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PubMed1999

Extensive lipomatous metaplasia in bilateral macronodular adrenocortical hyperplasia.

OBJECTIVE: We describe a case of macronodular hyperplasia with marked adrenal enlargement in which mature adipose tissue was a significant component. To our knowledge, this condition has not been reported previously. METHODS: A 42-year-old woman with newly diagnosed Cushing's syndrome underwent endoscopic bilateral adrenalectomy to remove bilateral adrenal masses. RESULTS: Both adrenal glands displayed features of macronodular hyperplasia with marked adrenal enlargement, and abundant mature adipose tissue was identified in some nodules of both glands. CONCLUSIONS: Lipomatous metaplasia is histologically demonstrated in a case of macronodular hyperplasia with marked adrenal enlargement. This distinctive change may be secondary to metaplastic transformation of either stromal cells or adrenocortical cells. The presence of lipomatous metaplasia would appear to indicate adrenocortical process, since, to our knowledge, it has never before been described in the adrenal nodule.

Adipose Tissue↗
PubMed1999

[Osseous metaplasia of the endometrium as a cause of infertility. Hysteroscopic approach].

The osseous metaplasia of the endometrium is very rare cause of infertility. The hysteroscopic approach is a effective method to recover the fertility in most of the cases in a short period. The case of a infertile woman who was previous studied and has indications for laparoscopic and hysteroscopic approach. The infertility workup showed a intracavitary calcification on ultrasonography. During the surgery, the diagnosis of endometriosis and osseous metaplasia of the endometrium were done and treated with histologic confirmation. The patient conceived in her second spontaneous cycle. The hysteroscopy is the first approach in the treatment and should be doing with laparoscopy for the detection of other causes of infertility.

Adult↗
PubMed1997

[Clinical study on modified sijunzi decoction in treating intestinal metaplasia of gastric mucosa].

OBJECTIVE: To investigate the effects of Modified Sijunzi decoction (MSJZD) in treating gastric pre-cancerous lesion. METHODS: Two hundreds and two patients with chronic gastritis and intestinal metaplasia (IM) of gastric mucosa diagnosed by gastroscopy and pathological examination of biopsy were divided into 2 groups, 117 cases of the treatment group were treated with MSJZD and 85 cases of the control group were treated with Weimeisu. For both groups, re-examination was taken after a 3-month treatment. RESULTS: The cure rate and total effective rate of IM in the treatment group were 55.6% and 87.2% respectively, while in the control group were 11.8% and 55.3% respectively (P < 0.01). CONCLUSIONS: The intestinal metaplasia process of gastric mucosa is reversible and MSJZD has good effect on it. This study provided a new way of pre-cancerous lesion treatment and gastric cancer prevention.

Adult↗
PubMedDate not supplied

Stromal osseous metaplasia in metastatic adenocarcinoma of the gallbladder.

A case of stromal osseous metaplasia in the abdominal scar metastasis of a gallbladder adenocarcinoma is described. The occurrence of stromal osseous metaplasia in carcinomas probably does not affect prognosis; however, it must be recognized to avoid a misdiagnosis of carcinosarcoma.

Adenocarcinoma↗
PubMed2000

Expression of metallothionein II in intestinal metaplasia, dysplasia, and gastric cancer.

Differential display is a valuable tool for the identification of differentially expressed genes in human carcinogenesis and development. The search for differentially expressed genes in gastric cancer and its premalignant lesions may help to define molecular alterations in the gastric mucosa that may precede the development of gastric cancer. Using the differential display technique, we identified a cDNA fragment, encoding metallothionein (MT) IIa mRNA. We performed immunohistochemical analysis using a monoclonal antibody directed against human MT and tissues obtained from 34 patients with gastric cancer and 20 healthy individuals to determine the expression and localization of MT in gastric cancer and its associated premalignant lesions and to correlate our findings with histomorphological features and Helicobacter pylori status. In addition, MT expression was assessed in gastric tissues obtained from patients with gastric cancer and first-degree relatives of patients with gastric cancers and healthy individuals using reverse transcription-PCR analysis. Northern blot analysis confirmed the overexpression of MT IIa in gastric cancer. In the normal gastric tissues, no MT immunoreactivity was observed at the superficial gastric epithelium toward the top of gastric glands. However, MT immunoreactivity was detected at the foveolar neck of the gastric glands. Immunohistochemical analysis revealed an intense MT immunoreactivity in gastric cancer cells, independent of tumor stage, grade of differentiation, or tumor type. Furthermore, areas of dysplasia and intestinal metaplasia also exhibited intense MT immunoreactivity. Reverse transcription-PCR analysis of gastric biopsies obtained from first-degree relatives of patients with gastric cancer revealed the frequent expression of MT Ia in this high-risk group as compared with healthy subjects (P < 0.01). The overexpression of MT in gastric cancer and the expression of MT in intestinal metaplasia and dysplasia, as well as the expression of MT in the gastric mucosa of first-degree relatives of patients with gastric cancer, point to a role for MT in the early process of malignant transformation of the gastric mucosa.

