Increasing frequency of gastric lymphoma in two national institutes of health in Mexico

BACKGROUND

Some studies performed in developed countries with caucasian population have suggested an increase in the frequency of primary gastric lymphoma (PGL) in the past two decades.

OBJECTIVE

To establish the frequency of PGL in two National Institutes of Health in Mexico in an interval of 18 years.

METHODS

We reviewed 1,854 gastric malignant neoplasms diagnosed between 1979-1996 in mestizo patients seen at two different institutions. One of them (INC) is an oncological hospital, whereas the other one (INN) is a general hospital which treats patients with benign as well as malignant gastrointestinal diseases.

RESULTS

A hundred and sixty three (8.8%) gastric lymphomas were identified from 1,854 gastric malignant tumors. The incidence of PGL showed a two to three-fold increase in the last years of the study in both institutions. The increased frequency was highly significant when compared to the initial rate. This increase does not appear to be due to patient selection criteria nor to the number of malignant gastric tumors in our institutions.

CONCLUSIONS

Our results indicate an increased frequency of PGL the patient population of two National Institutes of Health in Mexico during the last years. Additional studies are necessary in order to define in the increase in PGL is limited to certain geographical areas or ethnic groups.

Obstructive jaundice as the first clinical manifestation of a metastatic malignant melanoma in the ampulla of vater

The authors report a patient with obstructive jaundice as the first clinical manifestation of a primary malignant melanoma metastatic in the ampulla of Vater. After the histologic diagnosis of the metastases was made, the primary tumor was located in the skin of the back. Obstruction jaundice secondary to ampullary obstruction due to metastatic melanoma has only been reported twice, and in neither case was jaundice the first symptom of the disease.

Oral manifestations as a hallmark of malignant acanthosis nigricans

We present a case of malignant acanthosis nigricans (AN) that initially manifested in the oral cavity. In the present report, the patient had typical clinical and histological findings of oral and esophageal AN, with subtle skin changes, associated with a gallbladder adenocarcinoma. The importance of the clinical oral examination is emphasized because the recognition of oral lesions led to the diagnosis of AN and to the following detection of the internal malignancy. Since the tumours associated with AN are highly malignant, it is of the utmost importance to recognize the skin and mucous membrane changes in adults.

[Duodenal pseudomelanosis]

Pseudomelanosis duodeni is a rare entity characterized by dark pigmentation of duodenal mucosa of uncertain etiology and clinical significance. We report a case with endoscopic and pathologic correlation. Some aspects about etiology, clinical and histopathologic characteristics are discussed.

[Serum level of prostatic specific antigen in 100 patients with prostatic biopsy]

OBJECTIVE

To define the PSA levels (Prostatic Specific Antigen) in our patients with benign or malignant prostatic biopsy.

METHODS

100 patients with clinical suspicion of prostatic carcinoma (high levels of PSA and/or abnormal findings at digito-rectal examination) and who underwent a prostatic needle biopsy were reviewed.

RESULTS

There were 66 benign and 34 carcinomas. The median PSA was 11.2 ng/mL in the benign cases and 45.6 in cancer. In cases with small increases in PSA (49.9 ng/mL), 94% were benign; there was still a majority of benign cases (63%) in patients with a PSA of 10-29.9 ng/mL. Only in those with levels of 30+, malignancy was a majority (81%).

CONCLUSIONS

There was a considerable overlap of PSA levels in our benign and malignant patients, and only values of 30+ ng/mL were highly suggestive of carcinoma. Our levels are higher than those informed in the literature and may have been due, at least partly, to the source of our reagent kits for PSA assays (Cedex from France and Diagnostic Products Corp from the U.S.).

[Giant acinic cell parotid gland adenocarcinoma of the papillary- cystic type]

A case of a 38-year-old male having an acinic cell adenocarcinoma of the parotid gland is reported. The tumor measured 22 cm and histologically it was of the papillary-cystic type. The following features were of interest: 1) the tumor size surpassed the size of previous reported acinic cell adenocarcinomas by 9 cm; and 2) the rarity of its histological variety (cystic papillary) demanded immunohistochemical and electron microscopic studies to confirm the diagnosis.