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PubMed1981

[Argyrophil cell cancers of the stomach and intestines].

Among 2400 malignant tumors of the gastrointestinal tract, in 12 tumors (11 gastric and 1 jejunal) having the structure of solid cancer, argyrophil cells constituted the basis of the tumor tissue. Argyrophil cell carcinomas were frequently of the saucer-like shape, their microscopic picture combined the features of intestinal carcinoids and oat-cell carcinomas of the lungs. In addition to cytoplasmic secretory granules best detectable by the method of Grimelius, 7 tumors showed signs of mucus formation. Argyrophil cell carcinomas appear to be poorly differentiated variants of the gastrointestinal tract apudomas.

Diagnosis, Differential↗
PubMed1983

[Morphological studies on precancerous lesions of the stomach and large intestine].

Precancerous conditions (high cancer-risk status) in the stomach and large intestine were discussed from a histological point of view. As to the conditions for the stomach, polyps (hyperplastic polyps and atypical epithelial lesions of flatly elevated type, so-called ATP), intestinal metaplasia and chronic ulcer (including ulcer scar), and as to those for the large intestine, adenomas and mucosa with some mucous changes were selected for this study. ATP was considered to be a neoplastic lesion rather than a hyperplastic or regenerative one, appearing with a high risk for a carcinoma of well-differentiated type: the lesion showed high incidence of focal carcinoma, particularly the ones more than 2 cm in diameter. Intestinal metaplasia has been frequently observed in the Japanese and when this change is drastically taken place, a consideration should be taken as a high risk factor for a well-differentiated carcinoma. Chronic gastric ulcer does not imply by itself a precancerous condition; however, the stomachs with ulcer seem to produce a several times higher incidence of coexistent carcinomas elsewhere in the stomach compared those without ulcer. Whether or not most of the invasive carcinomas are developed from adenomas remains debatable, even though adenoma of the large intestine is commonly suggested as a precancerous condition. A de novo carcinoma making an invasive carcinoma should also be considered. An increased sialomucin production in the mucosa of the large intestine occurred in a wide range also a possible factor for existence of carcinomas. Mucin changes demonstrated by Culling et al were discussed.

Adenoma↗
PubMed1982

[Surgical treatment of malignant polyps of the large intestine].

The report deals with the results of surgery in 1247 cases of colonic polyps. Malignant polyps were observed in 101 cases (8.1%). Eighty percent of polyps were up to 10 mm in size. Seventy five percent of malignant polyps were more than 10 mm in diameter. 94.4% of malignant polyps were in the rectum and sigmoid colon. Electro excision of malignant polyps via fibrocolonscope or rectoscope has been used on a large scale in recent years. Within five years after operation, newly-developed tumors were detected on the same sites in 11 cases (11.8%) (benign tumors--5, malignant polyps--4, carcinoma of large bowel--2). Newly-developed tumors were found at other sites in 26 patients (benign tumors--20, malignant polyps--5 and large bowel cancer--1).

Adult↗
PubMed1996

Malignant melanomas in the small intestine: a study of 103 patients.

OBJECTIVES: Malignant melanoma shows an unusual predilection to metastasize to the small intestine. A proportion of small bowel melanomas occur without history of an antecedent primary. We evaluated a group of patients with malignant melanoma in the small intestine to further our understanding of this disease. METHODS: We reviewed 103 cases of malignant melanoma in the small intestine (77 surgical resections and 26 autopsies) accessioned at the Armed Forces Institute of Pathology between 1945 and 1991 for demographic, chronological, and pathological features. RESULTS: Mean age at time of primary was 45.6 yr for surgical and 34.1 yr for autopsy cases (p = 0.01). Mean age at time of small intestinal involvement was 52.2 yr for surgical and 42.7 yr for autopsies (p = 0.03). Primary lesions preceded intestinal disease by an average of 5.6 yr for surgical and 2.1 yr for autopsies. The age distribution of surgical patients with and without known primary melanomas at the time of small intestinal melanoma was not significantly different. The same was true for autopsy patients. Using regression analysis, the linear relationship of age at primary melanoma (AAP) on age at small intestinal melanoma (AASI) was given by AAP = 2.30 + 0.85 (AASI), and that of AASI on AAP was given by AASI = 3.94 + 1.02 (AAP) (r = 0.93 and p < 0.0001 for both regressions). CONCLUSIONS: Our data and results support the concept that small bowel involvement by melanoma, even without a known primary, is most probably metastatic. The age at which an unknown primary occurred in cases of intestinal melanoma, or the age at which intestinal metastasis may appear in cases with known primary melanoma, can be estimated. There appear to be two subsets of primary melanoma: one that occurs among younger patients and is more aggressive with rapid metastasis and early death and one that occurs among older patients, is more indolent, and metastasizes less rapidly.

Adult↗