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PubMed1986

Distribution of the degranulated and non-degranulated mast cells in nasal polyp.

All of the nasal polyps obtained from 83 patients had mast cells which stained with toluidine blue in their tissue. Degranulated mast cells occurred much more in the deep stroma than in the part near the surface of the polyp. More degranulation of mast cells should have occurred in the superficial tissue than in the deep stroma if the inhaled allergen had reacted with specific IgE antibody on the mast cells in the polyp. The degranulation in the deep stroma in the nasal polyp means that another mechanism besides IgE-mediated degranulation must be operative in the mast cells. The pedicle of the nasal polyp had more mast cells and more degranulated ones than had the body and apex. Thus the pedicle is probably more important in the etiology of polyp formation in nasal mucosa than the body and apex from the viewpoint of the activity of histamine from degranulated mast cells on the blood vessels and nasal glands.

Cytoplasmic Granules↗

PubMed1986

[Endoscopic diagnosis and management of colonic polyps].

Colonoscopic diagnosis of colonic polyps is a rather easy task, although some small polyps might be missed when they are situated around the steep angulation or behind the fold. A correct diagnosis of mucosal carcinoma is difficult not only by colonoscopy but also by biopsy because the cancer focus may be small or not exposed on the polyp surface. Therefore, colonoscopic polypectomy is the best procedure of choice for correct histologic diagnosis of mucosal and invasive carcinoma. Only by polypectomy can correct diagnosis of invasive carcinoma be made, although there are various endoscopic signs such as irregularity of the surface configuration and white spots on the surrounding mucosa suggesting invasive carcinoma. Over the course of several years experience of colonoscopy we have encountered small flat elevations under 1 cm in diameter of which 58% were benign adenomas and 42% contained minute foci of carcinoma. These small flat lesions might have been missed quite easily during routine examination in the past and they might play an important role in the pathogenesis of colonic carcinoma. Benign polyp and mucosal carcinoma can be adequately treated by polypectomy only, whereas invasive carcinoma needs further treatment as it has a risk of node metastasis. Risk factors influencing metastasis are lymphatic permeation, poorly differentiated carcinoma, massive invasion close to the cut end. Only when one of these findings is seen in the removed polyp, further surgical treatment must be considered. However, the patient's general condition, age and site of the polyp should be carefully taken into account in order to choose the appropriate treatment in each individual case as the risk of metastasis under such situations mentioned above is not so high. Management of invasive carcinoma is still a controversial issue and a long-term, clinicopathologic study will be needed to solve this question.

Biopsy↗

PubMed1986

[Relations between stomach polyps and stomach cancer--results of follow-up after endoscopic polypectomy].

We report on 468 polypectomies on 303 patients in 23,260 gastroscopies. In 230 endoscopic follow-up controls on 129 patients 4 carcinomas are found, and that once after a hyperplastic polyp and thrice after hyperplasiogenic polyps. In comparison to our routine gastroscopies the number of the carcinomas is distinctly lower in the control of polyps, so that the hyperplasiogenic polyps in our gastroscopies do not represent a particular risk group for a carcinoma of the stomach. After polypectomy should be controlled: adenimas, polyps with severe dysplasias, hyperplasiogenic polyposes and stomachs in which polyps remained.

Cell Transformation, Neoplastic↗

PubMed1979

Histogenesis of adenomatous polyps in the human large intestine.

Detailed histologic analyses have been performed in 75, minute, colorectal polyps from familial polyposis patients. All polyps were composed of typical adenomatous tissue, with, in addition, some normal-looking glands still to be found among the neoplastic elements. Bifurcating glands were not observed, and branching patterns were present in 27% of the polyps only. In 86% of the lesions, the number of gland openings along the polyp surface was larger than the number of gland bases observed along the muscularis mucosae. This difference increased with polyp size (r = 0.9043). Those data, together with previous radioautographic observations, suggest that formation of new adenomatous glands mainly results from an infolding of the surface epithelium between normal, preexisting glands. This mechanism sharply contrasts with villous polyps in which papillary projections arise upwards from the mucosal surface.

Cell Transformation, Neoplastic↗

PubMed1985

The immunological basis of nasal polyp formation.

Forty-six patients were studied to assess the role of immunological factors in the formation of nasal polyps. Total IgE levels did not correlate with positive skin testing and were generally higher in polyp sac fluid than in corresponding sera. Asthmatics had significantly higher IgE levels in both serum and polyp fluid than nonasthmatics. Specific IgE (RAST) found in polyp specimens could not be detected by conventional skin or serum testing in nine of 15 patients. By direct immunofluorescence IgE was present in 81% of polyp specimens compared with 13% in mucosal controls. These data indicate that nasal polyp formation may be an IgE mediated disease process and conventional skin or serum testing may not detect this local allergic process.

