- Email: [email protected]
Sa1053 Endoscopic Features of Mantle Cell Lymphoma With Involvement of the Digestive Tract
Abstracts St. Paul’s hospital in Vancouver, B.C. Inclusion criteria: age >19, planned outpatient colonoscopy, and willingness/ability to participate by reading the online English material supplied by sending the subject a specific domain (which contains the educational platform of information for their colonoscopy). Exclusion criteria: None. Consecutive patients enrolled into the study (target of 450 participants). Data Collected: demographics, cancellations, bowel preparation cleanliness scores as per Boston bowel preparation quality (BBPS) and Ottawa bowel preparation score. Primary end points: percentage of patients that achieve an excellent BBPS following web-based instructions vs paper instructions. Assessment of patient satisfaction, preparation tolerability and patient activation score through post colonoscopy follow-up surveys. Results: 450 patients have been recruited and had their data analyzed. 197 are male; mean age 55 years (range 20-81). 223 were assigned to Group A (paper based) and 227 to Group B (web based). A Fisher’s exact test showed a significant difference in the proportion of subjects achieving an excellent BBPS score 8 (Group A Z 37% (82/223), Group B Z 47% (106/227) pZ0.0357) and a significant decrease in the number of subjects with inadequate preps BBPS3 (Group A Z 8.9% (20/223), Group B Z 3.5% (8/227) pZ0.0191). There was no significant difference in patient reported satisfaction (pZ0.8415), helpfulness (pZ0.9847) or clarity of instructions (pZ0.8936). Conclusions: Analysis detected a significant difference in patients achieving excellent bowel preparation scores between interactive individualized web based instructions vs written instructions. Due to the significant increase in excellent preps and a decrease in inadequate preps our office has transitioned to using the web platform as standard of care. We are currently running an open label study to continue monitoring the outcomes of patient who use the web platform.
most common manifestation called “lymphomatoid polyposis”, characterized by identification of multiple lymphoid polyps, mainly in tne small and large intestine to superficial ulcers and large tumors most common in valve ileocecal or normal appearing mucosa. Aim: Describe the clinical and endoscopic features of MCL affecting the upper and lower digestive tract. Materials & Methods: A retrospective study was carried out, based on a series of cases of patients with diagnosis of MCL with involvement of the digestive tract in a period of ten years. Descriptive statistics were performed with frecuences and percentages of the endoscopic features observed. Results: we reviewed 85 patients records with diagnosis of MCL, of which ten (11.7%) had affection of the gastrointestinal tract in a period of ten years. 4 patients had multiple gastrointestinal symptoms like anorexy (40%), abdominal pain (30%) and abdominal distension (20%). The most common endoscopic features reported in upper endoscopy were polypoid lesions (66%), thickened folds (44%) and nonspecific mucosal changes (33%). Gastric antrum was the location most common involved in 77%, followed by the body in 66% and duodenum in 55%. Colonoscopy findings were polypoid lesions in 100% of the patients, ulcerated lesions in 40% and edematous mucosa and tumor in 20%, the transverse colon, sigmoid and rectum were each affectted in 60% of the patients. Conclusion: Polypoid lesions are the most common endoscopic features in patients with MCL of the GI tract. The gastrointestinal condition of patients with MCL should be investigated even if they have nonspecific symptoms and this must include upper endoscopy and colonoscopy. Gastrointestinal involvement has an impact on the staging of the disease.
