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Chemoprevention of azoxymethane-induced colon carcinogenesis by dietary feeding of S-methyl methane thiosulfonate in male F344 rats.

Modifying effects of dietary exposure of S-methyl methane thiosulfonate (MMTS) isolated from cauliflower Brassica oleracea L. var. botrytis on rat colon carcinogenesis induced by azoxymethane (AOM) and on the expression of cell proliferation biomarkers were investigated in two experiments. In experiment 1, male F344 rats were given three s.c. injections of AOM (15 mg/kg body weight) and fed 100 ppm MMTS for 5 weeks, starting 1 week before the first dose of AOM. The frequency of colonic aberrant crypt foci was determined at 5 weeks after the start. Feeding of 100 ppm MMTS for 5 weeks significantly decreased the number of aberrant crypt foci/colon. Colonic mucosal ornithine decarboxylase activity and the number of silver-stained nucleolar organizer regions per nucleus in colonic epithelium were significantly decreased by MMTS treatment compared with those of AOM alone. In experiment 2, effects of dietary feeding of MMTS at two doses (20 and 100 ppm) during the postinitiation phase on intestinal tumorigenesis initiated with AOM were investigated by using a long-term experiments in male F344 rats. Incidence of intestinal neoplasms of rats fed MMTS-containing diets after AOM exposure were reduced in a dose-dependent manner. Feeding of MMTS during the postinitiation phase decreased the number of aberrant crypt foci/colon, colonic ornithine decarboxylase activity, 5-bromodeoxyuridine-labeling index in colonic epithelium, and polyamine level in blood compared with those of AOM alone. These results suggest that MMTS might be a possible chemopreventive agent for intestinal neoplasia.

Animals↗

Suicide, cancer, and other causes of death among California veterinarians, 1960-1992.

Previous studies reporting on mortality patterns in veterinarians have been restricted to deaths among white male veterinarians. In an effort to examine the mortality of male and female veterinarians of all races, we conducted a standardized proportionate mortality ratio (SPMR) analysis of 450 California veterinarians who died between January 1960 and December 1992. In comparison to State of California general population statistics, white male veterinarians had significantly elevated mortality from malignant melanoma of the skin (SPMR 3.47, 95% CI 1.74, 6.94), cancer of the large intestine (SPMR 1.74, 95% CI 1.04, 2.09), rheumatic heart disease (SPMR 3.50, 95% CI 1.90, 6.43), and suicide (SPMR 2.50, 95% CI 1.84, 3.38). White female veterinarians had significantly elevated mortality from suicide (SPMR 5.89, 95% CI 3.02, 11.48). We also examined veterinary mortality for different lengths of time in the profession. Significantly elevated SPMRs were noted for suicide in veterinarians in the profession for less than 30 years; deaths due to malignant melanoma of the skin and rheumatic heart disease in veterinarians in the profession 20 years or more; and cancer of the large intestine in veterinarians in the profession 30 years or more. Because of significant findings in mortality from suicide among veterinarians of both sexes, it was recommended that future studies and efforts toward suicide prevention include both male and female veterinarians.

Adult↗

Influence of tumour site on presentation, management and subsequent outcome in large bowel cancer.

To demonstrate any difference in outcome between patients with carcinoma at various sites within the large bowel, analysis of a large number of patients is necessary. From the Large Bowel Cancer Project, 4292 patients have been evaluated to compare mode of presentation, surgical management, pathological findings and outcome. Carcinoma at the splenic flexure was associated with the highest risk of obstruction (49 per cent); postoperative cardiopulmonary complications (36 per cent); in-hospital mortality (18 per cent); and the lowest age-adjusted 5-year survival (28 per cent), even after curative resection (38 per cent). This survival disadvantage was seen even in those without obstruction. Further, it was not accounted for by differences in age, sex, Dukes' stage or tumour differentiation between the various sites as stratification by these variables failed to alter significance (log rank chi 2 = 11.1; d.f. = 4; P less than 0.05). Compared with carcinoma of the left colon and rectum, tumours in the right colon were more likely to be poorly differentiated and locally advanced (in terms of fixation and penetration of the bowel wall) but were not associated with a higher risk of either distant spread at presentation or local recurrence. Age-adjusted 5-year survival following curative surgery was higher for the right colon (65 per cent) than the left (59 per cent).

Adult↗

Myosarcomas of the small and large intestine: a clinicopathologic study.

A retrospective study was made of 38 myosarcomas of the small and large intestines (34 leiomyosarcomas and 4 malignant leiomyoblastomas). Endoenteric, small, and noninvasive tumors were successfully treated by simple wedge excision, cautery snare removal, or segmental bowel resection with a high 5-yr cure rate of 86% (12/14). Exo-enteric tumors often invaded adjacent structures or perforated into the peritoneal cavity. Extensive resection procedures, including pancreaticoduodenectomy, abdominoperineal resection, and pelvic exenteration salvaged only 13% (2/16) of these patients. Three clinicopathologic factors adversely affected prognosis: i) tumor size greater than 5 cm in diameter, ii) extra-intestinal invasion or free perforation, and iii) high histopathologic grade of malignancy. The presence of none, one, two, or three of these adverse factors gave decreasing 5-yr survival rates of 100, 44, 31, and 0%, respectively. These observations suggest use of a multimodal treatment program that may minimize treatment failure from local as well as distant disease.

