RESUMEN
We report a rare case of a cellular neurilemoma (schwannoma) of the descending colon, mimicking carcinoma, not accompanied by von Recklinghausen's disease. The differential diagnostic problems are discussed and the possibility of a site-specific, modified Schwann cell of myenteric plexus origin is suggested.
Asunto(s)
Neoplasias del Colon/diagnóstico , Neurilemoma/diagnóstico , Anciano , Colectomía , Colon/patología , Enfermedades del Colon/diagnóstico , Enfermedades del Colon/patología , Enfermedades del Colon/cirugía , Neoplasias del Colon/patología , Neoplasias del Colon/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Obstrucción Intestinal/diagnóstico , Obstrucción Intestinal/patología , Obstrucción Intestinal/cirugía , Plexo Mientérico/patología , Neurilemoma/patología , Neurilemoma/cirugía , Sangre Oculta , Células de Schwann/patologíaRESUMEN
OBJECTIVE: To find out what influence erythropoietin and granulocyte macrophage colony stimulating factor (GM-CSF) had on the healing of left colonic anastomoses in rats. DESIGN: Experimental study. SETTING: University hospital of Ioannina, Greece. ANIMALS: 40 rats. INTERVENTIONS: An end to end anastomosis was created in the left colon. The rats in the experimental groups were treated with erythropoietin, or GM-CSF, or the two in combination. MAIN OUTCOME MEASURES: Tensile breaking strength of the anastomosis, histological characteristics of the anastomosed segment, changes in body weight, and packed cell volume (PCV) during the experiment. RESULTS: The tensile breaking strength of the anastomosis on the seventh postoperative day was significantly greater in the erythropoietin group (mean 2.8N, 95% confidence interval (CI) 0.12N, p 0.0004) than in the control group (mean 1.60N, 95% CI 0.12N). It did not differ from the GM-CSF groups (mean 1.67N, 95% CI 0.21N, p 0.68) or erythropoietin GM-CSF (mean 1.67N, 95% CI 0.11N, p 0.44). The PCV was significantly higher in the two groups given erythropoietin (p < 0.001) but not in the GM-CSF group (p 0.8) while that in the control group was significantly lower (p < 0.001). The body weight followed the same pattern, being significantly more in the two groups given erythropoietin (p = 0.03 and 0.003) but not in controls (p = 0.09) or the GM-CSF group (p = 0.2). CONCLUSIONS: Erythropoietin enhances the healing of anastomosis in rat colon by increasing the number of fibroblasts and accelerating the maturation of new vessels.