Gastric MALT lymphoma usually presents with various endoscopic morphologic characteristics. The majority of the endoscopic findings of low-grade gastric MALT lymphoma reveal multiple and superficial erosions or ulceration with mucosal nodularity, but high-grade gastric MALT lymphomas show ulceroinfiltrative and fungating lesion. However, low-grade gastric MALT lymphoma that presents as advanced gastric cancer is very rare. We experienced a case of low-grade gastric MALT lymphoma with perigastric lymph node infiltration; it presented as advanced gastric cancer, and it was treated with H. pylori eradication and CHOP chemotherapy. So we report on this case along with a review of related literatures.
Drug Therapy ; Lymph Nodes ; Lymphoma, B-Cell, Marginal Zone* ; Stomach Neoplasms* ; Ulcer

BACKGROUND/AIMS: The endoscopic and clinical findings of gastrointestinal (GI) Burkitt lymphoma in Koreans are not well known. METHODS: From January 1995 to July 2007, 80 patients (47 adults and 33 children) were diagnosed with Burkitt lymphoma at our institution. The clinical and endoscopic manifestations were analyzed in the adult patients (n=20, median age=52 yr) with GI Burkitt lymphoma. RESULTS: The most frequent symptom was abdominal pain (50%) followed by epigastic soreness (30%). Among the 20 patients with GI Burkitt lymphoma, 11 (55%) had gastric lesions, 4 (20%) had colonic lesions, 3 (15%) had both gastric and duodenal lesions, 1 (5%) had both gastric and colonic lesions, and 1 (5%) had gastric, duodenal and colonic lesions. For the 13 patients who had endoscopic pictures available, the most common type of disease was the ulcerative type (38.5%) followed by the ulcerofungating and ulceroinfiltrative types (23.1% and 23.1%, respectively). Most of the patients were diagnosed with advanced disease. The most common clinical stage was stage IVE (60%) by the Musshoff staging system. All 20 patients received combination chemotherapy, and the 5-year survival rate was 64%. CONCLUSIONS: For patients with GI Burkitt lymphoma, the most commonly involved site was the stomach. Most lesions were ulcerative with or without fungating morphology. Considering the advanced stage of most patients, the prognosis after systemic chemotherapy was favorable.
Abdominal Pain ; Adult ; Burkitt Lymphoma ; Colon ; Drug Therapy, Combination ; Humans ; Prognosis ; Stomach ; Survival Rate ; Ulcer

Animals ; Anti-Ulcer Agents ; therapeutic use ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Gastrointestinal Diseases ; drug therapy ; Humans ; Liver Diseases ; drug therapy ; Plants, Medicinal ; chemistry ; Polysaccharides ; isolation & purification ; therapeutic use ; Stomach Neoplasms ; drug therapy ; Stomach Ulcer ; drug therapy

Helicobacter pylori (H. pylori) is currently considered the most important exogenous factor in the genesis of gastritis and peptic ulcer disease. However, the optimum regimen for the eradication of H. pylori remains unclear. The purpose of this study was to evaluate the eradication rate of H. pylori, the side effects, and the patients' compliance with regard to various drug regimens. We also analyzed factors influencing the eradication of H. pylori. One hundred and eighty patients were included and divided into four groups: 42 patients (Group I) received tripotassium dicitrato bismuthate (240 mg b.i.d.), metronidazole (250 mg t.i.d.) and amoxicillin (500 mg t.i.d.) for 14 days; 55 patients (Group 2) received omeprazole (20 mg b.i.d.) and amoxicillin (1000 mg b.i.d.) for 14 days; 36 patients (Group 3) were treated with omeprazole (20 mg b.i.d.), metronidazole (250 mg t.i.d.) and amoxicillin (500 mg t.i.d.) for 14 days; and 47 patients (Group 4) received omeprazole (20 mg q.d.) and amoxicillin (500 mg t.i.d.) for 14 days and then tripotassium dicitrato bismuthate(240 mg b.i.d.) and nizatidine (150 mg q.d.) for 14 days. The diagnosis of H. pylori was made by histology. The eradication of H. pylori was defined both by histology (H&E and Giemsa stain) and by rapid urease test (CLOR) showing negative for H. pylori 4 weeks after the completion of therapy. Of the 180 patients, 95 patients had non-ulcer dyspepsia, 40 patients had gastric ulcer and 45 patients had duodenal ulcer. The eradication rate of H. pylori was highest (89.3%) in Group 3, as compared with Group 1 (68.9%), Group 2 (65.4%), and Group 4 (48.9%). The eradication rate was significantly higher in Group 3 than in Groups 2 and 4 (p< 0.05). There was no significant difference in the eradication rate among clinical diagnosis, sex and age. But, in the conventional triple therapy (Group 1), the eradication rate was higher in male (78.6%) than in female (46.2%). The side effects in order, were nausea (22.1%), dizziness (19.5%), abdominal pain (11.6%) and diarrhea (97%), and there was no difference among the drug regimens. The compliance of the patients was good (more than 80% irrespective of drug regimen). On the basis of these findings, the side effects of the drugs seemed minimal, and the compliance of patients was good irrespective of the drug regimen. In conclusion, the triple therapy with omeprazole, metronidazole and amoxicillin was the most effective regimen and could be recommended for H. pylori eradication.
Adult ; Anti-Ulcer Agents/*therapeutic use ; Antibiotics/*therapeutic use ; Duodenal Ulcer/microbiology ; Dyspepsia/microbiology ; Female ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Human ; Male ; Middle Age ; Stomach Ulcer/microbiology

