RESUMEN
We report the case of a 69-year-old white woman who developed a natural killer (NK)-like T-cell lymphoma involving primarily the stomach. The tumour consisted of large and pleomorphic lymphocytes infiltrating the gastric mucosa. Immunohistochemistry performed on paraffin sections showed the neoplastic cells to be CD3+, CD5-, CD8-, CD43+, CD45RO+, and CD57+. In addition, these cells also expressed HLA-DR, granzyme B, and, to a lesser extent, the CD30 activation marker. No pathologic features suggesting Helicobacter pylori, Epstein-Barr virus infection, or lymphocytic gastritis were found within adjacent normal mucosa. The patient had no previous history of coeliac disease, and her serology for H. pylori was negative. Since lymphomas are usually considered the neoplastic counterpart of normal lymphocytic subsets, it is possible that in this case the tumour cells originate from a distinct cytotoxic T-cell population normally present within the gastric mucosa. The pathogenesis of this highly unusual neoplasm, however, remains a mystery.
Asunto(s)
Mucosa Gástrica/patología , Células Asesinas Naturales , Linfoma de Células T/patología , Neoplasias Gástricas/patología , Anciano , Ensayo de Inmunoadsorción Enzimática , Femenino , HumanosRESUMEN
Sucralfate is an effective medication for treatment of gastroduodenal ulcers, and 99mTc-labeled sucralfate has been found to adhere to ulcers. In this study, we examined the reliability of confirming the diagnosis of gastroduodenal ulcers--previously detected by endoscopy and histology--by means of sucralfate labeled with 99mTc, imaging 1 and 2 hr after oral administration. Eighteen out of 23 patients were positive by scintigraphy with this method (sensitivity = 78%). In five patients with gastroduodenal bleeding, the study was positive. The procedure was well tolerated and offered a noninvasive procedure that can be performed at the bedside in critically ill patients, and in follow-up of fragile patients.