Adult↗

PubMed1985

[Clinical study of ureteral polyp: three cases report and review].

Three cases of ureteral polyp are reported. The first case was an adult fibrous polyp. The second was the first report as a single, lower ureteral polyp in a child in Japan. The third was a granulomatous polyp accompanied by ureteral stones. About 130 cases of ureteral polyp have been reported in Japan. Although it has been classified into 4 to 7 histological types, the concept of ureteral polyp itself is confusing as its origin remains controversial.

Child↗

PubMed1983

Aberration of poly(adenosine diphosphate-ribose) metabolism in human colon adenomatous polyps and cancers.

The activities of three principal enzymes engaged in the biosynthesis and degradation of poly(adenosine diphosphate-ribose) [poly(ADP-ribose)] were examined in cell nuclei isolated from adenomatous polyps (tubular adenomas of familial polyposis coli, villous adenoma, and tubulovillous adenoma), cancers, and normal mucosa of human colon. The activities of poly(ADP-ribose) synthetase in adenomatous polyps [161 +/- 46 (S.E.) pmol/min/mg DNA] and cancers (114 +/- 32 pmol/min/mg DNA) were, on an average, about 3 and 2 times, respectively, higher than those in normal mucosa (52 +/- 24 pmol/min/mg DNA); the difference was statistically significant (p less than 0.001). The activity of poly(ADP-ribose) glycohydrolase was also significantly high in adenomatous polyps (13.0 +/- 3.4 nmol/min/mg DNA), but not in cancers (10.1 +/- 2.5 nmol/min/mg DNA), compared with normal mucosa (5.2 +/- 1.4 nmol/min/mg DNA) (p less than 0.001). The activity of ADP-ribosyl protein lyase, in contrast, was lower in adenomatous polyps (152 +/- 40 pmol/min/mg DNA) than in normal mucosa (345 +/- 111 pmol/min/mg DNA) and cancers (288 +/- 80 pmol/min/mg DNA) (p less than 0.001). Analyses of reaction products with snake venom phosphodiesterase digestion revealed that poly(ADP-ribose) synthesized in nuclei of normal mucosa, adenomatous polyps, and cancers had the average chain lengths of 2.9, 1.7, and 9.7 ADP-ribose units, respectively. Based upon these values and total amounts of ADP-ribose incorporated, the amount of poly(ADP-ribose) synthesized per mg DNA in 30 min was calculated as 308, 1510, and 106 pmol in the above three types of colon tissues, respectively. These results suggested that a larger amount of monomers and short oligomers of ADP-ribose was synthesized in adenomatous polyps, while a smaller number of longer polymers was produced in cancers as compared with normal mucosa. Immunohistochemical analysis of these tissues using anti-poly(ADP-ribose) antibody supported this view.

Adenoma↗

PubMed1984

[Long-term observation of patients with gastric polyps].

104 Patients with gastric polyps and 8 patients with gastric polyposis were controlled between 1 and 7 years after polypectomy. In about 20% of the cases recidivations of polyps were found. Patients with primarily multiple polyps had more frequently recidivations than patients with solitary polyps. The recidivation polyps are in most cases small and histologically above all hyperplastic. In 4 cases a carcinoma of the stomach developed after 1-4 years. In patients with polyposis of the stomach no development of the carcinoma was observed. Patients with polyps of the stomach and polyposis of the stomach should annually be examined endoscopically.

Female↗

PubMed1983

Distribution of colorectal neoplasms. A left to right shift of polyps and cancer.

A 20-year retrospective review was made of all patients undergoing operative procedures for both adenocarcinoma and benign polyps of the colorectum at the two teaching hospitals of the University of South Carolina. A total of 1,112 patients with adenocarcinoma and 429 patients with benign polypoid disease were identified. Classification of each adenocarcinoma according to location showed a 12 per cent increase in the number of right-sided lesions and a 44 per cent decrease in rectosigmoid lesions when compared with historical series. Despite this proximal shift, the rate of association of benign adenomatous polyps contained in cancer resections (13 per cent) is similar to previous series. Furthermore, evaluation of benign adenomatous polyps showed a similar increase of proximal colonic lesions and a decrease of rectosigmoid adenomas. The results of this retrospective study support the concept that adenocarcinoma is occurring with increasing frequency in the right colon. Despite this left to right shift, a constant association of benign polyps within cancer resections was found, supporting the concept of a polyp-cancer sequence. This study identified a similar shift in benign adenomatous polyps alone, supporting the concept that benign neoplasias are premalignant and are probably responsible for the increased incidence of proximally located colonic adenocarcinomas.

Adenocarcinoma↗

PubMed1980

[Polyps of the sigmoid and rectum following ureterosigmoidostomy].

