Polyposis coli and the stomach.
Explore the source record for details and available documents.
Adenoma↗
SEARCH · Search PubMed
Results for “Intestinal Polyposis”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Primary gastrointestinal non-Hodgkin's lymphomas. Clinical presentation and results of treatment.
During the period of 1978-1988, 36 patients were treated for primary gastrointestinal non-Hodgkin's lymphoma (PGIL) at the Second Department of Surgery, Helsinki University Central Hospital. There were 16 gastric, 15 small intestinal, four large bowel lymphomas, and one case of diffuse multiple lymphomatous polyposis (MLP) of the gastrointestinal tract. Most frequently the disease occurred in middle-aged patients equally in both sexes. Symptoms were non-specific. Abdominal pain was the most common symptom occurring in 30 patients (83%), followed by nausea in 17 patients (47%). Fever occurred in seven patients (20%). Bleeding occurred in ten patients (28%), obstruction in five (14%), and perforation in three patients (8%). An abdominal mass was felt in ten patients (28%). Radiological findings were mostly non-specific but suggested malignant tumour. A definitive diagnosis was difficult to confirm by endoscopic examination. Thirty-five patients underwent surgery, curative in 19 (12 gastric, five small intestine lymphomas (SIL), two large intestine lymphomas (LIL)), and palliative in 12 patients (two gastric, eight SIL, one LIL, and one case of MLP). One patient (gastric) underwent exploration and three had other procedures (two SIL, one LIL). 89% of the patients who had a curative resection survived five years, compared with 28% of those who had palliative resection. The stage of the disease was a very important prognostic factor: the five-year survival was 92% for patients with Stage I disease, while none of the patients with Stage IV disease survived five years. Also, adjuvant therapy was a statistically significant variable affecting survival, and the site of the tumour. Patients with gastric lymphoma had better survival than those with small and large intestinal lymphoma.
Adult↗
Double contrast small bowel enema in a case of selective duodeno-jejunal amyloidosis.
Double contrast small bowel enema in a patient with selective amyloidosis of the duodenum and jejunum revealed an unusual radiologic pattern, mimicking multiple polyposis. Many submucosal polypoid lesions, sessile or pedunculated, were scattered throughout the duodenum and proximal jejunum. The lesions had smooth borders and did not show any retraction at the base. Other typical radiologic patterns of intestinal amyloidosis described in the literature were not observed in the present case. Differential diagnosis from multiple polyposis and diffuse lymphoproliferative neoplastic diseases is discussed.
Aged↗
[Desmoids associated with multiple familial polyposis: description of a clinical case].
The Authors report a case of great desmoid tumor of the abdominal wall with intestinal adhesions and enterocutaneous fistula, in a patient with Gardner's syndrome, who underwent total colectomy with ileorectal anastomosis. The patient was treated at first with non steroidal antiinflammatory drugs, then with local chemotherapy. The Authors performed a second surgical procedure resecting the tumor and opening a temporary ileostomy. Despite of these treatment patient showed a local recurrence. Desmoid tumor is a neoplastic benign lesion arising from aponeurotic muscle tissue. Local infiltration and post-operative recurrence are very common. Several surgical and medical treatments are proposed, but they are not totally effective. Surgical treatment might be radical, with wide resection to reduce local recurrences. Radiotherapy and chemotherapy are second choice treatments.
Abdominal Muscles↗
Cyclooxygenase 2 is up-regulated and localized to macrophages in the intestine of Min mice.
Expression of cyclooxygenase 2 (COX-2) is believed to play an important role in adenoma formation in murine polyposis models, and inhibition of COX-2 activity may, at least, partly explain the chemopreventative activity of non-steroidal anti-inflammatory drugs against colorectal cancer in humans. However, the mechanism by which COX-2 acts in intestinal tumorigenesis remains unresolved because of conflicting data on the cellular localization of COX-2 in intestinal mucosa. Using immunohistochemistry with specific COX-2 antiserum, we have shown that COX-2 protein is localized to interstitial cells at the base of and within adenomas of the small and large intestine of multiple intestinal neoplasia (Min) mice. No COX-2 staining was observed in dysplastic epithelial cells within adenomas or in histologically normal epithelium. Moreover, COX-2 staining was observed in lamina propria cells of histologically normal intestine of Min mice. No staining was demonstrated in wild-type littermates. The rat monoclonal antibody F4/80 was used to show that COX-2-positive cells represented a subset of the macrophage population present in the intestine of Min mice. Localization of COX-2 to macrophages implies a paracrine effect of COX-2 function on epithelial cells in adenomas and also on histologically normal epithelium. Up-regulation of COX-2 expression in lamina propria macrophages may precede loss of the second functional Apc allele in epithelial cells before adenoma formation in the Min mouse model of intestinal tumorigenesis.
