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At least 973 records · Page 54Linked to original sources
PubMed1987

The transitional polyp of the colorectal mucosa.

45 cases of small polypoid lesions occurring in the colorectal mucosa free of inflammatory or neoplastic disease are presented. The lesions were removed at colonoscopy and displayed neither features of hyperplastic (metaplastic) polyps nor features of a neoplastic proliferation. Morphologically these small lesions were characterized by elongated and widened crypts, enlarged goblet cells with an increase in mucous production. Histochemically there was a reversion of the usual pattern of mucin production in the colorectal mucosa: an increase in sialomucin production and a decrease in sulfomucins. Thus these lesions demonstrate the same morphological and histochemical features as the transitional mucosa surrounding carcinoma and adenoma in the large bowel. These "transitional" polyps could represent an early step in the development of neoplastic processes in the colorectal mucosa and precede adenomas.

Colonoscopy↗
PubMed2002

The use of ultrasound to demonstrate small bowel polyps in a patient with Peutz-Jeghers syndrome.

A 21-year-old woman presented to the accident and emergency department with a 2-day history of lower abdominal pain. Her lips had the stigma of melanosis. Previously, she had received a diagnosis of Peutz-Jeghers syndrome, although no polyps had been detected in small and large bowel barium studies performed approximately 8 years before. Clinically, the patient had mild deep lower abdominal tenderness, and a mass was palpable in the suprapubic region. Urgent ultrasound showed ileoileal intussusception and small polyps in the lumen of the small bowel. At laparotomy, ileoileal intussusception was confirmed. It was not possible to reduce it because of nonviable small bowel, so 20 cm of the ileum, including the intussusception, was excised. After this, intraoperative enteroscopy was performed, showing further polyps in the small bowel distal and proximal to the intussusception, which were excised locally. Only a few reports in the literature describe ultrasound used to diagnose to condition. Intraoperative enteroscopy has been recommended as the treatment of choice because it allows identification of polyps that previously would have been missed.

Adult↗
PubMed1974

Studies of lactic dehydrogenase content in rectal mucosal biopsies.

The total lactic dehydrogenase (LD) content and LD isoenzyme ratios were studied in homogenized rectal mucosa from 31 patients with established non-specific mucosal ulcerative colitis and from 16 normal subjects. The total LD content was found to be significantly increased in patients with active ulcerative colitis when compared with patients with inactive colitis or with normal subjects. There was a similar though not a significant increase in the slow moving isoenzymes of LD in samples of rectal mucosa from patients with active colitis. The LD isoenzyme pattern was in the normal range in two of the three patients with histological premalignant changes in rectal biopsy specimens. There was a statistically significant linear correlation between the total lactic dehydrogenase content of rectal mucosa and the carcino-embryonic antigen levels in whole serum. Both the total content and isoenzyme ratios of LD were increased in neoplastic tissue obtained from patients with carcinoma of the colon and with tissue from benign rectal polyps.

Adult↗
PubMed1983

Synchronous carcinomas of the large intestine.

Sixty-one (3.0%) of 2029 patients managed operatively for carcinoma of the large intestine had synchronous carcinomas. In 47 (77.0%) of the 61 patients the carcinomas were in the same or adjacent segment(s) of large intestine. Adenomatous polyps were present in 18 (30%) patients compared to 269 (14%) of 1968 patients with a single cancer. A curative resection was performed in 40 of 61 patients, palliative resection in 16 and a non-resection palliative operation in five. Two patients required proctocolectomy and eight subtotal colectomy with ileorectal anastomosis. Cancer specific survival for the entire group and for those treated by curative resection did not differ significantly from that of patients with a single carcinoma. It is concluded that: (1) the presence of a second carcinoma does not significantly alter the survival prospects; (2) both pre-operative large intestinal examination and careful operative palpation of the entire large intestine should be performed, and (3) the significantly higher incidence of adenomatous polyps in patients with synchronous carcinomas is consistent with the polyp/cancer sequence hypothesis.

Adult↗
PubMed1976

Colonic polyps: antecedent- or associated-lesions of large bowel cancer.

Many pathologists, gastroenterologists, and oncologists agree that villous (papillary) adenomas of the large bowel are at risk for the development of large bowel cancer. The role of adenomatous polyps (tubular adenomas) in the genesis of large bowel cancer is not a point of agreement. Future studies with molecular biologic techniques of colon polyps and adjacent mucosa and of the colonic mucosa of animals under treatment with colon carcinogens may clarify the role of colon polyps and other factors in the genesis of large bowel cancer. Polyps larger than 1.0 cm should be removed thrugh the proctosigmoidscope or the colonoscope.

