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M Stolte

Publications and source records attributed to M Stolte.

At least 361 records · Page 20Linked to original sources
PubMed1994

Factors influencing lymph node infiltration in primary gastric malignant lymphoma of the mucosa-associated lymphoid tissue.

The spread of primary gastric non-Hodgkin's lymphomas of the mucosa-associated lymphoid tissue (MALT) to the perigastric lymph nodes is a very important step concerning the prognosis of these tumours. In order to evaluate the parameters that influence the infiltration of the lymph nodes we retrospectively investigated 145 surgical specimens with gastric MALT lymphoma. The involved factors, i.e. depth of infiltration, degree of malignancy, and largest tumour diameters were strongly intercorrelated and partly showed significant correlations with the lymph node infiltration as well. Further statistical analysis by means of logistic regression revealed that depth of infiltration was the only parameter that remained significantly correlated with lymph node infiltration. Our data further support the notion that the depth of infiltration is a very important prognostic factor in MALT lymphomas. This could contribute to the explanation as to why the so-called early lymphomas with an infiltration limited to mucosa and submucosa have a much better prognosis than more advanced tumours. Our data thus support the thesis that gastric MALT lymphomas show clinicopathologic similarities with gastric carcinomas. We suggest that the depth of infiltration should be included in the pathological reports concerning primary gastric lymphomas of the MALT.

Adult↗
PubMed1994

Sarcocysts (Sarcocystis sp.: Sporozoa) in the European badger, Meles meles.

Sarcocysts from the tongue muscle of a European badger (Meles meles) are reported for the first time and described by light and transmission electron microscopy. Judging from the ultrastructure of the cyst wall, the parasite is similar to the species Sarcocystis gracilis Rátz, 1909 sensu Erber, Boch & Barth (1978) from roe deer and possibly identical with it. This is noteworthy regarding the intermediate host specificity.

Animals↗
PubMed1994

Evidence of a malignant cycle in early gastric lymphoma.

In order to investigate whether, by analogy with early gastric carcinomas, evidence of a malignant cycle could be found in early gastric non-Hodgkin's lymphomas (EGL), a study of 135 surgical specimens (46 gastrectomies, 80 aboral resections, nine local excisions) was performed. A malignant cycle was considered to have been shown when regenerative changes in the mucosa and fibrosis of the adjacent submucosa were detected. The depth of tumour infiltration was characterized using the UICC classification for gastric carcinomas. An EGL was found in 51.1% of cases (n = 69). The correlation between depth of infiltration and the histological classification of tumours proved statistically significant (p < 0.0001). Evidence of a malignant cycle was demonstrated in 72.5% of EGLs as compared with 27.3% in gastric lymphomas showing deeper infiltration (AL). The same held true for the histological classification of lymphomas. Findings consistent with a malignant cycle were found in 72.7% of low-grade compared with 37.7% of high-grade lymphomas. The difference in distribution proved to be statistically significant in both cases (p < 0.001). Most cases were localized in the antral region (53.6% of EGLs, 40.9% of ALs) and the lower third of the stomach (44.9% of EGLs and 33.3% of ALs). Detecting evidence of a malignant cycle, especially in EGL, has important diagnostic implications, requiring a careful search for minute lymphoma-associated irregularities in the neighbourhood of healed lesions, with the aim of determining the proper locations for a diagnostic biopsy.

Aged↗
PubMed1994

Frequency, location, and age and sex distribution of various types of gastric polyp.

Data on the frequency and location of the various types of gastric polyps are highly inconsistent. In a retrospective analysis of 5515 gastric polyps obtained from 4852 patients in the period between 1969 and 1989, including reexamination of 197 surgical, 1572 polypectomy, and 3746 biopsy specimens, the most frequent types found were Elster's glandular cysts (fundic gland polyps) (47.0%), followed by hyperplasiogenous polyp (28.3%), tubular adenoma (9.0%), adenocarcinoma (7.2%), inflammatory fibroid polyp (3.1%), carcinoid tumor (1.7%), Brunner's gland heterotopia (1.2%), and tubulopapillary adenoma (1.0%). Peutz-Jeghers polyps, juvenile polyps, and pancreatic heterotopia were found in younger patients (mean ages: 33.39 and 45 years, respectively), whereas the age of most patients (66%) with glandular cysts was between 40 and 69 years. Patients with any of the other types of gastric polyps were mostly (55-100%) over 60 years of age at the time of diagnosis. Glandular cysts, hyperplasiogenous polyps, inflammatory fibroid polyps, and carcinoid tumors were significantly more common in women, while all the other polyps were more or less equally distributed between the sexes. Glandular cysts and carcinoid tumors were relatively small (mean diameter 8 mm), and were mostly located in the corpus (100% and 83%, respectively). Medium-sized pancreatic heterotopias, Brunner's gland heterotopias, and inflammatory fibroid polyps (mean sizes 7-10 mm) were usually located in the antrum (100%, 81%, 80%, respectively), while the other polyps had an average size of between 10 and 16 mm and were distributed equally throughout the stomach.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1994

Healing of protein losing hypertrophic gastropathy by eradication of Helicobacter pylori--is Helicobacter pylori a pathogenic factor in Ménétrier's disease?

