Collagenous duodenitis and collagenous colitis: a short clinical course as evidenced by sequential endoscopic and histologic findings.
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Adult↗
Biomedical subjects
S Eidt
Publications and source records attributed to S Eidt.
[Extramedullary plasmocytoma of the bronchial system].
We present a case of primary plasmocytoma of the left upper bronchus. Occlusion led to atelectasis of the left upper lobe and subsequent poststenotic pneumonia. Therapy consisted of local excision of the bronchus and postoperative radio-therapy. This type of lung-conserving therapy in a case of primary plasmocytoma has not been described before.
Bronchi↗
Molecular biology in diagnosis and epidemiology of Helicobacter pylori: PCR for the detection and AP-PCR for characterization of patient isolates.
Infection with Helicobacter pylori causes chronic active gastritis and has been associated with gastric and duodenal ulcer disease. In biopsy samples of 110 patients with clinical symptoms of active gastritis, H. pylori was detected by means of the polymerase chain reaction (PCR), using species-specific primers defining a 858 bp DNA fragment of H. pylori urease beta-subunit. Sensitivity and specificity of the PCR was compared with culture, histology and Warthin-Starry stain (WSs), detection of H. pylori urease antibodies in serum and urease testing with the Campylobacter-like organism (CLO) test. PCR yielded specific amplification products in 53 cases, whereas culture of the organisms was positive in a subset of 50 cases. Only direct detection in histological sections of biopsy specimens had a higher sensitivity, with 65 positive samples. In contrast, the CLO test was negative in eleven culture-positive and PCR-positive cases. Significant urease antibody titres were found in 39 patients with histologically confirmed diagnosis. These results placed the sensitivity of PCR between tat of the Warthin-Starry stain (WSs) and that of culture. Therefore, PCR can be proposed as a useful rapid and time-saving technique for the detection of H.pylori in gastritis. For epidemiological purposes, fingerprinting with arbitrarily chosen primers by AP-PCR was evaluated. Strain-specific patterns with up to 13 fragments were achieved with 10-nucleotide or longer primers (21-nt) with a G + C content > or = 55%. Thirty-five of 40 strains investigated by this method were distinguishable with a single primer. These results suggest a high level of DNA sequence diversity within this species with the possibility of confirming the clonality in consecutive isolates from a single individual. Alternatively, an increased in-vivo mutation rate could be responsible for DNA divergence, resulting in specific strains for each individual patient.
Antibodies, Bacterial↗
p53 expression in gastric cancer: clinicopathological correlation and prognostic significance.
For evaluation of the prognostic relevance of p53 expression in gastric cancer, the immunohistochemical tissue status of 133 primary gastric cancer patients was investigated for p53 expression and the association between p53 tissue status and clinicopathological parameters was analyzed. P53 immunoreactivity was detected in the nuclei of cancer cells in 35 cases (26.3%). The nuclear p53 immunoreaction was closely associated with tumor location, lymph node metastasis, and curability. Tumors with positive p53 stain reactions frequently metastasized to lymph nodes (metastatic rate: 91.4%) in contrast to tumors with negative p53 stain reactivity (71.4%, P = 0.021). Immunohistochemical analysis of primary gastric cancer appears to be an accurate and simple method of screening for p53 expression. In combination with common prognostic parameters, determination of p53 tissue status might help to detect prognostically unfavorable subgroups of gastric cancer patients.
Adenocarcinoma↗
[Visual evoked potential bispectral analysis using robust distribution classification].
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Electroencephalography↗
Heterotopic pancreas. A difficult diagnosis.
Heterotopic pancreas is seen in one of every 500 laparotomies or 0.55-13% of autopsies. Despite modern diagnostic procedures (endoscopy, endoscopic ultrasound) it is difficult to diagnose preoperatively. A 51-year-old patient with a 30-year history of recurrent gastric ulcers was diagnosed with a gastric wall tumor. Endoscopic biopsy sample showed normal gastric mucosa. Endoscopic ultrasound and contrast radiography were not able to specify the gastric wall tumor. The local excision and histologic preparation of the tumor showed heterotopic pancreatic tissue within the gastric submucosa without any signs of malignancy. Three years postoperatively the patient is without any complaints. There have been no further signs of gastric ulcers.
