Search PubMed⌕ Search

Biomedical subjects

C A Rubio

Publications and source records attributed to C A Rubio.

At least 109 records · Page 6Linked to original sources
PubMed1989

Intramucosal gastric cysts simulating submucosal cysts.

A total of 2.004 sections from 41 gastrectomy specimens were reviewed for the presence of submucosal cysts. In nine of the gastrectomy specimens, cysts were found protruding into the submucosal space (in one specimen, two such cysts were found). All ten cysts were seen surrounded by the muscularis mucosae, even those without any apparent connection with the mucosa. Deeper cuts of the paraffin blocks demonstrated a continuity between the muscle fibres surrounding the cysts and the muscularis mucosae. A gap in the muscularis mucosae was also demonstrated, through which cysts pushed the muscle fibres into the submucosal area. No specific association between cysts and adenocarcinoma of the stomach was found in the present work.

Atrophy↗
PubMed1989

A morphometric method to discriminate normal from dysplastic/carcinoma in situ squamous epithelium in the human esophagus.

The possibility to differentiate normal squamous epithelium from dysplastic/cis in the human esophagus by means of quantitative morphometry was investigated in surgical specimens from 31 consecutive patients. The epithelium was divided into three equal zones, and a total of 186 areas was investigated. Of all variables employed, the interzonal variation between the three epithelial layers was the one showing the highest degree of efficiency (95%) in discriminating normal esophageal epithelium from dysplastic/cis lesions. Nuclear density, nuclear area, nuclear irregularity, nuclear parallelity and nuclear ovality were the most efficient discriminatory individual morphological variables. A 100% sensitivity in discriminating normal squamous epithelium from dysplastic/cis through morphometric evaluation was achieved by considering nuclear area in the superficial zone, nuclear perpendiculairty in the intermediate zone, nuclear density in the total epithelial thickness and interzonal variation of these variables. On the other hand, the specificity in discriminating dysplasia/cis lesions from normal squamous epithelium was only 96.8%. This was due to the fact that one case, by visual impression considered as dysplasia, was morphometrically recorded as normal. The view of that case showed that our initial visual impression of a dysplastic lesion proved to be erroneous, and today that case would be recorded as a reactive lesion due to chronic inflammation.

Analysis of Variance↗
PubMed1989

Mapping intestinal metaplasia by histochemistry and morphometry.

A gastrectomy specimen housing an adenocarcinoma of intestinal type was divided into 60 blocks. Sections were stained with Alcian blue pH 2.5 (to detect foreign mucins). Alcian blue fields were quantitated with a MOP 30 connected to a computer. The mucosa analysed in the 60 sections measured 3788.3 mm2 and that occupied by Alcian blue stained goblet cells 300.9 mm2 (or 7.9% of the total mucosal area). The number of Alcian blue positive fields was significantly larger in the intermediate zone followed by the antral zone, the lowest value was found in the corpus. However, the gastric mucosa with Alcian blue positive cells was larger in the antrum than in the intermediate zone due to the fact that the area of the fields with Alcian blue positive cells was significantly larger in the antrum than in the intermediate zone. The size and number of Alcian blue positive fields were significantly larger along the greater than along the smaller curvature. All measurements were done by a trained technician. The method (using histochemistry, morphometry and skilled technical assistance) will be applied to study the distribution of intestinal metaplasia in gastrectomy specimens from populations with disparate incidences of gastric carcinoma.

Adult↗
PubMed1989

Paneth cell adenoma of the stomach.

A case of Paneth cell adenoma of the stomach in a 75-year-old woman is reported. At histological examination, a tubular adenoma with low-grade (moderate) dysplasia was found. The dysplastic cells had distinct coarse cytoplasmic granules that stained red with eosin and PAS but were negative with alcian blue pH 2.5. The adenoma may have developed from paneth cells present in areas of preexisting intestinal metaplasia.

Adenoma↗
PubMed1989

Histological classification of intraepithelial neoplasias and microinvasive squamous carcinoma of the esophagus.

