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Screening Test for Colorectal Cancer: Colonoscopy and Fecal Immunochemical Test.

Jong Hoon LEE

The Korean Journal of Gastroenterology.2012;59(5):389-391. doi:10.4166/kjg.2012.59.5.389

No abstract available.

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Colocolic Intussusception Caused by Lipoma.

Taek Geun JEONG ; Suck Chei CHOI ; Geom Seog SEO

The Korean Journal of Gastroenterology.2012;59(5):386-388. doi:10.4166/kjg.2012.59.5.386

No abstract available.
Adult ; Colonic Diseases/*diagnosis/etiology/surgery ; Colonoscopy ; Humans ; Intussusception/*diagnosis/etiology/surgery ; Lipoma/complications/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed

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Gastrointestinal Metastasis from a Primary Adenocarcinoma of the Lung Presenting with Acute Abdominal Pain.

Chien Ter HSING ; Ha Yeon KIM ; Jung Hyun LEE ; Ji Sun HAN ; Jong Hun LEE ; Jin Seok CHANG ; Seok Reyol CHOI ; Jin Sook JEONG

The Korean Journal of Gastroenterology.2012;59(5):382-385. doi:10.4166/kjg.2012.59.5.382

Symptomatic gastro-intestinal metastasis in lung cancer is extremely rare and only a few case reports have been published. Here, we report a case with lung adenocarcinoma that presented with acute abdominal pain, nausea and vomiting due to duodenum, jejunum, and colon obstruction by the gastro-intestinal metastasis. The patient underwent colonoscopy and the pathologic report was adenocarcinoma. When there are similar histologic findings in both colon and pulmonary lesion, the question is whether both lesions are primary cancer or the colon lesions are metastases from lung cancer. Microscopic examination of a conventional pathologic section was not sufficient to make this determination. Immunohistochemistry was positive for thyroid transcription factor-1 (TTF-1) and cytokeratin 7 (CK7), and negative for cytokeratin 20 (CK20) and caudal-related homeobox transcription factor-2 (CDX-2) on colon mucosa specimen. Accordingly, we used immunohistochemical marker for differential diagnosis of primary adenocarcinoma of the lung with gastro-intestinal metastasis.
*Abdominal Pain ; Adenocarcinoma/*diagnosis/pathology ; Colonoscopy ; Diagnosis, Differential ; Gastrointestinal Neoplasms/*pathology/secondary ; Homeodomain Proteins/metabolism ; Humans ; Immunohistochemistry ; Keratin-20/metabolism ; Keratin-7/metabolism ; Lung Neoplasms/*diagnosis/pathology ; Male ; Middle Aged ; Nuclear Proteins/metabolism ; Tomography, X-Ray Computed ; Transcription Factors/metabolism

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A Case of Synchronous Early Gastric Cancer and Diffuse Large B Cell Lymphoma Treated with Endoscopic Submucosal Dissection and Chemotherapy.

Jae Hyun PARK ; Jae Young JANG ; Yong Duck CHO ; Seok Ho DONG ; Hyo Jong KIM ; Byung Ho KIM ; Young Woon CHANG

The Korean Journal of Gastroenterology.2012;59(5):377-381. doi:10.4166/kjg.2012.59.5.377

Among malignant tumors of the stomach, adenocarcinoma takes up about 95% and the remaining are mostly lymphomas, being less than 5%. The majority of lymphomas are B cell lymphomas, and the most common types are low-grade B cell lymphoma of mucosa-associated lymphoid tissue and diffuse large B cell lymphoma (DLBL). The synchronous occurrence of adenocarcinoma and lymphoma in the stomach is being reported rarely. Especially the concurrence of adenocarcinoma and DLBL is very scarce and less than 10 cases have been reported inside and outside this country. In the past, the general treatment for cases of concurrence of adenocarcinoma and DLBL when surgery is possible according to cancer stages was gastrectomy, followed by single or combined chemotherapy and radiation treatment. However, when considering that most cases of concurrent adenocarcinoma were early gastric cancer which is limited to the mucosa, endoscopic submucosal dissection (ESD) can become an alternative treatment method for gastrectomy. We report the experience with chemotherapy and ESD done together instead of surgery, in patients concurrently diagnosed with early gastric cancer and gastric lymphoma.
Adenocarcinoma/*drug therapy/surgery ; Anti-Bacterial Agents/therapeutic use ; Antineoplastic Agents/therapeutic use ; Drug Therapy, Combination ; Helicobacter Infections/drug therapy ; Humans ; Lymphoma, Large B-Cell, Diffuse/*drug therapy/pathology ; Male ; Middle Aged ; Stomach Neoplasms/*drug therapy/surgery

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Gastroduodenal Intussusception Due to Pedunculated Polypoid Gastrointestinal Stromal Tumor.

