Neuroendocrine differentiation in gastric adenocarcinomas associated with severe hypergastrinemia and/or pernicious anemia.

Patients with hypergastrinemia secondary to achlorhydria have an increased risk of developing ECL cell carcinoids and gastric adenocarcinomas. Hypergastrinemia is central in the pathogenesis of ECL cell carcinoids, but the link between gastrin and gastric carcinomas is controversial. During neoplastic transformation ECL cells may, however, lose many of their neuroendocrine characteristics, making them difficult to recognise as neuroendocrine with conventional immunohistochemical techniques. Neuroendocrine differentiation was therefore examined in eight gastric adenocarcinomas found in seven patients with severe hypergastrinemia and/or pernicious anemia using a monoclonal antibody towards chromogranin A and immunohistochemistry without and with a sensitive signal amplification technique. The Sevier-Munger method was used as a more specific marker of ECL cells. Seven of the carcinomas contained scattered neuroendocrine tumour cells. When using signal amplification, an increase in the number of immunoreactive neoplastic cells was seen. In many tumours, clusters or confluent sheets of such cells were disclosed, suggesting a neuroendocrine and ECL cell origin. These tumours may therefore be ECL cell carcinomas and hypergastrinemia may thus be involved in the tumourigenesis.

[Ultrasonography in inflammatory bowel diseases--preliminary results]. / Ultrasonografi ved inflammatoriske tarmsykdommer--foreløpige erfaringer.

BACKGROUND: After installing an ultrasound machine within the gastroenterologic unit at Alesund Hospital in February 2001, we wanted to evaluate its usefulness in inflammatory bowel diseases compared with endoscopy. MATERIAL AND METHODS: We describe findings in 22 patients investigated from February to December 2001. Ultrasonography was performed using a combination of B-mode, power Doppler and duplex Doppler ultrasound techniques. The bowel disease was diagnosed by histology in all patients. RESULTS: Ultrasonography revealed wall thickness, disease extent and hyperaemia within the pathological segment of the bowel in all patients. Furthermore, the method demonstrated several pathological conditions related to the bowel disease which were not revealed by colonoscopy. INTERPRETATION: Transcutaneous abdominal ultrasonography gives additional information to endoscopy in patients with inflammatory bowel diseases.