We reviewed a total of 119 resected esophagi with intraepithelial neoplasias of low grade (including slight or moderate dysplasias), high grade (including severe dysplasia and carcinoma in situ), or microinvasive squamous carcinoma (i.e., not invasive beyond the submucosa and without metastases in regional lymph nodes). Epithelial buds bulging into the stroma were noted in noninvasive intraepithelial lesions. The most severe degree of histological alteration was used to characterize each case. Of the 119 cases, five were low-grade, 38 were high-grade, and the remaining 76 specimens contained microinvasive squamous carcinoma. Of these, 23 invaded only the lamina propria. Nine invaded the muscularis mucosae, 16 invaded the inner half of the submucosa, and the remaining 28 invaded the outer half of the submucosa. Epithelial buds were divided according to their configuration into types I, II, and III. Grade I was characterized by regular epithelial buds of the same size, grade II had regular buds that varied in size, and grade III had irregular buds (i.e., buds of varying length and width with irregular contours). Our study of 66 specimens with microinvasive squamous carcinoma showed that one of the two specimens that had low grade dysplasia also had type III buds, while 56 of the remaining 64 (87.7%) with high grade dysplasia also had type III buds. Microinvasion originated at the tip of the type III epithelial buds in 12 specimens. Similar results have been demonstrated in experimental animals. We conclude that in the esophageal mucosa, there is a close relationship among the degree of squamous cellular atypia, the formation of epithelial buds, and the progression toward invasive carcinoma.

Carcinoma in Situ↗
PubMed1989

Mucosal cysts in Barrett's mucosa with dysplasia.

The frequency of glandular cysts occurring in the Barrett's mucosa was investigated in areas adjacent to invasive adenocarcinoma in 32 resected esophagi. Cysts in the metaplastic glands of the Barrett mucosa were present in areas with and without dysplasia in 31 of the 32 specimens. The mean cyst index (i.e. the number of glandular cysts divided by the length-in mm-of mucosa analyzed) was 2.3 in the non-dysplastic Barrett mucosa, and 2.5 in the Barrett mucosa with dysplasia. Significantly lower indices (p less than 0.001) were found in areas with metaplastic glands covered by "healing" squamous epithelium (0.47) and in the gastric mucosa of the same patients (0.15) as well as in 10 control esophagi underneath normal squamous epithelium (0.11). The outlet of the dilated glands was often obstructed by clusters of dysplastic cells or papillary formations with atypical cells, substantiating on obstructive-causal mechanism in these cysts. Other cysts were partially or totally replaced by dysplastic epithelium. The present findings may be of importance for the histological differential diagnosis between dysplasia and highly differentiated adenocarcinomas in biopsy specimens from the Barrett Mucosa.

Adenocarcinoma↗
PubMed1989

A method of quantitating Paneth cell metaplasia of the stomach by image analysis.

Paneth cells are one of the histologic components of intestinal metaplasia of the stomach, as are mucin-producing goblet cells. With the aid of an image quantifier, the distribution of Paneth cells histochemically labeled with acid fuchsin was analyzed for a gastrectomy specimen containing an adenocarcinoma of the intestinal type; the topographic distribution of goblet cells histochemically labeled with Alcian blue (pH 2.5) was also analyzed. The specimen was cut into 63 blocks (0.5 X 4.0 cm) in four zones; antrum (zone I), intermediate region (zone II) and fundus (zones III and IV). Paneth cells were found only in sections containing mucin-producing goblet cells. Paneth cells were found in 12.5% of the 16 sections from the antral zone I containing Alcian blue-positive goblet cells. The rates were 44.4% for the intermediate zone II and 55.5% for the distal fundic zone III. The total area occupied by Paneth cells was significantly lower in the gastric mucosa as compared to the duodenal mucosa. The "Paneth cell index" (total Paneth cell area/total goblet cell area) was highest in the duodenum, followed by the distal fundic zone III. This method of quantitating Paneth cell metaplasia of the stomach will be used to investigate the topographic distribution of those cells in populations with low and high incidences of intestinal metaplasia.

Adenocarcinoma↗
PubMed1988

Ulcerative colitis in protracted remission. A quantitative scanning electron microscopic study.

