Search PubMed⌕ Search

Biomedical subjects

B C Morson

Publications and source records attributed to B C Morson.

At least 109 records · Page 6Linked to original sources

The evolution of cancer of the colon and rectum.

The malignant potential of adenomas of the colon and rectum varies with size, histological type and grade of epithelial atypia. The adenomatous polyp is usually small and has a low malignant potential, whereas tumors with a villous structure are usually larger and have a much higher cancer rate. Severe atypia is more common in villous adenomas than in adenomatous polyps. Evidence is presented which suggests that most cancers of the colon and rectum have evolved through the polyp-cancer sequence although the majority of adenomas do not becoma cancerous during a normal adult life span. The slow evolution of the polyp-cancer sequence is stressed. The implications of the polyp-cancer sequence for the design of cancer prevention programmes and the study of the aetiology of large bowel cancer are discussed.

Adenoma↗

Inflammatory bowel disease: the surgical pathology of Crohn's disease and ulcerative colitis.

Ulcerative colitis and granulomatous colitis are distinct entities, but up to 10 per cent of colectomy specimens remain unclassified. Ulcerative colitis is primarily a mucosal disease, and other changes appear to be secondary to this process. By contrast, Crohn's disease, or granulomatous colitis, involves the whole thickness of the bowel wall. About 20 per cent of the cases of Crohn's disease involve the small and large bowel, while another 20 per cent are restricted to the large bowel. Since granulomatous colitis is a patchy disease, and many of the changes are deep within the bowel wall, rectal biopsy may not be as helpful as in ulcerative colitis. Fully developed granulomas are present in only a small minority of cases, and a diagnostic report of granulomatous colitis may be given in the absence of granulomas. In biopsy material, the differentiation of inflammatory bowel disease from ischemic colitis and pseudomembranous colitis may be difficult. In the absence of specific demonstration of an organism it may also be impossible on rectal biopsy to distinguish amebic or bacillary dysentery from ulcerative colitis. Even by colectomy, 29 of 300 specimens were sufficiently atypical so as not to warrant a label of Crohn's disease, or ulcerative colitis. Cancer of the colon, which is common in ulcerative colitis, is rare in Crohn's disease, but may also represent a definite complication in the latter. Immunologic studies are still confusing, but it is suggested that patients with ulcerative colitis and Crohn's disease may have a state of altered immunologic reactivity.

Animals↗

Pseudo-carcinomatous invasion in adenomatous polyps of the colon and rectum.

The histology of pseudo-carcinomatous invasion in adenomatous polyps of the colon and rectum is described and the appearances are contrasted with those seen in malignant polyps. The recognition of pseudo-carcinomatous invasion is important in the differential diagnosis of benign and malignant polyps of the large bowel. Failure to distinguish it from carcinoma may lead to wrong treatment and false reports of the incidence and prognosis of cancer of the colon and rectum. The evidence suggests that pseudo-carcinomatous invasion may be the result of repeated twisting of the stalk of a polyp which causes haemorrhage and this facilitates the passage of non-malignant adenomatous epithelium through the muscularis mucosae.

Adenocarcinoma↗

A study of six patients with hypertrophy of the gastric mucosa with particular reference to albumin metabolism.

Six patients with hypertrophy of the gastric mucosa (Menetrier's disease) have been studied. An incorrect diagnosis was initially made in four patients. The correct diagnosis was suggested by the appearances either of barium meal radiographs of the stomach or at gastroscopy. Estimates of both basal and maximal gastric acid secretion were within normal limits. A definitive histological diagnosis requires an adequate full-thickness biopsy of the wall of the stomach; a peroral gastric mucosal biopsy is of no value in this context. There was no evidence of premalignant change in the histological material available but five of the patients were shown to have concomitant superficial gastritis. Subtotal gastrectomy in four of the patients was followed by a striking amelioration of abdominal pain, which was only temporary in one patient. Albumin metabolism was studied in five of the patients, four of whom had concomitant superficial gastritis. None of the patients had hypoalbuminaemia. However, the fractional catabolic rate of albumin measured with ((131)I)-albumin was shown in four of these patients to be increased, while the absolute catabolic rate was similar to that in control subjects. Similar results were obtained for albumin synthesis in three of the patients using the ((14)C)-carbonate method. In two of the patients subtotal gastrectomy was associated with a marked reduction of the fractional catabolic rate of albumin and in one, using ((125)I)-fibrinogen, with a relatively less marked reduction in the fractional catabolic rate of fibrinogen. These results indicate that abnormal albumin metabolism can be demonstrated in patients with this syndrome in spite of normal plasma albumin concentrations. The detection of the abnormal albumin metabolism can be of diagnostic value in patients with this gastric lesion. The abnormalities of albumin metabolism found are consistent with excessive loss of albumin into the stomach and the presence of superficial gastritis could have contributed to protein loss.

Adult↗