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PubMedDate not supplied

Inflammatory fibroid polyp. Review of the literature.

Inflammatory fibroid polyp is a rare polypoid lesion of the gastrointestinal tract, histologically characterized by a mixture of proliferation of fibroblasts and small blood vessels, accompanying a marked eosinophilic infiltrate. The lesion largely affects adults and is more common in the antrum of the stomach, but have occasionally been reported in the small bowel and colon. Clinical symptoms are variable, depending on the location and size of the lesion. Although it is generally believed to represent a reactive, nonneoplastic condition, their histogenesis remains controversial. The pathological features, hypothesis about pathogenesis and etiology, ultrastructural and immunohistochemical findings are discussed in this review of the literature.

Adolescent↗
PubMed1994

[Intestinal obstruction with invagination caused by an inflammatory fibroid polyp of the small intestine].

We observed the rare case of a 50-year-old man with intestinal obstruction due to an inflammatory fibroid polyp (IFP) of the jejunum. Here, we report its clinical and pathological characteristics, and its histologic appearance. Limited small bowel resection led to complete recovery of the patient. In a short review of the literature, possible pathogenetic mechanisms as well as diagnostic and therapeutic means are discussed. Although rare, IFP should be considered in the differential diagnosis of small bowel obstruction.

Anastomosis, Surgical↗
PubMed1977

Massive fibroid.

This ten-year study of the massive fibroid at the Queen of Angels Hospital will reveal an average of 66 cases per year which could be classified as large and massive. Only about ten cases per year qualify as massive (four gestational months or larger). There were none considered giant size (25 lbs or more).The literature is replete with these, one of which (weighing 100.2 lbs) will be reported in detail. The mortality rate continues to be considerable in these (14.8 to 16.7 percent). In the smaller tumors, mortality is rare and morbidity is minimal.Bleeding, pain, and pressure symptoms, due to impingement on neighboring organs, are the principal symptoms. Sarcomatous change, fortunately, still remains quite rare.Treatment usually involves a pre-operative dilatation and curettage when bleeding is a problem, followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy where indicated. Appendectomy is usually incidental. Anesthesia is usually spinal, if not otherwise contraindicated.Ultrasound is a new and refined diagnostic tool.

Female↗
PubMedDate not supplied

Management of uterine fibroids.

Until recently the management of uterine fibroids has been exclusively surgical in the form of either hysterectomy or myomectomy. The development of minimally invasive techniques and the introduction of LHRH agonists has allowed more conservative management to maintain or restore fertility.

Adult↗
PubMed1996

Presence of an insulin-like growth factor I autocrine loop predicts uterine fibroid responsiveness to tamoxifen.

Uterine leiomyoma is an estrogen-responsive tumor, and the present studies examine the ability of the antiestrogen tamoxifen to modulate leiomyoma cell growth. Tamoxifen is an effective form of hormonal therapy for breast cancer, although the mechanism by which tamoxifen inhibits tumor growth is not well understood and may involve mechanisms other than the action of tamoxifen as an estrogen antagonist. Tamoxifen was found to inhibit the proliferation of three of five leiomyoma-derived cell lines (ELT cell lines) in vitro, including an estrogen receptor-negative cell line. The ability of tamoxifen to decrease leiomyoma growth was found to correlate with expression of insulin-like growth factor I (IGF-I) by the tumor cells, suggesting that the inhibitory effects of tamoxifen were associated with expression of this growth factor. The existence of an IGF-I autocrine loop in the cells was investigated, because transcripts for both IGF-I and its cognate receptor were expressed in the tamoxifen-responsive cell lines. An IGF-I RIA demonstrated secreted IGF-I protein in serum-free medium conditioned by the IGF-I-expressing cell line ELT 3, and this same medium supported the growth of IGF-requiring MCF-10A cells, indicating the presence of biologically active IGF-I in the conditioned medium. Exogenous IGF-I stimulated ELT 3 cell proliferation, confirming that this growth factor is mitogenic for leiomyoma cells. IGF-I neutralizing antibody inhibited ELT 3 growth, indicating that the levels of IGF-I produced by the leiomyoma cells were physiologically significant. These data demonstrate the existence of an IGF-I autocrine loop in tamoxifen-sensitive leiomyoma cells, supporting the hypothesis that the presence of an IGF-I autocrine loop predicts uterine fibroid responsiveness to tamoxifen.

Animals↗
PubMed1996

Endoscopic features of gastric inflammatory fibroid polyps.

OBJECTIVES: The inflammatory fibroid polyp (IFP) is a rare benign lesion that can occur throughout the digestive tract. The aim of this study is to describe endoscopic features of gastric IFPs and to determine the clinical value of endoscopic removal. METHODS: Upper gastrointestinal endoscopy was performed in 13 patients with gastric IFPs. The IFPs were resected either by endoscopic removal or gastrectomy, and confirmed histologically as IFPs. To evaluate the diagnostic value, endoscopic features of the lesions were analyzed. RESULTS: The most frequent features were semi-pedunculated protrusions (61.5%), covered with a smooth surface of normal mucosa (100%), and located in the antrum or prepyloric region (100%). Bridging folds were observed in three of the 13 lesions (23.1%). The central surface of all 10-mm or larger lesions had an erythematous depression (three lesions), ulceration (five lesions), or white cap on the polyp (one lesion). Endoscopic biopsies failed to confirm IFP in any lesions. CONCLUSIONS: IFPs are commonly visualized as semi-pedunculated elevations, covered with a smooth surface of normal mucosa, and located in the antrum or prepyloric region. The 10-mm or larger lesions have central changes. Endoscopic removal of gastric IFPs is a useful method for both accurate diagnosis and treatment in view of negative results with the use of standard biopsy forceps.

