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Fundic gland polyposis in patients without familial adenomatosis coli: its incidence and clinical features.

Thirty-five cases of fundic gland polyposis detected by roentgenographic examination, gastrofiberscopy, and endoscopic biopsy were divided into two groups. The first group consisted of 23 cases without familial adenomatosis coli and is termed the nonadenomatosis coli group; the second group contained 12 cases with familial adenomatosis coli and is termed the familial adenomatosis coli group. Incidence of fundic gland polyposis was only 0.085% (23 of 27,000 cases) in the non-adenomatosis coli group but 38.7% (12 of 31 cases) in the familial adenomatosis coli group. In both groups, fundic gland polyps were multiple, small (less than 8 mm in diameter), and located in the body and fundus of the stomach. A solitary or large polyp was occasionally observed in the non-adenomatosis coli group. Histologic examination revealed simple hyperplasia of the fundic glands and microcysts in both groups. The age range was 51.6 +/- 12.3 yr (mean +/- SD) in the non-adenomatosis coli group and 25.3 +/- 8.6 yr in the familial adenomatosis coli group. The ratio of males to females was 5:18 in the non-adenomatosis coli group, and 7:5 in the familial adenomatosis coli group. The number of fundic gland polyps was smaller in the non-adenomatosis coli group than in the familial adenomatosis coli group. Our observations suggest that this lesion frequently coexists with familial adenomatosis coli, but that it is not specific to this disease.

Adolescent↗

[Colonorectal adenoma: relationships among histological structure, dimensions of the polyps, and age distribution].

Among 1258 polyps from the lower gastro-intestinal tract removed by rectoscopy or coloscopy and examined histologically there were 744 adenomas, 72% tubular, 27% papillary and 1% villous. 96.5% of all adenomas were extracted from patients aged over 40 years. Four fifths of the tumours were found in the rectum and sigmoid colon. Only 6% of the tubular adenomas were more than 15 mm in diameter, compared with 32% of papillary and 57% of villous adenomas. The special significance of the adenomas lies in their potential malignancy (adenoma-to-cancer sequence).

Adult↗

Osseous metaplasia in benign colorectal polyps.

We report two unique cases of metaplastic ossification occurring within a tubulovillous adenoma and a juvenile polyp. In both lesions, well-formed bony spicules were present that were adjacent to living epithelial cells. The metaplastic bone revealed vimentin positivity and cytokeratin negativity. The pathogenesis of osseous metaplasia in colorectal tumors remains unclear, but the process seems to have no clinical significance.

Adenoma, Villous↗

Adenomatous and carcinomatous changes in hamartomatous polyps of the small intestine (Peutz-Jeghers syndrome): report of a case and review of the literature.

The authors report the unique case of a patient with the Peutz-Jeghers (P-J) syndrome who had multiple small bowel hamartomatous polyps, some of which also showed adenomatous and carcinomatous changes. Over the course of 30 years, over 100 small bowel and colonic polyps were resected; all histologically demonstrated the typical features seen in hamartomatous polyps. Several jejunoileal polyps excised during the last few months of the patient's life showed not only hamartomatous features but also adenomatous epithelium. As far as the authors can determine, this is the first documented case of adenomatous changes found within a small bowel hamartomatous polyp. In addition, at least one duodenal polyp demonstrated areas of hamartoma, adenoma, and in situ carcinoma. The literature on the occurrence of gastrointestinal adenomas and carcinomas in patients with the P-J syndrome is reviewed, and the relationship of hamartomas, adenomas, and carcinomas of the gastrointestinal tract is discussed.

Adenoma↗

Colorectal ornithine decarboxylase activity in human mucosa and tumors: elevation of enzymatic activity in distal mucosa.

To examine the value of ornithine decarboxylase (ODC) assay as a biological marker of potential malignancy in large bowel, we harvested 43 colorectal carcinoma, 7 adenoma, 6 polyps, and 77 normal-appearing mucosa at surgery from patients with colorectal carcinoma. In addition, 13 normal rectal mucosa were obtained at biopsy from patients with benign diseases or diseases unrelated to colorectal carcinoma as normal control. ODC activity was significantly higher in polyps and adenocarcinomas than in normal-appearing mucosa from patients with colorectal carcinoma. ODC activity in normal-appearing mucosa varied throughout the large intestine, with significantly higher activities in the distal segment of the large bowel. The higher ODC activity detected in the sigmoid colon and rectum correlates with the larger incidence of tumor development in this region of the large bowel. This observation needs to be taken into consideration when ODC activities of the colorectal mucosa are measured as biological markers of potential malignancies.

Adenoma↗