Diagnosis and Prognosis of Gastrointestinal Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 19956

Special Issue Editor


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Guest Editor
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Interests: inflammatory bowel disease; ulcerative colitis; Crohn’s disease; gastrointestinal tuberculosis; acute pancreatitis; chronic pancreatitis

Special Issue Information

Dear Colleagues,

Recent times have seen exponential advances in the diagnosis and management of gastrointestinal diseases. Researchers and scientists across the globe have helped in improving the diagnostics of various gastrointestinal diseases such as inflammatory bowel disease, acute and chronic pancreatitis, and gastrointestinal malignancies. The issues of importance include the differentiation of these and other gastrointestinal diseases from their mimics. Once diagnosed, it is crucial to prognosticate about the outcomes and intervene early to improve the outcomes of these diseases. This Special Issue will cover areas including

  • Pancreatic diseases
  • Biliary diseases
  • Luminal diseases

We invite original work and reviews that report developments in improving the diagnosis and prognostication of gastrointestinal diseases.

Dr. Vishal Sharma
Guest Editor

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Keywords

  • inflammatory bowel disease
  • gastrointestinal tuberculosis
  • acute pancreatitis
  • chronic pancreatitis
  • celiac disease
  • biliary disease
  • gall bladder diseases
  • pancreatic cancer
  • colon cancer
  • diverticulitis
  • gastrointestinal infections
  • esophageal cancer
  • Barrett esophagus

Published Papers (13 papers)

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Editorial

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5 pages, 185 KiB  
Editorial
Enduring Dilemmas in Gastroenterology
by Vishal Sharma
Diagnostics 2024, 14(1), 65; https://doi.org/10.3390/diagnostics14010065 - 27 Dec 2023
Viewed by 555
Abstract
Making a correct diagnosis is the first, and most important, step in the therapeutic journey of a disease [...] Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)

