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PubMed1975

Endoscopic assessment of gastric polyps.

The results of fibre gastroscopy in 100 patients with gastric polyp are reported. The polyps were removed in 38 patients. All cases were followed up. No malignant transformation of the polyp was demonstrable in any of the cases. The polypous growth proved to be early gastric carcinoma in two cases, neurogenic sarcoma in one case. The polyp was associated with gastric carcinoma in 11 cases, with gastric sarcoma in one case, and with tumours of other digestive organs in five cases. It has been concluded that 1. diagnosis and correct assessment of gastric polyps rest on the evidence of endoscopy. 2. In the majority of cases polypoid lesions of the stomach are either benign or malignant from the very outset. Endoscopy coupled with biopsy directed at the representative sites of the polyp permits differentiation between benigh and malignant cases with a fair degree of accuracy. 3. Removal of polyps should be selective. 4. Association of gastric polyps with gastric carcinoma is far more frequent than malignant transformation of the polyp. 5. Endoscopic follow-up of polyps is imperative even in polypectomized cases. 6. Detection of a gastric polyp necessitates a search for tumours of other organs.

Adult↗
PubMed1977

Mesenchymal cell atypicality in inflammatory polyps.

Excised nasal polyps should be examined histologically for classification as to aetiological process. Recently a 'pseudosarcomatous' change was reported in nasal polyps. We reviewed one hundred excised polyps for mesenchymal atypicality and found a wide degree of mesenchymal atypicality in the majority of nasal polyps. Nasal and choanal inflammatory polyps are the most frequent nasal masses which the otolaryngologist has to treat. Surgical excision is frequently required to alleviate the nasal symptoms of polyps unresponsive to medical therapy. Excised nasal polyps should be examined histologically for classification as to possible aetiological mechanisms and to rule out neoplastic lesions (Shea, 1947). Smith, Echevarria, and McLelland (Smith, 1974) recently described 'pseudosarcomatous changes' in nasal polyps. This stimulated us to investigate our inflammatory nasal polyps for these histological changes. Causal observations demonstrated an impressive number of inflammatory polyps with varying amounts of atypical mesenchymal stroma cells. To quantitate these alterations, we reviewed the histological slides from one hundred patients with excised inflammatory polyps and the results are the subject of this report.

Humans↗
PubMed1976

Nature of juvenile polyps in the large intestine.

Forty-five juvenile polyps were found among approximately 390 mucosal polyps of the large intestine. Various degrees of epithelial pseudostratification were found among juvenile polyps and the larger-sized polyps of both juvenile type and adult one tended to have a more advanced degree of epithelial pseudostratification. The glands of both juvenile polyps and adult ones revealed a closely resembled or almost identical pattern of size-distribution-pattern of the glandular size in both normal mucosae and hyperplastic mucosae of long-standing ulcerative colitis. Transition of juvenile polyps into adult ones was suggested by the cases with increase in numbers of glands and their orifices to the surface of the polyp and there were some polyps showing an intermediate form between juvenile polyps and adult ones. On the basis of histologic characteristics and age incidence of the patients, it may be said that a juvenile polyp is an immature variant of an adult polyp.

Adolescent↗
PubMed1977

Histology of nasal polyps of different etiology.

The aim of the present study is to elucidate the correlation between etiology and histology in nasal polyps with special regard to cystic fibrosis (CF). Nasal polyps from 15 children with CF and a control group of non-CF polyps from 15 adult patients were examined by light-microscopy. The histological evaluation was carried out on a blind basis in order to avoid bias. Among the parameters used, the tissue eosinophilia proved to be the most valuable factor in the differentiation between CF and non-CF polyps, as only few eosinophils were found in the CF-polyps. The polyp glands were few and generally pathological. Some characteristics abnormalities in the grandular morphology are apparently more common in CF polyps. It is concluded, that the histological examination of nasal polyps is of importance for the correct classification of the patient, but the diagnosis of CF cannot be made based on microscopy of polyps. Further studies including blinded histological examination of nasal polypous tissue might contribute to a more differentiated diagnose of nasal polyposis.

Adolescent↗
PubMed1976

[Juvenile colonic mucosal polyps in adults].