Adolescent↗

Clinicopathological features and management of immunoproliferative small intestinal disease and primary small intestinal lymphoma in Pakistan.

This study was performed to confirm the existence of immunoproliferative small intestinal disease (IPSID) in Pakistan. Clinicopathological features of 12 patients with histologically confirmed disease were analysed. Patients were mostly young males with median age of 24.6 years. Two thirds belonged to poor socioeconomic class. Main presenting features were chronic diarrhoea and weight loss. Eleven patients had radiologic evidence of malabsorption syndrome. Endoscopic findings of mucosal thickening, edema, and flattened villi were present in the majority. Patients had both secretory and non-secretory types of disease. Six patients presented with stage A disease. Four responded to antibiotics or steroids, although mucosal abnormalities persisted in three. Two stage A patients evolved into stage C disease, one was lost to follow-up, the other is alive with disease. Three patients presented with stage B disease. Two responded completely to chemotherapy, the third refused treatment and expired after 16 months. Three patients had stage C disease at diagnosis. They received aggressive combination chemotherapy and remain in complete remission with a median follow-up of 2.2 years. This is the first series of patients with IPSID reported from Pakistan. Clinicopathological features and therapeutic results are consistent with the experience elsewhere. Increased awareness may result in early diagnosis and better management.

Adult↗

The spectrum of small bowel melanoma.

Twenty-one patients with documented secondary small bowel involvement by malignant melanoma are reviewed. Roentgen mainfestations are discussed and illustrated. A vigorous diagnostic approach emphasizing enteroclysis is described. Clinical awareness and aggressive radiologic investigation are providing these patients with earlier surgical and adjuvant therapy, which appears to be leading to increased length of survival.

Adolescent↗

Disseminated peritoneal leiomyomatosis with malignant change, in a male.

Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder, characterized by the occurrence of multiple leiomyomas scattered throughout the peritoneal cavity. Until this report DPL had been observed only in women and there is only one previous case with malignant change. A case of DPL in a male, complicated by sarcomatous transformation is reported. DPL has a definite malignant potential; patients with the disease should be followed closely for signs of progression.

Adult↗

[Inflammatory fibroid polyps of the gastrointestinal tract].

Inflammatory fibroid polyps of the gastrointestinal tract represent a relatively rare entity. Although the histopathological classification, the etiology and the pathogenesis of this lesion remains unclear, the biological dignity is commonly understood as benign. Nevertheless, these polyps are able to cause gastrointestinal bleeding, intestinal obstruction or intussusception which often provides the indication for surgical treatment. In endoscopical biopsies unexpected difficulties for the pathologist may arise from the fact that these uncommon lesions often show a submucosal growth pattern. With reference to two case reports, the clinical, diagnostic and histopathological aspects of inflammatory fibroid polyps will be discussed. An additional literature review of the etiology, immunohistochemistry and differential diagnosis is presented.

Aged↗

Low-contrast detectability in volume rendering: a phantom study on multidetector-row spiral CT data.

To cope with the increasing amount of CT data, there is growing interest in direct volume-rendering techniques (VRT) as a diagnostic tool. The aim of this phantom study was to analyze the low-contrast detectability (LCD) of VRT compared with multi-planar reformations (MPR). Soft tissue lesions were simulated by spheres of different diameters (3-8 mm). The average lesion density was 15 HU compared with a background density of 35 HU. Two different CT protocols with 40 and 150 mAs were performed on a multi-detector row CT. The scanning parameters were as following: 140 kV; 2x0.5-mm slice collimation; pitch 2 (table movement per rotation/single slice collimation), and reconstruction with 0.5-mm slice thickness at 0.5-mm interval. A B30 kernel was used for reconstruction. The VRT was performed by mapping Hounsfield values to gray levels equal to a CT window (center: 60 HU; window: 370 HU ). A linear ramp was applied for the opacity transfer function varying the maximum opacity between 0.1 and 1.0. A statistical method based on the Rose model was used to calculate the detection threshold depending on lesion size and image noise. Additionally, clinical data of 2 patients with three liver lesions of different sizes and density were evaluated. In VRT, LCD was most dependent on object size. Regarding lesions larger than 5 mm, VRT is significantly superior to MPR (p<0.05) for all opacity settings. In lesions sized 3-5 mm a maximum opacity level approximately 40-50% showed a near equivalent detectability in VRT and MPR. For higher opacity levels VRT was superior to MPR. Only for 3-mm lesions MPR performed slightly better in low-contrast detectability (p<0.05). Compared with MPR, VRT shows similar performance in LCD. Due to noise suppression effects, it is suited for visualization of data with high noise content.

