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Volume 77 - 2014 - Fasc.4 - Letters

Giant gastric tubulovillous adenoma : A rare upper gastrointestinal bleeding

Polyps are defined as proliferative lesions of the gas- trointestinal mucosa growing into the lumen (1). Gastric polyps are typically asymptomatic. These lesions can be seen during approximately 2-6% of endoscopic proce- dures (2). Rarely adenomas lead to bleeding, and become symptomatic with anemia, abdominal pain and gastric outlet obstruction. Hyperplastic polyps, the most com- monly identified histological type, is considered non- neoplastic. The most common types of hyperplastic pol- yps in the stomach are fundic gland and adenomatous polyps (3). Adenomatous polyps of the stomach consti- tute 8% to 10 of all polyps and have three different sub- types : tubular, villous and tubulovillous polyps. Villous and tubulovillous adenomas have a high risk of develop- ing malignancy. AlsO. the risk of malignancy increases proportionally to the diameter of the polyp.


An unusual cause of giant gastric ulcer

Burkitt's lymphoma (BL) may involve different gastrointestinal sites, and small bowel is the commonest organ (1). Involvement of the stomach is observed in less than 10% of the patients during the course of the disease (1-3). Primay gastric BL is extremely rare (1). Here we report a case with involvement of stomach by giant BL ulcer presented with gastrointestinal bleeding initially.


Early detection of Klatskin tumor through the hepaticoduodenostomy

Hepaticoduodenostomy (HD) is a procedure used for biliary reconstriction in injuries bilary tree during chole- cystectomy (1). To our knowledge, no cases of Klatskin tumor early diagnosed through HD are reported in the medical literature. Herein, we firstly report a case of Klatskin tumor early diagnosed through HD. A 70-year-old female was admitted to our hospital with dyspeptic complaints. Upper gastrointestinal endos- copy revealed a surgical anastomosis (hepaticoduo- denostomy) in duodenal bulb (Fig. 1) and a papillary pol- ypoid lesion 5 mm in diameter was detected in the biliary tract near the anastomosis (Fig. 2). Histopathological examination of endoscopic biopsy sample from the lesion revealed cholangiocarcinoma (Klatskin tumor).


The MDCT-scan as an important tool in the management of relapsing, overt upper gastrointestinal bleeding : letter to the editor

Severe life-threatening hemorrhage in the duodenum is nearly always due to an arterial bleeding in peptic- or NSAID-induced ulcerations. In patients with overt arterial duodenal bleeding without visible ulcerations, congenital vascular malformations must be considered, especially in younger patients.


A case of mantle cell lymphoma in the colon

A 65-year-old man was diagnosed with mantle cell lymphoma, stage IVB, in 2003. He was treated with combination chemotherapy followed by upfront consoli- dative high-dose chemotherapy and autologous hemato- poietic stem cell transplantation. A complete remission was achieved in 2004. Ten years later the disease re- lapsed with peripheral blood and bone marrow involve- ment. A thoracic and abdominal CT (computed tomogra- phy) scan showed multiple enlarged axillary, mesenterial and retroperitoneal lymph nodes.