Research

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14 pages, 1212 KiB  
Article
A Logistic Regression Model for Predicting the Risk of Subsequent Surgery among Patients with Newly Diagnosed Crohn’s Disease Using a Brute Force Method
by Kohei Ogasawara, Hiroto Hiraga, Yoshihiro Sasaki, Noriko Hiraga, Naoki Higuchi, Keisuke Hasui, Shinji Ota, Takato Maeda, Yasuhisa Murai, Tetsuya Tatsuta, Hidezumi Kikuchi, Daisuke Chinda, Tatsuya Mikami, Masashi Matsuzaka, Hirotake Sakuraba and Shinsaku Fukuda
Diagnostics 2023, 13(23), 3587; https://doi.org/10.3390/diagnostics13233587 - 03 Dec 2023
Viewed by 751
Abstract
Surgery avoidance is an important goal in Crohn’s disease (CD) treatment and predicting the risk of subsequent surgery is important to determine adequate therapeutic strength for patients with newly diagnosed CD. Herein, we aimed to construct a prediction model for the risk of [...] Read more.
Surgery avoidance is an important goal in Crohn’s disease (CD) treatment and predicting the risk of subsequent surgery is important to determine adequate therapeutic strength for patients with newly diagnosed CD. Herein, we aimed to construct a prediction model for the risk of subsequent surgery based on disease characteristics at the patients’ initial visit. We retrospectively collected disease characteristic data from 93 patients with newly diagnosed CD. A logistic regression model with a brute force method was used to maximize the area under the receiver operating characteristic curve (auROC) by employing a combination of potential predictors from 14 covariates (16,383). The auROC remained almost constant when one to 12 covariates were considered, reaching a peak of 0.89 at four covariates (small-bowel patency, extensive small-bowel lesions, main lesions, and the number of poor prognostic factors), and it decreased with increasing covariate size. The most significant predictors were small-bowel patency, extensive small-bowel lesions, and age or major lesions. Therefore, this prediction model using covariates may be helpful in determining the likelihood that a patient with newly diagnosed CD will require surgery, which can aid in appropriate treatment selection for high-risk patients. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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11 pages, 1622 KiB  
Article
Metabolic Dysfunction-Associated Fatty Liver Disease in Taiwanese Patients with Inflammatory Bowel Disease: A Study in Patients with Clinical Remission
by Shun-Wen Hsiao, Ting-Chun Chen, Pei-Yuan Su, Chen-Ta Yang, Siou-Ping Huang, Yang-Yuan Chen and Hsu-Heng Yen
Diagnostics 2023, 13(20), 3268; https://doi.org/10.3390/diagnostics13203268 - 20 Oct 2023
Viewed by 1118
Abstract
The prevalence of inflammatory bowel disease (IBD) has increased worldwide. The prevalence of metabolic dysfunction associated fatty liver disease (MAFLD) has also risen. However, there is limited research on the connection between MAFLD and IBD in the Asian population. This study aims to [...] Read more.
The prevalence of inflammatory bowel disease (IBD) has increased worldwide. The prevalence of metabolic dysfunction associated fatty liver disease (MAFLD) has also risen. However, there is limited research on the connection between MAFLD and IBD in the Asian population. This study aims to analyze the prevalence and clinical significance of MAFLD in Taiwanese IBD patients with clinical remission. We retrospectively analyzed IBD patients who received transient elastography for liver fibrosis and controlled attenuation parameter evaluation for liver steatosis. This study enrolled 120 patients with IBD, including 45 Crohn’s disease (CD) and 75 ulcerative colitis (UC). MAFLD prevalence in IBD was 29.2%. Patients with MAFLD had a shorter disease duration (2.8 years vs. 5.3 years, p = 0.017), higher alanine aminotransferase levels (24 U/L vs. 17 U/L, p = 0.003), a lower estimated glomerular filtration rate (91.37 mL/min/1.73 m2 vs. 103.92 mL/min/1.73 m2, p = 0.004), and higher γ-glutamyl transferase (γ-GT) (24 mg/dL vs. 13 mg/dL, p < 0.001). The prevalence of significant fibrosis in IBD with MAFLD was 17.1%. Significant fibrosis was found in older age (58.5 years vs. 40 years, p = 0.004) and the high type 2 diabetes mellitus proportion (50.0% vs. 10.3%, p = 0.049). A trend of longer disease duration was found in significant fibrosis (4.9 years vs. 1.6 years, p = 0.051). The prevalence of MALFD in IBD was 29.2%. and 17.1% of them had significant fibrosis. In addition to the intestinal manifestation, the study findings remind clinicians that they should be aware of the possibility of hepatic complications for IBD patients. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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13 pages, 3497 KiB  