Implantation of the ureters in the sigma is practicable as far as cystectomy or congential malformations are concerned. The problem of the development of sigma-rectum polyps following ureterosigmoidostomy (uss) is being discussed within the description of three own case reports. The polyp of our first case is classified as an adenomatous polyp with marked retention of mucus. The polyp of our second case is regarded as a polypoid hamartia caused by the operation. The polypoid lesion of our third case must be regarded as a heterotopia of the urinary tract in connection with the known malformation of the urogenital tract of this patient. Patients who had undergone uss have an increased risk for the development of rectal carcinoma. But on the other hand the polypoid lesions following use must not necessarily be predecessors of carcinomas! In rather seems that the polyps following uss are very heterogenous. Only the first case being described in the present report may be regarded as a potential predecessor of a carcinoma. A tabulated review of the literature of the described polyps after uss is given. Etiological aspects are being discussed.

Adolescent↗

PubMedDate not supplied

[Stomach polyps. Clinical and therapeutic considerations].

The main clinical and therapeutic problems of gastric polyps are examined on the basis of 7 personal cases and the literature on the subject. 5 of the cases were adenomatous polyps proper, one of them in malignant degeneration and associated with polyposis of the large intestine. In 2 other cases, the histopathological picture revealed Peutz-Jeghers type hamartomatosis polyps confined to the gastric region without the typical cutaneo-mucous stigmata or familial character. Classification of polyps must allow not only for aetiopathogenetic or clinical criteria but for histopathological and histogenetic criteria also. A clear-cut distinction must be made between adenomatous polyps, of definite malignant potential, and pseudoneoplastic polypoid lesions that are essentially benign. The main diagnostic techniques available to handle a symptomatology that is often oligosymptomatic and aspecific, or associated with complications (such as ulcers, haemorrhage, stenosis or, not least, malignant transformation) are reviewed and stress laid on the importance of endoscopy prior to histopathological study which is of value only if carried out on a totally removed polypous lesion. The guidelines for indicating and selecting the radial surgical technique are presented.

Adult↗

PubMed1982

The management of gastric polyps.

Gastric polyps are rare. Most patients either are asymptomatic or present with symptoms of vague epigastric pain and bloating. An upper gastrointestinal tract study can demonstrate gastric polyps in 85 to 90 per cent of the patients. Features that increase the suspicion of carcinoma include the presence of adenomatous polyps greater than 2 centimeters in diameter, especially if they are multiple. In most patients, gastrotomy and removal of the polypoid mass with a cuff of normal mucosa are sufficient treatment. In patients who have invasive adenocarcinoma found upon biopsy of the polyp, gastric resection should be done. In most patients with carcinoma in situ, wedge resection is adequate treatment. Endoscopy for the diagnosis and treatment of polyps is appropriate in selected patients with pedunculated polyps that are less than 2 centimeters in diameter. The morbidity after operation or endoscopy is similar. Patients who are at high risk of having carcinoma develop should be observed yearly by endoscopic examination and biopsy.

Female↗

PubMed1981

Inaccuracy of radiographic measurements of colon polyps.

Polyp size is one of the main determinants of the surgical management of polyps in areas without colonoscopy services. We reviewed 47 patients with 59 polyps at two hospitals. Polyp dimensions were measured directly from air contrast barium enema radiographs, and again after resection and fixation. In over 95% of polyps the radiographic size exceeded the pathologic size by 10 to 100%. Since surgery may be decided on the basis of polyp size, an inaccurate measurement may result in unnecessary colonoscopy or laparotomy. We therefore recommend a correction factor derived from measuring a rectal tube of known diameter.

Colonic Neoplasms↗

PubMedDate not supplied

Endoscopic polypectomy of the large bowel: management of cancer-bearing polyps.

From January 1974 to May 1979, among 2,338 endoscopic examinations of the large bowel, 184 polypectomies were performed. Forty-two cases of familial polyposis coli were excluded from this study. Of the remaining 142 cases, 21 had cancer foci: fourteen were mucosally confined carcinomas, and seven submucosally invading carcinomas. Endoscopic polypectomy was considered a radical treatment for the former and not satisfactory for the latter. Therefore macroscopic type of polyp, location of carcinoma in the polyp, and lymphatic and venous permeation were the main criteria evaluated for the strategy of treatment in cases of submucosally invading carcinoma-bearing polyps. Radical resections are necessary in cases of semipedunculated polyp with carcinoma located near the base, and in cases of pedunculated polyps with carcinoma extending to the stalk. However, as general criteria for the management of submucosally invading carcinoma-bearing polyps have not yet been established, radical resections are indicated in cases which do not fit the generally accepted criteria, in order to attempt a curative treatment. Endoscopic polypectomy therefore seems to be of great value in the early detection of colorectal cancers and their treatment.

