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Synchronous occurrence of Waldenström macroglobulinemia and HER2-positive gastric adenocarcinoma with gastrointestinal stromal tumor: a rare case report.

There are very few reports of gastric cancer (GC) and gastrointestinal stromal tumor (GIST) occurring at the same time in the literature. In particular, the collision of GIST and human epidermal growth factor receptor-2 (HER-2)-positive gastric carcinoma in a patient with Waldenström macroglobulinemia (WM) has never been reported. We report the case of an 80-year-old male who initially presented with dizziness with fatigue for more than 1 month. He underwent total gastrectomy. Pathology revealed GC (moderately to poorly differentiated tubular adenocarcinoma), GIST (low-risk category) and low-g

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… One month before hospitalization, the patient visited the local hospital for gastroscopy examination, and gastroscopy revealed space-occupying lesions in the fundus and body of the stomach. Pathologic examination revealed poorly differentiated adenocarcinoma. … The tumor markers were elevated ( Supplementary Table 1B ), and gastroscopy revealed extensive hyperemic erosion of the esophageal mucosa with bleeding. We considered the possibility of gastric cancer recurrence, and zanubrutinib was suspended. …

[Surgery-based multimodal therapy for cervical esophageal squamous cell carcinoma: a retrospective analysis of 117 cases].

Objective: To evaluate the efficacy of a surgery based multimodal therapy for locally advanced resectable cervical esophageal squamous cell … ales, aged from 45 to 77 years. There were 35 cases with T1-T2 stage and 82 cases with T3-T4 stage. Gastroscopy screening upon admission identified synchronous middle-inferior esophageal carcinoma in 11 cases and synchronous hypopharyngeal cancer in 4 cases. Treatment regimens were as follows: surgery with postoperative adjuvant radiotherapy in 72 cases; surg …

Clinical comparative study of fluorescence rapid on-site evaluation (F-ROSE) real-time visual detection versus ¹³C-urea breath test for helicobacter pylori.

BACKGROUND: ¹³C-urea breath test (¹³C-UBT) is widely used for Helicobacter pylori (H.pylori) detection but has limitations including inabili … onship between DOB values and viable bacterial counts. METHODS: A total of 180 patients undergoing gastroscopy were consecutively enrolled and received synchronous F-ROSE quantitative detection and ¹³C-UBT. F-ROSE used acridine orange-ethidium bromide (AO-EB) dual fluorescent staining to count total, viable, and nonviable bacteria under × 400 high-power fiel …

Which of Vonoprazan Alone or Intravenous Proton Pump Inhibitor Followed by Vonoprazan Is Optimal for Reducing Delayed Bleeding in Gastric Endoscopic Submucosal Dissection?

UNLABELLED: <p>Introduction: In gastric endoscopic submucosal dissection (ESD), both vonoprazan alone and intravenous proton pump inhibitor (PPI) followed by vonoprazan have lower delayed bleeding risk than PPI alone. This study aimed to clarify an optimal acid-suppressive method in gastric ESD. METHODS: This population-based cohort study included patients who underwent gastric ESD on only vonoprazan (vonoprazan alone group) or intravenous PPI followed by vonoprazan (intravenous PPI group) using the Diagnosis Procedure Combination database in Japan between 2014 and 2021. The primary outcome w

Vonoprazan or Proton Pump Inhibitor for Gastric Endoscopic Submucosal Dissection in Patients Taking Antithrombotic Agents.

BACKGROUND AND AIM: Delayed bleeding is a major concern after gastric endoscopic submucosal dissection (ESD), especially in patients taking antithrombotic agents. The aim of this study was to evaluate the superiority of vonoprazan (VPZ) over proton pump inhibitor (PPI) in preventing delayed bleeding after gastric ESD in patients taking antithrombotic agents. METHODS: A multicenter, open-label, randomized controlled trial was conducted in 10 Japanese centers. Gastric neoplasm patients taking antiplatelets or anticoagulants were enrolled and randomly allocated in a 1:1 ratio to either the VPZ (

Carcinosarcoma and sarcomatoid carcinoma of the stomach: Two case reports.

