The OLGA-OLGIM staging and the interobserver agreement for gastritis and preneoplastic lesion screening: a cross-sectional study.

Stomach cancer (SC) incidence and mortality are relevant public health issues worldwide. In Colombia, screening for preneoplastic lesions (PNL) and the presence of H. pylori is not routinely performed. Therefore, the aim of this study was to evaluate OLGA-OLGIM staging and the interobserver agreement in gastritis and preneoplastic lesions in patients with gastroduodenal symptoms from Colombia. A cross-sectional study was conducted in 272 patients with gastroduodenal symptoms. Gastric biopsies were taken following the Updated Sydney System with the OLGA-OLGIM classification, and the results were evaluated by two pathologists. Chronic gastritis and PNL were reported in 76% and 24% of the patients, respectively. Furthermore, 25% of the patients with PNL displayed gastric atrophy (GA) and 75% intestinal metaplasia (IM). Agreement in the histopathological reading for IM was good, whereas for OLGA was variable, and for the H. pylori quantity was poor. OLGA-OLGIM stages 0-II were the most frequent (96%), while stage III (4%) and SC (4%) were the least frequent. Age and coffee consumption were associated with a higher prevalence of PNL. This work determined that 4% of the population is at high risk of developing SC and would benefit from follow-up studies. Reinforcement of training programs to improve the agreement in histopathology readings is required.

Neoplasias mucinosas del apéndice / Mucinous Neoplasm of the Appendix

Se presenta el caso de una paciente femenina de 52 años de edad que consulta por dolor abdominal al servicio de urgencias, donde se le realizan estudios imaginológicos y se sospecha de mucocele. Se confirma el diagnóstico por patología de mucocele del apéndice por neoplasia mucinosa apendicular de bajo grado. En este artículo se describe la presentación clínica de la paciente y se analizan los hallazgos en los estudios por imágenes, en cirugía y en patología. Posteriormente se hace una revisión de la literatura de los tumores mucinosos del apéndice, con énfasis en los hallazgos imaginológicos. Estos tumores son raros, presentan diferente histología y no tienen predilección de género. Se presentan principalmente como abdomen agudo, aunque tienen otras formas de presentación que pueden confundir al clínico. Como se describe, los estudios por imágenes cumplen un papel importante en el diagnóstico, seguimiento y detección de complicaciones.

We present the case of a 52- year- old woman who complains of abdominal pain to the emergency room, ultrasound and CT scan suggested the diagnosis of mucocele and was confirmed by pathology as mucocele of the appendix due low grade appendix mucinous neoplasm. In our review we describe clinical presentation of the patient and discuss imaging findings as well as findings in surgery and pathology. Subsequently, there is a literature review and the mucinous tumors of the appendix, with emphasis in the imaging techniques. These tumors are rare, have different histology and no gender predilection. They occur mainly as acute abdomen, although they have other forms of presentation which may mislead the clinician. As described, imaging techniques play an important role in the diagnosis, follow-up, and detection of complications

Tumor de Vanek o pólipo fibroide inflamatorio gástrico. Presentación de dos casos en Medellín / Presentation of two cases of Vanek's tumor (inflammatory fibroid polyp) in Medellín

Se reportan dos casos de pólipo fibroide inflamatorio (PFI) o tumor de Vanek. El primero corresponde a una mujer de 63 años, con cuadro clínico de dolor abdominal. En la endoscopia digestiva se encuentra pólipo antral, que se reseca; el estudio anatomopatológico informa los hallazgos clásicos de un pólipo fibroide inflamatorio. El segundo caso es un paciente de sexo masculino, 63 años, que ingresa en choque hemorrágico por hematemesis masiva. En la endoscopia se evidencia una lesión de Dieulafoy en el cardias y una lesión polipoide en antro que se reseca. El estudio anatomopatológico informa una histología inusual que requiere estudio de inmunohistoquímica para confirmar el diagnóstico de PFI.

We report on two cases of inflammatory fibroid polyps in the stomach (Vanek's tumor). The first patient was a 63-year-old woman with abdominal pain for whom resection of an antral polypoid lesion was done. This polyp presented classical histopathology. The second case was a 63-year-old male patient who was admitted to the hospital with hemorrhagic shock due to hematemesis. During endoscopy a Dieulafoy's lesion was found in the cardia of the stomach and a polypoid lesion was found in the antrum. Unusual histopathology required that the diagnosis be confirmed by immunohistochemistry.

Espiroquetosis del colon. Un caso en Medellín, Colombia / Colonic spirochetosis. A case report in Medellin, Colombia

Nosotros reportamos un caso de espiroquetosis intestinal, en un hombre de 61 años de edad con cuadro clínico de diarrea crónica. El hallazgo fue encontrado luego de realizar una colonoscopia en la cual se tomaron biopsias de varios pólipos. En el estudio anatomopatológico se informa espiroquetosis intestinal. En nuestra experiencia es el primer caso que se diagnostica en 6.639 colonoscopias realizadas y se constituye en el primer caso publicado en el país.