Adenocarcinoma↗

PubMedDate not supplied

Adenomyomatous, lower uterine segment and endocervical polyps in cervicovaginal smears.

To the best of our knowledge, the specific features of polyps in cervicovaginal smears have not been described; that fact prompted us to undertake this study. Fifty-seven cases of polyps below the uterine fundus with cytohistopathologic correlations were analyzed. The tissue diagnoses were 2 cases of adenomyomatous, 2 cases of lower uterine and 53 cases of endocervical polyps. In the cervicovaginal smears, adenomyomatous polyps presented as cohesive fragments with frayed edges, revealing spindle cells with bipolar cytoplasmic processes. Lower uterine segment polyps showed peculiar tissue fragments composed of several fractured arterioles connected by sheets of small stromal cells. Endocervical polyps presented as smooth-bordered, polypoid tissue fragments, lined at the outermost layer with simple columnar cells, sandwiched within a pale intermediate zone and packed at their inner core with numerous small, dark stromal cells. This specific finding, however, was observed in only one case. The remaining 52 patients had no specific findings in their smears.

Adenomyoma↗

PubMed1993

Hyperplastic polyps: a cell lineage which both synthesizes and secretes trefoil-peptides and has phenotypic similarity with the ulcer-associated cell lineage.

Hyperplastic polyps are common benign lesions of uncertain histogenesis, which occur in the colon in populations at risk for colorectal carcinoma. They contain neutral/MUC1 gene-related mucin which in turn is closely associated with the trefoil-peptide pS2, a major component of the ulcer-associated cell lineage, previously termed pseudopyloric metaplasia. We have examined 17 hyperplastic polyps for expression of the trefoil-peptides pS2 and human spasmolytic polypeptide by in situ hybridization and immunohistochemistry, as well as by using antisera to epidermal growth factor/urogastrone and its receptor and to epitopes of the product of the MUC1 gene to characterize any further similarity between these lesions and the ulcer-associated cell lineage and thus help elucidate the nature of the lesions. Our investigations show both human spasmolytic polypeptide and pS2 messenger RNA within the polyps, whereas only pS2 peptide could be demonstrated immunohistochemically. Epidermal growth factor/urogastrone, its receptor, and antisera to the MUC1 gene also showed widespread staining of these polyps. We suggest that hyperplastic polyps are formed of a lineage that both synthesizes and secretes trefoil-peptides and the MUC1 mucin and that hyperplastic polyps may be related to the phenotypically similar ulceration-associated cell lineage.

Cell Line↗

PubMed1994

[Changes in connective tissue metabolism in fibroblasts from nasal polyps].

Most studies investigating the etiology of nasal polyposis have concentrated on cellular infiltrations, particularly involving eosinophils and the mast cells which are easily seen. The stroma of polyps and its most significant cells, the fibroblasts, have been poorly investigated to date. We previously compared fibroblasts from normal skin with those explanted from nasal polyps and demonstrated that these show a significantly higher rate of proliferation. We now have investigated the metabolism of fibroblasts explanted from nasal polyps. Compared with fibroblasts explanted from normal skin those explanted from nasal polyps showed a significantly higher rate of proteoglycan synthesis, a significantly lower rate of fibronectin synthesis and no difference in collagen synthesis. Since important parameters of connective tissue are changed, nasal polyps show not only changes in epithelial cells and local tissue immunity, but also in their connective tissue component cells. These findings indicate that fibroblasts may play an important role in the pathogenesis of nasal polyps.

Cell Division↗

PubMed1993

[Expression of HLA-DR, DP, DQ antigens in fibrous sino-nasal polyps].

In the last years nasal polyps have been studied by several authors with different methodologies; however, their etiology is still unclear. In this paper we have analyzed in four nasal polyps of fibrous type, the HLA class II (HLA-DR, DP, DQ) molecule expression by means of immunohistochemical techniques (immunoperoxidase and immunophosphatase). A strong inflammatory cell infiltration, a percentage increase of both HLA-DR+ and HLA-DQ+ cells (normal nasal mucous membrane stroma infiltrating cells: DR+ < 40%, DP+ < 2%, DQ+ < 3%; fibrous polyps infiltrating cells: DR+ = 68%, DP+ < 2, DQ+ = 7%) as well as a clear positivity for DR expression of both surface and glandular epithelia were observed in all polyps. Furthermore, in the stalk area of one of the studied polyps DR+DQ+ cells with macrophagic features and having tight. connections with the vessels were observed. The scanty vascularization with the presence of activated mononuclear and mast cells might be responsible for polyp growth by locally producing an anomalous concentration of growth factors.

Antigens, Neoplasm↗