Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018




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Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Case report
Year : 2012 | Month : September | Volume : 6 | Issue : 7 | Page : 1316 - 1318 Full Version

Lymphangioma of the Stomach- A case Report


Published: September 1, 2012 | DOI: https://doi.org/10.7860/JCDR/2012/.2435
Sainath K. Andola, Reema Harwrwal, S M Patil, Shubi

1. Professor and HOD, Department of Pathology, 2. Resident, Department of Pathology, 3. Professor, Department of Surgery, 4. Resident Department of Surgery, MR. Medical College, Gulbarga, Karnataka, India.

Correspondence Address :
Dr. Sainath K. Andola
Professor and HOD, Department of Pathology,
MR. Medical College, Sedam Road,
Gulbarga-585105- Karnataka, India.
Phone: 09448881818
E-mail: drskandola@gmail.co

Abstract

Lymphangiomas are benign lymphatic tumours that may occur virtually at any anatomic locations. They are particularly uncommon in the abdomen. We are presenting here a case of a 30 years female who presented with a mass per abdomen of 3 months duration, with fever, chills and vomiting. USG and CT reported this case to be an infected pseudocyst of the pancreas with a differential diagnosis of a hydatid cyst and enteric duplication of the cyst. Excision of the sub-mucosal mass from the posterior wall of the stomach was done and it was histopathologically diagnosed as lymphangioma of the stomach. The case is being presented because of its rarity, with a brief review of the literature.

Keywords

Lymphangioma, Intra-abdominal lymphangioma

INTRODUCTION
Lymphangiomas are benign lesions of vascular origin that show a lymphatic differentiation. They occur at many anatomic locations and they may have a paediatric or an adult clinical presentation. Most (95%) of them occur in the neck and the axillary regions; the remaining 5% are located in the mesentery, retroperitoneum, abdominal viscera, lung and the mediastinum. Among them, lymphangioma of the stomach is very rare (1). Gastric lymphangiomas have been reported in less than 100 cases worldwide since 1953 (2).Most of the lymphangiomas of the abdominal cavity originate from the mesentery in which most of the lymphatic channels are included. Therefore, the lymphangiomas of the abdominal cavity were previously called mesenteric cystic lymphangiomas (MCLs)(3). To date, various locations of MCLs have been reported; where the stomach is an extremely rarely involved organ (1). The greater and the lesser omentums which are attached to the stomach, are the typical sites of MCLs in the intra-abdominal cavity. Endoscopic ultrasonography has become an indispensable tool for differentiating these gastric tumours. The treatment of these lymphangiomas depends on their sizes, locations and the presence of complications. Excision of the tumour is the treatment of choice, which gives provides excellent prognosis. This case has been presented because of its rarity.

Case Report

A 30- years old female presented with a mass per abdomen of 3 months duration, which was associated with fever, chills and vomiting. The per abdominal examination revealed a palpable mass in the right epigastrium and in the right lumbar region. The mass measured around 12x10cm and it was painless.
Investigation:
The routine CBC, urine examination and LFT were within normal limits. USG of the abdomen revealed a hyperechoic mass which arose from the right hypochondriac region and extended upto the epigastrium, which was suggestive of a benign cystic lesion. CT of the abdomen reported it as an infected pseudocyst of the pancreas with a differential diagnosis of a hydatid cyst/an enteric duplication cyst. The patient underwent an exploratory laparotomy and the mass, which was sub-mucosal in origin, was excised from the posterior Reportwall of stomach,. Grossly, an oval mass which measured 10x6x5cms, with a smooth glistening outer surface, which was yellowish white in colour and mimicked a lipoma, was seen.
Cut/Section:
gray white to yellowish. Microscopically, dilated lymphatic spaces which were lined by flat endothelial cells, large cystic spaces which contained a pale eosinophilic material with scattered lymphoid cells and lymphoid aggregates in between the spaces were seen. A histological diagnosis of lymphangioma of the stomach made. The post operative course was uneventful.

