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Immunohistochemical characterization of canine intestinal epithelial and mesenchymal tumours with a monoclonal antibody to hepatocyte paraffin 1 (Hep Par 1).

Monoclonal antibody hepatocyte paraffin 1 (Hep Par 1) is reported to be highly specific and sensitive for hepatocellular tumours of humans and dogs. However, in a previous study we observed immunoreactivity for Hep Par 1 in an intestinal adenocarcinoma metastatic to the liver. In this paper, we examined normal intestine and 57 canine intestinal tumours including adenocarcinomas of the small and large intestine, colonorectal polyps, mucinous carcinomas, stromal tumours, leiomyosarcomas, fibrosarcoma, plasmacytomas, and osteosarcoma for immunoreactivity for Hep Par 1. Normal intestinal epithelial cells were strongly labelled, particularly at the base of crypts. However, epithelial cells in small intestinal neoplasms had variable reactivity for Hep Par 1. In contrast, normal colonic epithelium was seldom labelled, but hyperplastic or neoplastic colonic epithelium was usually reactive to Hep Par 1. Five of seven small intestinal adenocarcinomas, two of three large intestinal adenocarcinomas, two of three mucinous adenocarcinomas, and all (29) rectal polyps were positive for Hep Par 1. The staining was diffuse, granular and cytoplasmic. The only non-epithelial tumours positive for Hep Par 1 were two of four leiomyosarcomas. Hep Par 1 can be used to differentiate hepatocellular from biliary neoplasms but its value in differentiating metastatic tumours to the liver is questionable due to the reactivity of Hep Par 1 in many intestinal tumours.

Animals↗

The inhibitory effects of mangiferin, a naturally occurring glucosylxanthone, in bowel carcinogenesis of male F344 rats.

Mangiferin, 1,3,6,7-tetrahydroxyxanthone-C2-beta-D-glucoside, is one of xanthone derivatives and C-glucosylxanthones, is widely distributed in higher plants and is one of constituents of folk medicines. Recent studies showed that mangiferin has a potential as an anti-oxidant and an anti-viral agent. In this study, we examined the effects of mangiferin in rat colon carcinogenesis induced by chemical carcinogen, azoxymethane (AOM). We performed two experiments: a short-term assay to investigate the effects of mangiferin on the development of preneoplastic lesions by AOM, aberrant crypt foci (ACF), and the following long-term assay for the influence of mangiferin on tumorigenesis induced by AOM. In the short-term assay, 0.1% mangiferin in a diet significantly inhibited the ACF development in rats treated with AOM compared to rats treated with AOM alone (64.6+/-22.0 vs. 108.3+/-43.0). In the long-term assay, the group treated with 0.1% mangiferin in initiation phase of the experimental protocol had significantly lower incidence and multiplicity of intestinal neoplasms induced by AOM (47.3 and 41.8% reductions of the group treated with AOM alone for incidence and multiplicity, respectively). In addition, the cell proliferation in colonic mucosa was reduced in rats treated with mangiferin (65-85% reductions of the group treated with AOM alone). These results suggest that mangiferin has potential as a naturally-occurring chemopreventive agent.

Animals↗

[Plain radiographic examination and abdominal echography in intestinal occlusion syndrome. Preliminary note].

