Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type.Although lymphoma can involve any part of the gastrointestinal tract,the most frequent sites in o...Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type.Although lymphoma can involve any part of the gastrointestinal tract,the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region.Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare.Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions.Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract,although recently the frequency of other forms has also increased in certain regions of the world.Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma,they are not specific,thus mandating histopathological analysis for its definitive diagnosis.There has been a tremendous leap in the diagnosis,staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways.展开更多
Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare r...Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria. A combination of the Rome Ⅲ criteria, a physical examination, blood tests, gastros-copy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following:genetic factors, dietary intake, intestinal flora, or lowgrade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.展开更多
目的研究腹型过敏性紫癜患儿的临床表现、内镜及病理学特点,以提高对腹型过敏性紫癜的诊断水平。方法以浙江大学医学院附属儿童医院2002年1月-2007年5月住院的57例行上消化道内镜检查时未出现皮肤紫癜患儿为研究对象,回顾性分析腹型过...目的研究腹型过敏性紫癜患儿的临床表现、内镜及病理学特点,以提高对腹型过敏性紫癜的诊断水平。方法以浙江大学医学院附属儿童医院2002年1月-2007年5月住院的57例行上消化道内镜检查时未出现皮肤紫癜患儿为研究对象,回顾性分析腹型过敏性紫癜患儿的临床、内镜及病理学资料。结果消化道症状主要为腹痛46例(80.7%)、呕吐32例(56.1%)、便血11例(19.3%)、腹泻4例(7.0%)、腹胀1例(1.8%);同时伴关节肿痛3例(5.3%)。实验室检查主要为外周血白细胞增高(33例,57.9%),1/5左右的病例出现 C 反应蛋白升高、白蛋白降低或腹腔积液情况。内镜下主要表现37例为略高出黏膜的点状出血和淤斑或成片状(64.9%),14例出现糜烂或多发溃疡伴出血(24.6%),4例颗粒状或结节状增生(7.0%),弥漫性出血2例(3.5%)。病变在十二指肠降段出现率最高且最严重(55例,96.5%),其次为十二指肠球部(32例,56.1%)、胃(18例,31.6%),食道较少(1例,1.8%)。组织病理学呈毛细血管炎表现,3例(5.3%)的患儿同时伴幽门螺杆菌感染。49例(86.0%)患儿在内镜检查后1～7 d 内出现皮肤紫癜,8例至出院未出现皮肤紫癜,其中2例失访,6例(10.5%)随访至今(1～5年)未见皮肤紫癜。结论十二指肠降部病变在腹型过敏性紫癜极其常见,上消化道内镜检查对腹型过敏性紫癜有极高的诊断价值。展开更多
基金Supported by Hubei Province Natural Science Fund of China,No.2009CDA071Wuhan University Independence Fund of China,No.303275894
文摘Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type.Although lymphoma can involve any part of the gastrointestinal tract,the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region.Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare.Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions.Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract,although recently the frequency of other forms has also increased in certain regions of the world.Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma,they are not specific,thus mandating histopathological analysis for its definitive diagnosis.There has been a tremendous leap in the diagnosis,staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways.
文摘Irritable bowel syndrome (IBS) is a common gastro-intestinal (GI) disorder that considerably reduces the quality of life. It further represents an economic burden on society due to the high consumption of healthcare resources and the non-productivity of IBS patients. The diagnosis of IBS is based on symptom assessment and the Rome Ⅲ criteria. A combination of the Rome Ⅲ criteria, a physical examination, blood tests, gastros-copy and colonoscopy with biopsies is believed to be necessary for diagnosis. Duodenal chromogranin A cell density is a promising biomarker for the diagnosis of IBS. The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS:heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut. One hypothesis proposes that the cause of IBS is an altered NES, which would cause abnormal GI motility, secretions and sensation. All of these abnormalities are characteristic of IBS. Alterations in the NES could be the result of one or more of the following:genetic factors, dietary intake, intestinal flora, or lowgrade inflammation. Post-infectious IBS (PI-IBS) and inflammatory bowel disease-associated IBS (IBD-IBS) represent a considerable subset of IBS cases. Patients with PI-and IBD-IBS exhibit low-grade mucosal inflammation, as well as abnormalities in the NES of the gut.
文摘目的研究腹型过敏性紫癜患儿的临床表现、内镜及病理学特点,以提高对腹型过敏性紫癜的诊断水平。方法以浙江大学医学院附属儿童医院2002年1月-2007年5月住院的57例行上消化道内镜检查时未出现皮肤紫癜患儿为研究对象,回顾性分析腹型过敏性紫癜患儿的临床、内镜及病理学资料。结果消化道症状主要为腹痛46例(80.7%)、呕吐32例(56.1%)、便血11例(19.3%)、腹泻4例(7.0%)、腹胀1例(1.8%);同时伴关节肿痛3例(5.3%)。实验室检查主要为外周血白细胞增高(33例,57.9%),1/5左右的病例出现 C 反应蛋白升高、白蛋白降低或腹腔积液情况。内镜下主要表现37例为略高出黏膜的点状出血和淤斑或成片状(64.9%),14例出现糜烂或多发溃疡伴出血(24.6%),4例颗粒状或结节状增生(7.0%),弥漫性出血2例(3.5%)。病变在十二指肠降段出现率最高且最严重(55例,96.5%),其次为十二指肠球部(32例,56.1%)、胃(18例,31.6%),食道较少(1例,1.8%)。组织病理学呈毛细血管炎表现,3例(5.3%)的患儿同时伴幽门螺杆菌感染。49例(86.0%)患儿在内镜检查后1～7 d 内出现皮肤紫癜,8例至出院未出现皮肤紫癜,其中2例失访,6例(10.5%)随访至今(1～5年)未见皮肤紫癜。结论十二指肠降部病变在腹型过敏性紫癜极其常见,上消化道内镜检查对腹型过敏性紫癜有极高的诊断价值。