Endoscopy↗
PubMed1995

Abdominal myomectomy as a treatment for symptomatic uterine fibroids.

Using the previously described approach, I find abdominal myomectomy in general to be a procedure quite comparable with other major pelvic procedures, such as hysterectomy. My postoperative course is associated with a 12% complication rate, the majority of which represents transient febrile morbidity, which resolves quite promptly. In addition, my transfusion rate is 3% or less and my postoperative length of stay is 2 to 3 days. This is consistent with other currently reported series and in my estimation justifies the continued philosophy of offering abdominal myomectomy as a primary treatment for symptomatic uterine fibroids regardless of future childbearing options.

Adult↗
PubMed1997

Inflammatory fibroid polyp of proximal ileum causing recurrent intussusception.

A 64-year-old female presented with episodes of small bowel obstruction. Ultrasound and barium meal showed a polypoidal lesion in the proximal segment of small bowel. The patient underwent emergency surgery because of signs of impending acute intestinal obstruction. Pathology showed characteristics features of an inflammatory fibroid polyp (IFP) which is an important though rare benign cause of small bowel obstruction. We document clinical and pathological aspects of this case.

Aged↗
PubMed1997

CD34 expression by inflammatory fibroid polyps of the stomach.

The phenotype of the proliferated spindled cells and the histogenesis of inflammatory fibroid polyp (IFP) have been a matter of debate. To clarify the immunohistochemical profile of the main cellular component, we reviewed histologically and studied immunohistochemically 11 cases (12 lesions) of IFP of the stomach. The lesions ranged in size from 0.4 to 3.0 cm (mean, 1.0 cm). All of the IFPs occurred in the antrum. Seven cases (63.6%) were accompanied by carcinoma or adenoma, which in two cases was present in covering epithelium. Grossly, eight IFPs were sessile, and four were polypoid. Microscopically, seven (58.3%) occupied both the mucosa and submucosa. Four (33.3%) were confined to the mucosa, and one was localized only in the submucosa. They were characterized by proliferation of relatively uniform spindled cells, often in a whorl-like arrangement around the blood vessels and glands. Eosinophilic and lymphocytic infiltration of varying degree was always present. The spindled cells in all of the IFPs were diffusely immunoreactive for vimentin and CD34. Seven (58.3%) were focally positive for histiocytic markers, such as KP1 and HAM56. Three (25%) showed focal immunoreactivity for alpha smooth muscle actin. Cytokeratin, desmin, S100 protein, Factor VIII RAG, and Ki-67 were negative in these spindled cells. The principle proliferating cells in IFPs in this study showed variable degrees of histiocytic and myofibroblastic lines of differentiation. Under the influence of some etiologic factors, the primitive, uncommitted spindled mesenchymal cells exhibiting CD34 immunoreactivity around the blood vessels and glands in the lower portion of mucosa and submucosa might play a role in development of IFP.

Actins↗
PubMed1997

Endoscopic polypectomy of a large inflammatory fibroid polyp of the stomach: a case report.

Gastric inflammatory fibroid polyp (IFP) is a rare benign submucosal tumor. It consists of mesenchymal and spindle-shaped cell proliferations with inflammatory cell infiltrations. With the widespread use of fiberoptic endoscopy, gastric polypoid lesions are being recognized with increasing frequency. Conventionally, they have been treated using surgical excision, after which accurate pathological diagnosis was obtained. Recently, endoscopic polypectomy has been widely used and has shown good results in both diagnosis and treatment of polypoid lesions of the stomach. We report a case in which a large symptomatic gastric IFP was successfully removed using single-channel endoscopy.

Aged↗
PubMedDate not supplied

[Inflammatory fibroid polyp of the stomach. Report of a case].

Inflammatory fibroid polyp (IFP) is a rare lesion of the gastroenteric tract more frequently occurring at the level of the stomach. The etiopathogenesis of IFP as well as the nature of the cells constituting these lesions remain unknown. Abdominal pain and anaemia due to chronic blood loss are the most common presenting features but neither radiology and CT scanning nor endoscopy are capable to achieve any conclusive diagnostic information. Histologic examination of the specimen obtained by endoscopic or surgical excision is considered to be the only way for the definitive exclusion of a neoplastic nature. A case of IFP treated by means of total gastrectomy is presented.

Biopsy↗
PubMed1998

Fibroid polyps of intestinal tract are inflammatory-reactive proliferations of CD34-positive perivascular cells.

AIMS: Our aim was to determine the histogenesis of fibroid polyps (FP). These polyps are rare inflammatory-reactive, tumour-like lesions of unknown aetiology, arising in the submucosa or mucosa of the gastrointestinal tract. They are mainly due to a proliferation of characteristic spindle cells. METHODS AND RESULTS: Nine FP were investigated by light microscopy and immunohistochemistry with endothelial markers (Factor VIII, CD34, CD31), a neuronal marker (S100), muscular markers (desmin, alpha-smooth muscle actin) and histiocytic markers (PGMI, KP1, MAC387) using the highly sensitive avidin-biotin-peroxidase technique. We demonstrate, for the first time, a consistent positivity of the characteristic spindle cells of FP for CD34. The proposed endothelial, histiocytic or neuronal origin of FP could be completely ruled out. CONCLUSIONS: Because of the consistent positivity of the spindle cells of FP for CD34 we suggest an origin of these lesions from primitive perivascular or vascular cells. This origin and a probable relationship to gastrointestinal stromal tumours (GIST) is discussed.

Actins↗