Gastric Non-Hodgkin Lymphoma in a Helicobacter pylori-Infected Patient.

Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) is a rare gastric malignant neoplasm. While the association between Heliobacter pylori infection and gastric mucosa-assisted lymphoid tissue lymphoma is well established, data supporting its association with DLBCL are less robust. Here we present a rare case of PG-DLBCL diagnosed with H. pylori. An 82-year-old man presented to clinic with complaints of worsening epigastric pain. He underwent an endoscopy which revealed 1 large nonbleeding gastric ulcer. Histopathological and immunohistochemical analysis confirmed PG-DLBCL. He was started on H. pylori eradication (HPE) and subsequently completed 6 cycles of R-mini-CHOP chemotherapy. Since then, the patient maintained clinical and radiological remission for more than a year without recurrence. PG-DLBCL is an aggressive Non-hodgkin lymphoma (NHL) that usually presents late. It has been shown that HPE without chemotherapy in DLBCL codiagnosed with H. pylori is not an effective strategy. Thus, the standard of care for patients would be HPE and chemotherapy as in our patient. More research is needed to better understand association between H. pylori and DLBCL.

Combined endoscopic mucosal resection and full-thickness resection for large colorectal polyps: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Combined endoscopic mucosal resection (EMR) with endoscopic Full thickness resection (EFTR) is an emerging technique that has been developed to target colorectal polyps larger than 2 cm. We performed a systematic review and meta-analysis to evaluate this technique for the resection of large colorectal lesions. METHODS: We conducted a comprehensive search of multiple electronic databases from inception through August 2023, to identify studies that reported on hybrid FTR. A random-effects model was employed to calculate the overall pooled technical success, macroscopic complete resection, free vertical margins resection rate, adverse events, and recurrence on follow up. RESULTS: A total of 8 Study arms with 244 patients (30% women) were included in the analysis. The pooled technical success rate was 97% (95% CI 88%-100%, I2 = 79.93%). The pooled rate of macroscopic complete resection was achieved in 95% (95% CI 90%-99%, I2 = 49.98) with a free vertical margins resection rate 88% (95% CI, 78%-96%, I2 = 63.32). The overall adverse events rate was 2% (95% CI 0%-5%, I2 = 11.64) and recurrence rate of 6% (95% CI 2%-12%, I2=20.32). CONCLUSION: Combined EMR with EFTR is effective and safe for resecting large, and complex colorectal adenomas, offering a good alternative for high surgical risk patients. Regional heterogeneity was observed, indicating that outcomes may be impacted by differences in operator expertise and industry training certification across regions. Comparative studies that directly compare combined EMR with EFTR against alternative methods such as ESD and surgical resection are needed.

From Nonalcoholic Fatty Liver Disease to Metabolic Dysfunction-Associated Steatotic Liver Disease: Out with the Old, in with the New.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease (CLD) affecting a quarter of the global population [...].

Post-Transplant Hepatic Steatosis: A Condition Not to Overlook.

Recurrent or de novo steatotic liver disease (SLD) following liver transplantation (LT) is a rising concern among liver transplant recipients [...].

Suspecting Cardiac Amyloidosis in Congestive Heart Failure.

Amyloidosis is a rare multisystem disease due to deposition of abnormal protein fragments, and cardiac amyloidosis is progressive and difficult to diagnose due to its subtle and non-specific symptoms unless the physician maintains a high degree of suspicion. This case report focuses on amyloid deposition in the heart of an 84-year-old woman who presented with symptoms of uncompensated heart failure.