Adenoma↗
MSH2 deficiency contributes to accelerated APC-mediated intestinal tumorigenesis.
Accelerated intestinal tumorigenesis is probable in hereditary nonpolyposis colorectal cancer, a condition associated with germ line DNA mismatch repair (MMR) gene defects, and is believed to be caused by rapid accumulation of replication errors in critical genes, such as the APC (adenomatous polyposis coli) tumor suppressor gene. To study the potential contribution of MMR genes to accelerated intestinal tumorigenesis, we crossed the Min mouse, heterozygous for a germ line mutation of Apc, with an MMR gene (Msh2)-deficient mouse. MSH2 deficiency resulted in the development of many colonic aberrant crypt foci, as well as reduced survival of the mice, secondary to both a greater number and more rapidly developing adenomas. The mechanism of inactivation of the wild-type Apc allele depended on MSH2 status. In the presence of functional MSH2, all tumors demonstrated loss of heterozygosity. In contrast, whereas all adenomas were APC negative by immunostaining, only 5 of 34 adenomas from Apc+/-/Msh2-/- mice demonstrated loss of heterozygosity of the wild-type Apc allele, suggesting that somatic Apc mutations are responsible for the additional tumors. These findings provide evidence for the important role of MMR genes in accelerated intestinal tumorigenesis, thus supporting more aggressive surveillance strategies to prevent colorectal cancer in hereditary nonpolyposis colorectal cancer.
Adenoma↗
Non-multiple lymphomatous polyposis form of mantle cell lymphoma in the gastrointestinal tract.
Mantle cell lymphoma (MCL) comprises 2.5%-7% of all non-Hodgkin's lymphomas, and the gastrointestinal tract is involved in about 20% of cases. Multiple lymphomatous polyposis (MLP) is an uncommon disease that is regarded as the intestinal form of MCL. We present a rare case of gastrointestinal MCL without MLP, and demonstrate that rituximab was effective for the treatment of this patient. A 61-year-old man presented with continuous diarrhea and hematochezia for a period of 5 months. Superficial lymph nodes were not palpable, but both tonsilla were enlarged. The level of soluble interleukin (IL)2-receptor was 3480 U/ml (normal <500 U/ml). Colonoscopy showed diffuse redness with erosion, without observation of any venous capillary, with these findings continuing from the rectum to the ileum. Upper gastrointestinal endoscopy showed a slightly rough gastric mucosal surface, and chicken-skin like mucosa was observed in the second portion of the duodenum. Small-to-medium size lymphoma cells were seen histologically from the tonsilla to the rectum. The lymphoma cells were immunohistochemically positive for CD5, CD20, CD79a, and cyclin D1. Polymerase chain reaction analysis revealed a chromosomal translocation t(11;14)(q13;q32) in the bcl-1 gene. We diagnosed this as a case of MCL from these findings. For treatment, the patient received a total of ten courses of combination chemotherapy consisting of cyclophosphamide (1000 mg), doxorubicin (70 mg), vincristine (2 mg) and prednisolone (50 mg) (CHOP), which led to a partial remission. However, 2.5 years later, massive infiltrations of the lymphoma cells were found in the colon and stomach. As the infiltrating lymphoma cells expressed CD20 molecules on their surfaces, the patient was treated with a chimeric anti-CD20 monoclohal antibody, rituximab, which showed significant efficacy, and a second partial remission was achieved.
Antibodies, Monoclonal↗
Multiple lymphomatous polyposis of the gut.