The histology of all intestinal polyps removed endoscopically during the last 30 months has been reviewed. Among the 90 patients with a total of 154 polyps, 3 cases of juvenile polyps were found. All three were male adults who were aged 29, 34, and 50 years. In two patients the lesion was solitary, while one had polyposis with about 100 polyps. Macroscopically the juvenile polyps cannot be distinguished from adenomatous polyps, but their histologic appearance is typical. They are considered to be hamartomas and have no tendency to become malignant. Thus, juvenile polyposis does not represent a precancerous lesion as adenomatous polyposis does, and must therefore be treated differently. Therapy consists of endoscopic removal of all polyps. In order to differentiate juvenile from adenomatous polyps with certainty, histological examination of at least one polyp is necessary. This differential diagnosis is the indispensable precondition for appropriate therapy.

Adenoma↗
PubMed1977

The true choanal polyp-a case report.

Whether one could distinguish if a large polyp occupying the nasal pharynx derives from the mucosa of the posterior superior wall of the antrum, ethmoids, or the choanae is a matter not clearly understood. Existing literature is somehow confusing on this subject. One definite fact is that these polyps, whatever the site of their origin, are rare. From the histologic point of view, the general opinion among pathologists is that choanal polyps do not differ histologically from the simple mucous polyps of the nose. The case we are reporting concerns a 65-year-old caucasian male, who for many years had a sensation of fullness behind the nose. Examination revealed a polypoid growth protruding below the margin of the soft palate. Surprisingly roenthenograms were not contributory. This polyp was removed by threading a long soft wire over a regular nasal snare. The free loop of the wire was passed through the anterior nose down to the pharynx where the polyp was threaded into this loop, and by pulling the free end of the wires, the polyp was totally removed without any bleeding whatever. A pathology report is attached as well as a picture of the polyp.

Aged↗
PubMed1979

Clinicopathological study of juvenile polyp.

Thirty-two cases of juvenile polyp were investigated for the clinical and pathological findings. This type polyps occured frequently in the first decade with male predominance. Melena and bloody stool were found in all cases, prolapse of the polyps in 28%, and spontaneous amputation in 9.4%. The duration of symptoms were usually within 6 months. The polyps were found frequently in the rectum and sigmoid colon, about 75%. One case of juvenile polyposis in a 12 years-old male was found. The size of the polyps was usually within 2 cm in diameter and the majority of the polyps were pedunculated. Polypectomy was performed for all cases and additional partial resection for 2 cases with multiple polyps and polyposis. Recurrence and malignant transformation were not found. It should be considered that these are at least two types of histogenesis for the so-called juvenile polyp like as hamartomatous and inflammatory.

Adolescent↗
PubMed1975

[Stomach polyps in simians at the Sukhumi nursery].

Polyp-like changes in the mucous membrane of the stomach were noted in monkeys of the simian nursery in Sukhumi (100 cases). In 6 baboon hamadryads, in 4 Stum-tailed macaques and in one macaco rhesus they were diagnosed as the so-called polypous gastritis. In 5 Stum-tailed macaques there were noted gigantic folds of the pylorus. Of 84 macacos in 61 animals there was one polyp and in 23 macaques--2 and more polyps. Incidence of polyps among local monkeys was 0.48% in macaques rhesus and 2.3% in Stum-tailed macaques. Among imported monkeys the incidence of polyps was in macaques rhesus--0,31% and in Stum-tailed macaques--9,2%. Polyps in monkeys are considered as disregenatory formations, occasionally associated with parasitizing of helminths. In contrast to man, polyps in monkeys are not considered as precancer processes.

Animals↗
PubMed1977

Nasal polyps in cystic fibrosis.

In II polyps from patients with cystic fibrosis of the pancreas, the density, shape, and architecture of mucous glands were studied by the whole-mount method and compared with 102 non-cystic-fibrosis polyps. There were no differences in density which was in most polyps less than 0.5 gland/mm.2. The shape and architecture as well as other histological appearances of the polyp were also alike in both groups of polyps which could not be distinguished. The pathogenesis of nasal polyps in cystic fibrosis is discussed. Apparently, it is the same as that of non-cystic-fibrosis polyps.

Child↗
PubMed1977

Localization by immunoperoxidase and estimation by radioimmunoassay of carcinoembryonic antigen in colonic polyps.

