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At least 775 records · Page 43Linked to original sources
PubMed2005

Effects of interstitial fallopian tube polyps on isthmic tubal diameter.

OBJECTIVE: To study the apparent association between interstitial fallopian tube polyps and isthmic tubal dilatation. DESIGN: Retrospective clinical study. SETTING: Tertiary academic medical center. PATIENT(S): Sixty-five patients with normal hysterosalpingograms and 40 patients with interstitial tubal polyps (25 unilateral and 15 bilateral). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Proximal, medial, and distal isthmic diameters were measured digitally and normalized according to an internal standard. Polyp volumes were measured and divided into four groups according to increasing volume (<2 mm3, 2-5 mm3, 6-12 mm3, >12 mm3). RESULT(S): There was a significant increase in proximal isthmic tubal diameter in patients with interstitial polyps. Mean diameter increased from 0.6 mm to 0.9 mm. There was no significant change in more distal isthmic diameters. Larger polyps tended to be associated with larger luminal diameters. CONCLUSION(S): Interstitial fallopian tube polyps are associated with a significant increase in proximal isthmic luminal diameter as determined on hysterosalpingography. Although these polyps are nonobstructing and thus thought by most investigators not to affect fertility, their association with altered luminal diameter and perhaps altered function might be of clinical interest.

Fallopian Tube Diseases↗
PubMed2006

Success and complications of endoscopic removal of giant duodenal and ampullary polyps: a comparative series.

BACKGROUND: Increasing reports suggest that endoscopic removal of benign ampullary and duodenal polyps is safe and frequently definitive; however, most reported polyps have been small in size (<3 cm). We have developed experience with endoscopic removal of increasingly large and complex polyps. PATIENTS: Fifty-one cases of endoscopic removal were attempted and grouped according to size: group A (n = 22) polyps 1 to 3 cm and group B (n = 29) polyps 3 cm or larger, including 7 cases larger than 5 cm. When the ampulla was involved, biductal sphincterotomy and prophylactic pancreatic duct stent placement was performed first, followed by saline solution-assisted piecemeal polypectomy, argon plasma coagulation, selective endoclip placement, and recovery of all polyp fragments. INTERVENTIONS: Endoscopic removal of duodenal and ampullary adenomas. RESULTS: The outcomes of small and large adenoma removal include mean number of endoscopic retrograde cholangiopancreatographies required for complete removal (2.09 vs 2.56, P = .392), number of complications (4.5% vs 13.9%, P = .375), discovery of unsuspected cancer (0% vs 10.3%, P = .242), and final definitive resolution (100% vs 86.2%, P = .124). Complete removal was achieved in 92.2% of all patients. LIMITATIONS: This was a single center retrospective study. CONCLUSIONS: Large (>/=3 cm) ampullary and duodenal polyps comprised 56.9% of our endoscopically treated cases and present special challenges to definitive endoscopic removal. Successful removal of even very large sessile lesions is possible with minimal increase in risk.

Adult↗
PubMed2006

Nasal IL-5 levels determine the response to anti-IL-5 treatment in patients with nasal polyps.

BACKGROUND: Chronic rhinosinusitis with nasal polyps is characterized by an eosinophilic inflammation and high IL-5 levels. OBJECTIVES: Antagonizing the effect of IL-5 is a potential new treatment strategy in patients with nasal polyps. METHODS: In a double-blind, placebo-controlled, randomized, 2-center safety and pharmacokinetic study, 24 subjects with bilateral nasal polyps were randomized to receive a single intravenous infusion of reslizumab, a humanized anti-human IL-5 mAb, at 3 mg/kg or 1 mg/kg or placebo. We evaluated the safety and pharmacokinetics of reslizumab, and biologic activity was assessed by means of endoscopic evaluation of polyp size, symptoms, peripheral eosinophil counts, peripheral and local IL-5 levels, eotaxin levels, and eosinophil cationic protein levels. RESULTS: We demonstrated that a single injection of reslizumab up to 3 mg/kg is safe and well tolerated. Blood eosinophil numbers and concentrations of eosinophil cationic protein were reduced up to 8 weeks after treatment in serum and nasal secretions. Individual nasal polyp scores improved only in half of the treated patients for 4 weeks. Responders had increased IL-5 concentrations in nasal secretions at baseline compared with nonresponders, and logistic regression analysis revealed that increased nasal IL-5 levels (>40 pg/mL) predict the response to anti-IL-5 treatment. CONCLUSION: A single injection of anti-IL-5 reduces the size of nasal polyps for 4 weeks in half of the patients, and nasal IL-5 levels predict the response to anti-IL-5 treatment. CLINICAL IMPLICATIONS: Intravenous administration of a humanized anti-human IL-5 mAb is safe and reduces the size of nasal polyps in half of the patients.

