Acute abdomen due to anaphylactic intestinal edema associated with systematic mastocytosis: a case report.

BACKGROUND: Among various anaphylactic conditions resulting in acute abdomen, mast cell activation disorders, although rare, are included in the differential diagnosis. CASE PRESENTATION: This report describes a 63-year-old Caucasian man who was brought to the emergency room with sudden onset abdominal pain, vomiting, and diarrhea, with breathing difficulty, and with facial swelling after quarrelling with an acquaintance. Computed tomography showed edematous and swollen intestines, consistent with splenomegaly. Physical findings included maculopapular cutaneous mastocytosis. He also had a long history of repeated episodes of anaphylaxis requiring occasional epinephrine auto-injector administration; however, the precise cause of anaphylaxis was previously undetermined. Blood tests showed high serum concentrations of soluble IL-2R and tryptase, suggesting mast cell-related disease. Subsequent biopsies of his bone marrow and cutaneous rash confirmed the diagnosis of systemic mastocytosis (SM). CONCLUSION: SM was diagnosed in a patient with acute abdomen who visited the emergency room.

Clinicopathological and prognostic significance of mucin phenotype in gastric cancer.

BACKGROUND AND OBJECTIVES: Gastric and intestinal mucin phenotype cell markers are widely expressed in gastric carcinoma cells, irrespective of their tumor histological type. In the present study, we tried to reveal the clinicopathological significance of mucin phenotype in human gastric carcinomas. Moreover, we investigated the clinical significance of RUNX3 in association with mucin phenotype. METHODS: The mucin expression of MUC5AC, MUC6, MUC2, and CD10 was evaluated in 97 gastric carcinomas by immunohistochemistry. Tumors were classified into gastric (G), gastric and intestinal mixed (GI), intestinal (I), and null (N) phenotype according to combination of mucin expression. RESULTS: The rate of G, GI, I, and N phenotype was 40.0%, 38.1%, 10.3%, and 19.6%, respectively. Mucin phenotype was also significantly correlated with several clinicopathological findings. Patients with I phenotype had a significantly poorer prognosis than those with any other phenotypes. They also had a higher rate of postoperative liver metastasis. Multivariate analysis revealed that mucin phenotype was a significant independent prognostic factor. We suggested that Loss of RUNX3 expression might correlate with intestinal phenotype and postoperative outcome. CONCLUSIONS: Mucin phenotype has a significant prognostic value and may be a useful marker for the treatment of human gastric carcinoma.

Prognostic significance of platelet-derived growth factor-BB expression in human esophageal squamous cell carcinomas.

BACKGROUND: Cancer metastases are commonly found in the lymphatic system and tumor lymphangiogenesis requires the interplay of several growth factors. The expression of platelet-derived growth factor (PDGF)-BB and vascular endothelial growth factor (VEGF)-C in esophageal cancer was investigated to define their clinicopathological significance. MATERIALS AND METHODS: Using immunohistochemistry, the expression of PDGF-BB and VEGF-C was examined, along with lymphatic vessel density (LVD) in 53 patients with esophageal cancer. RESULTS: PDGF-BB and VEGF-C expression was positive in 31 cases (58.5%) and 38 cases (71.7%), respectively, and expression correlated with lymph node metastasis and lymphatic invasion. Furthermore, PDGF-BB expression correlated with the depth of tumor invasion and the size of the tumor, and PDGF-BB-positive patients had a significantly poorer prognosis than PDGF-BB-negative patients. The LVD in positive PDGF-BB or VEGF-C tumors was higher than in negative tumors. CONCLUSION: PDGF-BB may play a pivotal role in lymphangiogenesis and tumor growth in esophageal cancer.

High lymphatic vessel density correlates with overexpression of VEGF-C in gastric cancer.

Lymph node metastasis is one of the most important prognostic factors in malignant tumors. In this study, we investigated vascular endothelial growth factor (VEGF)-C expression in human gastric cancer using immunohistochemical techniques and determined the number of microvessels in peritumoral tissue. VEGF-C expression was positive in 22 of 79 cases (27.8%), and correlated with the presence of lymphatic invasion and lymph node metastasis. We confirmed by reverse transcription-polymerase chain reaction (RT-PCR) that VEGF-C mRNA expression is observed more commonly in cancer tissues than normal tissues. For 59 gastric tumors, we examined lymphatic vessel density (LVD) using the specific lymphatic vessel endothelial hyaluronan receptor (LYVE) -1 antibody. VEGF-C expression was observed in 10 of 25 cases (40%) that exhibited a high LVD. Furthermore, high LVD exhibited a significant correlation with VEGF-C expression. Our findings suggest that VEGF-C plays a pivotal role for lymphangiogenesis and tumor growth in gastric cancer.