Sa1052 Signet Ring Cell Carcinoma of Early Gastric Cancer, Is Endoscopic Treatment Really Risky? Hee Seok Moon*, Hyun Yong Jeong, Jaekyu Sung, Sun Hyung Kang gastroenteology, chungnam national university hospital, Daejeon, — Select —, Korea (the Republic of) Backgorund/Aim: Signet ring cell carcinoma (SRC) is a poorly differentiated cancer of the stomach. Generally, poorly differentiated cancer is believed to show poor prognosis and aggressive behavior. Recently, however, there is debate on the aggressiveness of SRC in early gastric cancer (EGC). We therefore studied postoperation biopsies to investigate the aggressiveness of SRC in EGC. Method: We reviewed medical records of patients with EGC who had surgery from January 2011 to December 2015 in a tertiary hospital in Daejeon, South Korea. We evaluated the histologic type, invasion depth, lymphovascular invasion (LVI) and lymph node (LN) metastasis after surgery. Results: 822 EGC lesions from 789 patients were studied. 498 patients had well to moderate differentiated cancer while 65 had poorly differentiated cancer, 91 had SRC, 26 had poorly differentiated with SRC, 41 had mixed type, 10 had medullary carcinoma and 91 patients had poorly cohesive carcinoma other than SRC. LN metastasis was associated with the histologic type of EGC (pZ0.000). 9% of differentiated cancer, 21.5 % of poorly differentiated cancer, 5.5 % of SRC, 11.5% of poor differentiation with SRC, 26.8 % of mixed type, 20 % of medullary type and 15.4 % of poorly cohesive carcinoma other than SRC showed LN metastasis. The risk of SRC was not higher than well to moderated differentiated cancer (ORZ0.842, pZ0.768). Risk of LVI was also similar with LN metastasis. Compared with differentiated cancer, Odds ratio of SRC was 1.969 (pZ0.172). There was no LN metastasis in SRC below < 3 cm (0/73). 5 LN metastasis were found in SRC above 3 cm (5/18, 27.8%). 1 LN metastasis were found in mucosal cancer of SRC (1/66, 1.5%), no LN metastasis in SM1 cancer, 2 in SM2 cancer (2/10, 20%), and 2 in SM3 cancer (2/7, 28.5%). Conclusion: Our results show that LN metastasis and LVI is not more aggressive in SRC when compared to differentiated cancer. SRC may be considered a candidate for endoscopic treatment. Key words: Signer ring cell carcinoma, lymph node, stomach, endoscopic treatment
POLYPOID LESION IN ASCENDING COLON
Sa1053 Endoscopic Features of Mantle Cell Lymphoma With Involvement of the Digestive Tract Flora M. Oña-Ortiz*, Jose-Guillermo De La Mora-Levy, Juan O. Alonso-Larraga, Julio Sanchez Del Monte, Melissa Jimenez Morales, Cesar R. Ortega Espinosa, Maria del-Carmen Manzano-Robleda, Angelica Hernandez-Guerrero INCAN, Mexico City, Mexico Background: Mantle Cell Lymphoma (MCL), is an aggressive subtype of non hodgkin lymphoma (NHL) of B phenotype. It represents 3% to 6% of the NHL with an anual incidence of 0.5 per 100,000 case series. It is most commonly diagnosed in advanced stages, with bone marrow and peripheral blood involvement, and generalized lymphadenopathy in 75%. Some patients have splenomegaly, hepatomegaly and extranodal disease such as lymphomatous polyposis of the colon; the MCL has a very aggressive behaviour with poor response to treatment. Gastrointesinal involvement at the moment of diagnosis is between 15-30%. Endoscopic findings vary from the
www.giejournal.org
POLYPOID LESION IN SPLENIC ANGLE
Volume 85, No. 5S : 2017 GASTROINTESTINAL ENDOSCOPY AB171
most common manifestation called “lymphomatoid polyposis”, characterized by identification of multiple lymphoid polyps, mainly in tne small and large intestine to superficial ulcers and large tumors most common in valve ileocecal or normal appearing mucosa. Aim: Describe the clinical and endoscopic features of MCL affecting the upper and lower digestive tract. Materials & Methods: A retrospective study was carried out, based on a series of cases of patients with diagnosis of MCL with involvement of the digestive tract in a period of ten years. Descriptive statistics were performed with frecuences and percentages of the endoscopic features observed. Results: we reviewed 85 patients records with diagnosis of MCL, of which ten (11.7%) had affection of the gastrointestinal tract in a period of ten years. 4 patients had multiple gastrointestinal symptoms like anorexy (40%), abdominal pain (30%) and abdominal distension (20%). The most common endoscopic features reported in upper endoscopy were polypoid lesions (66%), thickened folds (44%) and nonspecific mucosal changes (33%). Gastric antrum was the location most common involved in 77%, followed by the body in 66% and duodenum in 55%. Colonoscopy findings were polypoid lesions in 100% of the patients, ulcerated lesions in 40% and edematous mucosa and tumor in 20%, the transverse colon, sigmoid and rectum were each affectted in 60% of the patients. Conclusion: Polypoid lesions are the most common endoscopic features in patients with MCL of the GI tract. The gastrointestinal condition of patients with MCL should be investigated even if they have nonspecific symptoms and this must include upper endoscopy and colonoscopy. Gastrointestinal involvement has an impact on the staging of the disease.