Article
Galectin-8 Immunohistochemical Profile in Pancreatic Ductal Adenocarcinoma: Emerging Evidence for Its Prognostic Role
by Andreea Rusu, Irina-Draga Caruntu, Ludmila Lozneanu, Delia Gabriela Ciobanu, Cornelia Amalinei and Simona-Eliza Giusca
Diagnostics 2023, 13(20), 3215; https://doi.org/10.3390/diagnostics13203215 - 15 Oct 2023
Cited by 1 | Viewed by 770
Abstract
Pancreatic ductal adenocarcinoma (PDAC) represents the most frequent pancreatic malignancy, with stromal and epithelial heterogeneity reflected in outcome variability. Therefore, a molecular classification is promoted based on the validation of new diagnostic and prognostic markers. Galectin-8 (Gal8) has been pointed out as a [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) represents the most frequent pancreatic malignancy, with stromal and epithelial heterogeneity reflected in outcome variability. Therefore, a molecular classification is promoted based on the validation of new diagnostic and prognostic markers. Galectin-8 (Gal8) has been pointed out as a prognostic factor for survival in several types of tumors. Due to limited existing data on PDAC, our study aimed to evaluate the Gal8 profile in PDAC alongside its prognostic status. A total of 87 cases of PDAC were immunohistochemically investigated, and Gal8 immunoexpression was qualitatively and semi-quantitatively assessed and correlated with classical clinicopathological parameters and survival. Gal8 immunoexpression was identified to be mostly nuclear and cytoplasmic, followed by exclusively cytoplasmic and exclusively nuclear. A statistical analysis between Gal8 profiles defined by negative, low, or high scores and clinicopathological characteristics showed significant differences in tumor size, pN stage, and lympho-vascular invasion. Although a Cox regression analysis did not support the prognostic status of Gal8, and we did not confirm its relationship with OS, our results show that exclusively nuclear labeling was associated with an increased mean OS compared with cytoplasmic and nuclear labeling (29.37 vs. 17.93 months). To the best of our knowledge, this is the first study to report a detailed pattern of Gal8 immunostaining in PDAC and to correlate this pattern with clinicopathological characteristics and survival. Our results show that Gal8 immunoexpression is associated with a more aggressive phenotype, thus opening perspectives for larger studies to validate Gal8 as a prognostic factor. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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13 pages, 5528 KiB  
Article
Clinical and Radiological Parameters to Discriminate Tuberculous Peritonitis and Peritoneal Carcinomatosis
by Daya K. Jha, Pankaj Gupta, Pardhu B. Neelam, Rajender Kumar, Venkata S. Krishnaraju, Manish Rohilla, Ajay S. Prasad, Usha Dutta and Vishal Sharma
Diagnostics 2023, 13(20), 3206; https://doi.org/10.3390/diagnostics13203206 - 13 Oct 2023
Viewed by 1675
Abstract
It is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients suspected as having tuberculous [...] Read more.
It is challenging to differentiate between tuberculous peritonitis and peritoneal carcinomatosis due to their insidious nature and intersecting symptoms. Computed tomography (CT) is the modality of choice in evaluating diffuse peritoneal disease. We conducted an ambispective analysis of patients suspected as having tuberculous peritonitis or peritoneal tuberculosis between Jan 2020 to Dec 2021. The study aimed to identify the clinical and radiological features differentiating the two entities. We included 44 cases of tuberculous peritonitis and 45 cases of peritoneal carcinomatosis, with a median age of 31.5 (23.5–40) and 52 (46–61) years, respectively (p ≤ 0.001). Fever, past history of tuberculosis, and loss of weight were