Aydemir, Selim | Tekin, Solak Nilgün | Aktunç, Erol | Numanoğlu, Gamze | Üstündağ, Yücel

Article | 2004 | Turkish Journal of Gastroenterology15 ( 3 ) , pp.192 - 195

Amaç: Celiac hastalığı ince barsakların glutene intoleransı sonucu oluşan bir hastalıktır. Epidemiolojik çalışmalarda prevalansı hakkında çok farklı veriler vardı. Hastalarda genellikle çok geniş spektrumda semptom ve bulgulara neden olabildiğinden celiac hastalığı tanısının konulması zor olabilmektedir. Hastalığın erken evrede yakalanması önemlidir. Çünkü bu hastalarda barsak lenfoması gelişme riski artmıştır. Celiac hastalığı olan hastalarda rekürren aftoz stomatit prevalansındaki yükseklik nedeniyle rekürren aftoz stomatitli hastaların celiac hastalığı yönünden araştırılması asemptomatik celiac hastalığı olan hastaların tanı alma . . .sını sağlayabilir. Bu çalışma rekürren aftoz stomatit nedeniyle başvuran olgularda celiac hastalığı prevalansını saptamak için planlanmıştır. Yöntem: Çalışma gurubu olarak rekürren aftoz stomatit öyküsü olan, kontrol grubu olarak ise rekürren aftoz stomatit öyküsü olmayan olgular alındı. Tüm olgularda anti gliadin IgG, antigliadin IgA ve anti endomisium antikorları bakıldı. Ayrıca endoskopi yapılarak duodenum distal kesiminden biyopsiler alındı. Bulgular: Rekürren aftoz stomatit öyküsü olan 41 olgunun ikisinde patolojik inceleme ile doğrulanan celiac hastalığı bulundu (%4.8). Celiac hastalığı saptanan bu iki olgunun her ikisinde de anti gliadin IgA ve endomisium antikorları pozitif bulundu. Anti gliadin IgG antikoru ise olguların birinde pozitifti. Kontrol grubundaki 49 olgunun hiçbirinde celiac hastalığı saptanmadı. Sonuç: Rekürren aftoz stomatit olgularında celiac hastalığı açısında ileri incelenmeler yapılmalıdır. Endoskopinin invaziv ve daha pahalı olması nedeniyle rekürren aftoz stomatitli olgularda celiac hastalığı ı araştırmak için öncelikli olarak serolojik tetkikler yapılmalı, seroljik markır pozitif olan olgularda endoskopik olarak duodenum ikinci kesiminden biyopsiler alınmalıdır. Background/aims: Celiac disease is a condition related to the small intestine’s intolerance to gluten. In epidemiologic studies the prevalence is highly variable. The diagnosis can be difficult due to the wide spectrum of signs and symptoms. As the risk for intestinal lymphoma is higher in these patients, early diagnosis has its privileges. The higher prevalence of recurrent aphthous stomatitis in celiac disease led us to investigate the celiac disease prevalence in patients with recurrent aphthous stomatitis, which might assist in diagnosis of asymptomatic celiac disease patients. The aim of this study was to determine the prevalence of celiac disease in patients presenting with recurrent aphthous stomatitis. Methods: The study group consisted of patients having a history of recurrent aphthous stomatitis. The control group included patients not having aphthous stomatitis. Antibodies to gliadin IgG and IgA and antibodies to endomysium were determined from the serum samples of all patients. Biopsies were obtained from the distal part of the duodenum. Results: Biopsies of two patients (4.8%) out of 41 belonging to the study group were diagnosed as celiac disease. In serum samples of both, antibodies to gliadin IgA and antibodies to endomysium were found to be positive. Antibodies to gliadin IgG antibody were positive in only one of these two patients. None of the 49 patients in the control group was diagnosed as celiac disease. Conclusion: Further evaluation of recurrent aphthous stomatitis patients for celiac disease must be performed. As the endoscopic procedures are invasive and costly, evaluation of recurrent aphthous stomatitis patients for celiac disease must include serologic markers at the beginning. If any positivity is determined in markers, then endoscopic procedures including biopsies of the duodenum must be considered as the second-step intervention Daha fazlası Daha az

Onak Kandemir N. | Dogan Gün B. | Irkörücü O. | Tokgöz H. | Barut F. | Cömert M. | Özdamar Ş.O.