Multiple lymphomatous polyposis is very rare. We report two cases affecting duodenum, small intestine and colon/rectum, both with extensive disease, making radical surgery impossible and chemotherapy the treatment of choice. One patient died 23 days after initial treatment of myocardial infiltration, and the other is still alive 21 months after initial treatment.
Aged↗
G1 delay in cells overexpressing prostaglandin endoperoxide synthase-2.
Colorectal cancer is the second leading cause of death from cancer in the United States. Continuous use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) has been shown to reduce the risk of colorectal cancer in humans by 40-50%. Patients with familial adenomatous polyposis who take NSAIDs, such as sulindac, undergo a regression of intestinal adenomas. Rodents exposed to carcinogens that cause colon cancer have a 50-60% reduction in the size and number of colonic tumors when treated continuously with NSAIDs. One common target for these drugs is prostaglandin endoperoxide synthase, also referred to as cyclooxygenase (COX). We and others have shown recently that COX-2 levels are increased dramatically in 85-90% of human colorectal adenocarcinomas and in 40-50% of colonic adenomas. We prepared intestinal epithelial cells that express the COX-2 gene permanently and found that they have altered adhesion properties and resist undergoing apoptosis. We report here that these cells also have a 3-fold increase in the duration of G1, lower levels of cyclin D1 protein, and a marked decrease in retinoblastoma kinase activity associated with cyclin-dependent kinase 4. The delay in G1 transit may relate to the resistance of these cells to undergo programmed cell death, which could affect their tumorigenic potential.
Adenoma↗
Incidence and significance of argentaffin and paneth cells in some tumours of the large intestine.
The incidence of argentaffin and Paneth cells in epithelial tumours of the large intestine was investigated. Argentaffin cells were found in adenomatous polyps, villus adenomas, polyposis coli, Peutz-Jehgers' polyps, juvenile polyposis, and adenocarcinomas. Paneth cells were not found in metaplastic or juvenile polyps. The crypt unit was destroyed in neoplasia and argentaffin and Paneth cells occurred either as a result of sequestration or were taking part in the neoplastic process. The crypt unit was retained in the disorders of epithelial growth. The identification of argentaffin and Paneth cells enabled the crypt to be defined and thus provided a useful, practical aid in the differentiation between neoplasms and disorders of epithelial growth.
Adenocarcinoma↗
The ileal pouch-anal anastomosis: surgical technique and current clinical results.
During the six-year period between January 1981 and January 1987, 582 ileal pouch-anal anastomoses were constructed at the Mayo Clinic-affiliated hospitals for either ulcerative colitis (509 patients) or polyposis coli (71 patients). Two patients had Crohn's disease. Two patients died postoperatively. Pelvic sepsis, intestinal obstruction, and pouchitis were seen in 4%, 13%, and 14%, respectively. At one year postoperatively, the mean number of stools was 5.6 during the day and 1.5 during the night. Younger patients and those with polyposis had fewer stools. Incontinence was observed in 2% patients during the day and 3% during the night. Ileal pouch-anal anastomosis is safe, provides satisfactory continence, and improves the quality of life of patients who require proctocolectomy.
Adenomatous Polyposis Coli↗
[Turcot syndrome illustrated by two clinical cases].
Turcot syndrome denotes the association between either familial polyposis coli (FPC) or sporadic non-familial polyposis coli, and primary neuroepithelial tumors of the central nervous system (CNS). The clinical and morphological intestinal features in both FPC and Turcot syndrome are the same: the histological picture shows typical (tubular) adenomas, often with adenocarcinomatous transformation. As associated CNS tumors astrocytomas, glioblastomas, spongioblastomas, and medulloblastomas are reported. As a modification of ITOH's classification of 1985 we distinguish between four groups: patients with fewer than 100 polyps (group I); patients with fewer than 10 polyps (group II); patients with FPC or sporadic non-familial polyposis (group III); patients with either CNS tumors or FPC with a direct relative with Turcot syndrome and/or FPC (group IV). In patients belonging to the fourth group the diagnosis of Turcot syndrome should not be made. We report on two patients belonging to group II and group IV respectively, and depict the clinical features as well as the heterogenic appearance of Turcot syndrome as outlined in the literature.