RATIONALE: Carcinosarcoma and sarcomatoid carcinoma of the stomach are rare, malignant, and biphasic tumors with high mortality. The differential diagnosis of these 2 diseases remains challenging. In the present study, we present 2 cases of carcinosarcoma and sarcomatoid carcinoma of the stomach. PATIENT CONCERNS: A 54-year-old woman was admitted with complaints of epigastric pain for 4 months, but she became serious for 10 days accompanied by melena. A 75-year-old man was admitted with complaints of epigastric pain for 1 month. DIAGNOSIS: The female had a Borrmann type III irregular ulcerat

Endoscopic resection of large (≥ 4 cm) upper gastrointestinal subepithelial tumors originating from the muscularis propria layer: a single-center study of 101 cases (with video).

BACKGROUND AND AIMS: Although endoscopic resection (ER) is already established as a minimally invasive technique for small (< 4.0 cm) upper gastrointestinal subepithelial tumors originating from the muscularis propria layer (MP-SETs), published data of ER for large (≥ 4.0 cm) upper gastrointestinal MP-SETs are extremely rare and limited to case reports. This retrospective study aimed to evaluate the feasibility and safety of ER for large (≥ 4.0 cm) upper gastrointestinal MP-SETs in a large case series. METHODS: Between June 2012 and December 2018, 101 patients with large (≥ 4 cm) upper gastro

Clinical Values of Dental Floss Traction Assistance in Endoscopic Full-Thickness Resection for Submucosal Tumors Originating from the Muscularis Propria Layer in the Gastric Fundus.

BACKGROUND: Endoscopic full-thickness resection (EFTR) derived from endoscopic submucosal dissection has gradually been accepted and even promoted for the treatment of submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. However, there are some difficulties when EFTR is used to treat MP lesions in the gastric fundus. This study intends to explore whether EFTR can be made simpler, safer, and more effective with the traction assistance of dental floss. METHODS: The clinical data of patients (trial group) with lesions in the MP layer in the gastric fundus undergoing EFTR

Female Gender is a Poor Predictive Factor of Functional Dyspepsia Resolution after Helicobacter pylori Eradication: A Prospective, Multi-center Korean Trial.

BACKGROUND/AIMS: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. METHODS: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencin

Association between serum levels of high sensitive C-reactive protein and inflammation activity in chronic gastritis patients.

BACKGROUND: Gastritis is an important premalignant lesion and recent studies suggested a production of inflammatory cytokine-like C-reactive protein during gastritis. This study aimed to determine any relationship between high sensitive C-reactive protein (hs-CRP) and inflammation activity among patients with gastritis. METHODS: Demographic and clinical variables of participants were collected by a validated questionnaire. Using histology of the gastric mucosa, Helicobacter pylori status was investigated and serum concentrations of hs-CRP were measured among dyspeptic patients. Correlation be

[Expression of plasminogen activator system components in the gastric mucosa in portal hypertensive gastropathy].

OBJECTIVE: to study the expression of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1) in the gastric mucosal (GM) vascular endothelium and epithelial cells of patients with portal hypertensive gastropathy (PHG) and those with portal hypertension (PH) without signs of PHG as compared to a control group. MATERIAL AND METHODS: GM biopsy specimens from patients with PHG, those with PH without signs of PHG, and controls with the normal gastric mucosa were immunohistochemically examined. RESULTS: Comparison of the expression of uPA in the GM vascular endoth

Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma: magnifying endoscopy findings.

Gastric mucosa-associated lymphoid tissue lymphoma is uncommon and most patients have an indolent clinical course. The clinical presentation and endoscopic findings can be subtle and diagnosis can be missed on white light endoscopy. Magnifying endoscopy may help identify the abnormal microstructural and microvascular patterns, and target biopsies can be performed. We describe herein the case of a 64-year-old woman with Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma diagnosed by screening magnification endoscopy. Helicobacter pylori-eradication therapy was given

Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphomas: A review.

Since Isaacson and Wright first reported on the extra-nodal marginal zone B-cell lymphoma of the stomach in 1983, following studies have clarified many aspects of this disease. We now know that the stomach is the most affected organ by this disease, and approximately 90% of gastric mucosa-associated lymphoid tissue (MALT) lymphomas are related to Helicobacter pylori (H. pylori) infection. This implies that approximately 10% of gastric MALT lymphomas occur independent of H. pylori infection. The pathogenesis of these H. pylori-negative gastric MALT lymphomas remains unclear. To date, there have

Clinicopathologic analysis of 6 lymphomatoid gastropathy cases: expanding the disease spectrum to CD4-CD8+ cases.