significantly associated with tuberculous peritonitis (p ≤ 0.001, p = 0.038 and p = 0.001). Pain in the abdomen and history of malignancy were significantly associated with peritoneal carcinomatosis (p = 0.038 and p ≤ 0.001). Ascites was the most common radiological finding. Loculated ascites, splenomegaly and conglomeration of lymph nodes predicted tuberculous peritonitis significantly (p ≤ 0.001, p = 0.010, p = 0.038). Focal liver lesion(s) and nodular omental involvement were significantly associated with peritoneal carcinomatosis (p = 0.011, p = 0.029). The use of clinical features in conjunction with radiological findings provide better diagnostic yields because of overlapping imaging findings. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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17 pages, 10978 KiB  
Article
Endoscopic and Histopathological Characteristics of Gastrointestinal Lymphoma: A Multicentric Study
by Quang Trung Tran, Thinh Nguyen Duy, Bao Song Nguyen-Tran, Tung Nguyen-Thanh, Quy Tran Ngo, Nam Phuong Tran Thi, Vi Le and Thuan Dang-Cong
Diagnostics 2023, 13(17), 2767; https://doi.org/10.3390/diagnostics13172767 - 26 Aug 2023
Viewed by 1752
Abstract
Background: Extranodal non-Hodgkin lymphoma (NHL) is more prevalent in the gastrointestinal (GI) tract than in other sites. This study aimed to determine the endoscopic characteristics of primary gastrointestinal non-Hodgkin lymphomas. Methods: We investigated 140 patients from three tertiary referral hospitals with [...] Read more.
Background: Extranodal non-Hodgkin lymphoma (NHL) is more prevalent in the gastrointestinal (GI) tract than in other sites. This study aimed to determine the endoscopic characteristics of primary gastrointestinal non-Hodgkin lymphomas. Methods: We investigated 140 patients from three tertiary referral hospitals with primary malignant lymphoma of the gastrointestinal tract. Characteristics of the lesions were evaluated and analyzed using image-enhanced endoscopy, endoscopic ultrasound, and histopathology. Results: The median age was 60.5 (range: 11–99), and 59 (42.1%) were female. The most frequent complaint was abdominal pain (74.3%), followed by bloody feces (10%) and diarrhea (2.9%). B symptoms were observed in 15 (10.7%) patients. GI obstruction was the most common complication (10.0%), followed by hemorrhage (7.9%) and perforation (1.5%). Regarding endoscopic findings, the identified sites were the following: the stomach (61.4%), colon (10%), small intestine (10%), ileocecum (8.6%), rectum (6.4%), and duodenum (3.6%). Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma are most prevalent in the stomach. Helicobacter pylori was identified in 46 cases (39.0%), with MALT lymphoma being the most infected subtype. Nearly all gastrointestinal non-Hodgkin lymphomas manifested as superficial type (25–59.6%) and ulcer type (15.6–50%) under endoscopy. We found that fungating type and protruding with ulcer type were more frequent types of aggressive lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma) compared to the indolent types (MALT lymphoma, follicular lymphoma, duodenal-type follicular lymphoma, and small lymphocytic lymphoma) (p < 0.05). Conclusions: This study showed that most subtypes of gastrointestinal non-Hodgkin lymphomas exhibited same endoscopic features (superficial type and ulcer type). Aggressive gastrointestinal non-Hodgkin lymphomas (diffuse large B-cell lymphoma, mantle cell lymphoma, and T-cell lymphoma) were highly suspected when fungating lesions and protruding with ulcer lesions were encountered under endoscopy. Endoscopists should be aware of the connection between enhanced endoscopic characteristics and histological varieties of gastrointestinal lymphoma to improve diagnosis. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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18 pages, 1523 KiB  
Article
Prognostic Value for Perioperative Serum Total Cholesterol Level on Postoperative Long-Term Prognosis of Pancreatic Cancer: A Retrospective Clinical Study
by Han-Xuan Wang, Cheng Ding, Jin-Can Huang, You-Wei Ma, Shao-Cheng Lyu and Ren Lang
Diagnostics 2023, 13(8), 1402; https://doi.org/10.3390/diagnostics13081402 - 12 Apr 2023
Viewed by 758
Abstract
