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[Assessment of cell losses in the intestinal epithelium].

An attempt was made of quantitative evaluation of the epithelial cell separation in vitro from the descending colon of mice (strains A, BALB/C, CBA, C57Bl and random-bred mice) under unified procedure of the tissue desintegration in norm and under carcinogenesis, depending on the age and strain distinctions. The devised method of forced cell isolation enable us to separate single, differentiated enterocytes, being in the stage of desquamation, from intestinal mucose. The cell separation was shown to decrease with age. The BALC/C mice, with high frequency of 1,2-dimethylhydrasine-induced tumor appearance, were characterized by a more decreased cell separation than C57Bl mice, with low sensitivity to the carcinogen. The cell separation from tumor-free mucosal surface in mice with tumors in colon was also seen decreased, as compared with control animals. The data obtained show that the reported approach of forced cell isolation can be useful for the appraisal of cell loss in the intestine, and suggest that the cell loss is decreasing during cancerogenesis.

Aging↗

[Effect of age on induction of intestinal tumors in mice by 1,2-dimethylhydrazine].

1,2-Dimethylhydrazine was administered subcutaneously in a dose of 8 mg/kg bw to 2-, 8- and 12-month-old female CBA mice for 25 weeks. The animals were serially killed 26-35 weeks after the beginning of treatment. The incidence of colon tumors in 2-month-old mice was always significantly lower (P less than 0.001) than in 8- or 12-month-old mice. The incidence of tumors with invasive growth in 12-month-old mice was significantly higher (P less than 0.05) than in 8-month-old mice. Mathematical evaluation allowed the conclusion about the 1.8-fold shortening of the colon tumor latency period in old mice as compared to the young mice.

1,2-Dimethylhydrazine↗

[Malignant lymphomatous polyposis--a rare disease entity of malignant centrocytic lymphoma with characteristic endoscopic appearance].

It is considered as special gastrointestinal manifestation on the nodal centrocytic lymphoma of intermediate malignancy. We demonstrate a 77 years old male patient, who underwent colonoscopy because of rectal bleeding. We found the colonic mucosa dotted with small, flat, lentiform polyps. In the terminal ileum these polyps were much larger. No changes were seen in the esophagus. In the antrum we found flat elevations and in the duodenum again lentiform nodules. Presenting in stage IV of non-Hodgkin's lymphoma the patient was treated with five cycles of combined chemotherapy with prednimustin and mitroxanthrone without side effects. Restaging showed distinct remission of the disease with significant reduction of the mucosal alterations.

Aged↗

A rare case of peritoneal mesothelioma in a male with ascites.

Mesothelial lesions can present significant diagnostic problems. An accurate identification of the lesion is important in deciding what course of action to follow, as well as what the required treatment will be. We report the case of a man with untreatable ascites. Four years after the first symptom appeared, the patient suddenly began to lose weight. The CT scan showed a thickening of the peritoneal profile; a diffuse lesion of the mesothelium was then observed at laparotomy. Histological examination led to a diagnosis of malignant mesothelioma in a well-differentiated mesothelial lesion with diffuse involvement of the serosa of the small intestine and the lesser omentum.

Ascites↗

[Malignant tumors of the small intestine. Diagnostic problems and differentiated surgical therapy].

The data of 27 patients who suffered from malignant tumors of the small bowel between 1970 and 1992 were retrospectively documented and evaluated. In the mainly elderly patients (5th to 8th decade of life) the tumor was most frequently localized in the ileum (41%), followed by the jejunum (30%) and the duodenum (22%). Adenocarcinoma was the most frequent histological diagnosis. Only 28% of the tumors were limited to the intestinal wall. 40% had metastases, local or to other organs. Due to diagnostic problems only 30% of these tumors were found preoperatively. In 22% of the cases an explorative laparotomy and in 33% an emergency operation because of ileus and/or peritonitis led to the correct diagnosis. Still, in 64% of the patients a R0-resection was possible. Nevertheless, the median period of survival was only 24.8 months. But patients who were R0-resected survived 65 months.

Adenocarcinoma↗

[Diagnostic and treatment problems in primary malignant tumors of the small intestine].

Between 1984-1994, 8 cases of MTSI (7 males and one female, between 24-53 years age) have been operated in our Department, representing 2% from all malignant gastrointestinal tumours. The pain as a result of the obstruction, followed by chronic blood loss with anemia and perforation, (4 patients operated in emergency) were the most frequent symptoms, the tumors being localised on jejunum (3) and ileum (5) with a diameter to 3-15 cm. Lymphatic (4), hepatic (2) and peritoneal (I) metastases were present. We performed a wide resection of the bowel and mesentery, including lymph nodes (in 4 cases with radical intention). Histopathological findings: 4 adenocarcinoma, 3 leiomyosarcoma and a lymphoma. Postoperative treatment was selective and consisted in polychemotherapy (PCT) and cobalt therapy (60Co). There was no postoperative mortality, two local recurrences in 6 month. Survival rate at 5 patients was 32 month. At 5 years were in life 2 leiomyosarcoma and 1 adenocarcinoma and at 7 yrs, 1 leiomyosarcoma and 1 adenocarcinoma.