Choristoma↗
Depth of infiltration of primary gastric B-cell lymphomas--correlations with proliferation, apoptosis and expression of p53 and bcl-2.
Local extension has been shown to be a major prognostic factor in primary gastric B-cell lymphoma. In order to evaluate whether this parameter might be correlated with cell proliferation or its regulation, a retrospective study was performed. Fifty-three surgical specimens with primary gastric B-cell lymphomas were analysed concerning histological grading, depth of infiltration and Ann-Arbor stage. In addition, immunohistochemistry (p53[Do7], bcl-2[bcl-2-124], Ki-67 [MiB1]) and in situ end-labeling (apoptotic bodies) were applied. The depth of infiltration was significantly correlated with Ann-Arbor stage (p < 0.001) and histological grading (p < 0.002). Furthermore, the semiquantitatively evaluated expressions of Ki-67, apoptotic bodies and p53 revealed that tumours limited to the mucosa and submucosa had lower numbers of stained cells than lymphomas infiltrating the muscularis propria or beyond (p < 0.001 in all cases). Analysis of bcl-2 expression showed an inverse picture (p < 0.05). The importance of local spread of gastric lymphomas is underscored by our findings: in gastric lymphomas infiltrating the muscularis propria or beyond, powerful proliferative stimuli have been acquired, e.g. associated with p53 mutations, that are independent of the known mucosa-associated stimuli, Helicobacter pylori and auto-immunity.
Apoptosis↗
Atypical lymphoid infiltrations of the gastric mucosa--their interpretation and management by eradication of Helicobacter pylori.
Low-grade gastric lymphomas of mucosa-associated lymphoid tissue (MALT) may be extremely difficult to differentiate from atypical lymphoid infiltrations of the gastric mucosa caused by Helicobacter pylori (H. pylori) infection, especially if lympho-epithelial destructions are not detected. In order to clarify this diagnostic problem and to evaluate the potential benefit of clearing H. pylori-induced lymphoid infiltration a prospective study was performed. Our study included biopsy specimens from 61 patients, that showed excessive lymphoid infiltrations. Using histology and immunohistochemistry no definite diagnosis could be delivered. In 46 (76.4%) cases histological regression occurred 4 weeks after the end of therapy suggesting a reactive infiltrate. In 7 patients (11.5%) the histological picture remained unchanged, and in 8 (13.1%) the follow-up biopsies revealed lympho-epithelial destructions allowing the diagnosis of low-grade MALT lymphoma. On the basis of our data we conclude that eradication of H. pylori could provide an additional tool in the differential diagnosis between atypical lymphoid infiltrations of the gastric mucosa caused by H. pylori and an early primary gastric MALT lymphoma.
Adult↗
The histopathological spectrum of type A gastritis.
It has been recently shown that type A gastritis can be histologically diagnosed in the preatrophic stage. In order to evaluate whether parietal cell atrophy in AG might correlate with other histopathological findings in the antral and body mucosa, we retrospectively investigated 171 consecutive cases of histologically diagnosed preatrophic (active) or atrophic type A gastritis (H&E, Warthin-Starry). The prevalences of intestinal metaplasia (75% vs 44.4%) and micronodular hyperplasia (86.1% vs 52.4%) of endocrine cells in the oxyntic mucosa were significantly higher of parietal cell atrophy was present (p < 0.001 and p < 0.0001, respectively), whereas the prevalence of nodular lymphoid aggregates (77.8% vs 48.1%) and of Helicobacter pylori (14.3% vs 1.9%) in the oxyntic mucosa was significantly higher if parietal cell atrophy could not be detected (p < 0.001 and p < 0.01, respectively). In the antral mucosa, altered patterns of the inflammatory reaction could be demonstrated independent of the parietal cell mass possibly caused by impaired gastric acid production. Our data support the notion that the development of parietal cell atrophy in type A gastritis represents a stepwise process including initial pseudohypertrophy of these cells.