Adolescent↗
PubMed2004

Lung cancer metastatic to a cervical polyp.

BACKGROUND: We describe an unusual finding of a lung cancer metastatic to a cervical polyp. CASE: A 69-year-old female with metastatic lung cancer was referred for evaluation of an asymptomatic cervical polyp. The polyp was removed and pathologic examination revealed a focus of invasive adenocarcinoma with signet ring features within a polypoid fragment of squamous mucosa. All studies suggest a primary pulmonary origin. CONCLUSION: Cervical polyps occur in up to 5% of women and 1.7% contain carcinomatous changes. Most malignant polyps result from the progression of localized dysplasia, but distant metastases have been reported. We were unable to find any prior report of a primary lung cancer metastatic to a cervical polyp. Although removal or biopsy of asymptomatic polyps is reasonable, further studies need to be done.

Aged↗
PubMed2003

Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps.

BACKGROUND & AIMS: This study used a low lesion prevalence population reflective of the screening setting to estimate the sensitivity and specificity of computerized tomographic (CT) colonography for detection of colorectal polyps. METHODS: This prospective, blinded study comprised 703 asymptomatic persons at higher-than-average risk for colorectal cancer who underwent CT colonography followed by same-day colonoscopy. Two of 3 experienced readers interpreted each CT colonography examination. RESULTS: Overall lesion prevalence for adenomas >/=1 cm in diameter was 5%. Seventy percent of all lesions were proximal to the descending colon. With colonoscopy serving as the gold standard, CT colonography detected 34%, 32%, 73%, and 63% of the 59 polyps >/=1 cm for readers 1, 2, 3, and double-reading, respectively; and 35%, 29%, 57%, and 54% of the 94 polyps 5-9 mm for readers 1, 2, 3, and double-reading, respectively. Specificity for CT colonography ranged from 95% to 98% and 86% to 95% for >1 cm and 5-9-mm polyps, respectively. Interobserver variability was high for CT colonography with kappa statistic values ranging from -0.67 to 0.89. CONCLUSIONS: In a low prevalence setting, polyp detection rates at CT colonography are well below those at colonoscopy. These rates are less than previous reports based largely on high lesion prevalence cohorts. High interobserver variability warrants further investigation but may be due to the low prevalence of polyps in this cohort and the high impact on total sensitivity of each missed polyp. Specificity, based on large numbers, is high and exhibits excellent agreement among observers.

Aged↗
PubMed2005

Endoscopic resection of Peutz-Jeghers polyps throughout the small intestine at double-balloon enteroscopy without laparotomy.

BACKGROUND: Small-bowel enteroscopy with the double-balloon method was developed to improve access to the small intestine. This study evaluated the usefulness of this method for the resection of small-intestinal Peutz-Jeghers polyps. METHODS: Two patients with Peutz-Jeghers syndrome underwent nonsurgical double-balloon enteroscopic resection of polyps throughout the small intestine. OBSERVATIONS: Multiple polyps in the jejunum were successfully resected via the oral route, as were the polyps in the ileum via the anal route. All 18 polyps (10-60 mm in size) were resected without subsequent bleeding or perforation. Histopathologically, 3 large polyps (>30 mm diameter) were hamartomas with adenomatous components. CONCLUSIONS: Double-balloon enteroscopy was safe and useful for the diagnosis and the treatment of Peutz-Jeghers polyps throughout the small intestine. Double-balloon enteroscopic polypectomy might preclude complications of Peutz-Jeghers syndrome, including intussusception, bleeding, and tumorogenesis, thereby obviating the need for multiple laparotomies.

Adult↗
PubMed1981

Polyps in the acid-secreting area of the stomach.

