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PubMed1991

[Small polyps of the rectosigmoid].

The increasing interest in colorectal polyps is due to the fact that they may not only be diagnosed, but removed by endoscopic route. The aim of the study were small polyps of the rectosigmoid removed on rectoromanoscopy and their clinical significance. Included in the study were 193 small polyps, 0.5 cm in diameter, diagnosed on rectoromanoscopy and removed by mechanical way from 182 patients at the Proctologic Unit of the Department of Gastroenterology. Medical Academy in Sofia. Small polyps have a definite place and importance in colpoproctology. They should not be overlooked, since in the author's study 66.9 per cent were neoplastic, 55.7 per cent showed varying degree of dysplasia, 4.6 per cent appeared to be surface carcinoma in situ and 2 per cent were adenocarcinomas. Endoscopic polypectomy is considered obligatory for small polyps, both for diagnosis and for therapy.

Adenocarcinoma↗
PubMed1991

Multiple adenomas and synchronous hyperplastic polyps as predictors of metachronous colorectal adenomas.

The development of metachronous adenomas was evaluated in 56 patients, 34 men and 22 women, with a history of 139 removed adenomas and non-neoplastic polyps, in order to determine whether the presence of concomitant adenomas and hyperplastic polyps at the initial examination could predict a higher risk of new adenomas. Sixteen of the 56 patients developed 21 metachronous adenomas and 1 rectal carcinoma after a median follow-up of 2.8 years. Among the 16 patients developing metachronous adenomas there were significantly more men (P less than 0.01), patients with multiple adenomas (P less than 0.05) or patients with adenomas and synchronous hyperplastic polyps at the initial examination (P = 0.043) than among the 40 patients without new adenomas. The combination of multiple adenomas with synchronous hyperplastic polyps at the initial examination predicted best the risk of developing new adenomas (P = 0.005). The results of the study suggest that patients with multiple adenomas and synchronous hyperplastic polyps at the initial examination may comprise a new higher risk group for developing metachronous colorectal adenomas.

Adenoma↗
PubMed1991

[Endometrial polyps. A clinico-pathologic analysis].

A clinico-pathologic analysis of 92 cases of endometrial polyps was carried out and the endometrium adjacent to the polyps was studied in 69 cases. Most endometrial polyps occurred between 30-60 years of age, often accompanied by abnormal uterine bleeding. Immature endometrial polyp was the most common pathologic type (65.0%), usually associated to some extent with hyperplastic changes. Cystic glandular hyperplasia was observed in nearly half of the polyps obtained from postmenopausal patients. Different histologic pictures were found in the adjacent endometrial tissues, of which 59.4% showed normal changes.

Adult↗
PubMed1991

Lymphocytopenia, T-lymphocyte subsets, and colorectal polyps in automotive pattern and model makers.

Several studies have found pattern and model makers to be at increased risk for colorectal polyps and colorectal cancers. One study found an increased prevalence of lymphocytopenia. The association of total lymphocyte, CD4 (T-helper cell), CD8 (T-suppressor cell), CD2 (total T-cell), and CD16 (natural killer cell) counts with biopsy-proved colorectal polyp status was investigated in 70 patternmakers participating in one or more of four sequential screenings. In logistic regression analyses after adjusting for age or trade years, pack-years smoked, and material worked with most, a history of any type of polyp was significantly associated with total lymphocyte count (odds ratio of 2.01 for a 500 cell/cc decrease, P = 0.03), and somewhat associated with decreased CD4 and CD2 counts (P values of 0.06 and 0.07, respectively). In linear regression models adjusted for age, pattern and model makers had (regardless of polyp status) significantly lower CD4, CD8, CD2, and CD16 counts than did laboratory reference controls (P value less than 0.01 for each comparison). These findings appear consistent with a sequence of carcinogenesis initiated by pattern and model makers' work-place exposures that depress immune surveillance thus promoting the development of colorectal polyps as a precursor of carcinoma.

Adenocarcinoma↗
PubMed1991

Flow cytometric analysis of DNA content in colorectal polyps resected at endoscopy.