Adult↗
PubMed2000

[Nephrogenic metaplasia of the ureter].

The authors report a case of nephrogenic metaplasia of the ureter in a 35-year-old patient presenting with left low back pain, haematuria and frequency. Physical examination was not contributive. IVU showed a filling defect in the left iliac ureter. Ureteroscopy demonstrated a tumour nodule in the left iliac ureter. Ureteroscopic biopsy with histological examination showed nephrogenic metaplasia of the ureteric mucosa. Treatment consisted of ureterotomy with resection of the ureteric polyp, followed by closure of the ureterotomy over a double J stent. The course was favourable and postoperative follow-up (IVU, cystoscopy) at 6 months and 12 months was normal.

Adult↗
PubMed2000

N-(4-hydroxyphenyl)retinamide in the chemoprevention of squamous metaplasia and dysplasia of the bronchial epithelium.

Lung cancer remains the number one cause of cancer-related deaths in the United States. To reduce the mortality associated with this disease, individuals at risk must be identified prior to the development of lung cancer, and effective prevention strategies must be developed. One such strategy is to use retinoids like N-(4-hydroxyphenyl)retinamide (4-HPR), which has been found to possess chemopreventive activities in preclinical studies. In this study, 139 smokers were registered and 82 were randomized onto a double-blinded, placebo-controlled chemoprevention trial of 4-HPR administered p.o. (200 mg once daily). Of these, 70 participants were eligible for response evaluation. Biopsies were obtained at six predetermined sites in the bronchial tree from participants before and at the completion of 6 months of treatment. 4-HPR treatment had no measurable effect on histopathology (squamous metaplasia and dysplasia) in the bronchial epithelium of current smokers. 4-HPR was detected (104.5+/-64.0 ng/ml, mean +/- SD) in the serum of participants, supporting its potential bioavailability. Serum retinol levels decreased markedly (44% of placebo-treated patients) as a consequence of 4-HPR treatment. Notably, the mRNA level of retinoic acid receptor beta, which is typically increased by retinoid treatment, did not change in the bronchial epithelium of 4-HPR-treated participants. Clonal populations of bronchial epithelial cells were detected by analysis of loss of heterozygosity at putative tumor suppressor loci on chromosomes 3p, 9p, and 17p, and these changes were not altered by 4-HPR treatment. In conclusion, at this dose and schedule, 4-HPR was not effective in reversing squamous metaplasia, dysplasia, or genetic and phenotypic abnormalities in the bronchial epithelium of smokers.

Adult↗
PubMed1975

Mucous metaplasia and gap junctions in the vitamin A acid-treated skin tumor, keratoacanthoma.

Desmosomes are the usual cell junctions found in normal rabbit epithelium as well as in the untreated keratoacanthoma. This study reports the finding of a second cell junction, the gap junction, when epithelium, normal or tumorous, is subjected to topical applications of vitamin A acid. The gap junction forms early in mucous metaplasia (after 2 days of application of vitamin A acid) and appears before the gross appearance of mucus. The presence of the gap junction occurs when there is an increase in the rough-surfaced endoplasmic reticulum and Golgi cisternae and vesicles. It is possible that the early appearance of the gap junction facilitates and mediates the mucous metaplasia. This suggestion is strengthened by the fact that the gap junction, once present in the mucus-producing tumor, is sparse when the tumor reverts back to the dry, keratotic condition upon cessation of vitamin A acid applications.

Administration, Topical↗
PubMed1998

[Microsatellite instability in gastric carcinoma and intestinal metaplasia].