Hypertrophic gastropathy--that is, Ménétrier's disease--was found, in a retrospective analysis, to be associated with Helicobacter pylori in more than 90% of patients. It is proposed that hypertrophic gastropathy represents a special form of H pylori gastritis in these patients. A case is described of a 28 year old woman with Ménétrier's disease associated with proved protein loss from the stomach. Treatment with cimetidine for more than three years had little benefit when colonisation by H pylori was detected. Density of H pylori colonisation and activity of gastritis, which was also present in the first biopsy specimens taken five years ago, were more pronounced in the body than in the antrum, which is in agreement with the characteristics of H pylori gastritis found in other cases with Ménétrier's disease. A 14 day antibacterial treatment course with 750 mg amoxicillin three times a day combined with 40 mg omeprazole three times a day was started in April 1991. This resulted in eradication of H pylori and the return to normal of giant folds and the mucosal histology. Serum protein concentrations returned to normal within six weeks and remained normal at two endoscopies during a two year follow up. This case report suggests that a subgroup of the patients with Ménétrier's disease may be healed by the eradication of H pylori.

Adult↗
PubMed1994

Helicobacter pylori gastritis and primary gastric non-Hodgkin's lymphomas.

AIMS: To evaluate further the relation between gastric malignant lymphoma of the mucosa associated lymphoid tissue (MALT) and Helicobacter pylori. METHODS: One hundred and sixty two surgical specimens of MALT lymphoma were retrospectively investigated to determine tumour type and inflammatory patterns. In 121 cases biopsy specimens obtained before surgery were available and stained with haematoxylin and eosin, periodic acid Schiff, Giemsa and Warthin-Starry stains. RESULTS: Residual lymphoid follicles were found less often in high grade malignant than in low grade malignant MALT lymphomas. Chronic active gastritis was shown within the mucosa at some distance from the tumours in 143 of 146 specimens. In all the cases for which biopsy specimens could be evaluated, colonisation of the mucosa by H pylori had occurred. Lymphoid follicles and lymphoid aggregates were detected in 82.7% of the antral, and in 85% of the body mucosa specimens. CONCLUSIONS: These data support the hypothesis that H pylori has an important role in the development of MALT lymphomas. Furthermore, the chronic inflammation preceding malignant transformation might enhance the probability of malignant transformation via chronic stimulation of the lymphoid tissue. This might in part indicate why MALT lymphomas occur most often in the stomach.

Adult↗
PubMed1994

Antral intestinal metaplasia in Helicobacter pylori gastritis.

The prevalence of antral intestinal metaplasia (IM) in underlying Helicobacter pylori (HP) gastritis was studied in biopsy specimens of the antral mucosa obtained from 2,692 patients with histologically proven HP gastritis. The prevalence of IM varied in the groups investigated: 47.4% in gastric ulcers, 30.5% in pyloric ulcers, 16.8% in duodenal ulcers, 21.8% in gastritis with no lesions and 9.8% in chronic antral erosions (p < 0.001). A hypothetical model for the role of HP in the development of IM is presented: HP probably promotes mucosal regeneration. The prolonged stimulatory effect on regeneration could then, in the course of time, lead to an increasing likelihood of IM developing.

Adult↗
PubMed1994

Prevalence of intestinal metaplasia in Helicobacter pylori gastritis.

BACKGROUND: The prevalence of intestinal metaplasia (IM) in underlying Helicobacter pylori gastritis was studied in 1446 patients. METHODS: Antral and body mucosa biopsy specimens (stains: hematoxylin and eosin, Warthin-Starry) were taken from five groups of patients: gastritis with no lesions, gastritis with duodenal, pyloric, or gastric ulcers or with chronic antral erosions. RESULTS: The prevalence of IM was higher in the antral than in the body mucosa (22.9% versus 2.8%; p < 0.001). Patients with IM had a higher mean age than those without IM in the overall group (p < 0.01). IM could be detected with the highest frequency in patients with gastric ulcers (p < 0.001). CONCLUSIONS: The higher prevalence of IM in the antral mucosa--the preferred location of gastric carcinomas--further supports the postulated association of H. pylori and gastric carcinoma. The various prevalences of IM might contribute to explaining the different probabilities of gastric carcinoma developing in the groups investigated.

Female↗
PubMed1994

Helicobacter heilmannii (formerly Gastrospirillum hominis) gastritis: an infection transmitted by animals?

