RESUMEN
An in vitro study of proliferative activity as shown by immunohistochemical detection of the uptake of bromodeoxyuridine was run on rectal biopsies from 400 patients with nonfamilial large bowel neoplasia: 200 adenoma; 150 adenocarcinoma; 50 adenoma plus adenocarcinoma. The controls were 400 subjects with negative personal and family histories of colorectal neoplasia. The number and height distribution of bromodeoxyuridine positive cells were determined by dividing the crypt into five longitudinal compartments. The total labeling index and the labeling index of each compartment were higher in all three groups compared with the controls. In subjects with adenoma, total labeling index and labeling index values were correlated with tumor size and decreased in function of the duration of the polyp-free colon state. The major zone of DNA synthesis had shifted to the intermediate and surface crypt compartments in all three groups. This stage II abnormality was more marked in adenoma patients with a high degree of dysplasia and in those with adenoma plus adenocarcinoma. Hyperproliferation and the proliferative compartment shift are cytokinetic abnormalities that coexist in the flat rectal mucosa of patients with colorectal neoplasia. Nonetheless, they are independent, controlled by different factors, and are expressions of different biological aspects of large bowel carcinogenesis.
Asunto(s)
Adenocarcinoma/patología , Adenoma/patología , Neoplasias Colorrectales/patología , Mucosa Intestinal/patología , Recto/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bromodesoxiuridina , División Celular , Femenino , Humanos , Masculino , Persona de Mediana Edad , Patología/métodosRESUMEN
The aim of this double blind trial was to compare omeprazole 20 mg once daily with ranitidine 150 mg b.i.d. in treatment of benign gastric ulcer, evaluating both rates and histological aspects of the ulcer healing process. Eighteen patients were randomized, 9 to each treatment; one patient (ranitidine group) was excluded from the analysis because of malignant ulcer. Omeprazole appeared to be more effective than ranitidine in healing gastric ulcer. A more rapid relief of symptoms was observed in the omeprazole group than in the ranitidine group. Both drugs reduced chronic atrophic gastritis (with a trend in favour of omeprazole), while omeprazole showed a prompter activity on the components of acute inflammation.
Asunto(s)
Omeprazol/uso terapéutico , Ranitidina/uso terapéutico , Úlcera Gástrica/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Método Doble Ciego , Esquema de Medicación , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Omeprazol/administración & dosificación , Ranitidina/administración & dosificación , Úlcera Gástrica/patologíaRESUMEN
Tubal carcinoma is the rarest neoplasia of the gynecological tract; it is found during the course of abdomino-gynecological surgery with an incidence of 1:1000. The authors report a case of papilliferous tubal carcinoma which was brought to their attention having not been recognised earlier. In fact, diagnosis was made at an advanced stage during the course of emergency surgery 2 days after hospitalisation. Intraoperative histological tests resulted in bilateral adnexectomy (without apparent damage to the tubes) as well as colostomy on the transverse colon due to stenosis of the sigmoid caused by serofibrinous peritonitis. The final histological analysis of the part removed confirmed the intraoperative diagnosis.
Asunto(s)
Carcinoma Papilar/patología , Neoplasias de las Trompas Uterinas/patología , Anciano , Femenino , HumanosRESUMEN
The paper describes the removal of a broad-based tubulo-villous adenoma from the middle rectum using a transanal endoscopic microsurgical technique. This procedure, which was introduced by Buess, Thess and Hutterer in 1983, represents an alternative to the classic transanal technique, compared to which it is more accurate, and to the trans-sacral and transperitoneal methods compared to which it is less invasive.
Asunto(s)
Pólipos Intestinales/cirugía , Microcirugia/métodos , Proctoscopía , Neoplasias del Recto/cirugía , Anciano , Canal Anal , Humanos , MasculinoRESUMEN
The paper reports a case of angiolipoma localised on the ileocecal valve. No cases of intestinal angiolipoma have been reported in the literature. The authors analyse the anatomopathological diagnostic criteria used, together with the clinical characteristics of a pathology which, even when examined macroscopically, resembles a malignant neoplasia of the colon. The authors conclude by underlining the importance of histological diagnosis for a correct surgical choice.