Adenocarcinoma↗
PubMed1983

Reliability of routine double-contrast examination (DCE) of the large bowel in polyp detection: a prospective clinical study.

A total of 2,118 consecutive patients, examined with double-contrast examination of the large bowel (DCE), were evaluated radiographically, clinically, and endoscopically for up to 48 months. A total of 402 polyps were diagnosed during the follow-up period. Of these, 307 were revealed at the first DCE and 95 at subsequent endoscopy or autopsy. The accuracy of the DCE for demonstrating or excluding patients with polypoid lesions of the colon was 97%, whereas the predictive value of a positive DCE report was 96% and a negative one, 97%. However, the ability to demonstrate every known polyp at DCE was only 63%, although the probability of a polypoid lesion demonstrated at DCE being a true polyp was 92%.

Adenoma↗
PubMed2004

De novo germline mutation in the serine-threonine kinase STK11/LKB1 gene associated with Peutz-Jeghers syndrome.

Peutz-Jeghers syndrome (PJS) is an autosomal dominant disease, characterized phenotypically by mucocutaneous pigmentation and hamartomatous polyposis. Affected patients are at an increased risk of developing gastrointestinal and other malignancies. Mutations in the STK11/LKB1 (LKB1) gene, which encodes for a serine-threonine kinase, have been identified as a genetic cause of PJS. Molecular analysis of the LKB1 gene in a simplex case of PJS revealed a substitution of cytosine (C) for guanine (G) at codon 246 in exon 6, resulting in the Tyr246X mutation. The nucleotide substitution leads to a premature stop codon at the 246 residue, predicting a truncated protein and presumed loss of kinase activity. Analysis of DNA from both parents of the PJS patient did not show this mutation, which is therefore a de novo mutation. We isolated DNA from microdissected gastrointestinal hamartomatous polyps in the PJS patient and investigated the loss of heterozygosity (LOH) at the LKB1 locus by real-time fluorescence polymerase chain reaction genotyping using a fluorescent resonance energy transfer technique. The results suggest a different mechanism from LOH in the formation of hamartomatous polyps.

AMP-Activated Protein Kinase Kinases↗
PubMed1996

[A rational surgical procedure in diffuse polyposis and multiple primary cancer against a background of polyps of the large intestine].

Under examination there were 292 patients. An analysis of results of treatment enabled the authors to conclude that surgical treatment of patients with diffuse polyposis of the colon is the method of choice. The method and volume of operations must be determined according to the involvement of the colon in polyposis, the age and state of the patients. The best method of surgery is a one-step radical operation-subtotal resection of the colon. Polyps concomitant to cancer of the colon should be ablated before the main operation since their histological analysis can change the volume of the planned radical operation. When choosing the method of surgical intervention for patients with primary-multiple cancer against the background of polyps the total portion of the colon with polyps should be ablated.

Colectomy↗
PubMed1999

Small bowel tumors and polyposis syndromes.

Tumors of the small bowel are uncommon and seldom suspected on a clinical basis. Together with the relative inaccessibility of the small bowel to endoscopic investigation, the rarity of these tumors undoubtedly delays the diagnosis. Small bowel tumors may be an interesting field of application for enteroscopy, which now can be readily performed with dedicated enteroscopic evaluation in patients with suspected small bowel neoplasia could improve prognosis and treatment. Enteroscopy may also play an important role in the surveillance of inherited polyposis syndromes, as in other precancerous condition of the small bowel. In Peutz-Jeghers syndrome it may reduce polyp-induced complications and improve planning for surgery; in familial adenomatous polyposis it may contribute to preventing upper gastrointestinal tract cancer.

Biopsy↗
PubMed1985

Remarkable improvement of clinical status in a patient with multiple lymphomatous polyposis of the gastrointestinal tract after repetitive chemotherapy.

The effect of repeated courses of chemotherapy on gastrointestinal tumors seen in a 43 year-old male patient with multiple lymphomatous polyposis involving the entire gastrointestinal tract was presented. Numerous polypoid lesions from the stomach to the rectum were the characteristic finding in this case. The biopsied specimens from polyps either of the stomach or large intestine showed diffuse lymphocytic accumulation in the submucosa, which is consistent with multiple lymphomatous polyposis of the gastrointestinal tract. Remarkable regression of the large masses in the gastrointestinal tract was obtained by two courses of VEMP therapy, along with improvement of hypoalbuminemia and a positive CRP. Recurrence of gastrointestinal masses in the cecum and rectum was also eliminated by six courses of CHOP therapy, and a total of nine courses of CHOP therapy led to complete disappearance of masses in the gastrointestinal tract. The present case is different from the others in terms of the following viewpoints that first the ensuing large masses favorably responded to repetitive chemotherapy, secondly the histopathological findings remained benign despite the fact that large nodular masses had recurred in the cecum and rectum, and thirdly the pathological changes were still confined to the gastrointestinal tract without developing systemic malignant manifestations.

