[Gastrointestinal inflammatory fibroid polyps. Clinical characteristics and follow-up in a series of 26 patients]. / Pólipo fibroide inflamatorio gastrointestinal. Características clínicas y seguimiento de una serie de 26 pacientes.

INTRODUCTION: Inflammatory fibroid polyp (IFP) is a protuberant lesion, located near the muscularis mucosae and composed of a proliferation of fusiform cells and conjunctive fibers surrounding capillaries and a variable inflammatory infiltrate. It is believed to be a poorly controlled inflammatory repair response. Our aim was to study the clinical, pathological and follow-up characteristics of a series of patients with IFP. PATIENTS AND METHOD: We studied 26 IFPs from 25 patients (16 women and 9 men) registered between 1985 and 2001 in a specific register of 3 centers in the city of Gerona (Spain). The variables analyzed were age, sex and clinical presentation, IFP localization and size, mucosal characteristics and associated disease, as well as follow-up information. Routine statistical analyses were performed. RESULTS: IFPs were antral in 16 patients, ileal in 7, jejunal in 2 and colonic in the remaining patient. Size determined whether they were symptomatic (35 +/- 13.6 mm) or asymptomatic (8.4 +/- 6.3 mm). Gastric polyps were significantly smaller than intestinal polyps. Symptomatic polyps (5 out of 16 gastric polyps and 9 out of 10 intestinal polyps) predominated in women and occurred at a significantly lower age than asymptomatic polyps (59.2 versus 74.1 years). Most gastric IFPs were associated with chronic atrophic gastritis while only one ileal polyp was associated with Meckels diverticulum. The mean length of follow-up was 60.6 months and, except in one patient who underwent incomplete resection, no recurrences of IFP were observed. CONCLUSION: IFP is a heterogeneous entity, depending on age at presentation, sex, size and location in the digestive tract. IFP does not recur after resection. The association of gastric IFP and chronic atrophic gastritis could suggest a modulatory effect of the mucosa on IFP growth.

Pólipo fibroide inflamatorio gastrointestinal. Características clínicas y seguimiento de una serie de 26 pacientes / Gastrointestinal inflammatory fibroid polyps. Clinical characteristics and follow-up in a series of 26 patients

INTRODUCCIÓN: El pólipo fibroide inflamatorio (PFI) es una lesión protuberante que se localiza cerca de la muscularis mucosae y está constituida por una proliferación de células fusiformes y fibras conjuntivas alrededor de los capilares y un infiltrado inflamatorio variable. Se considera una reacción inflamatoria reparadora mal controlada. El objetivo de este trabajo ha sido estudiar las características clínicas, anatomo-patológicas y de seguimiento de una serie de pacientes con PFI.PACIENTES Y MÉTODO: Se han estudiado 26 PFI (25 pacientes:16 mujeres y 9 varones) recogidos entre los años 1985 y2001 en un registro específico de 3 centros de la ciudad de Girona. Las variables analizadas fueron la edad, el sexo y la presentación clínica, la localización y el tamaño del PFI, las características de la mucosa y las enfermedades asociadas, así como información del seguimiento. Se realizaron las pruebas estadísticas habituales. RESULTADOS: El PFI fue antral en 16 casos, ileal en 7, yeyunalen 2 y colónico en el restante. Su tamaño condicionó su carácter sintomático (35 ± 13,6 mm) o asintomático (8,4 ±6,3 mm). Los pólipos gástricos fueron significativamente más pequeños que los intestinales. Los pólipos sintomáticos(5 de 16 gástricos y 9 de 10 intestinales) predominaron en mujeres y en edades significativamente inferiores que los asintomáticos (59,2 frente a 74,1 años). La mayoría delos PFI gástricos se asociaron a gastritis crónica atrófica, mientras que sólo un PFI ileal lo hizo a divertículo de Meckel. El seguimiento medio fue de 60,6 meses y, salvo en un caso de resección incompleta, no se constató recidiva del PFI. CONCLUSIÓN: El PFI es una entidad heterogénea según la edad de presentación, el sexo de los pacientes, su tamaño y la localización en el tubo digestivo. Tras la resección, el PFI no recidiva. La asociación de los PFI gástricos a gastritis crónica atrófica podría apuntar a un efecto modulador de la mucosa sobre el crecimiento del PFI

