESULTS: The restenosis rate per lesion was significantly lower in the Tranilast group than in the Control group on the 6-month follow-up CAG (Tranilast vs. Control group:19.5% vs. 40.2%, p=0.021). The minimal luminal diameter was significantly larger in the Tranilast group as compared to the Control group (1.99+/-0.76 vs. 1.50+/-0.83 mm p=0.002). One patient of the Tranilast group suffered from liver dysfunction and stopped medication. CONCLUSION: The oral administration of tranilast is safe and effective in the prevention of restenosis following PTCA in patients with angina.