OBJECTIVE: To investigate the role of microsatellite instability (MSI) in the carcinogenesis and development of gastric cancer (GC). METHODS: MSI was examined in 50 surgically resected gastric cancer specimens and 15 intestinal metaplasia specimens using PCR based methods. RESULTS: MSI was detected in 27/50 of GC and 3/15 of intestinal metaplasia at one or more loci. MSI was positive in all three cases of early GC. The incidence of MSI in well differentiated GC (86.6%) was significantly higher than that in poorly differentiated GC (P < 0.05). The frequency of MSI in intestinal type of GC (77.8%) was significantly higher than that in the diffused type (40%, P < 0.05). No significant correlation was found between MSI and age, sex, size, location, lymph node metastasis or clinical stage of GC. CONCLUSION: MSI is an early molecular marker in the carcinogenesis of GC and may play an important role in the development of GC.

Adenocarcinoma↗
PubMedDate not supplied

Expression of the RB protein, allelic imbalance of the RB gene and amplification of the CDK4 gene in metaplasias, dysplasias and carcinomas in Barrett's oesophagus.

In the present study, the role of allelic loss at the retinoblastoma gene (RB), expression of the retinoblastoma protein (pRb) and amplification at the CDK4 gene in the metaplasia--dysplasia--carcinoma sequence in Barrett's oesophagus (BO) was investigated. Samples of metaplastic specialised epithelium (SE; n = 28), low-grade dysplasia (LGD; n = 21), high-grade dysplasia (HGD; n = 19) and invasive adenocarcinoma (CA; n = 35) derived from 36 oesophagectomy specimens were included. Of the cases that were informative for the RB gene (n = 27), loss of heterozygosity (LOH) was found in none of the 22 SE, in none of the 14 LGD, in 1 of the 12 HGD (8.3%) and in 5 of the 27 CA (18.5%). Immunohistochemically, an enhanced expression of pRb protein in LGD, HGD and CA as compared with SE was found in most cases. In 4 carcinoma samples, however, a marked reduction (3 cases) or complete absence (1 case) of pRb protein expression was found. Two out of these 4 CA samples showed LOH in the RB gene whilst one case was heterozygous and one case was homozygous. In contrast to the positive controls used, CDK4 amplification was not detectable by means of differential PCR in any of the samples under investigation. The present study indicated that allelic loss of the RB gene occurs late in the metaplasia--dysplasia--carcinoma sequence in BO. Immunohistochemically determined loss of pRb protein expression may indicate LOH of the RB gene. CDK4 gene amplification does not seem to play a role in the development of oesophageal adenocarcinoma.

Adenocarcinoma↗
PubMed2001

Follicular adenoma of the thyroid gland with extensive bone metaplasia.

Follicular adenomas of the thyroid account for over 90% of benign neoplasms of the gland. They exhibit a wide range of morphological structures, from the classical follicular pattern to the peculiar hyalinizing trabecular pattern. Although follicular adenomas grow slowly, they are nonetheless subject to degenerative, most often hemorrhagic changes in their central portion. These hemorrhagic areas undergo further regressive changes such as sclerosis and calcification. However, the detection of a true bone formation with a trabecular structure and the presence of marrow is a very rare occurrence. A follicular adenoma with central cartilaginous metaplasia has been reported in literature but, to our knowledge, a follicular adenoma with bone metaplasia has never been described.

Adenoma↗
PubMed2002

Inhalation of aerosolized vitamin a: reversibility of metaplasia and dysplasia of human respiratory epithelia -- a prospective pilot study.

The objective of this preliminary uncontrolled study was twofold: First, to assess the feasibility of retinyl palmitate inhalation and second, to analyze the changes of metaplastic lesions of the respiratory epithelium (metaplasia or dysplasia) following retinyl palmitate inhalation. The response to a daily dose of 18.000 I.U. retinyl palmitate by inhalation over a period of 3 month was assessed in 11 subjects (9 smokers, 2 ex-smokers). Using white-light bronchoscopy combined with autofluorescence bronchoscopy, bronchial biopsies were taken before and after a 3 month-period. The biopsy samples were evaluated blind by a referee lung pathologist. The overall response rate (remission or partial remission) was 56% (95% CI 0.30 0.79; p<0.05). These data suggest that inhalation of retinyl esters could be a promising therapeutical approach for chemoprevention of lung cancer. Vitamin A; chemoprevention; lung cancer; squamous metaplasia; dysplasia; retinoids

Administration, Inhalation↗
PubMed2001

Intestinal metaplasia with dysplasia in pelvis of a horse-shoe kidney.