Hyo Sun SEOK ; Chong Il SHON ; Hyun Il SEO ; Young Ghil CHOI ; Won Gil CHUNG ; Hyun Sun WON

The Korean Journal of Gastroenterology.2012;59(5):372-376. doi:10.4166/kjg.2012.59.5.372

The gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the digestive tract showing differentiation along the line of interstitial cell of Cajal. The most GISTs in the stomach generally show the appearance of submucosal tumors. It is rare for GISTs to appear as a pedunculated polypoid lesion on endoscopy. We experienced a case of a 51-year-old man who had a pedunculated polypoid GIST. He was admitted to our hospital for nausea, vomiting, melena and severe anemia (hemoglobin 3.4 g/dL, hematocrit 10.8%). An upper endoscopy showed gastroduodenal intussusception due to a pedunculated polypoid mass. This report presents a rare case of endoscopically proven gastroduodenal intussusceptions due to pedunculated polypoid GIST in the stomach.
Duodenal Diseases/etiology/*pathology ; Gastrointestinal Hemorrhage ; Gastrointestinal Neoplasms/complications/*pathology ; Gastrointestinal Stromal Tumors/complications/*pathology ; Gastroscopy ; Humans ; Intussusception/etiology/*pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

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A Ten-year Follow-up of a Case with Gastric Adenoma Accompanied with Gastritis Cystica Profunda Treated by Endoscopic Submucosal Dissection.

Jung Hee KIM ; Sung Yeol JANG ; Jeong Ah HWANG ; Sung Hae HA ; Won Gyu CHOI ; Ju Sang PARK ; Eun Mee HAN

The Korean Journal of Gastroenterology.2012;59(5):366-371. doi:10.4166/kjg.2012.59.5.366

Gastritis cystica profunda (GCP) is an uncommon hyperplastic benign lesion, and histologically characterized by hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. GCP usually occurs at a gastroenterostomy site, although it can occasionally be found in an unoperated stomach. GCP is thought to be a possible precancerous lesion, since a few early gastric cancers associated with it were reported. Herein, we report a case of gastric adenoma associated with GCP in an unoperated patient. The sizes of both the GCP and adenoma overlying it have increased during a 10 year follow-up period. Adenoma on the latest biopsy showed low grade dysplasia, and it was successfully treated by endoscopic submucosal dissection.
Adenoma/complications/*diagnosis/surgery ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastritis/complications/*diagnosis/ultrasonography ; Gastroenterostomy ; Humans ; Precancerous Conditions ; Stomach Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

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Influenza A (H1N1) 2009 Pandemic Calm Down the Prevalence of Acute Hepatitis A in the Latter Half of 2009: Korean Population Study.

Jin Myung BYUN ; Sang Gyune KIM ; Yuan Yuan ZHANG ; Young Seok KIM ; Soung Won JEONG ; Sae Hwan LEE ; Jae Young JANG ; Soo Jin HONG ; Jong Ho MOON ; Hong Soo KIM ; Moon Sung LEE ; Boo Sung KIM

The Korean Journal of Gastroenterology.2012;59(5):360-365. doi:10.4166/kjg.2012.59.5.360