Cholesterol correlates with occurrence and progression of pancreatic cancer and has predictive value for postoperative prognosis in various cancers. Our study intended to reveal the relationship between perioperative serum total cholesterol (TC) level and postoperative prognosis of pancreatic cancer. We retrospectively analyzed the [...] Read more.
Cholesterol correlates with occurrence and progression of pancreatic cancer and has predictive value for postoperative prognosis in various cancers. Our study intended to reveal the relationship between perioperative serum total cholesterol (TC) level and postoperative prognosis of pancreatic cancer. We retrospectively analyzed the data of pancreatic cancer patients who underwent surgical treatment at our hospital from January 2015 to December 2021. ROC curves between serum TC level at each time point and 1-year survival rate were drawn, from which study object and optimal cutoff value was determined. Patients were divided into low and high-TC groups, and perioperative data and prognosis were compared. Risk factors for poor postoperative prognosis were identified by univariate and multivariate analysis. Overall survival rates at postoperative 1, 2 and 3 years in the low and high-TC groups were 52.9%, 29.4%, and 15.6% and 80.4%, 47.2%, and 33.8% (p = 0.005), respectively. Multivariate analysis confirmed tumor differentiation degree (RR = 2.054, 95% CI: 1.396–3.025), pTNM stage (RR = 1.595, 95% CI: 1.020–2.494), lymph node metastasis (RR = 1.693, 95% CI: 1.127–2.544), and postoperative 4-week serum TC level (RR = 0.663, 95% CI: 0.466–0.944) as independent risk factors for prognosis of pancreatic cancer. We conclude that postoperative 4-week serum TC level has certain predictive value for long-term postoperative prognosis of pancreatic cancer. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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12 pages, 2209 KiB  
Article
Perfusion Computed Tomography May Help in Discriminating Gastrointestinal Tuberculosis and Crohn’s Disease
by Raghav Seth, Pankaj Gupta, Uma Debi, Kaushal Kishore Prasad, Harjeet Singh and Vishal Sharma
Diagnostics 2023, 13(7), 1255; https://doi.org/10.3390/diagnostics13071255 - 27 Mar 2023
Cited by 2 | Viewed by 1294
Abstract
Gastrointestinal tuberculosis (GITB) and Crohn’s disease (CD) are close mimics. This prospective study aimed to evaluate the diagnostic performance of perfusion computed tomography (CT) in differentiating GITB from CD. Consecutive patients with ileocaecal thickening underwent perfusion CT of the ileocaecal region between January [...] Read more.
Gastrointestinal tuberculosis (GITB) and Crohn’s disease (CD) are close mimics. This prospective study aimed to evaluate the diagnostic performance of perfusion computed tomography (CT) in differentiating GITB from CD. Consecutive patients with ileocaecal thickening underwent perfusion CT of the ileocaecal region between January 2019 and July 2020. Two radiologists (blinded to the final diagnosis) independently assessed blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability at perfusion CT. These parameters were compared among the patients with GITB as well as active and inactive CD. Receiver operating characteristic curves were utilized for determining the diagnostic performance of perfusion CT. Interclass correlation coefficient and Bland–Altman analysis were performed to compare the observations of the two radiologists. During the study period, 34 patients underwent perfusion CT. Eight patients had diagnoses other than intestinal tuberculosis or CD. Thus, 26 patients (mean age 36 ± 14 years, 18 males) with GITB (n = 11), active CD (n = 6), and inactive CD (n = 9) were evaluated. BF, MTT, and permeability showed significant differences among the groups, while BV did not differ significantly among the groups. BF and permeability had 100% sensitivity and 100% specificity, while MTT had 61.5–100% sensitivity and 70–100% specificity for differentiating GITB from active CD and active from inactive CD. The interclass correlation coefficient for perfusion CT parameters was 0.88–1. Perfusion CT is a novel imaging technique that can improve the diagnostic performance of differentiating tuberculosis from CD. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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Review

