[Cystic polyposis of the stomach (fundic gland polyps)--relationship to the absence of Helicobacter pylori infection and a therapy with drugs suppressing gastric acidity]. / Cystická polypóza zaludku (polypy ze zlázek fundu)--vztah k neprítomnosti infekce Helicobacter pylori a k uzívání léku snizujících zaludecní aciditu.

BACKGROUND: Cystic gastric polyps (fundic gland polyps) have been diagnosed relatively frequently in recent years. The aim of the study was to assess their incidence and relation to possible etiological factors reported in the literature. MATERIAL AND METHODS: Over a 5 year period, we have endoscopically and histologically proved cystic polyps in 32 patients. All were examined for Helicobacter pylori infection using either the invasive rapid test, histological examination or 13C urea breath test. RESULTS: Cystic gastric polyps were found significantly more frequently in women (27) than in men (5). All patients were treated with long-term medication suppressing gastric acidity (26 patients with proton pump inhibitors, and 6 with H2 receptor blockers). Helicobacter pylori infection was not detected in either of the patients with proven cystic gastric polyps. Cystic gastric polyps have not the typical clinical picture and they are largely found incidentally during gastroscopic examination, especially in patients with reflux esophagitis or functional dyspepsia. CONCLUSION: The results confirm evidence in the literature of a close relation between cystic gastric polyps and intensive suppressive treatment of gastric acidity, particularly in combination with the current absence of Helicobacter pylori infection. Precise explanation of this relation and the etiology of cystic gastric polyps is still missing. Important is the fact that the literature reports do not indicate a risk of malignant transformation.

Changing prevalence of some selected gastrointestinal diseases vis-à-vis H. pylori infection.

BACKGROUND/AIMS: The aim of this prospective study was to evaluate the changing relative prevalence of peptic ulcer disease, gastroesophageal reflux disease and functional dyspepsia over 18 years (four periods) in a country with a significant decline of H. pylori prevalence. METHODOLOGY: In total, 3000 patients were studied. Only the first 750 consecutive dyspeptic patients in each period who were referred to endoscopy and in whom the abovementioned diseases were diagnosed were assessed. In each patient, H. pylori status was evaluated. RESULTS: From 1988 to 2006, the number of peptic ulcer disease patients decreased significantly while that of reflux esophagitis patients significantly increased. Prevalence of functional disease patients continued to be high. The prevalence of H. pylori in gastroesophageal reflux disease and functional dyspepsia patients declined significantly. CONCLUSIONS: The results show remarkable changes in the epidemiology of peptic ulcer disease and reflux esophagitis among the population with a decrease of H. pylori prevalence. The significant decrease of H. pylori among functional dyspepsia patients, which continues to have a high prevalence, indirectly supports the opinion that the role of H. pylori is of no dominant importance in this disease. The decline of peptic ulcer disease is partially explainable by the decrease of H. pylori infection in the general population, but other factors should be established.

Intravascular large B-cell lymphoma presenting as cutaneous panniculitis.

In this report the case of intravascular large B-cell lymphoma (angiotropic lymphoma, intravascular angioendotheliomatosis, malignant endotheliomatosis) with panniculitis features is present. The diagnosis was based on finding of typical CD20 positive tumorous cells within capillaries, veins, and small arteries in the biopsy of subcutaneous adipose tissue. An accurate and early diagnosis together with combined chemotherapy resulted in good response and remission of the disease.