INTRODUCTION: Inflammatory fibroid polyp (IFP) is a protuberant lesion, located near the muscularis mucosae and composed of a proliferation of fusiform cells and conjunctive fiberssurrounding capillaries and a variable inflammatoryin filtrate. It is believed to be a poorly controlled inflammatory repair response. Our aim was to study the clinical, pathological and follow up characteristics of a series of patients with IFP.PATIENTS AND METHOD: We studied 26 IFPs from 25 patients(16 women and 9 men) registered between 1985 and 2001 ina specific register of 3 centers in the city of Gerona (Spain).The variables analyzed were age, sex and clinical presentation, IFP localization and size, mucosal characteristics and associated disease, as well as follow-up information. Routine statistical analyses were performed. RESULTS: IFPs were antral in 16 patients, ileal in 7, jejunal in 2and colonic in the remaining patient. Size determined whether they were symptomatic (35 ± 13.6 mm) or asymptomatic (8.4 ±6.3 mm). Gastric polyps were significantly smaller than intestinal polyps. Symptomatic polyps (5 out of 16 gastric polyps and9 out of 10 intestinal polyps) predominated in women and occurred at a significantly lower age than asymptomatic polyps(59.2 versus 74.1 years). Most gastric IFPs were associated with chronic atrophic gastritis while only one ileal polyp was associated with Meckel’s diverticulum. The mean length of follow up was 60.6 months and, except in one patient who underwent in complete resection, no recurrences of IFP were observed. CONCLUSION: IFP is a heterogeneous entity, depending on age at presentation, sex, size and location in the digestive tract. IFP does not recur after resection. The association of gastric IFP and chronic atrophic gastritis could suggest a modulatory effect of the mucosa on IFP growth

Cytomegalovirus infection in patients with inflammatory bowel disease.

OBJECTIVE: It has been suggested that, in inflammatory bowel disease, cytomegalovirus behaves in the intestine as a nonpathogenic bystander, and even its finding in intestinal mucosa has unclear clinical relevance. We report our experience with a small series of patients with refractory inflammatory bowel disease and cytomegalovirus infection and their clinical outcome. METHODS AND RESULTS: Nine patients with moderate-severe attacks of inflammatory bowel disease did not respond to i.v. prednisone (1 mg/kg/day) for a mean of 24 days. Four of these patients were further treated with i.v. cyclosporine A (4 mg/kg/day). Cytomegalovirus infection was diagnosed in two patients after resection for treatment failure. In the remaining patients, cytomegalovirus infection was diagnosed in endoscopic mucosal biopsies and i.v. ganciclovir was then administered at a dose of 10 mg/kg/day for 2-3 wk. Five of these patients went into clinical remission, allowing corticosteroid and cyclosporine A discontinuation. Follow-up biopsies were performed and in all cases cytomegalovirus could not be detected in the colonic tissue. Two patients needed to be treated with intravenous cyclosporine A after antiviral therapy because of persistence of clinical symptoms despite the elimination of cytomegalovirus infection. CONCLUSIONS: Cytomegalovirus infection may play a role in the natural history of refractory inflammatory bowel disease and in some of its complications. The clearance of cytomegalovirus in colonic mucosa may lead some of these patients to remission.

[Inverted papilloma of the prostatic urethra. Histopathogenetic considerations]. / Papiloma invertido de uretra prostática. Consideraciones histopatogénicas.

We present a rare case of inverted papilloma of the prostatic ureter whose presenting features were gross hematuria and variable dysuria. Endoscopy revealed a polypoid appearance with a fine pedicle arising from the prostatic urethra. Treatment was by transurethral resection of the neoformation. The diagnosis was made on the histopathological findings. The different histopathogenic considerations published in the literature are discussed.

[Adenomatoid tumor of the epididymis: report of a new case]. / Tumor adenomatoide de epidídimo: aportación de un nuevo caso.

We report an additional case of adenomatoid tumor of the epididymis, an uncommon benign intrascrotal tumor. The aspects concerning its embryological origin and the different hypotheses that have been put forward relative to its etiology are discussed.