Adult↗
PubMedDate not supplied

[Gastric epithelial polyps (first part)].

The following is a statistical report regarding gastric polyps:Frequency determined through endoscopic examinations was 3.6%. The terms hyperplastic polyps and adenomas were used for the classification of epithelial polyps, considering the suprafoveal hyperplasias within the hyperplastic polyps, provided they were elevated lesions. Out of 2,283 polyps, 1,959 were hyperplastic (86%) and 324 were adenomas (14%). When analyzing 780 polyps, 86 (11%) were found to have the Nakamura III category. With regard to topography, in an examination of 2253 polyps, hyperplastic polyps were located as follows: 325 (17%) in the antrum, 1402 (73%) in the body and 202 (10%) in the fundus. Adenomas had a different distribution: 212 (65%) in the antrum, 100 (31%) in the body and 12 (4%) in the fundus. Out of 371 hyperplastic polyps examined, 49% were pediculate and 51% were sessile; on the contrary, 86 % of adenomas were sessile. The average age was 66.2 years in adenoma carriers, 58.5 in those having hyperplastic polyps, and 57.4 for suprafoveal hyperplasias. In 287 adenomas, 94.1% of carriers were over 40 years old. Out of 92 adenomas examined, 21.7% evidenced adenoma metaplasia and 72.8% evidenced metaplasia in adjacent areas. Only 5.5% had no metaplasia. In 105 hyperplastic polyps studied, intestinal metaplasia was found: 16.7% in the polyp and 60% in adjacent areas. No metaplasia was found in the remaining 23.3%. Average size of the adenomas was 14 mm and of hyperplastic polyps, 11 mm. A total of 195 adenomas were smaller than 10 mm. The percentage of malignization in 288 adenomas examined was closely related to their size: 214 (66%) smaller than 20 mm, had a malignization percentage of 7%; 74 (34%) larger than 20 mm, had 51% malignization, and 86.2% malignization was found in adenomas of over 40 mm.Global malignization percentage of adenomas was 18%. However, when adenomas with high grade dysplasia in the 4.1 category of the Viena classification (non-invasive high grade neoplasia) were considered, this percentage rose to 26%. Malignization of hyperplastic polyps was 0.8%. When gastric acidity was determined using the maximum stimulation method, out of 77 cases of patients with hyperplastic polyps, 55 (60%) had real achlorhydria, 10 (18%) hypochlorhydria, 11 (20%) normochlorhydria, and only 1 (4) hyperchlorhydria. D.A.B. was 1.97 mEql for hyperplastics and 1.60 mEql for adenomas. D.A.M. was 6.05 mEql for hyperplastics and 5.49 mEql for adenomas. Our experience as to normal cases showed 2.5 mEqh +/- 1.2 and 22 mEqh +/- 6, respectively, for D.A.B and D.A.M.

Adenoma↗
PubMedDate not supplied

[Gastric epithelial polyps (part two)].

The following is a statistical report regarding gastric polyps: Frequency determined through endoscopic examinations was 3.6%. The terms hyperplastic polyps and adenomas were used for the classification of epithelial polyps, considering the suprafoveal hyperplasias within the hyperplastic polyps, provided they were elevated lesions. Out of 2,283 polyps, 1,959 were hyperplastic (86%) and 324 were adenomas (14%). When analyzing 780 polyps, 86 (11%) were found to have the Nakamura III category. With regard to topography, in an examination of 2253 polyps, hyperplastic polyps were located as follows: 325 (17%) in the antrum, 1402 (73%) in the body and 202 (10%) in the fundus. Adenomas had a different distribution: 212 (65%) in the antrum, 100 (31%) in the body and 12 (4%) in the fundus. Out of 371 hyperplastic polyps examined, 49% were pediculate and 51% were sessile; on the contrary, 86 % of adenomas were sessile. The average age was 66.2 years in adenoma carriers, 58.5 in those having hyperplastic polyps, and 57.4 for suprafoveal hyperplasias. In 287 adenomas, 94.1% of carriers were over 40 years old. Out of 92 adenomas examined, 21.7% evidenced adenoma metaplasia and 72.8% evidenced metaplasia in adjacent areas. Only 5.5% had no metaplasia. In 105 hyperplastic polyps studied, intestinal metaplasia was found: 16.7% in the polyp and 60% in adjacent areas. No metaplasia was found in the remaining 23.3%. Average size of the adenomas was 14 mm and of hyperplastic polyps, 11 mm. A total of 195 adenomas were smaller than 10 mm. The percentage of malignization in 288 adenomas examined was closely related to their size: 214 (66%) smaller than 20 mm, had a malignization percentage of 7%; 74 (34%) larger than 20 mm, had 51% malignization, and 86.2% malignization was found in adenomas of over 40 mm. Global malignization percentage of adenomas was 18%. However, when adenomas with high grade dysplasia in the 4.1 category of the Viena classification (non-invasive high grade neoplasia) were considered, this percentage rose to 26%. Malignization of hyperplastic polyps was 0.8%. When gastric acidity was determined using the maximum stimulation method, out of 77 cases of patients with hyperplastic polyps, 55 (60%) had real achlorhydria, 10 (18%) hypochlorhydria, 11 (20%) normochlorhydria, and only 1 (4) hyperchlorhydria. D.A.B. was 1.97 mEql for hyperplastics and 1.60 mEql for adenomas. D.A.M. was 6.05 mEql for hyperplastics and 5.49 mEql for adenomas. Our experience as to normal cases showed 2.5 mEqh +/- 1.2 and 22 mEqh +/- 6, respectively, for D.A.B and D.A.M.

