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Hypoalbuminaemia and gastric mass
  1. K Honein1,
  2. J Boujaoude1,
  3. C Ghora2
  1. 1Department of Gastroenterology, Hotel-Dieu de France Hospital, Saint Joseph University, Lebanon
  2. 2Department of Pathology, Hotel-Dieu de France Hospital, Saint Joseph University, Lebanon
  1. Correspondence to:
    Professor J Boujaoude
    Department of Gastroenterology, Hotel-Dieu de France Hospital, Saint Joseph University, Beyrouth 961, Lebanon; jboujhotmail.com

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Clinical presentation

A 45 year old woman presented with longstanding dyspepsia associated with oedema and a 4 kg weight loss over the previous six months. She gave no history of haematemesis or blood in stool, nocturnal sweating, or chronic diarrhoea. There was no familial history of gastric carcinoma. Surgical history included cure of eventration. Physical examination revealed tenderness in the epigastrium. Routine laboratory investigations revealed: haemoglobin 9.6 g% (normal range 10–14), mean corpuscular volume 80 fl (normal range 75–95), serum albumin 25 g/l (normal range 35–50), C reactive protein <3 (normal range <10), lactate dehydrogenase 355 IU (normal range <600), and β2 microglobulin 2 (normal range 0.5–1.2). The patient underwent upper gastrointestinal endoscopy with gastric biopsy and endoscopic ultrasound of the stomach (fig 1–3).

Figure 1

 Upper gastrointestinal endoscopy.

Figure 2

 Endoscopic ultrasound of the stomach.

Figure 3

 Full thickness gastric mucosal biopsy.

Question

What is the diagnosis? What other entities could present with this endoscopic and histological picture?

See page 1589 for answer

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Footnotes

  • Robin Spiller, editor

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