Samples from 64 consecutive resected colorectal polyps were preserved in liquid nitrogen and analyzed by flow cytometry to assess the nuclear DNA content, which was compared to the histopathologic findings. The frequency of aneuploidy in these nonselected polyps was 17.2%. There was a significant correlation between the diameter of the polyp and the frequency of aneuploidy (P = .04), with all aneuploid polyps being greater than or equal to 10 mm. Similarly, aneuploidy was significantly more frequent for polyps that were both greater than or equal 20 mm and showed at least severe dysplasia (P = .02). On the other hand, there was no correlation between the ploidy and the gross histopathologic type (tubular, tubulovillous or villous), and the proliferation index did not correlate with any of the parameters studied.

Adult↗
PubMedDate not supplied

[Gastric polyps. Experience at the department of endoscopy of the Salvador Zubirán National Institute of Nutrition].

During 1981-1989 we seen 54 patients with gastric polyps in the Instituto Nacional de la Nutrición SZ, Endoscopy Dept., México City. We found 100 polyps among 15,974 upper endoscopy studies (0.33%), being multiple in 22 patients with an overall of 68 polyps. Females had a predominance of 2:1 with prevalence from the 5th to 8th decades. All were asymptomatic in regard to polyps. Its main locations were in antrum (46%) and corpus (39%). They measured an average of 8 mm with a range from 5 to 25. Only three adenomatous polyps shows dysplastic changes, two with moderate dysplasia and one, bigger than 20 mm, had severe dysplasia (carcinoma in situ). Histological findings were: Inflammatory (chronic gastritis) 30%, adenomatous 22%, hyperplastic 17% and hamartomatous 13%. In seven patients we seen recurrence at follow up.

Adolescent↗
PubMed1990

[Hematic infiltrates and the expression of HLA-DR antigens in naso-sinusoidal polyps of the fibrous type].

In this study fibrous nasal polyps, obtained from four patients, were analyzed by means of immunocytochemical methods for the presence of interstitial hematic cell infiltrate and HLA-DR molecule expression. This histologic type accounted for 36.4% of nasal polyps studied. Our results demonstrated that cells belonging to monocyte-macrophage lineage were mainly detected within fibrous and edematous zones (greater than 50%), whereas T cells were found within the subepithelial peripheral connective tissue (greater than 60%). Surface and gland epithelial cells appeared to be more intensely stained for HLA-DR molecules than nasal epithelium of normal subjects, thus indicating that the intensity of HLA-DR molecule expression correlated with the presence of a hematic cell infiltrate. Nasal polyps are a frequent pathology whose etiology has not yet been completely clarified. The present study provides additional information about the fibrous polyp structure and can support some speculations on the nasal polyp etiology.

Blood Cells↗
PubMed1990

[Proctoscopic versus histologic diagnosis of rectal polyps].

On the basis of the endoscopic appearance, 71 rectal polyps were assessed as adenomata or non-neoplastic polyps, after which the endoscopic diagnosis was compared with the results of histological examination. The diagnosis based on macroscopic examination of the polyps proved correct in only 62% of the cases. It is concluded that the diagnosis of adenoma cannot be established solely on the proctoscopic appearance of a polyp and, as adenomata are premalignant, removal of all polyps found at proctoscopy is recommended.

Adenoma↗
PubMed1990

Polyps in the gallbladder. A prevalence study.

The prevalence of gallbladder polyps as assessed by ultrasonography in a random population was 4.6% among men and 4.3% among women. The size of most polyps was 3 mm or more but never exceeded 10 mm. The prevalence of polyps was not significantly associated with age, sex, social factors, weight factors, physical activity, diabetes mellitus, pregnancies, use of exogenous female hormones, intake of alcohol, or plasma lipids. Polyps among men were significantly associated with a history of no smoking. This lack of risk factor profile resembled that of cholesterolosis, as seen in the literature, whereas it was quite different from that of gallstones. It is concluded that polyps in the gallbladder are common in a random population, and, although it is known from the literature that some cases may represent gallstones, the vast majority most probably represent the polypoid variation of cholesterolosis.

Adult↗
PubMed1989

Etiology of nasal polyps associated with aspirin-sensitive asthma.