Intestinal metaplasia of renal pelvis occurs uncommonly and is usually secondary to persistent chronic irritation or inflammation. It is considered to be precursor of adenocarcinoma. A case of horse-shoe kidney which showed extensive intestinal metaplasia and focal severe dysplasia in the renal pelvis is being presented. The metaplastic change in this case is being attributed to persistent inflammation due to more chances of stasis in horse-shoe kidney coupled with renal calculi.

Humans↗
PubMed2002

[Expression of pi glutathione S-transferase in intestinal metaplasia and its relationship with Helicobacter pylori infection].

OBJECTIVE: To study the dynamic change of glutathione S- transferase pi (GST-pi) in normal gastric mucosa, gastric mucosa with intestinal metaplasia (IM) and gastric cancer and to investigate the relationship between human carcinogen detoxification system and the virulence of Helicobacter pylori(H.pylori) in the stage of IM. METHODS: Two hundred and nineteen biopsy specimens of gastric mucosa, including 30 cases with normal gastric mucosa, 171 cases with IM and 18 cases with gastric cancer, were examined. The expression of GST-pi was detected by S-P immunohistochemical method. High-iron diamine /alcian blue pH2.5/periodic acid -Schiff (HID-ABpH 2.5-PAS) method was used to classify IM. H.pylori infection was confirmed or excluded by hematoxylin-eosin (HE) staining, of H.pylori-DNA PCR and ELISA. The 80 cases with H.pylori infection were treated by bismuthate + amoxicillin + metronidazole for three months and then biopsy specimens were taken again from the original sites. RESULTS: The GST-pi expression rate was 69.6% in gastric mucosa with IM, significantly higher than that in gastric cancer (44.4%, P < 0.05) and that in normal gastric mucosa (0%, P <0.01). The GST-pi expression rate in IM II, IM III, and IM I decreased in sequence (83.3%, 71.1%, and 48.9%). The GST-pi expression rate in IM without H.pylori infection was 79.0%, significantly higher than that in IM with HP infection (64.2%, P <0.05). The positive rate of GST-pi expression in H.pylori eradicated group was 81.9%, significantly higher than that before H.pylori eradication (63.8%, P < 0.01). The GST-pi expression rate decreased from normal gastric mucous to IM and to gastric cancer, and from IM I -->II-->III too. CONCLUSION: IM III with low or no expression of GST-pi is a high-risk condition of gastric cancer. The risk of gastric cancer increases when low or no expression of GST-pi is combined with H.pylori infection. The carcinogen detoxification role of GST-pi and the virulence of H.pylori might interact each other in the stage of intestinal metaplasia, the precancerous condition of gastric cancer.

Carcinogens↗
PubMed2002

[Intestinal metaplasia at the esophagogastric junction. Prevelence and association in patients undergoing endoscopy].

AIM: Short segments of intestinal metaplasia (IM) at the esophagogastric junction is an unclear entity. Several studies have reported wide variations in its prevalence and in the factors associated with its development. Recently, this entity has been divided into esophageal IM and cardiac IM, as two different lesions in etiopathogenesis and prognosis. We studied the prevalence of these conditions and their association with gastroesophageal reflux disease (GERD) and Helicobacter pylori infection. METHODS: In 161 patients, biopsies were obtained from the distal esophagus (2), just below the Z line (3), and in the gastric antrum (4). IM was diagnosed on the basis of staining of goblet cells with Alcian blue and was classified as esophageal if ILZ < IEG or cardiac ILZ = IEG. H. pylori was determined by rapid urease (CLO-test) and histology. Diagnosis of GERD was based on typical symptoms, endoscopy, and histology. In 54 patients with IM (73%) esophageal manometry and 24-hour pH-metry was also performed. RESULTS: IM was detected in 74 patients (46%); IM was esophageal in 33 patients (20.5%) and cardiac in 41 patients (25.4%). Patients with IM were significantly older than those without (p = 0.007) and took proton pump inhibitors more frequently (p = 0.004). No correlation was found between reflux symptoms, esophageal lesions or histological changes with either type of IM. No differences between esophageal or cardiac IM were detected by esophageal pH-metry. H. pylori infection was unrelated to cardiac IM, but these patients had a lower frequency of endoscopic and histological changes in the distal esophagus. CONCLUSIONS: Intestinal metaplasia is a common finding in patients sent for gastroscopy and is probably an acquired lesion that increases in prevalence with age. We found no associations between esophageal IM and GERD, evaluated by typical symptoms, endoscopic and histological changes and pH-metry. H. pylori infection showed no relation to cardiac IM.

