Homayoun Shojamanesh

Mantle Cell Lymphoma of the Gastrointestinal Tract in a Patient with Renal Cell Carcinoma.

A 71-year-old man with a history of renal cell carcinoma with previous surgery for the disease presented for surveillance colonoscopy. Three tubular adenomas had been removed during colonoscopy 3 years earlier. During the surveillance colonoscopy, a tubular adenoma was removed, as were five small leftcolon polypoid lesions, two of which are shown in a; these were removed (b). Histological staining (c) showed an atypical lymphocytic infiltrate consistent with mantle cell lymphoma (also referred to as lymphomatous polyposis) of the gastrointestinal tract. There is no other reported case of a patient with renal cell carcinoma and gastrointestinal tract mantle cell lymphoma and adenomatous polyps.

A new cause for Zollinger-Ellison syndrome: non-small cell lung cancer

Numerous epidemiologic studies suggest a relationship between lung cancer and peptic ulcer disease. Furthermore, various lung cancers synthesize and release a number of peptides such as gastrin and gastrin-releasing peptide that could cause acid hypersecretion; however, Zollinger-Ellison syndrome (ZES), because of a lung tumor, has never been described. We report such a patient for the first time. A 60-year-old man with a non-small cell lung carcinoma (large cell type) presented with diarrhea, heartburn, abdominal pain, and duodenal ulcers. Evaluation showed ZES was present (fasting hypergastrinemia, hyperchlorhydria) and control of all symptoms by omeprazole. No abdominal or cardiac tumor, the other known locations of gastrinomas causing ZES, was found on detailed tumor imaging studies. Resection of the lung tumor resulted in a decrease in gastrin levels to normal values. Plasma radioimmunoassays showed elevated gastrin, chromogranin A and normal levels of gastrin-releasing peptide, and 9 other hormones. The tumor showed similar immunocytochemical results. The characteristics of this case are compared with 100 cases of sporadic abdominal gastrinomas, and the evidence reviewed suggests why ZES should be considered in patients with lung cancer with peptic symptoms.

Evaluation of proposed gastric acid secretory criteria for diagnosis of Zollinger-Ellison syndrome (ZES): a prospective study of 235 patients

Evaluation of proposed gastric acid secretory criteria for diagnosis of Zollinger-Ellison syndrome (ZES): a prospective study of 235 patients