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An Incidental Finding of Gastric Mucosa-Associated Lymphoma (MALToma) in a Sleeve Gastrectomy with Literature Review. Case Rep Hematol 2020; 2020:8855127. [PMID: 33343951 PMCID: PMC7728489 DOI: 10.1155/2020/8855127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 12/01/2022] Open
Abstract
Mucosal-associated lymphoid tissue (MALT) lymphoma can typically be identified as a mass lesion or nodularity endoscopically and macroscopically. We report an incidental finding of a Helicobacter pylori gastric mucosal-associated lymphoid tissue (MALT) lymphoma in a sleeve gastrectomy specimen with no gross examination findings.
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Ricci C, Agostinelli C, Ambrosi F, Garelli S, Zinzani PL, Rottoli M, Sabattini E. Gastric MALT Lymphoma in a Sleeve Gastrectomy Specimen: Case Report and Literature Review. Bariatr Surg Pract Patient Care 2018. [DOI: 10.1089/bari.2018.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Costantino Ricci
- Department of Experimental, Diagnostic and Specialty Medicine, Haematopathology Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Agostinelli
- Department of Experimental, Diagnostic and Specialty Medicine, Haematopathology Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Ambrosi
- Department of Experimental, Diagnostic and Specialty Medicine, Haematopathology Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Silvia Garelli
- Department of Medical and Surgical Sciences (DIMEC), Endocrinology Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- Department of Experimental, Diagnostic and Specialty Medicine, Haematology Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matteo Rottoli
- Department of Medical and Surgical Science, Surgery of the Alimentary Tract, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elena Sabattini
- Department of Experimental, Diagnostic and Specialty Medicine, Haematopathology Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Zhao WJ, Tian ZB, Yao SS, Yu YN, Zhang CP, Li XY, Mao T, Jing X, Ding XL, Yang RM, Liu YQ, Zhang SQ, Yang L. High-fat-diet-induced obesity upregulates the expression of lymphoid chemokines and promotes the formation of gastric lymphoid follicles after Helicobacter suis infection. Pathog Dis 2017; 75:4082734. [PMID: 28911036 DOI: 10.1093/femspd/ftx101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/10/2017] [Indexed: 12/13/2022] Open
Affiliation(s)
- Wen-jun Zhao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Zi-bin Tian
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Shan-shan Yao
- Clinical Skill Training Center, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Ya-nan Yu
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Cui-ping Zhang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Xiao-yu Li
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Tao Mao
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Xue Jing
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Xue-li Ding
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Ruo-ming Yang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Ya-qian Liu
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
| | - Shuai-qing Zhang
- Department of Gastroenterology, Qilu Hospital of Shandong University (Qingdao), Qingdao 266000, China
| | - Lin Yang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao 266003, China
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Kruljac I, Mirošević G, Bešlin MB. Should We Inspect Small Intestine During Laparoscopic Bariatric Surgery? Obes Surg 2017; 27:1343-1344. [PMID: 28317079 DOI: 10.1007/s11695-017-2648-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ivan Kruljac
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, Vinogradska cesta 29, 10000, Zagreb, Croatia.
| | - Gorana Mirošević
- Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", University of Zagreb Medical School, Vinogradska cesta 29, 10000, Zagreb, Croatia
| | - Miroslav Bekavac Bešlin
- Department of Abdominal Surgery, University Hospital Center "Sestre Milosrdnice", University of Zagreb School of Dental Medicine, Zagreb, Croatia
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Kopach P, Genega EM, Shah SN, Kim JJ, Suarez Y. The significance of histologic examination of gastrectomy specimens: a clinicopathologic study of 511 cases. Surg Obes Relat Dis 2016; 13:463-467. [PMID: 28089436 DOI: 10.1016/j.soard.2016.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/04/2016] [Accepted: 11/11/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sleeve gastrectomy (SG) is quickly becoming the preferred procedure for bariatric surgery. According to the American Society for Metabolic and Bariatric Surgery guidelines, routine preoperative upper gastrointestinal endoscopies are not recommended universally for bariatric surgery. Some studies have shown that the histologic examination of SG specimens is insignificant and not a cost-effective practice. However, some speculate SG examination may unveil pertinent findings and prevent further progression of precursor lesions. OBJECTIVES This study aims to explore the clinically significant or actionable lesions that can be revealed with SG examination. SETTING Tufts Medical Center, Boston, USA. RESULTS We analyzed 511 SG specimens obtained during bariatric surgery. Incidental findings were grouped in 2 categories: clinically significant/actionable and minor lesions. The clinically significant lesions accounted for 5.8%. This category included 5 cases of gastrointestinal stromal tumor; one case of MALT lymphoma; 4 cases of autoimmune gastritis with concomitant pancreatic metaplasia or neuroendocrine dysplasia. Intestinal metaplasia without dysplasia was identified in 3 cases; 14 cases of Helicobacter pylori associated active gastritis; 1 case of iron pill induced gastritis and 1 case of gastric glandular siderosis. The minor lesions accounted for 6.3%, showing findings other than chronic gastritis. This category included 19 cases of fundic polyps and 1 case of hyperplastic polyp; one case of leiomyoma; 11 cases of H pylori negative active gastritis. CONCLUSIONS The majority of histopathology results after SG showed no significant changes. However, a few cases had clinically significant lesions in seemingly healthy patients, altering patient's postoperative management.
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Affiliation(s)
- Pavel Kopach
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA.
| | - Elizabeth M Genega
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA
| | - Sajani N Shah
- Department of Surgery, Tufts Medical Center, Boston, MA
| | - Julie J Kim
- Department of Surgery, Tufts Medical Center, Boston, MA
| | - Yvelisse Suarez
- Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA
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Abstract
BACKGROUND Obesity is associated with several comorbidities like diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. It is also well established that obese patients have an increased risk of several types of cancer like kidney, pancreas, endometrial, breast, and others. The bariatric surgeon needs to be aware of the problem of benign tumors and cancer in obese patients as well as the optimal management of these conditions that may be present at the time of evaluation for bariatric surgery, during the surgical procedure, and in the postoperative period. DATABASE A PubMed search for the words "cancer" and "bariatric surgery" and subsequent review of the abstracts identified 40 articles concerning cancerous, benign, and premalignant conditions in bariatric surgery patients. Data were then extracted from full-text articles. CONCLUSION Bariatric surgery decreases cancer risk especially in women. RYGB can be an effective treatment for Barrett's esophagus. Patients having esophageal cancer should not undergo bariatric surgery, while those who develop the same postoperatively are usually managed by a combined abdominal and thoracic approach (Ivor Lewis technique). Gastric cancer of the remnant stomach is usually managed by a remnant gastrectomy. A remnant gastrectomy during RYGB would be necessary in conditions that require endoscopic surveillance of the stomach like gastric polyps, intestinal metaplasia, and carcinoid tumors. Sleeve gastrectomy is an excellent option in a patient with GIST or a carcinoid who needs a bariatric operation. Preoperative endoscopy usually does not detect malignant conditions. Postoperative evaluation of the bypassed stomach is possible using various percutaneous and novel endoscopic techniques.
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Affiliation(s)
- Rao S Raghavendra
- Division of Metabolic Endocrine and Minimally Invasive Surgery, Mount Sinai Medical Center, NY, New York, USA.
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