Asunto(s)
Angiolipoma/diagnóstico , Neoplasias del Ciego/diagnóstico , Adenocarcinoma/diagnóstico , Anciano , Angiolipoma/patología , Angiolipoma/cirugía , Neoplasias del Ciego/patología , Neoplasias del Ciego/cirugía , Ciego/patología , Ciego/cirugía , Colectomía , Diagnóstico Diferencial , Humanos , Neoplasias del Íleon/diagnóstico , Válvula Ileocecal , MasculinoRESUMEN
A case of paraganglioma situated between right renal vein, right renal artery and inferior vena cava is here with described. The report constitutes the rise to frame with precision the tumor according with WHO classification. Moreover criteria are to be discussed for nature and seat diagnosis, as well for the choice of the best way of access.
Asunto(s)
Paraganglioma/cirugía , Neoplasias Retroperitoneales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Paraganglioma/diagnóstico por imagen , Paraganglioma/patología , Arteria Renal , Venas Renales , Neoplasias Retroperitoneales/diagnóstico por imagen , Neoplasias Retroperitoneales/patología , Factores de Tiempo , Tomografía Computarizada por Rayos X , Vena Cava InferiorRESUMEN
The authors report a rare case of littoral hemangioma of the spleen (LHS) accompanied by a revision of the literature on the argument. A male 65-year-old patient was referred to their attention with suspected ultrasonographic diagnosis of lymphoma with a splenic localisation. The complete CT diagnosis led to suspected splenic angioma. During surgery, anatomopathological analysis of the biopsy revealed LHS. The pathological anatomy showed lesions ranging in size from small foci to large nodules which almost completely replaced the splenic parenchyma. These areas were made up of vascular canals or axes that imitate splenic sinuses and have irregular lumen, often appearing as papillary projections and cyst-like spaces; they are bordered by high (cylindrical) endothelial cells that project into the vascular lumen and reveal hemophagocytosis; there is very little mitotic activity. The patient was discharged 7 days after surgery. The authors underline the extreme rarity of this neoplasm and the virtual absence of symptoms, although some cases report signs of hypersplenism, including platelet deficiency and anemia. The diagnostic iter must take care to exclude other pathologies affecting the spleen, including lymphoma, metastases and primary malignant splenic tumours. Lastly, a differential diagnosis must be made with the malignant variant, littoral hemangiosarcoma of the spleen.
Asunto(s)
Hemangioma/cirugía , Neoplasias del Bazo/cirugía , Anciano , Humanos , MasculinoAsunto(s)
Neoplasias Laríngeas/mortalidad , Adulto , Factores de Edad , Anciano , Femenino , Francia , Humanos , Italia , Masculino , Persona de Mediana Edad , Factores SexualesRESUMEN
Two cases of balloon cell malignant melanoma of the skin are reported. The first lesion was pigmented, the second was amelanotic. Histologically, the tumor mass was dermal and intraepidermal and almost exclusively composed of balloon cells. Many of the clear cells demonstrated postivity with the S-100 protein immunostaining. The problems of clear-cell tumor differential diagnosis are discussed.
Asunto(s)
Melanoma/patología , Neoplasias Cutáneas/patología , Anciano , Dorso , Humanos , Pierna , Neoplasias Pulmonares/secundario , Masculino , Melanoma/secundario , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patologíaRESUMEN
AIM: We describe a case of Aggressive Digital Papillary Adenocarcinoma, a rare skin neoplasm with acral location. RESULTS: The patient, a 66 year old man, presented with an ulcerated mass of the fifth toe of the left foot, 4.4 cm in size. Histologically the tumour was characterized by a solid-cystic structure, with extensive papillary component, comedo necrosis and focal eccrine differentiation. Immunohistochemistry showed diffuse positivity for cytokeratins AE1/AE3 and 7, and, focal staining for Muscle Specific Actin, Vimentin and EMA. Chest CT scan showed the presence of a single pulmonary node, whose cytological features were consistent with a metastatic disease. CONCLUSIONS: The clinico-pathological features of the present are similar to those previously reported in the literature and confirms the aggressive nature of this neoplasm.
