Compromiso del apéndice cecal por linfoma folicular grado 2. Reporte de un caso de presentación clínica atípica

The involvement of the appendix by lymphomas, both primarily or secondarily, is extremely rare; primary lymphomas account for less than 0.02% of gastrointestinal neoplasm. We present the rare case of a patient who debuts with low gastrointestinal bleeding as the main symptom. Colonoscopy found an extra mucosal tumour on the posterior aspect of the ceccum and bleeding from the appendicular orifice. Primary appendicular tumour is confirmed on multislice computed tomography and laparoscopic right hemicolectomy is performed. The patient had an uneventful postoperative course and was discharged on the 6th postoperative day. The pathology report shows a infiltration of the cecal appendix by grade 2 follicular lymphoma.

Differences in upper gastrointestinal neoplasm detection rates based on inspection time and esophagogastroduodenoscopy training

Background and study aims Esophagogastroduodenoscopy (EGD) has utility in early detection of upper gastrointestinal (UGI) neoplasms. However, previous studies report shorter inspection times and inexperienced endoscopists contribute to overlooking gastric neoplasms. We investigated neoplasm detection rates according to inspection time and extent of EGD training. Patients and methods In this retrospective observational study, we reviewed routine EGDs for 3,925 consecutive cases between October 2014 and March 2015. We divided the endoscopists into three groups based on median inspection time during EGD without undergoing biopsy. Using cut-off median inspection times of 7 and 10 minutes, three, five, and eight endoscopists were classified into the fast, moderate, and slow groups, respectively. We compared detection rates according to inspection time and the extent of EGD training. Results The median inspection time among all endoscopists was 9.3 minutes (range, 6.6 – 12.0 min). The detection rate for UGI neoplasms was as follows: fast group, 3.6%; moderate group, 3.3 %; and slow group, 3.1 % (P = 0.807). The median inspection time was significantly shorter among the intensive training ≥ 1-year group than among the < 1-year group (< 1-year: median 6.3 min; range 8.2 – 13.9 min, ≥ 1-year: median 8.9 min; range 6.4 – 11.4 min, P < 0.001). The detection rate for UGI neoplasms was significantly higher among the intensive training ≥ 1-year group than among the < 1-year group (< 1-year: 2.2 %; ≥ 1-year: 3.7 %, OR = 1.65, 95 % CI: 1.02 – 2.68, P = 0.041). Conclusions There was no association between inspection times and neoplasm detection rates. The quality of EGD, as measured by neoplasm detection rates, may be improved by ≥ 1-year of intensive training.

Malrotation of Intestine with Carcinoma Colon in Adult

Malrotation of gut is a congenital anomaly and patients usually present in childhood. Occasionally it may present in adulthood. Patients are usually asymptomatic when malrotation of gut is detected during investigations or operation. Also it can cause longstanding abdominal symptoms, volvulus of gut. Rarely malrotation of gut may present with gastrointestinal neoplasm. We present a 60year old female presented with carcinoma caecum along with intestinal malrotation.