Early detection of response to imatinib therapy for gastrointestinal stromal tumor by using 18F-FDG-positron emission tomography and computed tomography imaging

有变形胃肠的基质肿瘤的 41 年的老女性被指 18F-FDG-positron 排放断层摄影术和计算断层摄影术(PET/CT ) 与 imatinib 在一个月前后扫描治疗(Glivec 收款机， Gleevec 收款机， Novartis，巴塞尔，瑞士) ，一个酷氨酸激酶禁止者(400 mg/d ) 。新陈代谢的反应在一月治疗前后被评估。最大的 standardised 举起价值(SUV ) 的减少是 79%( 从 9.8 ～ 2.1 ) 。正电子排放断层摄影术在 imatinib 治疗的一个月以后表明了完全的新陈代谢的反应。另外，以前的损害与花冠相比是计算机化的 tomographic 图象。根据 CT 图象在在治疗前后的肿瘤的尺寸没有差别。然而，新陈代谢的活动被禁止。18F-FDG-PET 是为对在有胃肠的基质肿瘤的病人的一个月 imatinib 治疗的反应的察觉的一个珍贵方法。

Leptin levels in the differential diagnosis between benign and malignant ascites

AIM: To evaluate the role of leptin levels in the differential diagnosis of ascites. METHODS: Ascitic leptin, TNFα and serum leptin levels were measured in 77 patients with ascites (35 with malignancies, 30 cirrhosis and 12 tuberculosis). Control serum samples were obtained from 20 healthy subjects. Leptin and TNFα levels were measured by ELISA. Body mass index (BMI) and percentage of body fat (BFM) by skin fold measurement were calculated for all patients and control groups. Peritoneal biopsy, ascites cytology and cultures or biochemical values were used for the diagnosis of patients. RESULTS: In patients with malignancies, the mean serum and ascites leptin levels and their ratios were significantly decreased compared to the other patient groups and controls. In tuberculosis peritonitis, ascitic fluid TNFα levels were significantly higher than malignant ascites and cirrhotic sterile ascites. BMI and BFM values did not distinguish between patients and controls. CONCLUSION: In patients with malignant ascites, levels of leptin and TNFα were significantly lower than in patients with tuberculous ascites.

Effect of sunitinib on metastatic gastrointestinal stromal tumor in patients with neurofibromatosis type 1: A case report

Gastrointestinal stromal tumor (GIST) represents the most common mesenchymal malignancy of the gastrointestinal (GI) tract. In neurofibromatosis (NF), the increased incidence of tumor needs to be considered even in non-symptomatic individuals. Patients with neurofibromatosis NF type 1 have an increased risk of developing GI tumors including rare types such as GIST. We report a case of GIST in a 53-year-old male patient with neurofibromatosis. The patient was diagnosed with NF four years ago and his medical history revealed that he was hospitalized 5 times with a provisional diagnosis of massive lower gastrointestinal bleeding. GIST was diagnosed at explorative laparotomy and the tumor was 21 cm × 13 cm × 7 cm in size. Immunohistochemical examination showed that vimentin, actin and CD117 were positive. Computerized tomography showed peritoneal implants three months later. Imatinib mesylate (600 mg/d) was initiated. However, control computerized tomography revealed liver and omental metastasis. The dosage was elevated to 800 mg/d. Despite high dosage, the progression of the metastatic lesions continued in the liver and omentum. The patient started oral sunitinib malate (Sutent? Pfizer Inc, New York, NY, USA) 50 mg per day for 4 consecutive weeks, followed by 2 wk off per treatment cycle. The metastatic lesions in the liver and omentum were decreased in size after four courses, suggesting that sunitinib is also an effective treatment modality for metastatic GIST in NF patients.

An interesting cause of esophageal ulcer etiology: Multiple myeloma of IgG kappa subtype

多发性骨髓瘤是成熟、不成熟的血浆房间的一个瘤。有腰痛，咽下困难，和左手臂疼痛的一个 50 岁的女人被介绍。上面的 endoscopical 检查被执行。在远侧的食管有盖住流出物的溃疡，从门牙在 30-32 定位了厘米，盖住整个粘膜。从损害获得的标本的组织病理学说的检查显示出与 IgG kappa 子类型的多发性骨髓瘤一致的血浆房间的参与。多发性骨髓瘤的食道的参与应该在与咽下困难介绍的病人被记住。