Asunto(s)
Adenocarcinoma Papilar/secundario , Enfermedades del Pie/patología , Neoplasias Pulmonares/secundario , Neoplasias de las Glándulas Sudoríparas/patología , Dedos del Pie/patología , Actinas/análisis , Adenocarcinoma Papilar/química , Adenocarcinoma Papilar/patología , Anciano , Biomarcadores de Tumor/análisis , Diferenciación Celular , Enfermedades del Pie/metabolismo , Humanos , Queratinas/análisis , Masculino , Mucina-1/análisis , Proteínas de Neoplasias/análisis , Vimentina/análisisRESUMEN
Of 1696 endoscopically removed polyps in the authors' series 62% were adenomas and 31 showed invasive carcinoma. 8 patients were not available for follow-up, and 7 underwent surgical resection with negative findings. There was no evidence of recurrent cancer in the remaining 16 over a 1-6 year span of follow-up, although one unrelated rectal carcinoma and an adenoma were found. By combining the data of 10 Italian Centres, 44 further patients were available, who had had endoscopic polypectomy as the only management of cancerous adenomas, adding no additional example of recurrent carcinoma. It is concluded that endoscopic polypectomy can, providing strict histological criteria are satisfied, provide definitive resection of some cancerous adenomas. A detailed follow-up regime including physical examination, occult blood testing, repeated endoscopy, paired tumour antigen levels and ultrasonography has been used to confirm the absence of recurrence in our series.
Asunto(s)
Adenocarcinoma/cirugía , Neoplasias del Colon/cirugía , Colonoscopía , Pólipos Intestinales/cirugía , Adenocarcinoma/patología , Adulto , Anciano , Neoplasias del Colon/patología , Femenino , Estudios de Seguimiento , Humanos , Pólipos Intestinales/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de NeoplasiaRESUMEN
Two cases of inverted urothelial papilloma are presented. In the first case the inverted papilloma was in the ureter and varying degrees of cellular atypia were demonstrated on histology: 7 years later, a single bladder lesion consisting of papillary transitional cell carcinoma and inverted papilloma developed in the same patient. In the second case a bladder tumor consisting of inverted papilloma mixed with papillary infiltrating transitional cell carcinoma was detected. The peculiar morphological findings, histogenesis and biological behavior of inverted urothelial lesions are discussed.
Asunto(s)
Carcinoma de Células Transicionales/patología , Papiloma/patología , Uréter/patología , Neoplasias Ureterales/patología , Neoplasias de la Vejiga Urinaria/patología , Vejiga Urinaria/patología , Anciano , Epitelio/patología , Humanos , MasculinoRESUMEN
A monoclonal antibody to bromodeoxyuridine was used in tissue specimens previously incubated with bromodeoxyuridine to show S-phase cells by immunohistochemical technique. Biopsy specimens of normal mucosa (n = 10), hyperplastic polyps (n = 10), adenomas with low-grade dysplasia (n = 20), adenomas with high-grade dysplasia (n = 10), and invasive adenocarcinomas (n = 10) of the large bowel were studied. Labeling index and cell proliferative patterns were analyzed. No statistically significant difference was found in labeling index between normal mucosa and hyperplastic polyps or between adenomas with high-grade dysplasia and adenocarcinomas. The labeling index was significantly lower in normal mucosa and in hyperplastic polyps than in adenomas and adenocarcinomas (p less than 0.001). The difference in labeling index between adenomas with high-grade dysplasia and low-grade dysplasia was also statistically significant (0.01 less than p less than 0.05). In normal mucosa and in hyperplastic polyps the proliferative zone was confined to the lower two-thirds of the crypt; no kinetic activity was found in the upper portions of the crypt or in surface epithelium. In adenomas the labeled cells were either present in the upper third or scattered along the whole axis of the crypt and in the surface epithelium. Labeling patterns in invasive carcinomas were similar to those observed in adenomas with high-grade dysplasia. The difference in proliferative patterns between hyperplastic polyps and adenomas supports a different significance of the two polypoid lesions in the histogenesis of large bowel cancer; our results confirm the subsequent steps of the adenoma-carcinoma sequence. Immunohistochemical labeling patterns observed with monoclonal antibody to bromodeoxyuridine in polypoid and cancer lesions of the large bowel are similar to those described by autoradiographic studies.