Adenomatous Polyposis Coli↗
[Laparoscopic surgery of benign small and large intestinal diseases].
Explore the source record for details and available documents.
Adenoma↗
Mesenteric fibromatosis in familial polyposis. A case report and a review of Japanese cases.
A 30-year-old female with mesenteric fibromatosis (MF) associated with familial colonic polyposis (FCP) was reported together with a review of Japanese cases of simple MF. Intestinal surgery can contribute to the pathogenesis of MF more intensely in cases associated with FCP than in simple MF cases. Furthermore, the biological behaviour of MF seems to be more aggressive in the former than in the latter.
Adenomatous Polyposis Coli↗
Infantile Cronkhite-Canada syndrome?--Case report.
This is a case report of juvenile gastrointestinal polyposis involving the gastrointestinal system from the stomach to the rectum. Only few cases have been reported and extra-intestinal manifestations of this syndrome include macrocephaly, hepatosplenomegaly, hypotonia, clubbing of fingers, anemia and protein-losing enteropathy. The disease usually has a poor prognosis, and the children rarely live more than 2 years.
Adenomatous Polyposis Coli↗
The role of cyclooxygenase-2 (COX-2) in two different morphological stages of intestinal polyps in APC(Delta474) knockout mice.
The expression of COX-2 participates strongly in polyp formation of adenomatous polyposis coli (APC)-mutated mice. However, the mechanism of growth inhibition by COX-2 inhibition remains unclear. The aims of this study were to assess the role of COX-2 during the process of polyp formation in APC(Delta474) knockout mice. Starting at 4 weeks of age, the treated group (T group) were given a diet containing JTE-522, a selective COX-2 inhibitor, and the control group (C group) were given a control diet. At 12 weeks of age, mice were killed and polyps located in a proximal 10 cm of the small intestine were classified into two morphological stages: large adenomas (>300 microm in diameter) which lacked normal villous structure, and small adenomas (</=300 microm) covered with normal villous epithelia. In both classes, after counting the incidence, adenomas were examined for vascularity, expression of COX-2 and VEGF protein, labeling proliferating cell nuclear antigen (PCNA) and apoptosis with the TdT-mediated dUTP nick end labeling method, including expression of Bcl-2 and Bcl-X. JTE-522 significantly reduced the incidence of large adenomas, but not of small adenomas. Although it did not affect the proliferating potential of adenomas, the apoptosis index increased significantly in the T group accompanied by a reduction in Bcl-X expression in both small and large adenomas. In the C group, macrophages with both COX-2 and VEGF expression were observed in the submucosa of large adenomas, where some large vessels were also observed. JTE-522 inhibited the VEGF expression of these macrophages, resulting in a decrease in vascular area. In conclusion, macrophages with COX-2 and VEGF expression in the submucosal layer are responsible for angiogenesis in large adenomas, and a selective COX-2 inhibitor reduced the growth of adenoma mainly by its inhibitory effect on angiogenesis.
Animals↗
Historical developments in familial polyposis coli.
The emergence of familial polyposis coli from the general group of conditions with multiple polyps of the large intestine into a well-defined separate entity started when histopathology became a science. The recognition of its two main features--inheritance as a Mendelian dominant characteristic and its high incidence of associated colorectal cancer--greatly helped in establishing a policy of treatment designed to prevent cancer. The removal of all or most of the large intestine before cancer had supervened has had considerable success in reducing the cancer incidence. However, the more recent awareness that the adenomas can frequently be found also in the upper gastrointestinal tract has introduced new problems, the solution of which is currently a matter of investigation.
Adenomatous Polyposis Coli↗
Giant hyperplastic polyposis of the colon.
A patient with multiple large hyperplastic (metaplastic) polyps of the colon is reported. Hundreds of polyps, some over 3 cm in size, were distributed uniformly throughout the large bowel. There was no evidence of polyps in the stomach or small intestine. The polyps, except for their large size, had the histologic features of hyperplastic polyps. This condition can be clinically confused with adenomatous polyposis coli.
Adenocarcinoma↗