Discussion

Abdominal cystic lymphangiomas are exceedingly rare benign tumours with an incidence of 1 in 20,000-250,000 cases (4). Fewer than 100 cases had been reported in the English literature till 2001 (2). The age at presentation occurs in a bimodal distribution, with greater than 80% patients presenting before the age of 5 and the remainder presenting around the age of 40 years. The aetiology of cystic lymphangiomas has not been fully understood, but the anomalous development of the lymphatics or inflammation and obstruction of the developed lymphatic channels have both been proposed as the possible mechanisms. Clinically, most of the cases of cystic lymphangiomas are asymptomatic and they are detected incidentally. Occasionally, they are large enough to cause obstruction or intussusception, depending on the size and location of the mass.Histologically, these lesions consist of irregularly dilated lymphatic channels which are lined by benign-appearing endothelial cells. Furthermore, these lesions often have a cystic appearance because of a progressive accumulation of fluid. The cyst contents are variable and they may include serous, haemorrhagic, chylous, or mixed fluid. Rarely, calcification may be present. Although the cystic lymphangiomas of the abdominal cavity were previously considered as mesenteric cysts, the histological difference between the lymphangiomas and the mesenteric cysts was recently established. In contrast to the mesenteric cysts which originate from the mesothelial tissue, lymphangiomas are composed of alternating lymphoid tissue, lymphatic spaces and foam cells. As most of the lymphangiomas of the abdominal cavity originate from the mesentery and form multi-lobular cysts, they are referred to as MCLs. A cystic lymphangioma is a rare benign submucosal tumour of the stomach which is thought to originate from the sequestered lymphatic tissue, that fails to communicate with the normal lymphatic system. It should be distinguished from other cystic lesions such as mesenteric cysts, enteric duplication cysts and pseudocysts of the pancreas. The early imaging, detection, and the diagnosis of the abdominal cystic lymphangiomas is important for the definitive treatment of these rare and treatable tumours. Imaging plays an important role in the preoperative evaluation, as lymphangiomas tend to be insinuating and as they may make a complete surgical resection difficult. The most specific method of evaluation which is used for cystic lymphangioma of the stomach is endoscopic ultrasonography (2). Lymphangiomas can become locally invasive and they often require surgical excision, with recurrence rates of 12% and 53%, when they are completely or partially resected respectively. A 10% incidence of recurrence has been reported with the incomplete resection of abdominal lymphangiomas (5). Fayad H studied 13 cases of abdominal lymphangiomas in the paediatric age group and observed nil mortality and no malignant transformations in the follow up cases. Once the cysts were excised, the prognosis was excellent (6). Knowledge on the imaging and the pathologic spectrum of the abdominal lymphangiomas is necessary when paediatric and adult patients with intra-abdominal cystic masses are evaluated.

References

1.
Kang TW, Lee SJ, Song HJ. Multidetector-Row CT. The findings on gastric cystic lymphangiomas: A case report. J Korean Radiol Soc 2008;59:261- 4.
2.
Kim HS et al., Gastric lymphangiomas. J Korean Med Sci 2001;16:229-32.
3.
Kim YB et al., A giant mesenteric cystic lymphangioma originating from the lesser omentum in the abdominal cavity. J Gastric Cancer 2011;11(4):243-47.
4.
Leland et al., Cystic lymphangioma of the lesser curvature of the stomach – A case report. Radiology Case. 2011 May; 5(5):31-37.
5.
Steyaert H, Guitard J, Moscovici J, et al., Abdominal cystic lymphangiomas in children: benign lesions that can have a proliferative course. J Pediatr Surg 1996;31:677-80.
6.
Fayad H. Abdominal cystic lymphangiomas in children. Annals of Paediatric Surgery 2009;5:132-36.

DOI and Others

ID: JCDR/2012/4595:2435

Financial OR OTHER COMPETING INTERESTS:
None.
Date of Submission: May 29, 2012
Date of Peer Review: Jul 09, 2012
Date of Acceptance: Aug 23, 2012
Date of Publishing: Sep 30, 2012

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