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Primary small bowel malignancies: single-center results of three decades.

We highlight one medical center's experiences with primary malignancies of the small bowel. During a 27-year period, 79 patients were treated for small bowel tumors. Of these, 15 (20%) were lost to follow-up; thus, 64 patients were reviewed retrospectively with emphasis on histological distribution and their topography, perioperative complications, overall survival, and prognostic factors. In our 64-patient series, 33 (51.6%) presented with adenocarcinoma; 10 (15.5%), lymphoma; 8 (12.1%), leiomyosarcoma; 5 (7.6%), neurogenic tumor; 2 (3%), unclassified carcinoma; 5 (7.6%), other types of sarcoma; and 1 patient presented with synchronous adenocarcinoma and lymphoma. Of all patients, 30 (46.9%) were curatively treated, whereas 34 (53.1%) underwent palliative procedures. Hospital lethality was 9.4% and mainly occurred in patients operated on under emergency circumstances. Reoperation rate was 29.7%. The observation period lasted at least five years or until death; three patients were alive less than five years postoperatively. Cumulative five-year survival rate was 22.5% in the adenocarcinoma group, 33.3% in the lymphoma group, 33.3% in the leiomyosarcoma group, and 22.2% in patients with other tumors. The uncharacteristic symptoms presented by patients suffering from small intestinal malignancies make early diagnosis difficult. Therefore, especially in patients with long-standing bowel diseases, malignancy should be considered. Early diagnosis and surgical treatment lead to a good prognosis as shown by our study.

Adenocarcinoma↗

Giant mesenteric lymphoid tumor (Castleman's lymphoma) - a case report.

An autopsy case of a giant mesenteric lymphoid tumor in a 57-year-old female was examined anatomo-biologically. A 17X15X6 cm3-sized pinkish gray-coloured medullary tumor occupying the mesenterium with no evident capsule, invaded the small intestine and pancrease head. Histologically, it was a lymphoid tissue consisting of hyalinized angiofollicular architecture having epithelioid cells and tingible body macrophages in the follicles. Some small-sized follicles showed typical Hassalloid architecture and other follicles consisted of monotonous growth of lymphocytes without a mantle zone, some of them fusing with each other. The histopathological appearance of the tumor was that of Castleman's lymphoma and of hyaline-vascular type of Keller's Classification. There was another 0.6X0.5X0.5 cm3-sized tumor having an angiofollicular architecture in the subserosa of the sigmoid colon. The present case was complicated with vertebral caries, hypogammaglobulinemia (1.2%), eosinophilia (50%) and panbronchobronchiolitis, the last one being responsible for her death.

Female↗

Endometriosis in rhesus monkeys.

Endometriosis was present in five out of six Rhesus monkeys who had to be sacrificed because of disease in a colony of 90. The monkeys lost appetite and became constipated. The abdomen was distended and often a pelvic mass could be palpated. At autopsy, 300-500 ml of blood-stained fluid was found in the abdomen together with intestinal or pelvic endometriosis. The ethiology of endometriosis in Rhesus monkeys is unknown. The most probable explanation is intraabdominal implantation of endometrial tissue through retrograde menstruation. The lesion is rare in animals in free ranging colonies. It is not known whether this is due to a higher frequency of pregnancies in animals with free access to matings or to its consequences, i.e. more infrequent menstruations.

Animals↗

[A study on histogenesis of gastrointestinal stromal tumors].

OBJECTIVE: The purpose of this study was to consider the histogenesis of gastrointestinal stromal tumors (GIST). METHOD: 36 cases of GIST were studied by light microscopy, histochemical and immunohistochemical techniques. RESULTS: In 15 cases of small intestine spindle cell tumors, various sized eosinophilic globules were observed between the tumor cells and were designated as skeinoid fibers, which stained blue with Masson's trichrome and strongly PAS-positive. The positive rate by immunohistochemical methods for S-100 protein and desmin were 44.44% and 8.33% respectively. The immunoexpression of tumor cells was unrelated to their differentiation. CONCLUSION: Complex immunophenotypes of GIST suggest primitive mesenchymal origin, and small intestine stromal tumors (SIST) are mostly neurogenic which may have been derived from neurilemmal cells or autonomous nerve tissue of the small intestine.

Adult↗

[Metastasis of malignant melanoma in the small intestine--case report].

Small bowel metastases of the malignant melanoma are usually discovered in 2-5% of the patients with malignant melanoma of the skin during the life. They are usually being diagnosed with a complication on the small bowel, such as occlusion, bleeding, anemia and perforation of the intestine. Authors show three patients with metastases of the malignant melanoma in the small bowel, which lead to invagination, subocclusion and anemia due to bleeding. In all the patients, resection of the small bowel was performed with termino-terminal anastomosis. One of them lived 7, the other 4 months after the surgery and is in pretty well condition, while third patient was not controlled at all.