Sa1052 Signet Ring Cell Carcinoma of Early Gastric Cancer, Is Endoscopic Treatment Really Risky? Hee Seok Moon*, Hyun Yong Jeong, Jaekyu Sung, Sun Hyung Kang gastroenteology, chungnam national university hospital, Daejeon, — Select —, Korea (the Republic of) Backgorund/Aim: Signet ring cell carcinoma (SRC) is a poorly differentiated cancer of the stomach. Generally, poorly differentiated cancer is believed to show poor prognosis and aggressive behavior. Recently, however, there is debate on the aggressiveness of SRC in early gastric cancer (EGC). We therefore studied postoperation biopsies to investigate the aggressiveness of SRC in EGC. Method: We reviewed medical records of patients with EGC who had surgery from January 2011 to December 2015 in a tertiary hospital in Daejeon, South Korea. We evaluated the histologic type, invasion depth, lymphovascular invasion (LVI) and lymph node (LN) metastasis after surgery. Results: 822 EGC lesions from 789 patients were studied. 498 patients had well to moderate differentiated cancer while 65 had poorly differentiated cancer, 91 had SRC, 26 had poorly differentiated with SRC, 41 had mixed type, 10 had medullary carcinoma and 91 patients had poorly cohesive carcinoma other than SRC. LN metastasis was associated with the histologic type of EGC (pZ0.000). 9% of differentiated cancer, 21.5 % of poorly differentiated cancer, 5.5 % of SRC, 11.5% of poor differentiation with SRC, 26.8 % of mixed type, 20 % of medullary type and 15.4 % of poorly cohesive carcinoma other than SRC showed LN metastasis. The risk of SRC was not higher than well to moderated differentiated cancer (ORZ0.842, pZ0.768). Risk of LVI was also similar with LN metastasis. Compared with differentiated cancer, Odds ratio of SRC was 1.969 (pZ0.172). There was no LN metastasis in SRC below < 3 cm (0/73). 5 LN metastasis were found in SRC above 3 cm (5/18, 27.8%). 1 LN metastasis were found in mucosal cancer of SRC (1/66, 1.5%), no LN metastasis in SM1 cancer, 2 in SM2 cancer (2/10, 20%), and 2 in SM3 cancer (2/7, 28.5%). Conclusion: Our results show that LN metastasis and LVI is not more aggressive in SRC when compared to differentiated cancer. SRC may be considered a candidate for endoscopic treatment. Key words: Signer ring cell carcinoma, lymph node, stomach, endoscopic treatment
POLYPOID LESION IN ASCENDING COLON
Sa1053 Endoscopic Features of Mantle Cell Lymphoma With Involvement of the Digestive Tract Flora M. Oña-Ortiz*, Jose-Guillermo De La Mora-Levy, Juan O. Alonso-Larraga, Julio Sanchez Del Monte, Melissa Jimenez Morales, Cesar R. Ortega Espinosa, Maria del-Carmen Manzano-Robleda, Angelica Hernandez-Guerrero INCAN, Mexico City, Mexico Background: Mantle Cell Lymphoma (MCL), is an aggressive subtype of non hodgkin lymphoma (NHL) of B phenotype. It represents 3% to 6% of the NHL with an anual incidence of 0.5 per 100,000 case series. It is most commonly diagnosed in advanced stages, with bone marrow and peripheral blood involvement, and generalized lymphadenopathy in 75%. Some patients have splenomegaly, hepatomegaly and extranodal disease such as lymphomatous polyposis of the colon; the MCL has a very aggressive behaviour with poor response to treatment. Gastrointesinal involvement at the moment of diagnosis is between 15-30%. Endoscopic findings vary from the
www.giejournal.org
POLYPOID LESION IN SPLENIC ANGLE
Volume 85, No. 5S : 2017 GASTROINTESTINAL ENDOSCOPY AB171