Letter | 2011 | Turkish Journal of Gastroenterology22 ( 2 ) , pp.235 - 236

[No abstract available]

Kandemir, Nilüfer Onak | Bahadır, Burak | Bektaş, Sibel | Barut, Figen | Yurdakan, Gamze | Gün, Banu Doğan | Engin, Hüseyin

Article | 2011 | Turkish Journal of Gastroenterology22 ( 1 ) , pp.77 - 82

Konjenital melanositik nevüs, odontogenez sırasında ortaya çıkan ve nöral-krest’den gelişen hamartomatöz lezyonlardır. Bu çalışmada konjenital melanositik nevüsden gelişen ve gastrointestinal sistem metastazları ile bulgu veren iki malign melanoma olgusu sunulmaktadır. İlk olgu, plevral ve peritoneal efüzyon ile başvuran 71 yaşında kadın hasta olup, endoskopik incelenmede doudenumda nodüler lezyonlar saptanmış ve biyopsi yapılmıştır. Karın ağrısı yakınması ile başvuran ikinci olgu 36 yaşında erkek hasta olup, ileumda invajinasyonlara neden olan kitlesel lezyonlar nedeniyle segmenter ileal rezeksiyon uygulanmıştır. Lezyonların histop . . .atolojik incelemesinde tüm mukoza katlarını infiltre eden diffüz neoplastik infiltrasyon görülmüştür. Belirgin atipi ve pleomorfizm içeren neoplastik hücrelerde S-100, HMB-45 ve Melan A immünreaksiyon saptanmıştır. Her iki olguya, malign melanoma tanısı verilmiştir. İlk olguda karın derisinde, ikinci olguda ise femoral bölgede konjenital melanositik nevüs saptanmış ve histopatolojik incelemelerde bu lezyonların malign melanoma yönünde transformasyon gösterdiği belirlenmiştir. Gastrointestinal sistemde malign melanoma gelişimi primer veya metastatik kökenli olabilir. Kesin tanı daima ayrıntılı klinik, histopatolojik ve immünhistokimyasal incelemeleri gerektirir. Congenital melanocytic nevi are hamartomatous lesions that develop from the neural crest and arise during odontogenesis. In this report, we present two malignant melanoma cases developed from congenital melanocytic nevi and revealed by gastrointestinal system metastases. The first case was a 71-year-old female who presented with pleural and peritoneal effusion and underwent biopsy due to detection of nodular lesions in the duodenum by endoscopic examination. The second case was a 36-year-old male patient who presented with abdominal pain in whom segmental ileal resection was performed due to mass lesions causing invaginations in the ileum. Histopathological examination of the lesions showed a diffuse neoplastic infiltration comprising the entire mucosal layers. In neoplastic cells having a marked atypia and pleomorphism, immunoreactions with S-100, HMB-45, and Melan A were detected. Both cases were diagnosed as malignant melanoma. Abdominal skin in the first case and the femoral region in the second case exhibited congenital melanocytic nevi, and those lesions were determined to show a transformation towards malignant melanoma in the histopathological studies. Malignant melanoma development in gastrointestinal system may have a primary or metastatic character. Definitive diagnosis always requires detailed clinical, histopathological and immunohistochemical analyses Daha fazlası Daha az

Onak Kandemir N. | Bahadir B. | Bektaş S. | Barut F. | Yurdakan G. | Dogan Gün B. | Engin H.

Article | 2011 | Turkish Journal of Gastroenterology22 ( 1 ) , pp.77 - 82

Congenital melanocytic nevi are hamartomatous lesions that develop from the neural crest and arise during odontogenesis. In this report, we present two malignant melanoma cases developed from congenital melanocytic nevi and revealed by gastrointestinal system metastases. The first case was a 71-year-old female who presented with pleural and peritoneal effusion and underwent biopsy due to detection of nodular lesions in the duodenum by endoscopic examination. The second case was a 36-year-old male patient who presented with abdominal pain in whom segmental ileal resection was performed due to mass lesions causing invaginations in the . . . ileum. Histopathological examination of the lesions showed a diffuse neoplastic infiltration comprising the entire mucosal layers. In neoplastic cells having a marked atypia and pleomorphism, immunoreactions with S-100, HMB-45, and Melan A were detected. Both cases were diagnosed as malignant melanoma. Abdominal skin in the first case and the femoral region in the second case exhibited congenital melanocytic nevi, and those lesions were determined to show a transformation towards malignant melanoma in the histopathological studies. Malignant melanoma development in gastrointestinal system may have a primary or metastatic character. Definitive diagnosis always requires detailed clinical, histopathological and immunohistochemical analyses Daha fazlası Daha az