Aged↗
Helicobacter pylori and the evolution of gastritis.
Following the isolation of Helicobacter pylori from the stomachs of patients with peptic ulcer in 1982, intensive research has examined the relationship between this organism and gastritis. H. pylori affects the grade and activity of gastritis, the quality of surface epithelial cells, and the nature of mucus production. Gastritis results from a direct action, involving bacterial cytotoxins and enzymes, and also in an indirect way through the effect of monocyte and granulocyte infiltration. Eradication of H. pylori leads to the long-term healing of gastritis. H. pylori is also associated with intestinal metaplasia and the development of mucosa-associated lymphoid tissue (MALT). Regression of MALT lymphomas has been reported after H. pylori eradication treatment.
Gastric Mucosa↗
[Autoimmune gastritis in its various stages].
Based on 196 consecutively diagnosed cases of autoimmune gastritis the histological spectrum of this disease was examined with special regard to the so called active autoimmune gastritis. The analysis revealed statistically significant differences. The chronic atrophic type showed more often microglandular hyperplasia of endocrine cells (p < 0.005) and revealed less often colonisation of the body mucosa by Helicobacter pylori (p < 0.001) than the active form. The inflammatory reaction of the antral mucosa, however, showed no differences. In addition immunohistochemical stainings were performed in 25 patients in whom parietal cell antibodies had been detected. In cases with active autoimmune gastritis T cells were found not only in the lamina propria but as well within the oxyntic glands as contrasted with the atrophic form. Only in the former group of patients furthermore B cells could be identified in the lamina propria. We conclude that especially with respect to the active form further knowledge of the progression of the autoimmune process might be gained.
Aged↗
Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group.
Lymphoma of gastric-mucosa-associated lymphatic tissue (MALT) type has been linked to infection with Helicobacter pylori. We investigated the effect on MALT lymphoma of eradicating H pylori infection. 33 patients with primary gastric low-grade MALT lymphoma associated with H pylori gastritis were treated with omeprazole (120 mg daily) and amoxycillin (2.25 g daily) for 14 days to eradicate H pylori. In addition to histology, PCR was used to examine proliferation of monoclonal B cells before treatment and during follow-up. All patients had at least two post-treatment examinations, and all became negative for H pylori, 2 after a second treatment course. On histology, 23 (70%) patients showed complete regression and 4 (12%) partial regression of lymphoma. 6 (18%) patients had no change after cure of H pylori infection. 1 was treated with chemotherapy. Of 5 treated surgically, 4 were found to have high-grade B-cell lymphoma on histology of the resected stomach and 1 a high-grade T-cell lymphoma. PCR showed complete disappearance of monoclonal B cells after cure of H pylori infection in 13 of 16 patients investigated. During median follow-up of 1 year no relapse of MALT lymphoma occurred. Low-grade primary gastric MALT lymphoma can completely regress after eradication of H pylori infection. However, longer follow-up is needed to clarify whether the remission is lasting.
Adult↗
Treat the infection and cure the cancer.
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Animals↗
[Colloid carcinoma of the urachus. Cytologic diagnosis and differential diagnostic classification].
We report a rare case of colloid carcinoma apparently of urachal derivation. In a patient presenting with nycturia cytological analysis of urine led to a tentative diagnosis of colloid carcinoma of urachal origin. Endoscopic and radiological investigations confirmed this provisional diagnosis. For this reason, the surgical procedure could be properly planned and restricted to the removal of the apex of the bladder and urachus.
Adenocarcinoma, Mucinous↗
[Analysis of inflammatory reaction and epithelial proliferation in corpus mucosa of the stomach. A contribution to carcinogenesis].