BACKGROUND/AIMS: There was a spiking incidence of acute hepatitis A (AHA) in 2009 summer, but it went down drastically after an outbreak of influenza A (H1N1). We assessed the relationship between 2009 H1N1 pandemic and AHA prevalence from August to December 2009. METHODS: We compared AHA cases nationwide and in our hospital for the period from the latter half of 2008 to the end of 2010. H1N1 cases in our hospital from August 2009 to December 2009 were included in the study and the correlation between 2009 H1N1 pandemic and AHA prevalence was assessed. RESULTS: The national surveillance system reported 2,233, 7,895, 15,231 and 7,660 AHA cases from 2007 to 2010, respectively. A similar trend was noted in our hospital in the same periods. Although the national total incidence was increased in 2009, it showed steep decreasing trend line in the final 21 weeks of 2009 (weeks 32-52), as compared with 2008 and 2010. The mean weekly incidence percentage (AHA cases in a week/total in a year) in weeks 32-52 of 2009 was 1.17+/-0.55%, significantly lower than that in 2008 and 2010 (1.61+/-0.43% and 1.56+/-0.51%; p<0.001). Furthermore, we found a significant negative correlation between 2009 H1N1 pandemic and AHA in our hospital for weeks 32-52 of 2009 (r=-0.597; p<0.001). CONCLUSIONS: The widespread occurrence of 2009 H1N1 pandemic highlighted the benefits of health care and good hygiene, such as effective hand washing and wearing of masks, which may have also interrupted hepatitis A virus transmission.
Acute Disease ; Hepatitis A/*epidemiology ; Humans ; Influenza A Virus, H1N1 Subtype/*isolation & purification ; Influenza, Human/*epidemiology/virology ; Pandemics ; Prevalence ; Republic of Korea/epidemiology ; Seasons

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Predictable Factors of Histologic Discrepancy of Gastric Cancer between the Endoscopic Forceps Biopsy and Endoscopic Treatment Specimen.

Ji Ho KIM ; Sung Hoon KIM ; Won Hyeong PARK ; Ji Sun JANG ; Jei So BANG ; Soo Hyun YANG ; Jong Hoon BYUN ; Yoon Jung KIM

The Korean Journal of Gastroenterology.2012;59(5):354-359. doi:10.4166/kjg.2012.59.5.354

BACKGROUND/AIMS: Recently, variable gastrointestinal track tumors including early stage malignancies are treated by endoscopic procedure. However, the discrepancy of histologic diagnosis may sometimes exist between the pretreatment forceps biopsy results and those of post treatment specimen. So the prediction of malignant lesion is important in the aspect of treatment selection. In this study, we investigated the predictable factors of the histologic discrepancy through the clinical, endoscopic features of the lesion diagnosed as adenocarcinoma in the post-endoscopic treatment specimen after the adenoma was diagnosed by the endoscopic forceps biopsy. METHODS: From March 2005 to April 2009, 129 gastric tumor lesions (129 patients) which were not diagnosed as malignancy and treated with endoscopic procedure were enrolled retrospectively. We compared the pretreatment endoscopic forceps biopsy results and post-treatment specimen biopsy results, then, analyzed the tumor characteristics. RESULTS: Twenty-one cases (16.3%) were diagnosed as malignancy after endoscopic treatment. Especially, discrepancy occurred more frequently in depressed lesions than in flat or elevated lesions (41.7% vs. 13.7%, p=0.012), and in lesions diagnosed as high grade adenomas than low or moderate grade adenomas (33.3% vs. 11.1%. p=0.004). CONCLUSIONS: In cases of depressed type lesions in the pretreatment endoscopy or those diagnosed as high grade adenoma in the pretreatment forceps biopsy, we should consider combined malignant lesion. Therefore, treatment modalities ensuring accurate diagnosis and potentially curative resection, should be carefully selected and performed in cases which have these features.
Adenoma/pathology/surgery ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Biopsy ; Female ; Gastroscopy ; Humans ; Male ; Middle Aged ; *Predictive Value of Tests ; Sex Factors ; Stomach Neoplasms/*pathology/surgery

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Usefulness of 18F-fluoro-2-deoxyglucose Positron Emission Tomography in Evaluation of Gastric Cancer Stage.