Adenomatous Polyps↗
PubMed2004

Inflammatory fibroid polyp of the ileum causing intussusception: a case report.

Inflammatory fibroid polyp is a rare polypoid lesion of the gastrointestinal tract, histologically characterized by an admixture of numerous small blood vessels, fibroblasts and edematous connective tissue, accompanying a marked inflammatory cell infiltrate which contains eosinophils. Although it generally presents as a polypoid mass in the gastric antrum, it can be seen throughout the gastrointestinal tract. It is believed to represent a reactive, nonneoplastic condition, but its histogenesis remains controversial. A case of inflammatory fibroid polyp of the ileum presenting clinically as intestinal obstruction due to intussusception is presented here.

Biopsy, Needle↗
PubMed1985

Fecal bile acid profiles of Japanese patients with adenomatous polyps of the large bowel: special reference to distribution, multiplicity, size and degree of dysplasia of the polyps.

Bile acids have been implicated in carcinogenesis of the large bowel, and since epidemiological, clinical and histopathological studies suggest a link between adenomatous polyps and cancer of the large bowel, fecal bile acid profiles were studied in 33 patients with adenomatous polyps of the large bowel and these data were analyzed with particular reference to the distribution, multiplicity, size and degree of dysplasia of the polyps. The more polyps and the greater the severity of dysplasia, the higher was the excretion of total bile acids (mean mumol/day: single vs multiple polyps, 344.8 vs 369.1; mild vs moderate vs severe dysplasia, 347.5 vs 370.0 vs 399.3). However, in patients with larger polyps, total fecal bile acid excretion tended to be lower (mean mumol/day: large vs small polyps, 267.7 vs 389.5). These differences were not statistically significant. When fecal bile acid profiles were analyzed with respect to the extent of bacterial metabolism determined from the degree of dehydroxylation and oxidoreduction, there was a large variation with no consistency in relation to the factors studied among the polyp patients. Deconjugation of bile acids in feces was almost complete without difference among the patients. These results seem to indicate that the significance of bile acid in the development of adenomatous polyps in Japanese subjects is likely to be small.

Adult↗
PubMed1980

Cronkhite-Canada syndrome: report of an unusual case.

This report describes the findings in a 58-yr-old woman with multiple gastrointestinal polyps, associated with diarrhea, abdominal discomfort, hypoalbuminemia, alopecia, nail atrophy, and pigmentary changes. The patient met the criteria of the Cronkhite-Canada syndrome. Pathological evaluation of her polyps revealed regenerative (inflammatory) pseudopolyps, rather than true adenomatous polyps recorded in some earlier descriptions of patients with this syndrome. This is the first report of the association of Cronkhite-Canada syndrome with multiple myeloma.

Alopecia↗
PubMed1983

The significance of microscopic invasive cancer in endoscopically removed polyps of the large bowel. A clinicopathologic study of 51 cases.

A clinicopathologic study of 51 patients with endoscopically removed large bowel polyps showing histologic evidence of malignancy, either focally, to a massive extent, or comprising the entire polyp, revealed only one absolute finding capable of predicting residual disease, namely, the presence of cancer at the resection line. Of 23 radical resections, only one was justified. This case showed evidence of residual disease in the colectomy specimen that could have been predicted on the basis of involvement of the diathermy margin by carcinoma. Of 28 patients having polypectomy alone, 1 patient developed a Dukes' B carcinoma. The polyp, removed 9 months previously from the same site, had shown involvement of the margin by carcinoma. A conservative approach is thus advocated in the absence of this finding.

Colectomy↗