A 3-layer immunoperoxidase technique was used to demonstrate carcinoembryonic antigen (CEA) in colonic polyps from patients with or without previous or concurrent malignancy. CEA was demonstrated in a higher percentage of the polyps received as fresh specimens that were rapidly frozen and fixed in ethanol, than in formalin-fixed, paraffin-embedded sections. Tissue CEA content of both colonic carcinomas and polyps was determined by radioimmunoassay, and it was found that benign colonic tumours had levels of tissue CEA comparable to colonic cancer, indicating that CEA concentration in a tumour does not reflect its grade of malignancy. In fact, in one case in which both colonic cancer and polyps were removed, the polyps had the higher quantities of tissue CEA. Further, tissue CEA concentration of a polyp was not dependent on its size or location. Studying the titres of circulating CEA in these patients revealed an elevation of plasma CEA in one-third of the patients with only colonic polyps, whilst the patients with cancer all had increased titres.

Carcinoembryonic Antigen↗
PubMed1978

Recurring hyperplastic gastric polyps following subtotal gastrectomy.

Mucosal polyps of the stomach are separated by histologic means into two major groups: (1) hyperplastic (or regenerative) polyps and (2) adenomas, including adenomatous polyps and villous adenoma. Hyperplastic polyps are not true neoplasms, but probably represent a reactive response to some form of mucosal injury. A little known but interesting manifestation of hyperplastic gastric polyps concerns their development, growth, and recurrence in the gastric remnant following subtotal gastrectomy. The clinical, radiologic, and pathologic findings in two cases of recurring symptomatic hyperplastic gastric polyps after subtotal gastrectomy are presented. It is proposed that reflux bile gastritis might have played an important etiologic role in the development of these recurring hyperplastic polyps.

Adult↗
PubMed1978

Atypical appearances of benign hyperplastic gastric polyps.

The vast majority of epithelial polyps of the stomach can be divided into two groups: (1) hyperplastic or regenerative polyps, and (2) adenomas. Of the two, hyperplastic polyps are much more common; they are nonneoplastic lesions which are typically asymptomatic, small, smooth-surfaced, and often multiple. Malignant transformation virtually never occurs in this group of polyps. Adenomas are true neoplasms; they are relatively large, have an irregular surface, and show a distinct tendency to undergo malignant transformation. In this paper the radiologic appearances of hyperplastic gastric polyps, with special reference to atypical findings, are discussed and illustrated. It is shown that simple hyperplastic polyps may present any or all of the radiologic criteria suggestive of gastric adenomas or even frank malignancy. Thus, while radiology plays a vital role in the initial detection and followup of gastric polyps, optimum clinical management of the patient is best based on knowledge of the histologic structure of the lesion obtained by endoscopy and biopsy.

Aged↗
PubMed1975

[The diagnostic and prognostic significance of epithelial blood group isoantigens in carcinomas and polyps of the colon (author's transl)].

Blood group isoantigens (BG) were detected in carcinomas and polyps of the colon and were related to the degree of differentiation, the histologic type, the age of the patients and the histologic signs of malignancy. 1. BG were found in 60-70% of colon carcinomas regardless of their differentiation. 2. BG-positive carcinomas were less often surrounded by lymphocytes and plasma cells than BG-negative ones. 3. BG were present in colon polyps as mucusassociated and as membrane-associated antigens depending on the differentiation of the cells. Hence, BG-activity can be regarded as additional criterium to assess objectively the differentiation of the tumor cells in a polyp. 4. The percentage of BG-positive polyps increased with dedifferentiation. 5. Polyps with foci of malignant degeneration were consistently BG-positive. 6. Villous polyps contained BG more often than the adenomatous ones. 7. The results support the concept that both villous and adenomatous polyps of the colon are precancerous lesions.

Blood Group Antigens↗
PubMed1976

The demonstration of carcinoembryonic antigen in colorectal carcinoma and colonic polyps using an immunoperoxidase technique.