Aged↗

Vanek's tumor (inflammatory fibroid polyp). Report of 18 cases and comparison with three cases of original Vanek's series.

Eighteen cases of Vanek's tumors are presented. The patients included nine men and nine women between the ages of 45 and 93 years (mean, 66.2 years). Nine cases were clinically diagnosed as polyps of the gastric antrum, five cases as polyps of the stomach (not otherwise specified), one polyp was located in the ileum and the three remaining polyps in the small intestine (not otherwise specified). The thirteen polyps with available size information measured from 0.4 to 5 cm in the greatest diameter (mean, 2.2 cm). Immunohistochemically, the affections were positive for vimentin (18/18) and CD34 (15/18). All the cases negative for CD34 also lacked concentric onion skin-like formations of the spindle cells around glands and vessels. The different immunophenotype and absence of concentric formations could be explained by the existence of two different lesions commonly designated as Vanek's tumor (inflammatory fibroid polyp) or by the hypothesis of various evolutional stages. In the differential diagnosis, it is important to distinguish namely eosinophilic gastroenteritis, gastrointestinal stromal tumor, inflammatory pseudotumor, hemangioendothelioma, and hemangiopericytoma. In contrast to gastrointestinal stromal tumors, genetically no substitution, deletion, or insertion occurred in c-kit exon 11 in all analyzed samples. Likewise, no deletion or insertion in part of c-kit exon 9 was observed.

Aged↗

Poorly differentiated adenocarcinoma with extensive rhabdoid differentiation: clinicopathological features of two cases arising in the gastrointestinal tract.

This paper describes the pathological features of two cases of composite extra-renal rhabdoid tumor; that is, poorly differentiated carcinoma with extensive rhabdoid differentiation, arising in the small intestine of a 64-year-old man and in the pancreas of a 77-year-old woman. In both cases the tumor behaved aggressively and the patients died from disseminated malignancy within 3 months of original presentation and diagnosis. To the best of our knowledge these are the first examples of such tumors in the small intestine and pancreas.

Adenocarcinoma↗

Intestinal pseudoobstruction as a paraneoplastic syndrome in ganglioneuroblastoma.

Intestinal pseudoobstruction may be part of a paraneoplastic syndrome. We report a teenage girl with ganglioneuroblastoma who presented with severe constipation. The intestinal pseudoobstruction was presumed to be due to inflammation of the myenteric plexus with destruction of the ganglion cells caused by antineuronal nuclear antibodies (ANNA or Anti-Hu).

Adolescent↗

Cytogenetic and clinicopathological characterization by fluorescence in situ hybridization on paraffin-embedded tissue sections of twenty-six cases with malignant lymphoma of small intestine.

OBJECTIVE: In small intestinal malignant lymphoma (SIML), the correlation between specific chromosomal abnormalities and clinicopathological features remains unclear. The aim of this study was to determine the frequency of chromosomal translocations involving the BCL1, BCL2, c-MYC, BCL6 and MALT1 genes by using fluorescence in situ hybridization directly on paraffin-embedded tissue sections (tissue-FISH). MATERIAL AND METHODS: Twenty-six cases diagnosed as having SIML between 1996 and 2003 were the subjects of the clinicopathological investigation conducted in this study. Tissue-FISH was performed with specific probes on paraffin-embedded tissue sections as described previously. RESULTS: The primary site was frequently located at the duodenum (9 cases, 35%). In accordance with the World Health Organization classification, 14 (53%) cases were diagnosed as having diffuse large B-cell lymphoma (DLBCL) and 6 (23%) as marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). Macroscopically, DLBCL and MALT lymphoma displayed various macroscopic features. Cytogenetically, IGH-BCL2 translocation was detected in 3 (21%) out of 14 DLBCL cases, but in none of the MALT lymphomas. BCL6 translocation was detected in 5 (35%) of 14 DLBCL cases and in 1 (17%) of 6 MALT lymphoma cases (17%). API2-MALT1 translocation was detected in 1 (7%) of 14 DLBCL cases and in 1 (17%) of 6 MALT lymphoma cases. CONCLUSIONS: The duodenum was preferentially involved in SIML. DLBCL and MALT lymphoma showed various macroscopic features. Tissue-FISH analysis disclosed that DLBCL is cytogenetically heterogeneous. Furthermore, our study validated tissue-FISH as an additional promising diagnostic tool for detecting specific chromosomal translocations in NHL.

Adolescent↗

Lymphocyte cytotoxicity in X-irradiation-induced adenocarcinoma of the rat small bowel. I. Measurement of target cell destruction by release of radioiodinated membrane proteins: brief communication.

A cell-mediated immune response as denoted by lymphocyte cytotoxicity was detected in Holtzman rats with X-irradiation-induced adenocarcinomas of the small bowel. Cytotoxicity was measured by target cell destruction as determined by release of intracellular 51Cr or radioiodinated (125I) membrane proteins. The radioiodination assay possessed an important advantage over the 51Cr technique in that the radiolabel was spontaneously lost slowly, thus permitting long-term studies.

Adenocarcinoma↗