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Gastric Collision Tumor of Adenocarcinoma and MALT Lymphoma: A Rare Coincidence or Proof of H. pylori Incrimination?

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Surgical Science 2016年第8期7卷 357-360页

作者： Haithem Zaafouri anis Hasnaoui Raja Jouini Dhafer Haddad Ahmed Bouhafa anis ben maamer Department of Surgery Habib Thameur Hospital Tunis Tunisia Department of Histopathology and Cytology Habib Thameur Hospital Tunis Tunisia

Collision tumors of adenocarcinoma and MALT (Mucosa-associated lymphoid tissue) lymphoma are often rare findings of resection specimens of gastric carcinomas. The fact that these two histological lesions are contiguous may suggest a common oncogene. As it is widely known, Helicobacter pylori (H. pylori) plays a leading role in gastric oncogenesis. Could it be responsible for these tumors? As of today, the exact mechanism is still unclear. However, some histological findings may suggest that H. pylori promotes the formation of MALT lymphoma which increases the risk of carcinomatous changes. Prognosis of collision tumors is tightly linked to the carcinoma lesion, which is generally poor due to diagnostic delay. Large scale strategies to eradicate H. pylori and detect early lesions could reduce the mortality of this disease.

关键词： Collision Tumor Gastric Lymphoma Adenocarcinoma Helicobacter pylori

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Primary cancers of the small bowel: About 20 cases

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Open Journal of Gastroenterology 2014年第2期4卷 81-87页

作者： Noomen Haoues Manel Mabrouk Haithem Zaafouri Rabii Noomene Ahmed Bouhafa anis ben maamer Abderraouf Cherif Department of General Surgery Habib Thameur Hospital Tunis Tunisia

Background: Cancers of the small bowel are rare. Diagnosis is late and difficult because of the lack of specific signs. Treatment is surgical. Prognosis is usually poor and depends on the histological type of tumor. Aim of Study: To specify the epidemiological, clinical and therapeutic characteristics of small bowel primary cancers in order to improve their prognosis. Material and Methods: This is a retrospective study about 20 cases of malignant tumors of the small bowel, collected in the department of general surgery of Habib Thameur Hospital in Tunis (Tunisia), from January 1994 through June 2011. Results: Our series involved 11 women and 9 men aged 62 on average (range: 44 - 80 years). In 45% of cases, the diagnosis was made in a patient rushed to hospital with clinical features of acute generalized peritonitis (66% of all surgical emergencies). Intestinal transit was performed in 5 patients only. Ultrasound abdominal examination was performed in 11 patients. Abdominal CT scan was performed in 7 patients, but the results were conclusive in 4 cases only (57%). Small bowel scanning was done in 5 patients only, but led to a positive diagnosis in all of them. All of our patients underwent surgery. Tumors of the small bowel were histologically divided as follows: carcinoid tumor (8 cases), leiomyosarcoma (7 cases), giant B-cell lymphoma (2 cases), malignant stromal tumor (2 cases) and malignant myxoid schwannoma (1 case). Malignant tumors of the small bowel most commonly arise in the ileum (60%) followed by the jejunum (35%). As for the long-term course, there was a recurrence at one year of a leiomyosarcoma and two recurrences of stromal tumors associated with liver metastases. Conclusion: Small bowel cancers are rare. Time to consultation is long and diagnosis is difficult and late due to the absence of typical presentation. Treatment is surgical and progression depends essentially on histological findings.

关键词： Primary Cancers Small Bowel Epidemiology Diagnosis

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