Colonoscopic biopsies from 32 patients were studied at the ultrastructural level using a scanning electron microscope (SEM). Sixteen of the 32 patients had a previous diagnosis of total ulcerative colitis (UCR greater than 10 years) in protracted remission. The colonic mucosa was normal at endoscopic and histologic examinations (UCRN). The remaining 16 patients had normal colonic mucosa, but had an adenoma or an adenocarcinoma elsewhere in the colon. Several ultrastructural parameters were investigated, such as the number of crypts per area, the distance between the crypts, the outline of mucosal units, the number of mucous cells, the outline of absorptive cells, and the number of villi per area. Quantitative determinations of SEM structures (including measurements with an interactive digital image analyzer system; MOP 30, Zeiss Contron) were made. The results showed no significant differences between the various parameters (except for the number of crypts per area) between patients with UCRN and controls. The possibility of a total (or quasi-total) restitutio ad integrum of the colonic mucosa in certain patients with UCR is discussed. An international policy regarding the colonoscopic surveillance of patients with UCRN should be elaborated. It is suggested that the time interval between control colonoscopic biopsies in patients with UCRN should be increased substantially.

Adenocarcinoma↗
PubMed1988

Six types of intraepithelial vacuoles in the human gastric mucosa.

Two types of goblet cells are classically described in the literature as markers of intestinal or colonic metaplasia of the gastric mucosa. In addition to those, four types of vacuolated cells in the gastric mucosa are herein described. One type corresponded to mucus-positive goblet cells (as in classical intestinal metaplasia) but containing in addition neuroendocrine granules. Another type presented vacuolated cells with cilia. Many of the ciliated cells had negative mucus reaction. Ciliated metaplastic cells were observed in cystically dilated pyloric glands. Another type was characterized by vacuolated cells without cilia, also in pyloric glands. The latter vacuoles often adopted an infranuclear position. Finally, cells with intraepithelial vacuoles (mucus-negative) centered by a lymphocyte were recorded in foveolar cells. Possible explanations for the occurrence of the type of intraepithelial vacuoles herein described were discussed. The occurrence of various types of intraepithelial vacuoles in the gastric mucosa should be borne in mind in the histological differential diagnosis of intestinal metaplasia in the gastric mucosa in H & E routine examinations.

Cilia↗
PubMed1988

Atypical mitoses in dysplasias of the Barrett's mucosa.

The frequency of mitotic figures, the proportion of atypical mitoses, and the spatial position (vertical or horizontal) of metaphasal plates were studied in resected specimens from 18 patients having Barrett's mucosa with dysplasia, and/or invasive adenocarcinoma. The number of dividing glandular cells increased (by comparison with the non-dysplastic Barrett's mucosa) in areas with dysplasia and with invasive adenocarcinoma, the largest percentage was found in the latter. Atypical mitoses were often found in areas with glandular dysplasia and with invasive adenocarcinoma. The highest frequency was found in adenocarcinoma. While 90.8% of the metaphases in Barrett's mucosa without dysplasia had a vertical position, only 39.5% of the mitoses in areas with dysplasia had the same position. It is conceivable, that the number of mitoses, the number of atypical mitoses as well as the spatial position of mitosis should be registered in the Barrett's mucosa with dysplasia in attempts to learn more about the biological behaviour of these lesions.

Adenocarcinoma↗
PubMed1988

Foveolar cell vacuolization in operated stomachs.

Gastric biopsies from 223 patients were scrutinized for the presence of subnuclear vacuolization in the foveolar epithelium. The results demonstrated that foveolar epithelial vacuolization occurred in seven (15.9%) of 44 patients who had a previous Billroth I gastrectomy and in 56 (87.5%) of 64 patients who had a Billroth II remnant stomach. None of the 21 patients who had a vagotomy and pyloroplasty, and only two (2.1%) of the 94 unoperated controls, had vacuolated foveolar cells. The vacuolization is apparently not related to the patients' sex, and it seems to develop some years following gastric resection. Since both human and experimental studies have demonstrated that the duodenogastric reflux is more frequent in Billroth II than in Billroth I operated stomachs, it appears that subnuclear vacuolization in foveolar gastric cells is a histological marker for protracted duodenogastric reflux.