Adult↗
PubMed2003

Lycopene supplementation inhibits lung squamous metaplasia and induces apoptosis via up-regulating insulin-like growth factor-binding protein 3 in cigarette smoke-exposed ferrets.

Higher intake of lycopene is related to a lower risk of lung cancer in human studies. Lung cancer risk is associated with higher plasma levels of insulin-like growth factor I (IGF-I) and/or lower levels of IGF-binding protein 3 (IGFBP-3). However, little is known regarding whether lycopene can inhibit cigarette smoke-induced lung carcinogenesis through modulation of IGF-I/IGFBP-3, cell proliferation, and apoptosis. We investigated the effects of lycopene supplementation at a low dose (1.1 mg/kg/day, which is equivalent to an intake of 15 mg/day in humans) and a high dose (4.3 mg/kg/day, which is equivalent to 60 mg/day in humans) on plasma IGF-I/IGFBP-3 levels, histopathological changes, proliferating cellular nuclear antigen (PCNA) expression, BAD phosphorylation, and apoptosis (caspase 3 assay) in lungs of ferrets with or without cigarette smoke exposure for 9 weeks. We found that ferrets supplemented with lycopene and exposed to smoke had significantly higher plasma IGFBP-3 levels (P < 0.01) and a lower IGF-I/IGFBP-3 ratio (P < 0.01) than ferrets exposed to smoke alone. Both low- and high-dose lycopene supplementations substantially inhibited smoke-induced squamous metaplasia and PCNA expression in the lungs of ferrets. No squamous metaplasia or PCNA overexpression were found in the lungs of control ferrets or those supplemented with lycopene alone. Furthermore, cigarette smoke exposure greatly increased BAD phosphorylation at both Ser(136) and Ser(112) and significantly decreased cleaved caspase 3 in the lungs of ferrets, as compared with controls. The elevated phosphorylation of BAD and down-regulated apoptosis induced by cigarette smoke in the lungs of ferrets was prevented by both low- and high-dose lycopene supplementations. Lycopene levels were increased in a dose-dependent manner in both plasma and lungs of ferrets supplemented with lycopene alone. However, lycopene levels were markedly lower in both plasma and lungs of ferrets supplemented with lycopene and exposed to smoke. Furthermore, smoke exposure increased cis isomers (26% for 13-cis and 22% for 9-cis) of lycopene in the lungs of ferrets, compared with that of ferrets supplemented with lycopene alone (20% for 13-cis and 14% for 9-cis). In conclusion, lycopene may mediate its protective effects against smoke-induced lung carcinogenesis in ferrets through up-regulating IGFBP-3 and down-regulating phosphorylation of BAD, which promote apoptosis and inhibit cell proliferation.

Animals↗
PubMedDate not supplied

Multiple inverted papilloma of the urinary bladder associated with glandular metaplasia of colic type. A case report.

A case of inverted papilloma of the urinary bladder associated with glandular metaplasia is presented. A bladder urothelial carcinoma was suspected after clinic and endoscopic findings, but the diagnosis was established only on histological picture. Morphological and histochemical peculiarities of the lesions are described, considering the case being the first with such an association-according to our knowledge. The malignant potential of inverted papilloma and glandular metaplasia are discussed.

Adult↗
PubMed1992

[Mucinous metaplasia of fallopian tube mucous membrane as a cause of pseudomyxoma peritonei].

A woman aged 49 years was relaparotomized at the Gynaecological Department of the "Rudolf Virchow" Medical Centre of the Free University of Berlin, following diagnosis of metastatic mucinous adenocarcinoma. Proliferative mucinous metaplasia of the Fallopian tube and consecutive peritoneal pseudomyxoma were established as clinical findings and were hypothetically attributed to mucinous metaplasia of the salpingofimbrial mucosa. Neither mucocele of the appendix nor ovarian tumour were found. This possible site origin has been rarely mentioned in any case report in the past.

Adenocarcinoma, Mucinous↗