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15 pages, 3411 KiB  
Review
Drug-Resistant Helicobacter pylori: Diagnosis and Evidence-Based Approach
by Vaneet Jearth, Mitali Madhumita Rath, Abhirup Chatterjee, Aditya Kale and Manas Kumar Panigrahi
Diagnostics 2023, 13(18), 2944; https://doi.org/10.3390/diagnostics13182944 - 14 Sep 2023
Cited by 2 | Viewed by 1676
Abstract
Helicobacter pylori (H. pylori) is the most common chronic bacterial infection, affecting approximately half of the world’s population. H. pylori is a Class I carcinogen according to the World Health Organization, and the International Agency for Research on Cancer (IARC) has [...] Read more.
Helicobacter pylori (H. pylori) is the most common chronic bacterial infection, affecting approximately half of the world’s population. H. pylori is a Class I carcinogen according to the World Health Organization, and the International Agency for Research on Cancer (IARC) has linked it to 90% of stomach cancer cases worldwide. The overall pattern points to a yearly reduction in eradication rates of H. pylori with the likelihood of success further decreasing after each unsuccessful therapeutic effort. Antimicrobial resistance in Helicobacter pylori is a major public health concern and is a predominant cause attributed to eradication failure. As a result, determining H. pylori’s antibiotic susceptibility prior to the administration of eradication regimens becomes increasingly critical. Detecting H. pylori and its antimicrobial resistance has traditionally been accomplished by time-consuming culture and phenotypic drug susceptibility testing. The resistance of H. pylori to different antibiotics is caused by various molecular mechanisms, and advances in sequencing technology have greatly facilitated the testing of antibiotic susceptibility to H. pylori. This review will summarize H. pylori antibiotic resistance patterns, mechanisms, and clinical implications. We will also review the pros and cons of current antibiotic susceptibility testing methods. Along with a comparison of tailored susceptibility-guided regimens and empirical therapy based on the latest evidence, an evidence-based approach to such situations will be explored. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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17 pages, 2627 KiB  
Review
Approach to Pancreatic Head Mass in the Background of Chronic Pancreatitis
by Sidharth Harindranath and Sridhar Sundaram
Diagnostics 2023, 13(10), 1797; https://doi.org/10.3390/diagnostics13101797 - 19 May 2023
Viewed by 3179
Abstract
Chronic pancreatitis (CP) is a known risk factor for pancreatic cancer. CP may present with an inflammatory mass, and differentiation from pancreatic cancer is often difficult. Clinical suspicion of malignancy dictates a need for further evaluation for underlying pancreatic cancer. Imaging modalities remain [...] Read more.
Chronic pancreatitis (CP) is a known risk factor for pancreatic cancer. CP may present with an inflammatory mass, and differentiation from pancreatic cancer is often difficult. Clinical suspicion of malignancy dictates a need for further evaluation for underlying pancreatic cancer. Imaging modalities remain the mainstay of evaluation for a mass in background CP; however, they have their shortcomings. Endoscopic ultrasound (EUS) has become the go-to investigation. Adjunct modalities such as contrast-harmonic EUS and EUS elastography, as well as EUS-guided sampling using newer-generation needles are useful in differentiating inflammatory from malignant masses in the pancreas. Paraduodenal pancreatitis and autoimmune pancreatitis often masquerade as pancreatic cancer. In this narrative review, we discuss the various modalities used to differentiate inflammatory from malignant masses of the pancreas. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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Other