Plain film of the abdomen is widely used in the diagnostic evaluation of intestinal occlusion. Even though this technique can yield a panoramic and high-resolution view of gas-filled intestinal loops, several factors, such as type and duration of occlusion, neurovascular status of the intestine and general patient condition, may reduce the diagnostic specificity of the plain film relative to the organic or functional nature of the occlusion. From 1987 to 1989, fifty-four patients with intestinal occlusion were studied combining plain abdominal film with abdominal ultrasound (US). This was done in order to evaluate whether the additional information obtained from US could be of value in better determining the nature of the ileus. US evaluation was guided by the information already obtained from plain film which better demonstrates gas-filled loops. The results show that in all 27 cases of dynamic ileus (intestinal ischemia, acute appendicitis, acute cholecystitis, acute pancreatitis or blunt abdominal trauma) US demonstrates: intestinal loops slightly increased in caliber, with liquid content, or loops containing rare hyperechoic particles, intestinal wall thickening and no peristalsis. In 27 cases of acute, chronic or complicated mechanical ileus (adhesions, internal hernia, intestinal neoplasm, peritoneal seedings) US shows: 1) in acute occlusion: hyperperistaltic intestinal loops containing inhomogeneous liquid; 2) in chronic occlusion: liquid content with a solid echogenic component; 3) in complicated occlusion: liquid stasis, frequent increase in wall thickness, moderate peritoneal effusion and inefficient peristalsis. In conclusion, based on the obtained data, the authors feel that the combination of plain abdominal film and abdominal US can be useful in the work-up of patient with intestinal occlusion. The information provided by US allows a better definition of the nature of the ileus.

Female↗

Appendiceal carcinoids in Crohn's disease.

Earlier investigations demonstrate an increased risk for colon cancer in Crohn's disease. For other intestinal neoplasms, such as carcinoids, studies are limited. In Crohn's disease, repeated endoscopic and imaging studies along with intestinal resections may facilitate clinical recognition of neoplastic diseases, including appendiceal neoplasms. To date, however, only sporadic cases of appendiceal carcinoids have been described in Crohn's disease. In the present study, in a single clinician database of 1000 Crohn's disease patients, three of the 441 patients who had undergone intestinal resection had appendiceal carcinoids, all of which were pathologically confirmed. All were observed in female patients and were not suspected before surgical treatment. In one case, even though management was not altered, the tumour had already invaded serosal fat indicating a potential for more advanced disease. In this series, a carcinoid tumour was found in a resection specimen during a later clinical case review and another was a microcarcinoid, implying that these tumours may be overlooked in Crohn's disease. The percentage detected in the entire database (0.3%) exceeds the reported rates of detection of appendiceal carcinoids after removal of the appendix for appendicitis, as well as the rate of detection of appendiceal carcinoids in autopsy studies. This percentage would be higher if only those having an intestinal resection were considered (0.68%). Additional studies are needed to further define this risk of appendiceal carcinoids in Crohn's disease.

Abdominal Pain↗

[Carcinoma of unknown origin. Diagnostic study of 48 cases and its clinical yield].

Forty-eight patients fulfilling the criteria for carcinoma of unknown origin (CUO) between April 1983 and December 1987 were retrospectively analyzed. Mean age was 62 (33-83). Twenty-seven were males (56%) and 21 females (44%). The most common site of metastasis was the bone (35%), followed by the liver (19%) and lymph nodes (19%). 58% of cases were adenocarcinomas. Overall 274 studies for the detection of the primary tumor were carried out, the diagnosis being achieved in 10 cases (3.65%) which corresponded to lung neoplasms (5 cases), prostatic adenocarcinoma with negative markers (2 cases), bile duct neoplasms (2 cases) and pancreatic carcinoma (1 case). In our series, the most useful studies were computed tomography (CT) and fibrobronchoscopy. The necropsy, carried out in 11 patients, yielded 8 additional diagnoses: pulmonary neoplasm (one case), gastric adenocarcinoma (2 cases), malignant melanoma (2 cases), small intestine neoplasm (one case), parotid cancer (one case) and hepatocarcinoma (one case). Thirty-five patients were treated with chemotherapy and/or radiation; 12 objective responses (3 complete and 9 partial) were achieved, with a median duration of the response of 10 months (range 0.2-78 +). In view of the low diagnostic yield of the studies in patients with CUO we feel that the diagnostic study may be limited to CT scan with evaluation of the possible usefulness of bronchoscopy in individual patients. Regarding therapy, it is to be noted that there was a tendency for a longer survival in patients who responded.

Adult↗