BACKGROUND: The source of infection with Helicobacter heilmannii (formerly Gastrospirillum hominis), a relatively rare causative agent of gastritis in humans, is not clear. It has long been known that this organism occurs in the stomach of domestic animals and pets. METHODS: By performing an epidemiologic investigation on possible contact of patients with Helicobacter heilmannii gastritis with such animals, we made an attempt to gain further information about the source of infection. RESULTS: Of 125 patients with confirmed H. heilmannii infection, 111 provided us with information about contact with animals. Some 70.3% of the patients had contact with one or more animals (as compared with 37% in the 'normal' population); 73% were males, and 1.6% had concomitant infection with H. pylori. CONCLUSIONS: Our analysis indicates that H. heilmannii gastritis is due to its transmission to humans by domestic animals or pets. Concomitant infections by H. heilmannii and H. pylori are very rare, and it is possible that H. heilmannii might protect from infection with H. pylori. However, the results of our retrospective analysis will have to be tested against those of a prospective study investigating the day-to-day situation of the individual patients in greater detail and also be compared with patients not infected with H. heilmannii.

Adolescent↗
PubMed1994

[Whipple's disease--a rare cause of secondary amyloidosis].

Two cases of Whipple's disease with secondary amyloidosis are described. One patient had a nephrotic syndrome, the other malabsorption. The chronic inflammatory stimulus of Whipple's disease is discussed as a trigger for the development of secondary amyloidosis. The clinical symptoms of seronegative arthritis, weight loss, chronic diarrhea, intermittent fever and lymphadenopathy may be the clue to the diagnosis of Whipple's disease. Peroral intestinal biopsy is the diagnostic procedure of choice. Adequate antibiotic treatment with a regimen of penicillin and trimethoprim-sulfamethoxazole is indicated and prevents the development of secondary amyloidosis.

Aged↗
PubMed1994

[Water melon stomach or antrum gastritis--differential diagnostic aspects].

The gastric-antral-vascular-ectasia (GAVE), the "Watermelon-stomach", is a capillary ectasia of the antrum mucosa. It appears as longitudinal intensive redness of the mucosa. This endoscopic picture is caused by fibromuscular obliteration of the lamina propria and vascular ectasia with fibrinthromby. The pathogenesis of the disease is unknown. Clinical manifestation is chronic blood-loss with consecutive anaemia. The "Watermelon-stomach" is often not recognized and mistaken as "refractory antrumgastritis". Laser-coagulation is a not-operative therapy of GAVE.

Biopsy↗
PubMed1994

[Diagnosis of factitious diarrhea (Munchausen syndrome) by colon biopsy].

The differential diagnosis of chronic diarrhea is broad. Most of the illnesses causing diarrhea can be diagnosed through a carefully taken medical history, stool examination, few complementary laboratory tests as well as an endoscopy and, if needed, a radiological examination. However, a few causes could still remain undiagnosed and special diagnostic techniques must then be implemented. The diagnosis of self-induced diarrhea by concealed laxative abuse is a special challenge and should be considered in every case of diarrhea where the cause remains unclear. This paper reports such a case where the diagnosis of the habitual laxative abuse with Bisacodyl was made with the help of the pathologist on the basis of stepwise taken colonic biopsies. The most important histological criteria are a champagne glass-like ectasia of the deep curved crypts, combined with increased goblet cell content and increased mucus production in the presence of an intact surface-epithelium.

Biopsy↗
PubMed1994

[24-hour gastric pH profile with 2 x 20 mg and 2 x 40 mg omeprazole in patients with Helicobacter pylori-associated gastroduodenal ulcer disease].

Fifty patients suffering from Helicobacter pylori associated duodenal (n = 25) or gastric ulcer disease (n = 25) were randomly treated with either omeprazole 20 mg b.i.d. (n = 25) or 40 mg b.i.d. (n = 25). From day 8 to 9, a 24-hour gastric pH measurement was performed in all patients. Patients with duodenal ulcer disease treated with 40 mg or 80 mg omeprazole demonstrated similar gastric pH patterns without statistically significant differences with regard to the mean (5.10 versus 5.17, p = 0.6439) and median pH (5.35 versus 5.30, p = 0.8277) as well as to the percent of time spent below distinctive pH thresholds. Patients suffering from gastric ulcer disease respond somewhat better to the higher omeprazole dose as compared to the 40 mg omeprazole regimen reaching statistical significance (mean pH: 5.04 versus 5.74, p = 0.0124; median pH: 5.30 versus 5.95, p = 0.0114; %-time spent below pH 2, 3, 4, and 5, respectively). In conclusion, there was virtually no (duodenal ulcer) or only a slight (gastric ulcer), probably clinically irrelevant, benefit to doubling the omeprazole dose (20 mg b.i.d. vs. 40 mg b.i.d.) with regard to the 24-hour gastric pH patterns.

Adult↗