Na Ri YOON ; Jae Myung PARK ; Hee Sun JUNG ; Yu Kyung CHO ; In Seok LEE ; Myung Gyu CHOI ; In Sik CHUNG ; Kyo Young SONG ; Cho Hyun PARK

The Korean Journal of Gastroenterology.2012;59(5):347-353. doi:10.4166/kjg.2012.59.5.347

BACKGROUND/AIMS: The usefulness of 18F-fluoro-2-deoxyglucose (FDG)-PET in detecting primary cancer, lymph node metastasis, and distant metastasis were studied in the gastric cancer patients. METHODS: The subjects were 392 gastric cancer patients who received FDG-PET and an abdominal CT test prior to surgery. The results of FDG-PET and CT were compared with the surgical and pathologic results. RESULTS: The primary site detection rate of FDG-PET was 74.4%, 50.3% in early gastric cancer and 92.0% in advanced gastric cancer. Detection rate was higher when tumors were larger than 3.5 cm, had deeper depth of invasion, and at a later stage (p<0.05, respectively). In multivariate analysis, tumor size, spread of tumor cells beyond the muscle layer (> or =T2), and lymph node metastasis were statistically significant factors in primary site detection rate. The sensitivity, specificity, and positive predictive value of FDG-PET to lymph node metastasis were 59.6%, 88.8%, and 81.1% respectively, sensitivity being lower compared to CT while specificity and positive predictive value were higher. Sensitivity, specificity, and positive predictive value to distant metastasis were, respectively, 66.7%, 99.2%, and 88.0%, similar to CT. In 21 of the 392 patients (5.4%), synchronous double primary cancers were detected. CONCLUSIONS: In gastric cancer, usefullness of FDG-PET is limited to the advanced stage. Diagnostic value of this test was not superior to CT. However, FDG-PET may be useful in detecting synchronous double primary cancers.
Aged ; Female ; Fluorodeoxyglucose F18/chemistry/*diagnostic use ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Positron-Emission Tomography ; Predictive Value of Tests ; ROC Curve ; Radiopharmaceuticals/chemistry/*diagnostic use ; Retrospective Studies ; Stomach Neoplasms/*diagnosis/radionuclide imaging ; Tomography, X-Ray Computed

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Clinical Characteristics of Patients Diagnosed as Peptic Ulcer Disease in the Third Referral Center in 2007.

Jin Joo KIM ; Nayoung KIM ; Hyun Kyung PARK ; Hyun Jin JO ; Cheol Min SHIN ; Sang Hyup LEE ; Young Soo PARK ; Jin Hyeok HWANG ; Jin Wook KIM ; Sook Hyang JEONG ; Dong Ho LEE ; Jung Mogg KIM ; Ji Hyun LEE ; Hyun Chae JUNG ; In Sung SONG

The Korean Journal of Gastroenterology.2012;59(5):338-346. doi:10.4166/kjg.2012.59.5.338

BACKGROUND/AIMS: In spite of the improvement of medical treatment for the peptic ulcer disease (PUD), PUD is still one of the common upper gastrointestinal diseases. The purpose of this study was to evaluate the risk factors and general characteristics of Korean patients diagnosed as PUD at a single third referral center. METHODS: A total of 310 patients, diagnosed as PUD through endoscopy during one year of 2007 at Seoul National University Bundang Hospital were, retrospectively, evaluated regarding age, gender, Helicobacter pylori (H. pylori) positivity, clinical manifestations, comorbidities and medications. In addition, PUD was analyzed in the aspect of ulcer location, type of visit, gastrointestinal bleeding, and age. RESULTS: The mean age was 61.5 years old (48.1% over 65) and 208 (66.7%) patients were men. The rate of H. pylori infection was 47.8%, and any ulcerogenic medication history such as antiplatelet agents and NSAIDs was found to be 21.0% (65 patients). The rate of idiopathic peptic ulcer without evidence of H. pylori and NSAIDs was found to be 40.6% (126 patients). Among 310 PUD patients, bleeding symptoms such as melena, hematemesis and hematochezia occurred in 110 patients (35.5%). CONCLUSIONS: PUD was more prevalent in the elderly patients and frequently associated with bleeding. Substantial proportion of PUD patients had neither H. pylori infection nor history of ulcerogenic medications, suggesting of increasing prevalence of idiopathic PUD.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Female ; Gastrointestinal Hemorrhage ; Gastroscopy ; Helicobacter Infections/complications/diagnosis ; Helicobacter pylori ; Hematemesis ; Humans ; Male ; Melena ; Middle Aged ; Peptic Ulcer/*diagnosis/drug therapy/epidemiology ; Platelet Aggregation Inhibitors/therapeutic use ; Prevalence ; Referral and Consultation ; Retrospective Studies ; Risk Factors ; Sex Factors

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