Barut, Figen | Kandemir, Onak Nilüfer | Karakaya, Kemal | Kökten, Neslihan | Özdamar, Şükrü Oğuz

Article | 2011 | Turkish Journal of Gastroenterology22 ( 3 ) , pp.324 - 328

Multifokal ve atlamalı tutulum, primer gastrointestinal lenfomalar için oldukça nadir görülen bir gelişim paternidir. Klinik ve makroskopik özellikleriyle Crohn hastalığını taklit eden kaldırım taşı görünümü ile dikkat çeken bir ince barsağın multifokal diffüz büyük B hücreli lenfoma olgusu, klinik ve patolojik özellikleri ile beraber sunulmuştur. 25 yaşındaki erkek olgunun jejunoileal rezeksiyon materyalinde, arada sağlam görünümde mukoza alanları izlenen, en büyüğü 2,5 cm çapında olan, ülsere, serozayı da infiltre eden polipoid görünümde multipl lezyonlar izlendi. Mikroskopik incelemede, belirgin nükleollü, veziküler nükleuslu, ge . . .niş eozinofilik sitoplazmalı, pleomorfik, atipik karakterde lenfoid hücrelerden oluşmuş tümöral infiltrasyon gözlendi. Bu atipik hücrelerde vimentin, LCA, CD20, CD79a ile B hücre fenotipinde immün reaksiyon izlendi. Olguya, diffüz büyük B hücreli lenfoma tanısı verildi. Crohn hastalığı belirti ve bulguları ile başvuran hastalarda nadir de olsa bu antitenin olabileceği vurgulanmıştır. Multifocal and skip involvement is quite a rare developmental pattern for primary gastrointestinal lymphomas. A 25-year-old male patient with diffuse large B-cell lymphoma of the small intestine, with macroscopic features and clinical aspects imitating Crohn’s disease and attracting attention with cobblestone-like appearance, is presented herein together with the clinical and pathological features. Multiple ulcerated lesions were also observed infiltrating the serosa with polypoid appearance, 2.5 cm in largest diameter, within the resected jejunoileal specimen, which displayed patchy, healthy-appearing mucosal areas. In microscopic examination, a tumoral infiltration was observed comprised of pleomorphic, atypical lymphoid cells with abundant eosinophilic cytoplasm, marked nucleoli and vesicular nuclei. A B-cell phenotype immunoreaction was observed by vimentin, LCA, CD20, and CD79a in those atypical cells. The diagnosis of the case was diffuse large B-cell lymphoma.The possibility of the presence of this disorder, although rare, is emphasized here for patients applying to the hospital with the signs and symptoms of Crohn’s disease Daha fazlası Daha az

Barut F. | Onak Kandemir N. | Karakaya K. | Kökten N. | Özdamar Ş.O.

Article | 2011 | Turkish Journal of Gastroenterology22 ( 3 ) , pp.324 - 328

Multifocal and skip involvement is quite a rare developmental pattern for primary gastrointestinal lymphomas. A 25-year-old male patient with diffuse large B-cell lymphoma of the small intestine, with macroscopic features and clinical aspects imitating Crohn's disease and attracting attention with cobblestone-like appearance, is presented herein together with the clinical and pathological features. Multiple ulcerated lesions were also observed infiltrating the serosa with polypoid appearance, 2.5 cm in largest diameter, within the resected jejunoileal specimen, which displayed patchy, healthy-appearing mucosal areas. In microscopic . . .examination, a tumoral infiltration was observed comprised of pleomorphic, atypical lymphoid cells with abundant eosinophilic cytoplasm, marked nucleoli and vesicular nuclei. A B-cell phenotype immunoreaction was observed by vimentin, LCA, CD20, and CD79a in those atypical cells. The diagnosis of the case was diffuse large B-cell lymphoma.The possibility of the presence of this disorder, although rare, is emphasized here for patients applying to the hospital with the signs and symptoms of Crohn's disease Daha fazlası Daha az