Adenocarcinoma↗

Recurrent acute pancreatitis caused by ampullary villous adenoma.

Neoplastic lesions of the ampulla of Vater are a rare cause of acute and recurrent pancreatitis. We have recently had the privilege of studying a 58-year-old woman who presented with recurrent pancreatitis. At endoscopic retrograde pancreatography, a mucosal abnormality of the ampulla of Vater was noted and documented to be a villous adenoma. It was resected surgically and the patient has been symptom free. This report documents the ninth patient in the English literature with pancreatitis secondary to a benign neoplasm of the ampulla of Vater. Six of the nine patients have been male. They have ranged in age from 42 to 68 years. Approximately 30% of villous adenomas of the duodenum contain foci of invasive or in situ carcinoma. Villous adenomas of the ampulla of Vater require aggressive therapy. Further, it has been noted that a number of patients with small intestinal neoplasms have concomitant large-bowel polyps.

Acute Disease↗

[Immunological aspects of gastrointestinal neoplasms].

The mammalian immune system appears to play an essential role in preventing the development, and/or in controlling growth and spread, of malignant tumor cells. Antigenic properties of neoplastic cells and defense mechanism of the tumor host are briefly reviewed. The relative importance of immune reactions and other "non-specific" means of host defense with regard to tumor development and growth are discussed in the light of available experimental and clinical evidence. An attempt is made to incorporate these considerations into a hypothesis relating to the development of intestinal neoplasms.

Antigens, Neoplasm↗

Small bowel neoplastic disease: demonstration by MRI.

This study demonstrates the appearance of small bowel tumors on MR images. Sixteen patients with tumors involving small bowel were studied by MRI. All tumors were proven with histopathology. Eleven patients had primary tumors of the small bowel, which included the following: four carcinoid tumors, three adenocarcinomas, two lymphomas, one leiomyosarcoma, and one leiomyoma. Five patients had recurrent or metastatic disease to small bowel: two patients had colon cancer, one patient had pancreatic cancer, one patient had uterine leiomyosarcoma, and one patient had chloroma (leukemia). MR examination included breath-hold T1-weighted spoiled gradient echo (all patients), immediate postgadolinium-spoiled gradient echo (10 patients), and 2 to 4 minutes postgadolinium T1-weighted, fat-suppressed images (all patients). Tumor size, local extent, signal intensity, and enhancement features of tumor and adjacent tissue were determined. Tumor ranged in diameter from 1 to 9 cm (mean, 4.0 cm). Tumors had similar signal intensity to normal small bowel on precontrast images. Fourteen malignant tumors showed heterogeneous enhancement greater than adjacent bowel on gadolinium-enhanced images. Tumor local extent was best shown on precontrast-spoiled gradient-echo images and postgadolinium T1-weighted fat-suppressed images. Image quality was most consistent on breath-hold images. The results of this study show that small bowel tumors are demonstrable on MR images. Precontrast breath-hold T1-weighted spoiled gradient-echo images and gadolinium-enhanced fat suppressed images demonstrate tumor extent most reliably.

Adult↗

No association of primary adenocarcinomas of the small bowel with Epstein-Barr virus infection.

Epstein-Barr Virus (EBV) infection is considered to play an etiologic role in human malignancies, including a subset of gastric and cardiac cancers. Adenocarcinomas of the small bowel comprise a very rare entity, with little knowledge about molecular properties and etiological aspects. We have investigated the prevalence of EBER expression (EBV-encoded small RNAs) in a series of small bowel adenocarcinomas (n=56) utilizing RNA in situ hybridization (EBER-RISH). The patients had undergone primary surgical resection at either the Technical University of Munich or at the University of Graz. A surgical series of 82 primary resected gastric (n=36) or cardiac (n=46) adenocarcinomas (TU Munich) was used as control group. None of the 56 small bowel carcinomas exhibited EBER expression whereas in the control group the rate of EBER expression accounted for 4.4% in the group of cardia carcinomas and 8.6% in the group of gastric cancers. These results indicate that EBV infection plays no etiologic role in primary small bowel adenocarcinomas.

Adenocarcinoma↗

Polypeptide YY (PYY) and pancreatic polypeptide (PP) in rectal carcinoids. An immunocytochemical study.

The frequency and distribution of polypeptide YY (PYY) and pancreatic polypeptide (PP) immunoreactive tumour cells of 14 small intestinal and of 27 rectal carcinoids were studied. All small intestinal and 14 rectal tumours were unreactive to both hormones. However, 13 rectal carcinoids contained a variable number of PP-immunoreactive cells. In four of these cases both PYY- and PP-immunoreactive cells were seen. The PP-immunoreactive cells greatly exceeded the number of PYY-immunoreactive cells. Two rectal carcinoids with PYY and PP immunoreactivities, but not the rest of the tumours, reacted also with an antiserum specific to the C-terminus of PP. This indicates that most PP immunoreactive rectal carcinoids lack the C-terminus sequence of the PP molecule.

Carcinoid Tumor↗