To elucidate conflicting evidence concerning the role of Helicobacter pylori (HP) in the evolution of gastric carcinoma, a retrospective analysis was performed on the corpus mucosa of gastric surgical specimens removed from patients with gastric carcinoma (n = 53) and pancreatic carcinoma (n = 45). Prevalence, activity and degree of chronic active gastritis (CAG) were investigated. Furthermore, proliferative activity was determined by the expression of the Ki67 antigen in epithelial cells of the neck region and the foveolae using immunohistochemistry. CAG and intestinal metaplasia were significantly more prevalent in patients with gastric than with pancreatic neoplasms. Degree and activity of CAG were higher in the group of patients with gastric carcinomas. Numbers of Ki67-positive nuclei were significantly higher in pronounced than in mild CAG. Our data are in keeping with the assumption that HP-associated CAG contributes to the development of gastric adenocarcinoma. As possible pathomechanism, it may be assumed that a conspicuously expressed inflammatory reaction triggers epithelial proliferation, with resulting higher vulnerability to mutagenic effects.
Adenocarcinoma↗
Tissue diagnosis of intestinal microsporidiosis using a fluorescent stain with Uvitex 2B.
AIMS: To detect intestinal microsporidiosis in paraffin wax embedded biopsy specimens using a fluorescence technique incorporating optical brighteners. METHODS: Eight HIV infected patients with confirmed intestinal microsporidiosis (six with Enterocytozoon bieneusi, one with Encephalitozoon intestinalis and one with Encephalitozoon cuniculi infection) and 10 without infection were studied. Tissue sections of paraffin wax embedded duodenal biopsy specimens were stained with 1% Uvitex 2B, coded and analysed independently by two investigators. RESULTS: In all eight cases with confirmed intestinal microsporidian infection, spores could be detected easily in tissue sections using the fluorescence technique. Spores or other elements consistent with microsporidiosis were not found in the 10 patients without infection. CONCLUSION: Staining of tissue sections from paraffin wax embedded intestinal biopsy specimens with stains incorporating Uvitex 2B is a rapid and easy technique for the diagnosis of intestinal microsporidiosis.
AIDS-Related Opportunistic Infections↗
Analysis of antral biopsy specimens for evidence of acquired mucosa-associated lymphoid tissue in HIV1-seropositive and HIV1-negative patients.
BACKGROUND: There is conflicting evidence concerning the prevalence of Helicobacter pylori gastritis in HIV1-infected patients. Furthermore, a possible influence of immunodeficiency on the acquisition of mucosa-associated lymphoid tissue (MALT) in the antral mucosa remains to be elucidated. METHODS: Seventy-seven consecutive HIV1-infected patients (mean age, 40.2 years) were compared in a prospective study with 77 HIV1-negative age-matched patients, using immunohistochemical stainings. RESULTS: In HIV1-infected patients the prevalence of H. pylori gastritis was lower and the inflammatory reaction less pronounced than in controls. Lymphoid follicles and intraepithelial B cells were significantly more often detected in HIV1-negative patients. CONCLUSIONS: Evidence of acquired MALT is only rarely found in HIV1-infected patients. These findings might contribute to the explanation of why low-grade gastric MALT lymphomas have not been reported in HIV1-infected patients so far.
Adult↗
The significance of Helicobacter pylori in relation to gastric cancer and lymphoma.
The evidence linking Helicobacter pylori and non-cardia gastric adenocarcinoma is accumulating. Patterns of strain specificities and host factors that increase epithelial proliferation and have implications for mutagenic effects are evolving. The decision by the World Health Organization and the International Agency for Research on Cancer to classify H. pylori as a 'definite' carcinogen, however, represents a milestone in the association of H. pylori with gastric carcinogenesis. The importance of H. pylori in gastric lymphoma has been underscored by the finding that H. pylori eradication can induce complete regression in low-grade mucosa-associated lymphoid tissue lymphomas, at least in the early stages of development.
Adenocarcinoma↗