The relation of gastric polyps to acid-secreting mucosa was examined in 120 patients with gastric polyps. Studies were made by the endoscopic Congo red test developed in this clinic. In 23 patients (19.1%) gastric polyps were located in acid-secreting mucosa and may have arisen from normal oxyntic mucosa. These polyps were of two histological types: oxyntic gland polyps containing many parietal cells, and nonoxyntic gland polyps without parietal cells. Only the former type appeared to secrete acid, judging endoscopically from the change of Congo red from red to blue-black on the surface of the polyps after administration of gastrin.

Adult↗
PubMedDate not supplied

Study of the gastric mucosal background in patients with gastric polyps.

The characteristics of gastric mucosal patterns in the polyp-bearing stomach were investigated by the endoscopic Congo red test and systemic four-points biopsy in 46 patients with hyperplastic polyps and 21 patients with gastric adenomas. In addition, function of the stomach in these patients was assessed by determination of gastric acidity and fasting serum gastrin level and by gastrin response test to a beef extract. In the investigation of the gastric mucosal pattern in hyperplastic polyp patients, Type A gastritis (involving the corpus but sparing the antrum) was most frequently found. On the other hand, extensive intestinal metaplasia from the pyloric antrum to the corpus was most often noted in the adenoma-bearing stomach. Hypergastrinemia was more marked in hyperplastic polyp patients, and may be involved in the pathogenesis of hyperplastic polyps. Attention should be paid to the detection of cancer in areas without polyps during endoscopic observation and reexamination of patients. On these occasions, the characteristics of the background mucosa for each type of polyp should be kept in mind.

Adenoma↗
PubMedDate not supplied

Association between histologic type of polyp and carcinoma in the stomach.

During a 5-year period, we examined by endoscopy or surgery 2634 stomachs: 2536 (group A) were free of lesions commonly recognized as mucosal "polyps"; 74 (group B) exhibited hyperplastic polyps; and 24 (group C) were found with neoplastic (adenomatous) polyps. Carcinomas were present in 318 (12.5%) of specimens in group A, compared with 10 (13.5%) in group B and 20 (83.3%) in group C. In the third group, 14 carcinomas were encountered within polyps, and 4 carcinomas occurred separately. The frequency of cancer associated with neoplastic polyps was relatively low (1 of 3) in patients younger than 50 years, but significantly high (19 of 21) in older patients. This series confirms the prevailing concept that patients harboring gastric adenomatous polyps are at distinct risk of gastric carcinoma, a risk that sharply rises with age. We conclude that patients found with gastric adenomatous polyps should be subject to careful and continued surveillance to ensure that supervening carcinoma be detected at the earliest possible phase.

Adenocarcinoma↗
PubMedDate not supplied

Are hyperplastic rectosigmoid polyps associated with an increased risk of proximal colonic neoplasms?

Diminutive polyps are frequent findings on screening flexible sigmoidoscopy. To determine the significance of distal diminutive polyps, we conducted a prospective study of 162 asymptomatic, average-risk subjects who were 50 years of age or older. Subjects were divided into four groups: 42 control subjects with no polyps in the rectosigmoid, 66 subjects with at least one diminutive adenoma in the rectosigmoid, 12 subjects with a mixed hyperplastic-adenomatous polyp in the rectosigmoid, and 42 subjects with only hyperplastic polyps in the rectosigmoid. Total colonoscopy was performed on all subjects. The prevalence of proximal adenomas was 42% in the adenoma group, 25% in the mixed group, 14% in the hyperplastic group and 12% in the control group. The prevalence of proximal adenomas was significantly higher (p = 0.006) in the adenoma group as compared with the control and hyperplastic groups. Increasing age was associated with an increased prevalence of proximal adenomas. Nearly two thirds of those over 65 years of age with distal diminutive adenomas had proximal colonic neoplasms. These results indicate that diminutive rectosigmoid adenomas are good markers for proximal neoplasms. Rectosigmoid hyperplastic polyps are not associated with an increased prevalence of proximal neoplasms. Total colonoscopy is not indicated if hyperplastic polyps are the only finding on flexible sigmoidoscopy.

Aged↗
PubMed1997

Distal hyperplastic polyps do not predict proximal adenomas: results from a multicentric study of colorectal adenomas.