Asunto(s)
Adenocarcinoma/metabolismo , Adenoma/metabolismo , Neoplasias del Colon/metabolismo , Pólipos del Colon/metabolismo , Pólipos Intestinales/metabolismo , Neoplasias del Recto/metabolismo , Anticuerpos Monoclonales , Bromodesoxiuridina/inmunología , División Celular , Células Epiteliales , Femenino , Humanos , Inmunohistoquímica , Mucosa Intestinal/metabolismo , MasculinoRESUMEN
Thin viable slices of normal or pathological human tissues were incubated in vitro with bromodeoxyuridine (BrdU). Later, cryostatic sections and histological sections from the same samples embedded in paraffin were examined by an immunohistochemical method using a monoclonal antibody anti-bromodeoxyuridine (anti-BrdU-MAb): on both cryostatic and histological sections, the nuclei of the S-phase cells proved positive. The optimization of the technique depends on the concentration of bromodeoxyuridine in the culture medium (160 microM), the duration of incubation (not less than two h), the method of DNA denaturation (2N or 4N HCl) and the dilution of the anti-BrdU-MAb (1:50). In vitro, immunohistochemical application of the BrdU/anti-BrdU-MAb method permits a quantitative assessment of the proliferative activity of a tissue as well as the direct location of the actively replicating cells in histological sections.
Asunto(s)
Bromodesoxiuridina/análisis , Interfase , Neoplasias/patología , Anticuerpos Monoclonales , Bromodesoxiuridina/inmunología , ADN , Histocitoquímica , Humanos , Técnicas para Inmunoenzimas , Desnaturalización de Ácido NucleicoRESUMEN
It is confirmed that occupational and paraoccupational exposure to mineral fibres, particularly asbestos fibres, plays a fundamental role in the induction of lung cancer and pleural mesothelioma. The possible association with other human cancers (e.g. larynx cancer, gastro-intestinal cancer, uro-genital cancer and emolinfopoietic cancer) is not yet demonstrated, even if some mineral fibres are identified in tissues different from the lung ones, such as kidney, bladder, and some biological fluids (e.g. urine of subjects with occupational exposure to asbestos). The possibility of damage caused to tissues in consequence of exposure to low concentration of mineral fibres (e.g. environmental exposure) has still to be defined. In this work we report the results of a mineralogical study by means of scanning electron microscopy with microprobe of a case of bladder cancer in a subject without professional exposure to mineral fibres where asbestos bodies are identified by optical microscopy.
Asunto(s)
Asbestos Serpentinas/efectos adversos , Carcinoma de Células Transicionales/etiología , Silicatos/efectos adversos , Neoplasias de la Vejiga Urinaria/etiología , Asbestos Serpentinas/análisis , Carcinoma de Células Transicionales/ultraestructura , Exposición a Riesgos Ambientales , Humanos , Masculino , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , Fibras Minerales/análisis , Silicatos/análisis , Manejo de Especímenes , Neoplasias de la Vejiga Urinaria/ultraestructuraRESUMEN
Adenomas that contain early invasive carcinoma (ACIC) represent the earliest form of clinically relevant cancer of the colorectum in most patients. In order to assess the incidence of nodal metastases of ACIC, we studied 31 patients in whom the colon was resected after endoscopic polypectomy (EP) done from 1975 to 1987. We also reviewed the pathologic features reported in individual cases and in literature series of ACIC with lymph node metastases published from 1958 to 1986. The lymph node metastatic potential of ACIC is relatively high, ranging from an average value of 8.5% in the literature of to 16.1% in our own study, and is equivalent to the range of 10%-17% that occurs in colorectal carcinomas that invade the submucosa. When an ACIC is seen in an EP specimen in which the polypectomy margin is normal, the decision as to whether the patient should enter a follow-up protocol or have radical surgical resection is determined by the assessment of the probability of the occurrence of nodal metastases. According to several authors, certain histopathologic features make it possible to distinguish between an ACIC with a high-risk of nodal metastases versus those with a low-risk. The most relevant pathologic parameters include the state of the resection margins, the grade of the invasive carcinoma, and the presence or absence of vascular invasion. Of 351 cases of ACIC that were operated on, derived from 16 literature series, 45.6% were high-risk cases and 8.5% had lymph node metastases. In our group of high-risk ACIC that had surgical resection subsequently, the lymph node metastatic rate was 35.7%. Our results help to estimate the nodal metastatic potential of early colorectal carcinomas and stress the importance of adequate pathologic evaluation in order to assess metastatic risk in these patients accurately.