Carcinoembryonic antigen (CEA) has been demonstrated in tissues, by immunofluorescence, with conflicting results. Originally thought to be persent in colorectal carcinoma only, the antigen was later demonstrated in inflamed colonic mucosa and polyps. Using formalin-fixed, paraffin-embedded tissues and an immunoperoxidase technique, we have attempted to demonstrate CEA in 12 colorectal carcinomas, in adjacent benign mucosa, and in 42 polyps of varying histologic type. CEA was demonstrated in all colorectal cancers but not in adjacent inflamed mucosa. The antigen could not be demonstrated in polyps except in five cases where CEA was shown in morphologically atypical glands only. With out technique, the demonstration of CEA is a reliable indicator of malignant change in colonic mucosa. The findings in polyps tend to support the concept of carcinoma in situ in adenomatous polyps and the polyp-cancer sequence.

Adenocarcinoma↗
PubMed1977

Nasal polyps in asthma and rhinitis. A review of 6,037 patients.

Data from records of patients with asthma and rhinitis in the Rhode Island Hospital Adult Allergy Clinic and in an adult allergy private were reviewed. The frequency of nasal polyps in the total population of 4,986 was 4.2%; in the asthmatic portion of the population the frequency was 6.7%, and in the rhinitis alone group the frequency was 2.2%. Asthmatics with negative allergy skin tests to inhalant allergers had significantly more nasal polyps than asthmatics with positive skin tests, 12.5% vs 5.0%, p less than 0.01. The frequency of nasal polyps increased with advancing years. Of the total 211 cases of nasal polyps, 71% had asthma and 29% had rhinitis alone. Also, 14% of the patients with nasal polyps had aspirin intolerance, primarily of the bronchospastic type. In addition, 1,051 patients with asthma and rhinitis from the Pediatric Allergy Clinic with a mean age of 6 yr were similarly evaluated. Only 1 (0.1%) of these pediatric patients had nasal polyps.

Adolescent↗
PubMed1979

Epithelial polyps of the large bowel: a pathological and colonoscopic study.

Ninety patients who had epithelial polyps or carcinoma of the large bowel and underwent at least 2 colonscopic examinations were studied. The cases were divided into three groups: patients who ;ad only one polyp; those in whom more than one epithelial polyp were found and those who had adenocarcinoma of the large bowel and underwent follow-up colonoscopic examinations. The distribution of the polpys was plotted as to type and distribution in the colon. There seemed to be a trend for the polyp found in follow-up examinations to be located proximal to the splenic flexure. In this regard it was noted that the subsequently found polyps in group II were smaller than those removed on the initial colonoscopic examination. No relationship could be found between any histologic type of epithelial polyp and the presence of carcinoma.

Adenocarcinoma↗
PubMed1975

Risk of recurrence of colon polyps.

At Wood Veterans Administration Center, 268 patients who had a polypectomy have been followed up to 20 years with semiannual proctosigmoidoscopic and barium enema examinations. For the present review of benign polyp disease, patients having coexisting carcinoma, chronic inflammatory disease, and those lost to followup have been excluded; 154 patients followed for a mean of 7 years comprise the study group. Thirty per cent of patients developed recurrent polyps. The risk of recurrence during the first year was 16 times that expected in a population of similar age and sex, but thereafter diminished steadily. After 48 months risk of polyp recurrence was little higher than the incidence expected in a normal population. Neither patient age, presenting symptoms nor the site or size of the initial polyp(s) were of any prognostic value regarding recurrence. Patients presenting with a villous adenoma or with more than 3 polyps had a significantly increased risk of recurrence may persist indefinitely. The overall incidence of colonic carcinoma may have been increased, but the location of subsequent cancer was not related to the site of a previously excised polyp.

Adult↗
PubMed1977

Nature and significance of colonic polyps.

The concept of inevitable premalignancy in all adenomatous polyps of the colon was challenged as early as 1958, and since that time much debate has centered about the malignant potential of adenomatous polyps of the colon. Current thinking indicates that the majority of colonic polyps fall into one of four categories: hyperplastic, villous adenoma, adenomatous, and villoglandular. Analysis of the present series of 387 colonic polyps removed endoscopically indicates that the villoglandular group has a notable malignant potential, and that the pure adenomatous polyp probably carries a minimal malignant threat. The present series does not challenge the accepted concept that hyperplastic polyps are of no malignant potential, and that villous adenomas are quite frequently malignant at the time of diagnosis.

Colonic Neoplasms↗