BACKGROUND: The association between distal hyperplastic polyps and proximal adenomas is still a matter of debate. We investigated this association while taking into account patient characteristics. METHODS: After exclusion of patients with inflammatory bowel diseases, familial adenomatous polyposis, or any cancer, 3088 eligible consecutive subjects aged 18 to 69 years underwent total colonoscopy in four gastroenterology units. The odds ratios (OR) of having proximal adenomas according to patient characteristics (age, sex, medical center, year of endoscopy, reasons for referral, and distal findings) were estimated in univariate and multivariate analyses. RESULTS: Patients with distal polyps of any type showed an adjusted OR of 2.5 (95% CI [1.9, 3.1] p < .001) of having proximal adenomas as compared with those without distal polyps. When distal adenomas and distal hyperplastic polyps were included in the multivariate model as independent factors, the presence of adenomas significantly increased the risk of proximal adenomas (OR = 2.8: 95% CI [2.2, 3.6] p < .001), whereas the presence of hyperplastic polyps did not (OR = 1.1: 95% CI [0.8, 1.5] p = .64). No association with number, size, or location of distal hyperplastic polyps was seen. CONCLUSIONS: Our data show that the presence of hyperplastic polyps should not be the sole indication for total colonoscopy because they are not associated with proximal adenomas when adjusting for patient characteristics and presence of distal adenomas.

Adenoma↗
PubMed2003

Endoscopic treatment of fibroepithelial polyps of the renal pelvis and ureter.

OBJECTIVES: To report our experience on the endoscopic treatment of large fibroepithelial polyps of the renal pelvis and ureter. Fibroepithelial polyps of the upper urinary tract are rare benign tumors that have traditionally been treated by open exploration and resection. METHODS: Five patients underwent either percutaneous or ureteroscopic treatment of a renal pelvic or ureteral fibroepithelial polyp by electroresection or holmium:yttrium-aluminum-garnet laser resection. RESULTS: All 5 patients were without recurrence after endoscopic resection. The mean follow-up was 19.6 months (range 6 to 41). The average length of stay was 3 days (range 2 to 5) and 0.5 day (range 0 to 1) for those undergoing percutaneous and ureteroscopic treatment, respectively. No major complications resulted from either approach, and no ureteral strictures have developed. All patients treated remain recurrence free. CONCLUSIONS: Endoscopic management of large fibroepithelial polyps of the renal pelvis and ureter is an acceptable treatment modality with minimal morbidity and durable treatment results. The percutaneous approach offers the advantage of identifying the base of the polyp under direct visualization, allowing safe destruction of the stalk and efficient removal of the entire polyp. To our knowledge, this is the first reported series of percutaneous, antegrade excision of fibroepithelial polyps.

Electrosurgery↗
PubMed1986

Mucosal hyperplastic polyps of the stomach. Do they have any potential to malignancy?

Gastric mucosal polyps were studied in gastric biopsies, taken from 481 patients who had been operated on for benign peptic ulcer. The material was classified according to the type of operation in the following 4 groups: Billroth-II resection, gastroenterostomy, pyloroplasty with vagotomy and Billroth-I resection. As control group served 1520 nonoperated patients with no ulcer or malignancy. The diagnosed polyps were classified in inflammatory, hyperplastic and neoplastic. Neoplastic polyps were observed only in the nonoperated stomachs with an incidence of 0.5%. The incidence of the hyperplastic polyps was 12.1% for Billroth-II resection, 14.9% for gastroenterostomy and 2.6% for the control group, with a significant difference between the operated and the nonoperated stomachs. The hyperplastic polyps constituted the commonest histological type of polyp in all the groups. The majority of them was observed close to the gastroenterostomy and it seems that there is a relation between their frequency and the time elapsed after the operation. A high degree of epithelial dysplasia in hyperplastic polyps was found in 22.2% of Billroth-II resection patients, in 6.3% of gastroenterostomy patients and in only 2.6% of the control group, with a significant difference between the operated and the nonoperated stomachs.

Cell Transformation, Neoplastic↗
PubMed2000

Immunocytochemical distribution of the c-H-ras protein in nasal polyps: localization to the terminal bars.