BACKGROUND: Since the international guideline of Helicobacter pylori eradication therapy was introduced into Korea, many reports about eradication outcomes have been documented. These data were published mostly from referred university hospital. However, in Korea, majority of patients has been treated with H.pylori eradication regimen in primary care setting. This study was performed to investigate the eradication rate of H. pylori in primary care office of Seoul, Korea. METHODS: Total 173 patients with H.pylori-positive gastroscopy results received eradication regimen-mainly one week PPI based triple therapy-from January 1998 to March 2003. Four weeks after completion of medication, urea breath test, biopsy and CLO test were performed to detect H.pylori. RESULTS: Total eradication rate was 87.9%. The eradication rate of male and female were 90.3% and 84.3%, respectively (p>0.05). The eradication rate of patients older than younger than 60 was 81.5% vs 89.0%, respectively (p>0.05). There was no statistical significance in annual eradication rate. In eradication rate, there was no significant difference among PPI regimen (omeprazole, rabeprazole, pantoprazole). Whether endoscopic diagnosis is gastric ulcer or duodenal ulcer, there was no statistical difference in eradication rate between them. In the same way, there was also no statistical difference between peptic ulcer and H.pylori associated gastritis. CONCLUSION: The current eradication rate of H. pylori in primary care setting of Korea was 87.9%. H.pylori eradication rate in primary care setting was not much different from that in referred hospital in Korea, but it was lower than that reported by controlled trials of 1995 (initial times of introduction of international guide line into Korea). So far, the results have been acceptable, but there still remains to be investigated in PPI-based triple therapy as H.pylori eradication in primary care setting in the future of Korea.
Biopsy ; Breath Tests ; Diagnosis ; Drug Therapy ; Duodenal Ulcer ; Female ; Gastritis ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea* ; Male ; Peptic Ulcer ; Primary Health Care* ; Rabeprazole ; Seoul ; Stomach Ulcer ; Urea

Gastric ulcer bleeding in neonatal period, mainly in preterm newborn babies or in neonates treated in intensive care units, is relatively frequent, However the occurrence of significant gastric ulcer bleeding in healthy full term infants is unusual. We experienced a case of massive upper gastrointestinal (GI) bleeding in a 3-day-old healthy full term infant. Endoscopic examination confirmed the presence of gastric ulcerations. Treatment was initiated with transfusion and histamine 2 receptor antagonist, and the clinical signs resolved. Mother's serum antibody to Helicobacter pylori (H. pylori) was positive. We collected stool of the patient including other 17 infants in the intensive care unit. A highly sensitive semi-nested PCR for H. pylori DNA was performed, but all infants including the patient revealed negative. H. pylori infection is not related with upper GI bleeding in healthy full term infants. In conclusion, the diagnosis of upper GI bleeding in infant can be easily made by means of pediatric endoscopy, which is a simple and a well tolerated examination.
Blood Transfusion ; Endoscopy, Gastrointestinal ; Female ; Histamine Antagonists/therapeutic use ; Humans ; Infant, Newborn ; Peptic Ulcer Hemorrhage/*diagnosis/drug therapy/therapy ; Stomach Ulcer/*complications

