Helicobacter pylori infection concomitant with metabolic syndrome further increase risk of colorectal adenomas

AIM: To investigate the association of colorectal adenomas with both Helicobacter pylori (H. pylori) infection and metabolic syndrome. METHODS: Using a cross-sectional hospital-based study, we analyzed physical examination data from 9311 healthy subjects with overnight physical examinations performed between January 2004 and December 2006. Examined data included gender, age, life style, anthropometric measurements, blood pressure, biochemical and hematological studies, H. pylori infection detected by esophagogastroduodenoscopy and biopsy urease tests, and colorectal adenomas detected with a complete total colonoscopy. RESULTS: The prevalence values for H. pylori infection, metabolic syndrome, and colorectal adenoma were39.2%, 18.7%, and 20.7%, respectively. Colorectal adenoma risk factors included male gender [odd ratio (OR): 2.005, 95% conf idence interval (CI): 1.740-2.310, P < 0.001], advanced age (OR: 1.046, 95% CI: 1.040-1.052, P < 0.001), smoking (OR: 1.377, 95% CI: 1.146-1.654, P = 0.001), increased body fat (OR: 1.016, 95% CI: 1.007-1.026, P = 0.001), higher white blood cell count (OR: 1.038, 95% CI: 1.005-1.073, P = 0.025), H. pylori infection (OR: 1.366, 95% CI: 1.230-1.517, P < 0.001), and metabolic syndrome (OR: 1.408, 95% CI: 1.231-1.610, P < 0.001). In addition, concomitant H. pylori infection with metabolic syndrome further increased the probability of colorectal adenomas. CONCLUSION: Our study revealed H. pylori infection with concomitant metabolic syndrome might further increase the risk of colorectal adenomas.

Synchronous adenocarcinoma and extranodal natural killer/T-cell lymphoma of the colon:A case report and literature review

Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.In the present study,we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo.He did not have fever,body weight loss or night sweat.Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid,easy bleeding mass in the sigmoid colon,respectively.Thought to have double carcinoma of the colon,he received simultaneous right hemicolectomy and sigmoidectomy.The pathological diagnosis was a synchronous ENKTL(ascending colon) and adenocarcinoma(sigmoid colon).The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.

Myoepithelial carcinoma of the stomach: A diagnostic pitfall

Myoepithelioma/myoepithelial carcinomas are not commonly found in soft tissues and are especially rare at visceral sites.This report describes a case of a rare low-grade myoepithelial carcinoma of the stomach.A61-year-old female patient presented with postprandial abdominal discomfort.Endoscopy revealed a 1.1 cm submucosal lesion.Local excision was performed after malignancy was confirmed by biopsy.The resection margin is free of tumor and she received no adjuvant therapy.The tumor was characterized by multinodular growth with biphasic epithelioid and spindle components.Infiltrative margin and nuclear pleomorphism are seen.Tumor cells were positive for both epithelial and myoepithelial markers.Evidence of epithelial differentiation was confirmed by electron microscopy.No EWSR1 rearrangement was detected.The final diagnosis was low-grade myoepithelial gastric carcinoma.The patient is currently well, and no evidence of recurrence or metastasis was found after ten-month of follow-up.Myoepithelial carcinoma should be considered in the differential diagnosis of a biphasic gastric tumor.

Concomitant gastric carcinoid and gastrointestinal stromal tumors:A case report

A gastric carcinoid tumor concomitant with gastrointestinal stromal tumor (GIST) is rarely encountered in clinical practice. We report a 65-year-old female who had a 0.8 cm gastric carcinoid tumor on the posterior wall of the upper gastric corpus detected during an esophagogastroduodenoscopy at a routine physical examination,and a concomitant 1.1 cm GIST on the anterior wall of the upper gastric corpus incidentally found during surgery of the gastric carcinoid tumor. Normal serum gastrin level and histological findings suggested that she had a type Ⅲ gastric carcinoid tumor and a GIST which were categorized a very low risk of malignancy,based on their small size and lack of mitosis. Both tumors were treated successfully by surgical excision. The patient had an uneventful recovery. Neither recurrence nor metastasis was found after a 28-mo follow-up.

Postoperative retroperitoneal desmoid tumor mimics recurrent gastrointestinal stromal tumor:A case report

Desmoid tumor is a locally invasive,myofibroblastic,nonmetastatic tumor.Its pathogenesis remains unclear and it may involve genetic abnormalities,sex hormones and traumatic injury,including surgery.Postoperative intra-abdominal desmoid tumor is rare,especially in the retroperitoneum.We report a case of postoperative retroperitoneal desmoid tumor that developed 29 mo after the first excision of a gastrointestinal stromal tumor.Sporadic trauma-related intraabdominal desmoid tumors reported in the English literature are also reviewed.Despite an extremely low incidence,postoperative desmoid tumor should be considered in the differential diagnosis when a recurrent neoplasm is found at least one year after operation.However,it is a clinical challenge to distinguish recurrent malignant neoplasms from desmoid tumors,and surgical resection is the treatment option depending on the anatomic location.

Solitary concomitant endocrine tumor and ductal adenocarcinoma of pancreas

Pancreatic tumors with combined exocrine and endocrine features are rare.Most reported cases are classified as mixed exocrine and endocrine carcinoma of the pancreas.We report the first case of solitary concomitant endocrine tumor and ductal adenocarcinoma of the pancreas.A 58-year-old patient was admitted for uncontrolled diabetes mellitus and body weight loss.The tumor was fortuitously discovered in the pancreatic tail after a tumor survey panel.Grossly,the solitary tumor had a central fibrous band that clearly divided it into two parts.On microscopic examination,the tumor contained both endocrine and exocrine components distinctly separated by the central fibrous band.The exocrine part showed a poorly-differentiated adenocarcinoma.The endocrine part was strongly immunoreactive to chromogranin,synaptophysin and glucagon.We reviewed the literature on pancreatic tumors with combined exocrine and endocrine features.A simple classification for this group of neoplasms is suggested,including five types:amphicrine,mixed,collision,solitary concomitant and multiple concomitant.