OBJECTIVE: This study was performed to investigate the role of proto-oncogene products, c-H-ras and c-erbB-2, in the pathophysiology of nasal polyps. METHODS: An immunocytochemical investigation of the expression of proto-oncogene products of c-H-ras and c-erbB-2 was performed on 16 nasal polyps and 15 nasal mucosa specimens. RESULTS: The c-H-ras protein was found to be localized to the terminal bars of apical cells of the epithelium in 11 of 16 nasal polyps and in seven of 15 nasal mucosa. Localized staining at the terminal bars for the c-H-ras protein was significantly more frequently observed in glandular-cystic type than in edematous type nasal polyps. Such localized staining was significantly more frequently seen in polyp specimens with invaginated epithelia than in those with no invaginated epithelium. Our findings confirmed that the c-erbB-2 protein was mainly localized to the plasma membrane in all samples. CONCLUSION: These results suggest that the c-H-ras protein localized to the terminal bars plays an important role in the pathophysiology of glandular-cystic type nasal polyps and that it may be related to invagination of nasal polyp epithelium.

Cytoplasm↗
PubMed2000

Phonomicrosurgical management of vocal fold polyps: the subepithelial microflap resection technique.

Vocal fold polyps are typically caused by acute and chronic trauma to the microvasculature of the superficial lamina propria (SLP). Shearing stresses that are induced by hyperfunctional glottal sound production lead to bleeding into the SLP and malformed neo-vascularized masses. Because the primary process does not involve the epithelium, the authors designed a technique to resect hemorrhagic polyps by epithelial cordotomy with partial or complete preservation of the vocal fold epithelium. This approach is different from the traditional microsurgical resection of hemorrhagic polyps by amputation with or without the carbon dioxide laser. Forty patients who underwent microlaryngoscopic resection of hemorrhagic polyps from 1996 through 1998 were reviewed retrospectively. Thirty-six of the 40 procedures were by epithelial cordotomy and subepithelial removal of the polyp contents. Sixteen of 36 were assisted by a subepithelial infusion of saline and epinephrine, and all were 3 mm to 6 mm. Four of 40 polyps were amputated; all of these were less than 3 mm and were pedicled on a narrow base. Cold instruments were used exclusively in all 40 patients. Postoperative laryngeal stroboscopy within 2 weeks revealed improved mucosal wave propagation and improved glottal closure in all 33 patients in whom postoperative strobovideolaryngoscopy was available. The epithelial cordotomy technique was introduced to minimize disturbance of normal SLP and epithelium. Despite the hemorrhagic nature of these lesions, cold instruments could be used exclusively with facility due to careful microdissection between the polyp and the residual normal SLP and the enhanced hemostasis provided by the subepithelial infusion of saline and epinephrine. The rapid return to improved glottal function is the result of this ultra tissue-sparing technique.

Adult↗
PubMed1999

A randomized, prospective study of endometrial resection to prevent recurrent endometrial polyps in women with breast cancer receiving tamoxifen.

STUDY OBJECTIVE: To assess the role of endometrial resection in preventing recurrence of tamoxifen-associated endometrial polyps in women with breast cancer. DESIGN: Randomized, prospective study (Canadian Task Force classification I). SETTING: Tertiary university-affiliated medical center. PATIENTS: Twenty consecutive women (age range 43-61 yrs). INTERVENTIONS: Hysteroscopic removal of tamoxifen-associated endometrial polyps with or without simultaneous resection of the endometrium. MEASUREMENTS AND MAIN RESULTS: Patients were randomized to undergo (10 women) or not undergo (10) concomitant endometrial resection. They were followed for at least 18 months (range 18-24 mo), including transvaginal ultrasonography every 6 months and hysteroscopy when endometrial irregularity was noted. The main outcome variable was recurrence of endometrial polyps; occurrence of uterine bleeding was also noted. In women who underwent endometrial resection, only one had a 1 x 1-cm endometrial polyp diagnosed and removed during follow-up. Seven women remained amenorrheic, and three experienced spotting for a few days every month. In the control group, six women had recurrent endometrial polyps requiring hysteroscopic removal (two-tail Fisher's exact test p <0.06). CONCLUSION: Recurrence of endometrial polyps, one of the most common problems in patients with breast cancer receiving long-term treatment with tamoxifen, may be reduced by performing endometrial resection at the time of hysteroscopic removal of polyps. The possible risk of occult endometrial cancer is yet to be determined. (J Am Assoc Gynecol Laparosc 6(3):285-288, 1999)

Adult↗
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↗