It is well known that nasal polyps occur at high frequency in aspirin-sensitive asthma (ASA). Their etiology, however, remains obscure. Therefore, histopathologic observations and measurements of arachidonic acid metabolites were carried out to investigate the etiopathogenesis of nasal polyps in ASA. Abundant eosinophils and degranulated mast cells were found in the tissue of nasal polyp-associated ASA cases. Electron-microscopic analyses of these eosinophils revealed that high-electron-dense material had disappeared from the cytoplasmic granules' central crystalloids. Arachidonic acid metabolites (PGE2, PGF2, 6-keto-PGF1 and TXB2) from the cyclooxygenase pathway were measured via gas mass-chromatography. Leukotrienes (LTC4 and LTD4) from the lipoxygenase pathway were measured via HPLC-radioimmunoassay. Especially noteworthy are the high level of leukotrienes and low level of prostaglandins in nasal polyp-associated ASA. The etiopathogenesis of nasal polyps in aspirin-sensitive asthma is postulated.

Arachidonic Acid↗
PubMed1989

[Comparative research on vocal polyps and nodules].

One hundred and eighty-four cases of vocal polyps and 64 cases of vocal nodules are reported. Of these cases, 6 polyps and 10 nodules had been studied with electron microscope: 40 cases of polyps and 15 cases of nodules were investigated histo-chemically with PAS, AB-PAS, HID-AB, Congo Red and other methods. It seems that polyps are distinctly different from nodules. They are different diseases. The main difference between them is that polyp of the vocal cord is caused primarily by circulation impediment, thrombosis, exudation and edema of the lamina propria of the mucous membrane due to inflammation, there is secondary atrophy of the epithelium of the cord, vocal nodule is caused primarily by vocal abuse, this leads to friction or dash of the vocal cords against each other, there is circumscribed hyperplasia or hyperkeratinization and secondary hyaline-degeneration in lamina propria of the cord. The differential diagnosis, pathogenesis and treatment had been discussed.

Adult↗
PubMed1989

[A case of malignant transformation of gastric hyperplastic polyp with metaplastic bone formation].

A case of malignant transformation of a gastric hyperplastic polyp with a metaplastic bone formation is reported. A large gastric polyp was revealed by X-ray examination and by endoscopy in the cardia of a 89-year-old female who had complained of nausea. A polypectomy was performed since the biopsied materials had contained some atypical glands intermingled with hyperplastic glands. Histologically, the polyp, 1.7 x 1.0 x 0.6 cm in size, was a hyperplasic polyp that was found to contain superficial dysplastic foci associated with a moderately differentiated type of a tubular adenocarcinoma. A metaplasic bone formation was found in stroma beneath the hyperplastic glandular epithelium. Thus, polypectomy of hyperplastic polyps of the stomach of more than 1 cm with dysplastic foci is recommended.

Adenocarcinoma↗
PubMed1989

[Benign ureteral polyps in a child].

A case of benign ureteral polyps at ureteropelvic junction in a 9-year-old boy is reported. He was hospitalized with episodes of gross hematuria and left flank pain. An excretory urogram showed the left hydronephrosis due to the ureteropelvic junction obstruction. At exploration, we found two polyps at the left ureteropelvic junction. Partial ureterectomy including the polyps and pyeloplasty were performed. Pathological examination showed fibrovascular polyps of the ureter. The patient still remains symptomless for one year after the operation with no signs of recurrent ureteral polyps.

Age Factors↗
PubMed1989

[Adenomatous polyps of the prostatic urethra. A report of four cases].

A benign prostatic urethral polyp is considered as an unusual lesion of the urethra. It attracts the patient or doctor's attention only when hematuria or hemospermia is noted. From August 1987 to June 1988, the authors found four cases of posterior urethral polyps in the Taitung Branch of Mackay Memorial Hospital. Hematuria was found in all of the 4 patients and hemospermia was found in one. Three patients presented gross hematuria, and one microscopic hematuria. Of the four, two had suprapubic soreness; one had perineal discomfort; and only one manifested no symptoms at all. All of the patients underwent a cystoscopic biopsy, and their specimens were stained and studied by the immunoperoxidase method. All of the specimens were PSA positive, and presented a picture of adenomatous polyp. Only one patient received transurethral electrocoagulation because of continued hematuria and perineal discomfort that persisted even after a two week medical course that appeared to be more effective to the previous one. In conclusion, the authors believe that more of such lesions will be discovered when more attention is paid to the posterior urethra; when adenomatous polyps are suspected in patients who have the above symptoms; and when polyps are considered as a possibility in the differential diagnosis.

