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2005| September-December | Volume 11 | Issue 3
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Leiomyosarcoma of the small intestine presenting as intussusception
Osman Hassan Noureldine, Areej Abduallah Bokhari, Omer Farouk El-Tinay
September-December 2005, 11(3):170-172
Gastric malignancy : Clinicopathologic spectrum and relationship to helicobacter pylori infection
Mohamed Bakhiet Satti, Abdulaziz Abdullatif Al-Quorain, Yousuf Mohamed Al-Gindan, Abdulrahman Abdulaziz Al Hamdan, Hassan Yousuf Al-Idrissi
September-December 2005, 11(3):149-156
Upper gastrointestinal cancer particularly of stomach is a relatively frequent form of cancer. Gastric H pylori infection has been implicated in the pathogenesis of both gastric carcinoma and gastric lymphoma. Gastric carcinoma has been addressed by many articles in the Kingdom of Saudi Arabia (KSA) and the Middle East, while only a few addressed gastric lymphoma.
Aim of the study:
To investigate the relative frequency of gastric carcinoma and gastric lymphoma and their association with H pylori infection in endoscoped patients.
Patients and methods:
A retrospective study of patients endoscoped at King Fahad Hospital of the University, Al-Khobar, KSA during the period 1983-1999 was performed. Endoscopy and pathology records were retrieved and reviewed. The histopathology slides were re-examined, applying immunohistochemical techniques on corresponding paraffin sections to classify the various tumors. H pylori were identified on routine histology and by utilizing Giemsa stain.
During the study period of 17 years (1983-1999), a total of 94 endoscopically-diagnosed, histologically-confirmed cases of gastric malignancy were identified. Of these, there were 55 gastric adenocarcinoma and 39 gastric lymphoma. H pylori was identified in the adjacent gastric mucosa in 18 of all cases of gastric adenocarcinoma and in 27 of the 39 cases of lymphoma.
The study demonstrates the comparatively high frequency of gastric lymphoma in this population and confirms the intimate association of H-pylori infection to both gastric adenocarcinoma and MALT-lymphoma. Gastric lymphoma should always be considered in the differential diagnosis of gastric malignancy and the use of immunohistochemistry is essential for the differential diagnosis of some of these tumors
among Saudis in Al-Gassim region
Qais Qutub Contractor, Tasneem Qais Contractor, Imran Ul Haque, El Mahdi El Badawi El Mahdi
September-December 2005, 11(3):157-163
Crohn's disease is being increasingly reported from Saudi Arabia and information about its pattern is still accumulating.
Aim of the study:
To describe and classify the disease and assess the response to therapy in patients referred to a tertiary care centre in Gassim region, Kingdom of Saudi Arabia (KSA).
Patients and Methods:
Fifteen Saudi patients found to have Crohn's disease over an eight-year period were studied. The presenting symptoms, area of involvement and the response to therapy were assessed.
There were five males and ten females. The age of 14 patients was less than 40 years. Symptoms had existed for more than one year before diagnosis in 14 patients. Common symptoms were diarrhea, pain during defecation, blood in stool and weight loss. The ileum was involved in three patients, the colon in four and the involvement was ileocolonic in eight patients. The behavior of the disease was non-stricturing nonpenetrating in eight, stricturing in two, penetrating in one and stricturing as well as penetrating in four patients. Three patients presented as acute appendicitis, four as intestinal obstruction and five with perianal disease. Histological diagnosis was possible in 12 patients. Thrombocytosis was present in seven patients and three had episodes of deep vein thrombosis. Eight patients responded to medical therapy. Surgical intervention was necessary in seven patients and three had multiple operations. One patient died during a median follow-up period of 18 months (range: 6 months to 8 years).
Crohn's disease occurs more commonly in young Saudi females. Patients are symptomatic for almost a year prior to diagnosis. The presentation is variable and response to therapy is satisfactory. Surgery is necessary in a high number of patients
Pattern of colorectal cancer at two hospitals in the western region of Saudi Arabia
Mahmoud Shaheen Al-Ahwal, Aisha Abdo Al-Ghamdi
September-December 2005, 11(3):164-169
Patients and Methods:
Data of all patients with CRC treated at two hospitals in the Western region of the Kingdom of Saudi Arabia (KSA), between 1993 and 2002, were collected and analyzed.
Out of the 121 patients evaluated, ten were excluded because of incomplete data. Out of 111 patients, 59 (53.2%) were males, with a male to female ratio of 1.13: 1 and 49 (44.1 %) were Saudis. Thirty-three patients (29.7%) were 40 years or less and 78 (70.3%) were more than 40 years. Colon cancer was found in 69 patients (62.2%) and rectal cancer in 42 (37.8%). Stages at presentation were; stage 0 (2.7%), stage I (11.7%), stage 11 (23.4%), stage III (20.7%), stage IV (22.5%) and the staging was unknown in 18.9% of the patients. The most common tumor grade was moderately differentiated (38.7%), followed by poorly differentiated (20.7%) and well differentiated 19.8% of the patients. Forty-four patients (39.6%) were alive at the time of data collection, 43 (38.7%) expired and 24 (21.6%) were lost to follow up. Correlation between age groups revealed that young patients had more advanced stage and poorly differentiated tumors than > 40 years old (p= 0.005 and 0.024 respectively).
Compared to data from Western countries, colorectal cancer in this population is more common in younger patients. It presents more commonly in a more advanced stage and poorly differentiated type than in older patients
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