Aged↗

[The effect of carotenoids on rat stomach carcinogenesis, induced by N-methyl-N'-nitro-N-nitrosoguanidine].

The effect of natural carotenoids on gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitroguanidine (MNNG) was studied in 4 groups containing 105 rats. Highly carotenoid complex from wild rose fruits was added to drinking water of Group 1 (30 rats) at a dose of 15 mg/kg (as calculated per beta-carotene) 3 times weekly; as well as MNNG was present in water (0.01%). The carotenoid complex was supplemented to the ration 2 months before MNNG treatment and was continued within 15 months; MNNG treatment occurred within 6 months. Group 2 (30 rats) and Group 3 (30 rats) were treated with MNNG and the carotinoid complex, respectively; the 4 group (15 rats) was used as an intact control. Tumors were detected in 16 rats of 28 animals studied in Group 1 (57.1%) and in 11 rats of 25 animals in Group 2 (44%) (P < 0.05); malignization was found in the stomach and small intestine. The rate of involvement with gastric tumor in Group 1 was 3-fold higher as compared with those in the only MNNG treated animals--50% and 16%, respectively (P < 0.01). Tumors of the small intestine were detected in 5 rats of Group 1 (17.8%) and in 9 rats of Group 2 (36.6%); differences were statistically insignificant. However, carcinogenesis tended to accelerate. The mean time of stomach and small intestine tumor detection in Group 1 was equal to 286 and 276 +/- 46 days, respectively, and in Group 2--339.7 +/- 25.4 and 350.7 +/- 25.4 days, respectively (differences are insignificant.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Intestinal leiomyoma. Case report and discussion of the difficult assessment of grade].

The case of a male patient operated for a leiomyoma of the jejunum is presented. The clinical symptoms, the morphological differential diagnosis and the problems evaluating aggressiveness of this tumour are discussed. We intend to demonstrate that histopathological diagnostic implicate a certain grade of uncertainty too. With the example of leiomyoma we like to show that diagnosis means a tight cooperation of the clinician and his pathologist by collecting clinical and histomorphological data.

Humans↗

Response of Ehrlich carcinoma and the small intestine of mouse to combined treatment with chlorpromazine and X-rays.

The effect of combined treatment with chlorpromazine (20 mg/kg body weight) and X-rays at different dose levels was tested on the growth of Ehrlich carcinoma tumor in solid or ascites form in mice. The radiation response of murine gut was also examined separately but under similar experimental conditions. The results obtained indicate that chlorpromazine did not influence the radiation response of all the test systems used in this study. The relevant literature, reviewed in short, shows that the interaction between chlorpromazine and X-rays can result in enhanced radiation response, non-interference or increased radiation tolerance. Therefore any combined effect of chlorpromazine and X-rays observed cannot be generalised.

Animals↗

[Clinical picture, diagnosis and treatment of multiple primary synchronous cancer of the large intestine].

Clinical course and procedures for diagnosis of primary multiple synchronous cancer of the colon are discussed on the basis of the data on 52 patients treated at the Institute's Clinic in 1962-1986. In 30.5%, these tumors were accompanied by single or multiple polyps of the colon. A significant role of endoscopy in the diagnosis was demonstrated. As a result of complex examination of the organ, a correct preoperative diagnosis of multifocal cancer was made in 48.1% of patients. Tumor multiplicity was established intraoperatively in 14 cases, at autopsy--in 2 (3.8%) and in the course of gross and histologic examination of the resected material--in 11 patients. Laparoscopy proved effective in 81.8%. Surgery is the major procedure for treatment of these tumors. Radical operation was carried out in 36 cases. The postoperative lethality rate was 13.9%. In the radical surgery group, 3-year survival was 61.7%.

Aged↗

[Lymphocytic infiltration and mitotic activity of the epithelium in villous tumors of the large intestine].

Morphostatistical analysis of the lymphocytic infiltration intensity and mitotic activity in 34 colon villous tumours is performed depending on the degree of dysplasia, the presence or the absence of invasive growth. The above parameters changed during the various stages of tumour progression and can be taken into account in the process of histological verification of difficult cases.

Adenocarcinoma↗

CT of the small bowel and mesentery.

The detection and definition of small bowel pathology is a frequent clinical and radiologic problem. Although contrast radiography and enteroclysis are the primary means of evaluating the small bowel, computed tomography (CT) has become increasingly important as a complementary examination. Initial diagnoses proffered by barium studies may be further characterized by CT and this additional information may have significant impact on patient management.

Humans↗