Adult↗
PubMed1988

[Fibrous epithelial polyps of the pyelo-ureteral junction in children. Presentation of 3 cases and review of the literature (33 cases)].

Primary ureteral tumors are rare and benign ones constitute only a small portion. Of the benign neoplasms, fibro epithelial polyps are probably the most common and could be considered to be an exceedingly rare cause of Hydronephrosis in children. The exact etiology of benign ureteral polyps is not certain but it is likely that they have a congenital one. They are mesodermal in origin and consist of a thick fibrous stalk covered by a layer of normal transitional epithelium. They are more commonly found in boys (80.6%), who present usually with abdominal pains or renal colics. Fibro-epithelial polyps often rise in the proximal ureter and renal pelvis, especially at the left side (69.4%). Radiographic signs are those of a non typical uretero-pelvic Junction obstruction. IVP and retrograde ureterogram usually demonstrate a long, thin, filiform, lucent filling defect within the ureteral lumen with moderate hydronephrosis. Appropriate treatment of these benign tumors is local excision with or without segmental resection. Prognosis should be considered as excellent without a report of recurrence. A review of the literature revealed 33 cases of ureteral polyps in children. We report here 3 additional cases of obstructing fibro epithelial polyps, observed in boys aged respectively 4, 8 and 9 years.

Child↗
PubMed1979

[Large colonic polyp: endoscopic or surgical removal?].

93 neoplastic polyps measuring more than 2 cm in diameter have been removed from the colon by endoscopy. 15% of the polyps showed severe atypia (focal carcinoma), and in 15% an invasive carcinoma was found. Polypectomy was complicated in 14 cases by bleeding, in 12 cases it was cured by endoscopy. In 1 case in which the colon was injured by coagulation the lesion healed spontaneously. The surgery rate due to complications of the endoscopic removal procedure or due to invasive carcinoma was 7% for the polyps with a diameter of 2-3 cm, 15% for those of 3-5 cm and 50% for polyps with a diameter of more than 5 cm. It is therefore suggested that neoplastic polyps of more than 5 cm in diameter should be removed by endoscopy in high risk patients only.

Carcinoma↗
PubMed1988

Lectin histochemistry in colorectal polyps.

Lectin histochemistry has permitted an assessment of the glycoconjugate expression in colorectal polyps (Table 8). The T-antigen, a cancer-associated antigen, is expressed in colorectal adenomatous polyps. The apparent expression of T-antigen is related to the methodology used for its detection. FITC-PNA does not bind to glycoconjugates in the normal colon, however it is a sensitive marker for glycoconjugates secreted by colorectal cancers. The binding of FITC-PNA in adenomatous polyps is related to size and histology. The use of biotinylated PNA (followed by avidin-biotin-peroxidase) or PNA:anti-PNA is a more sensitive technique, and the result is that binding may be seen in the normal colon as well as most neoplastic lesions. The use of polyclonal and monoclonal antibodies to the T-antigen are more specific than the PNA:anti-PNA technique. Binding of PAb and MAb anti-T-antigen to colorectal polyps is related to the size of the polyp for both probes, and binding is also related to the degree of dysplasia for the MAb. The future of this work may be directed at an attempt to determine whether a family of closely related antigens are expressed in colorectal neoplasia with varying degrees of affinity for different probes of the T-antigen.

Colonic Neoplasms↗
PubMed1988

[Morphogenesis of polyps in diffuse polyposis of the colon].

Sixty operative specimens of the colon or its fragments removed for diffuse juvenile polyposis (the diagnosis was clinical) were evaluated morphologically. A structural study of the polyps ranging in size from the smallest to large lobular formations elicited a significant role of inflammation in polyp morphogenesis. Large polyps often show fragments of typical adenomatous structure. These adenomatous sites mark a higher risk of malignant transformation which develops in polyps of mixed structure in diffuse juvenile colon polyposis. Structurally, there are more reasons for referring juvenile polyps to adenomas than to hamartomas.

Adenocarcinoma↗