PURPOSE: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. MATENRIALS AND METHODS: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. RESULTS: The lower one-third of the stomach was the most frequent site (42%), and the most frequent chief complaint was epigastric pain (54%). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases (82%), a carcinoma in 15 cases (13%), an ulcer in 4 cases (4%), and a gastrointestinal stromal tumor in 1 case (1%). The stage distributions by Musshoff's criteria were 71 cases (54%) of stage IE, 36 cases (27%) of stage II1E, 8 cases (6%) of stage II2E, 2 cases (2%) of stage IIIE, and 15 cases (11%) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases (23%) of low grade, 96 cases (73%) of intermediate grade, and 5 cases (4%) of high grade. Chemotherapy-related complications occurred in 25 cases (22%) while operation-related complications occurred in 6 cases (5%). Seventeen patients (13%) only underwent surgery, 19 (14%) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients (73%) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was 85% in stage I or II and 47% in stage III or IV (P=0.0000). CONCLUSION: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.
Biopsy ; Drug Therapy ; Gastrointestinal Stromal Tumors ; Hospitals, General ; Hospitals, University ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Radiotherapy ; Stomach ; Ulcer

Small cell carcinoma (SmCC) of stomach is a very rare and aggressive malignancy with extremely poor prognosis. Most patients with gastric SmCC die within 1 year of diagnosis. A standard treatment for gastric SmCC has not been established, but surgical excision and/or combination chemotherapy should be considered to promote long term survival. We report a case of small cell carcinoma of stomach in a 66-year-old woman with dysphagia. A gastroscopic examination revealed a polypoid mass with ulceration on the lesser curvature of the gastric body extending to the gastro-esophageal junction. An endoscopic biopsy showed a solid proliferation of small, monotonous tumor cells with hyperchromatic nuclei and scanty cytoplasm. Immunohistochemically, the neoplastic cells were positive for chromogranin, synaptophysin and NSE, and negative for CD45. No tumor was detected on examination of the chest. Therefore, primary SmCC was diagnosed preoperatively.
Aged ; Biopsy ; Carcinoma, Small Cell* ; Cytoplasm ; Deglutition Disorders ; Diagnosis ; Drug Therapy, Combination ; Female ; Humans ; Prognosis ; Stomach* ; Synaptophysin ; Thorax ; Ulcer

Marginal zone B-cell lymphoma of the gastrointestinal tract most commonly affects the stomach. Endoscopic findings of primary gastrointestinal lymphoma are various and heterogeneous. Lesions may appear as ulcers, erosions, or erythemas. Gastrointestinal lymphomas presenting as multiple polyps on endoscopy are rare. No case of marginal zone B-cell lymphoma manifesting as multiple polyps has been reported on the stomach, although a few cases have been reported in the colon. We present a rare case of a 77-year-old female patient diagnosed as primary gastric marginal zone B-cell lymphoma presenting as multiple polyps. She was fully treated by combination chemotherapy.
Aged ; Colon ; Drug Therapy, Combination ; Endoscopy ; Erythema ; Female ; Gastrointestinal Tract ; Humans ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Polyps ; Stomach ; Ulcer

Gastric cancer is the most common malignancy in Korea. Although five years survival rate of gestric cancer has been gradually improved due to advances in the diagnostic technique and therapeutic modalities, the advanced gastric cancer remains a disease with poor pragnosis. At the time of diagnosis, the disease, is usually advanced and longterm survivor is uncommon without a proper surgical treatment or chemotherapy. We experienced a case of advanced gastric cancer who lived for more than 6 years after making a diagnosis, without curative surgical therapy or chemotherapy. The patient at age of 76 year-old, was seen in St. Mary's hospital due to gastroinestinal bleeding in January of l985. A large ulcerating cancer in the diameter of 2.0 cm was found at the posterior wall of body with endoscopy and confirmed the diagnosis of stomach cancer by the endoscopic biopsy. He was recommended the surgical intervention of gastric cancer but he denied the operation due to his age, He had been treated symptomatically with H2 receptor antagonist and antacid with relief of symptoms. Thereafter he had been followed-up clinically at every 2-4 weeks, and the lesion was examined 3-4 times in a year endoscopically, In May l990, an endoscopic esophageal dilation was done due to esophageal stricture with tumor invasion at the lower esophageal sphincter. He was expired in July, 1991 in this hospital. Here we report a case of long term survived advanced gastric cancer who had been followed-up for 6 and half years clinically and endoscopically with review of literatures.
Aged ; Biopsy ; Diagnosis ; Drug Therapy ; Endoscopy ; Esophageal Sphincter, Lower ; Esophageal Stenosis ; Hemorrhage ; Humans ; Korea ; Stomach Neoplasms* ; Survival Rate ; Survivors ; Ulcer