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Editor's quiz: GI snapshot
Dyspepsia and weight loss in a 47-year-old man
  1. Mohan Ramchandani1,
  2. Sundeep Lakhtakia1,
  3. Domenico Galasso2,
  4. Todd Baron3,
  5. Anuradha Sekaran4,
  6. D Nageshwar Reddy1
  1. 1 Gastroenterology and Therapeutic Endoscopy Department, Asian Institute of Gastroenterology, Hyderabad, India
  2. 2 Digestive Endoscopic Unit, “A. Gemelli” Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
  3. 3 Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
  4. 4 Pathology Department, Asian Institute of Gastroenterology, Hyderabad, India
  1. Correspondence to Dr Mohan Ramchandani, Gastroenterology & Therapeutic Endoscopy Department, Asian Institute of Gastroenterology, 6-3-661 Raj Bhavan Road, Sangeet Nagar, Somajiguda, Hyderabad, Andhra Pradesh 500082, India; ramchandanimohan{at}gmail.com

https://doi.org/10.1136/gutjnl-2014-308599

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    A 47-year-old man presented with mild epigastric pain, dyspepsia and 4 kg weight loss for the last 2 months. There was no history of fever, GI bleeding, cough or pertinent past illnesses or surgery. Physical examination was unremarkable. Routine laboratory tests were within the normal range except for mild anaemia (haemoglobin concentration 11.4 g/dL) and increased erythrocyte sedimentation rate (54 mm/h). ECG and chest X-ray were normal, and serology of HIV, HBV and HCV were negative. Upper endoscopy showed several multilobulated subepithelial lesions (SEL) in the gastric body, cardia and antrum with normal overlying mucosa (figure 1A). Serum chromogranin A and urinary …

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    Footnotes

    • Contributors MR and SL supervised the endoscopic ultrasound-guided fine needle aspiration procedure, revised and critically contributed to the manuscript. DG and DNR revised and critically contributed to the manuscript. TB performed the endoscopic ultrasound-guided fine needle aspiration procedure, revised and critically contributed to the manuscript. AS is the pathologist who correctly gave the final diagnosis. She also revised and critically contributed to the manuscript. All authors meet all the conditions required by ICMJE Recommendations state for authorship credit.

    • Competing interests None.

    • Ethics approval

    • Provenance and peer review Not commissioned; externally peer reviewed.