12 pages, 1132 KiB  
Case Report
Appendiceal Signet Ring Cell Carcinoma: An Atypical Cause of Acute Appendicitis—A Case Study and Review of Current Knowledge
by Branko Andjelkovic, Bojan Stojanovic, Milica Dimitrijevic Stojanovic, Bojan Milosevic, Aleksandar Cvetkovic, Marko Spasic, Stefan Jakovljevic, Danijela Cvetkovic, Bojana S. Stojanovic, Danijela Milosev, Minja Mitrovic and Vesna Stankovic
Diagnostics 2023, 13(14), 2359; https://doi.org/10.3390/diagnostics13142359 - 13 Jul 2023
Cited by 1 | Viewed by 2701
Abstract
Appendiceal signet ring cell carcinoma (ASRCC) is a rare and aggressive form of appendiceal cancer, often presenting with nonspecific symptoms that overlap with acute appendicitis. Early diagnosis and appropriate management are crucial for improving patient outcomes in these rare malignancies. This case report [...] Read more.
Appendiceal signet ring cell carcinoma (ASRCC) is a rare and aggressive form of appendiceal cancer, often presenting with nonspecific symptoms that overlap with acute appendicitis. Early diagnosis and appropriate management are crucial for improving patient outcomes in these rare malignancies. This case report and literature review aims to raise awareness among clinicians about ASRCC of the appendix as a cause of acute appendicitis and highlight the importance of considering this diagnosis in patients with atypical presentations or unexpected histopathological findings. We present a 65-year-old female patient with ASRCC who underwent successful surgical treatment and remains disease-free at the one-year follow-up. It also highlights the necessity of early detection and appropriate treatment in order to improve patient outcomes. In addition, a comprehensive literature review is provided, discussing the clinical presentation, histopathological characteristics, potential pathogenesis, treatment options, and prognosis of ASRCC. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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11 pages, 4133 KiB  
Case Report
The Malignant Gastrointestinal Neuroectodermal Tumor (GNET): A Distinct Entity and the Challenging Differential Diagnosis with Mesenchymal, Lymphoid, and Melanic Tumors: A Case Report and Brief Review of the Literature
by Mădălina Boșoteanu, Miruna Cristian, Mariana Așchie, Radu Andrei Baz, Alina Marta Zielonka, Georgeta Camelia Cozaru and Luana Andreea Boșoteanu
Diagnostics 2023, 13(6), 1131; https://doi.org/10.3390/diagnostics13061131 - 16 Mar 2023
Cited by 1 | Viewed by 1164
Abstract
(1) Background: A malignant gastrointestinal neuroectodermal tumor (GNET) is an ultra-rare primary neoplasm with a distinctive histopathological, immunohistochemical, molecular, and ultramicroscopic profile, synonymous terminology with clear cell sarcoma-like tumor of the gastrointestinal tract. This case report aims to describe a case of GNET [...] Read more.
(1) Background: A malignant gastrointestinal neuroectodermal tumor (GNET) is an ultra-rare primary neoplasm with a distinctive histopathological, immunohistochemical, molecular, and ultramicroscopic profile, synonymous terminology with clear cell sarcoma-like tumor of the gastrointestinal tract. This case report aims to describe a case of GNET with challenging mesenchymal, lymphoid, and melanic tumor differential diagnosis. (2) Case presentation: We discuss the case of a 67-year-old male patient who presented with diffuse abdominal pain, intermittent lack of intestinal transit, and frequent episodes of nausea, followed by segmental resection of the jejunum and sigmoid colon. The patient had no relevant medical history. The surgical specimen underwent immunohistochemical staining and morphological evaluation. (3) Results: Histopathological analysis reveals a moderately homogeneous polyhedral-epithelioid and spindle cell neoplastic proliferation with a zonal discohesive pattern and extensive and focal fasciculated architecture. Twenty monoclonal antibodies were used for immunostaining, which allowed GNET to be diagnosed on the basis of the tumoral immune profile, characterized by positive reactivity of S100, SOX10, and CD 56. (4) Conclusions: The poor prognosis of GNET is highlighted in the present study, along with the vital importance of differential diagnosis issues with mesenchymal, lymphoid, and melanic tumors, which make the diagnosis difficult for both pathologists and clinicians. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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5 pages, 2599 KiB  
Interesting Images
Acute Esophageal Necrosis in Acute Pancreatitis—Report of a Case and Endoscopic and Clinical Perspective
by Monica Grigore, Iulia Enache, Mirela Chirvase, Andrada Loredana Popescu, Florentina Ionita-Radu, Mariana Jinga and Sandica Bucurica
Diagnostics 2023, 13(3), 562; https://doi.org/10.3390/diagnostics13030562 - 03 Feb 2023
Cited by 1 | Viewed by 1678
Abstract
Esophageal stroke, also known as acute esophageal necrosis or Gurvits syndrome, is an entity that has gained more and more recognition in the last two decades. It is also named “black esophagus” because of striking black discoloration of the esophageal mucosa, with an [...] Read more.
Esophageal stroke, also known as acute esophageal necrosis or Gurvits syndrome, is an entity that has gained more and more recognition in the last two decades. It is also named “black esophagus” because of striking black discoloration of the esophageal mucosa, with an abrupt transition to normal mucosa at the gastroesophageal junction. Its most common clinical presentation is represented by upper gastrointestinal bleeding and esophagogastroduodenoscopy is the main diagnostic tool. Among the etiopathogenetic and multiple predisposing factors described are hypovolemia, shock state, ischemia, congestive heart failure, acute renal failure, infections, trauma, and diabetes mellitus. Current management of this condition consists of treating the underlying pathology, nil per os, and antacid administration in uncomplicated cases. Although most of the cases have favorable prognosis, complications such as pneumomediastinum or esophageal stricture may occur and fatal cases are a consequence of underlying comorbidities. Full article
(This article belongs to the Special Issue Diagnosis and Prognosis of Gastrointestinal Diseases)
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