Lymphomatoid gastropathy, which was first reported in 2010, is a rare NK-cell proliferation of cyCD3, CD4, CD5, CD8, CD56 phenotypes with unknown etiology. The diagnosis is challenging, as there is histopathologic similarity to malignant lymphoma. In the 2010 report on 10 cases, all lesions were located in the stomach, and all regressed without any therapy. In the present study, we analyzed 6 cases of lymphomatoid gastropathy by investigating the clinicopathologic, immunohistochemical, and molecular findings. Endoscopic and morphologic appearances of all cases were consistent with previous rep

Abdominal plain film before gastrostomy tube placement to predict success of percutaneous endoscopic procedure.

OBJECTIVES: Percutaneous endoscopic gastrostomy (PEG) tube feeding is a convenient method for children requiring long-term enteral nutrition. Preoperative fitness of the majority of pediatric PEG candidates is graded as American Society of Anesthesiologists physical status ≥ III, indicating increased risk for peri- and postoperative morbidity. The success rate of endoscopic insertion is high, but variations in the anatomy may lead to failure of PEG placement and repeated exposure to anesthesia for surgical gastrostomy. We evaluated the efficiency of using abdominal plain film with gastric insu

Management and clinical outcomes of type I gastric carcinoid patients: retrospective, multicenter study in Japan.

BACKGROUND AND AIM: Type I gastric carcinoids (TIGC) are associated with chronic atrophic gastritis (CAG) with hypergastrinemia and hyperplasia of enterochromaffin-like cells. Several treatment options are currently available for these tumors including total gastrectomy, partial resection, antrectomy, endoscopic resection and endoscopic surveillance. The present study evaluated different treatment approaches and clinical outcomes of patients with TIGC in Japan. METHODS: Between 1991 and 2011, 82 patients with TIGC were identified at multicenter institutions in Japan. Patient demographics, tum

Outcome of screening endoscopy in common variable immunodeficiency disorder and X-linked agammaglobulinemia.

Gastrointestinal symptoms are common in patients with common variable immunodeficiency disorders (CVID) and less frequent in X-linked agammaglobulinemia (XLA) although the exact prevalence is not well established. In this study, endoscopic screening was performed in 30 patients with CVID and four patients with XLA. Endoscopic and/or histological abnormalities were detected in 25 of 30 patients with CVID (83 %), regardless of symptoms, and in nine of these patients the results prompted medical treatment. Helicobacter pylori-associated gastritis, adenomatous polyps, and lymphoid hyperplasia were

Biopsy from the base and edge of gastric ulcer healing or complete healing may lead to detection of gastric cancer earlier: an 8 years endoscopic follow-up study.

BACKGROUND/AIMS: To assess the incidence of gastric cancer development in gastric benign ulcer patients and to evaluate the value of biopsy by taking specimens from both the base and edges of ulcers in contrast to the traditional biopsy which takes specimens from the edges of ulcers only. METHODOLOGY: An endoscopic followup of more than 1 year was conducted on 456 gastric ulcer patients in our hospital for a duration over 8 years. We collected clinical, endoscopic and pathological data and obtained at least 6 biopsies from both the edges and the bases of ulcers healing or complete healing, re

Comparison of Billroth I and Roux-en-Y reconstruction after distal gastrectomy for gastric cancer: one-year postoperative effects assessed by a multi-institutional RCT.

PURPOSE: This randomized, controlled trial evaluated the clinical efficacy of Billroth I (BI) and Roux-en-Y (RY) reconstruction at 1 year after distal gastrectomy for gastric cancer. METHODS: The primary end point was the amount of body weight lost at 1 postoperative year, and secondary end points included other items related to nutritional status such as serum albumin and lymphocyte count, as well as endoscopic examination findings of the remnant stomach and esophagus. Of the 332 patients enrolled, 163 were assigned to the BI group and 169 were randomized to the RY group. RESULTS: The loss

[A 14-month surviving patient on advanced esophageal cancer with big lymph node metastasis to cardia responding to S-1 plus cisplatin (CDDP) therapy at home].

This case was a 70s male patient. He was hospitalized with some dysphasia and a severe body weight loss since August 2004. The diagnosis was the esophageal cancer (type 2, 11 cm) with big lymph node metastasis on cardia (8 cm), and also pathologically poorly differentiated squamous cell carcinoma from two legions. He wanted a home chemotherapy for it. We administered a combination chemotherapy of S-1 plus cisplatin (CDDP) therapy. An eight-day admission within an each course to CDDP treatment and nutritional support were required for adverse events of anorexia (grade 3), but for other days hom