Adult↗
PubMed1988

Ciliated metaplasia in the gastric mucosa. In an American patient.

We report the first case of ciliated gastric metaplasia found in a Caucasian American patient. Cilia were found in cystically dilated glands underneath a gastric adenoma. The rarity of ciliated metaplasia among Caucasians and its high frequency among the Japanese suggests a difference in the gastric mucosa in the two populations.

Adenoma↗
PubMed1988

Musculo-fibrous anomaly in Barrett's mucosa with dysplasia.

We investigated the histological alterations occurring in the muscularis mucosae, the lamina propria mucosae, and the submucosa in areas adjacent to invasive adenocarcinoma in 32 resected esophagi with Barrett's mucosa. In 26 of the 32 specimens, we observed a thickening of the muscularis mucosae, with overgrowth of the muscle fibers into the lamina propria mucosae. In other areas, collagen-rich fibrotic tissue replaced the muscularis mucosae, the lamina propria mucosae, and even the submucosa. In 31 of the 32 specimens, we noted cystic dilatations of the esophageal glands. Normal esophageal glands and cystically dilated glands with dysplastic lining were often surrounded, compressed, and deformed by the fibrotic tissue. The compression of the glandular outlets by the collagen-rich tissue or by proliferating dysplastic cells appeared to be the two main factors in the histogenesis of these cysts. This may result in difficulty in differentiating, in biopsy specimens, between normal and dysplastic esophageal glands "trapped" in the collagen-rich fibrotic tissue and true invasive adenocarcinoma in the Barrett's mucosa.

Adenocarcinoma↗
PubMed1988

Intramucosal cysts of the stomach. VIII: Histochemical studies.

Intramucosal cysts of the human stomach have been earlier classified on the basis of their epithelial lining into 1. fundic, 2. foveolar, 3. pyloric, 4. with intestinal metaplasia and 5. with ciliated metaplasia. Four histochemical methods (high iron diamine (HID)-Alcian blue pH 2.5 (AB), PAS, Concanavalin A (ConA), and Grimelius reaction were used. The cells of foveolar cysts contained neutral mucins and sialomucins, and those of pyloric cysts, neutral mucins, sialomucins, mannose-rich glycoprotein and argyrophilic material. The goblet cells in intestinal metaplastic cysts contained neutral mucins and sialomucins as well as sulphated mucins, while ciliated cells in ciliated metaplastic cysts demonstrated mannose-rich glycoproteins and argyrophilic material (although some ciliated cells were negative for both). The cells of fundic gland cysts were negative for all tested methods. The frequency of intramucosal gastric cysts is known to be high in stomachs having adenocarcinoma, and low in stomachs with peptic ulcers. Several reports have demonstrated alterations in the composition of gastric mucins in stomachs harbouring an adenocarcinoma. Consequently, the histochemical stains may prove of value to investigate the true significance of intramucosal cysts in gastric carcinogenesis.

Adenoma↗
PubMed1988

Ciliated metaplasia in a gastric adenoma in a Swedish patient.

The second European case of ciliated gastric metaplasia is presented, this time in a Swedish patient. Cilia were found in cystically dilated glands underneath a gastric adenoma. The possibility that cilia represent adaptative metaplasia aimed at expelling the retained mucus within the cysts is discussed.

Adenoma↗
PubMed1988

The lymphoepithelial phenomenon of the stomach. A case report.

A large number of lymphocytes each surrounded by a clear halo were found in the foveolar epithelium of the fundic region and the antrum in a gastric biopsy from a patient with epigastric complaints. Electron microscopical studies demonstrated the presence of intraepithelial "in-halo" lymphocytes both underneath, between two contiguous, and within foveolar gastric cells. Normal numbers of lymphocytes (without haloes) were found in the lamina propria, suggesting that this epithelial lymphocytosis may be unrelated to "classical" chronic gastritis. The possibility of an autoimmune phenomenon at the foveolar cell level was discussed. The absence of intraepithelial lymphocytes in the glandular epithelium suggests that this phenomenon may be unrelated to the type of autoimmunity found in pernicious anaemia.

Aged↗