1/14. Histomorphometric characteristics and cellular kinetics of colorectal polyps with epithelial serrated proliferation adjacent to carcinoma.Four cases of colorectal polyps with epithelial serrated proliferation (CP-ESP) with malignant transformation were studied. In CP-ESP adjacent to carcinoma, if the nuclear size in the surface layer was significantly smaller than those in the bottom and the middle layers of the crypts, the specimen was defined as zone formation positive. If there was no significant difference among the layers, the specimen was defined as zone formation negative. Cell kinetics were evaluated using Ki-67 immunostaining. The CP-ESP regions of cases 1 and 2 showed zone formation with inferior and lateral glandular branching, and were qualitatively hyperplastic on cell kinetics. Cases 3 and 4 showed inferior and lateral glandular branching with no zone formation, and were kinetically neoplastic (adenoma). The histogenesis of hyperplastic polyps with atypia (cases 1 and 2) involves the hyperplastic polyp-carcinoma sequence. In contrast, the development of tubulovillous adenoma or serrated adenoma (cases 3 and 4) may involve the tubulovillous adenoma-carcinoma or serrated adenoma-carcinoma sequence.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/14. Colonic intra-epithelial carcinoma occurring in a hyperplastic polyp via a serrated adenoma.We present a case of intra-epithelial carcinoma occurring in a serrated adenoma of the colon. The pedunculated polyp, which measured 12 x 10 x 6 mm, was endoscopically removed from the ascending colon of a 78-year-old woman. Histologically, the polyp mainly consisted of serrated adenomatous glands, and had foci of intra-epithelial carcinoma at the top. Hyperplastic (metaplastic) areas were also present in both borders between the serrated adenomatous area and the surrounding normal mucosa. A sequential increase in the degree of dysplasia, and in the number of nuclei positively reactive for Ki-67 and p53 was evident from the hyperplastic areas toward the foci of carcinoma. The polyp described here may represent a carcinogenic potential of hyperplastic polyp via serrated adenoma.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
3/14. Localized form of colitis cystica profunda--a case of occurrence in the descending colon.An unusual localization of localized colitis cystica profunda in a 31-year-old man is described. The patient presented as anal bleeding and a protruding mass at the descending colon; the mass was polypoid and was made up of papillary epithelial hyperplasia with downward herniation of glands into the submucosa. Only one similar case involving a descending colon has been reported in the world literature.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
4/14. Inflammatory myoglandular polyp--a rare but distinct type of colorectal polyps.The aim of this paper was to report another example of a rare type of colorectal polyps, the inflammatory myoglandular polyp, and to reaffirm this type of polyp as a distinct entity. This solitary pedunculated polyp was detected after a single episode of rectal bleeding. It was situated in the sigmoid colon, measured 2.5 cm in greatest diameter, and was composed almost exclusively of smooth muscles and hyperplastic glands. The patient had neither chronic colitis nor diverticula. Clinical presentation, localization, and histology give this type of polyp a unique appearance and justify its designation as a separate entity.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
5/14. Two cases of inverted hyperplastic polyps of the colon and association with adenoma.Here we report two cases of inverted hyperplastic polyps of the colon. The first patient showed three inverted hyperplastic polyps in the ascending colon, one of which was associated with adenoma. We immunostained this adenoma-associated polyp using anti-beta-catenin antibody and found accumulation of beta-catenin in the cytoplasm of the adenomatous lesion but not in the inverted hyperplastic polyp. This suggested an adenomatous polyposis coli (APC) mutation in the adenomatous region but not in the inverted hyperplastic polyp. The inverted hyperplastic polyp in the second patient was located at the caecum and was studied using magnifying colonoscopy. The polyp appeared to be flat and elevated with a depressed pit in the centre. After spraying with methylene blue dye, the pit pattern of the lesion was observed and small asteroid pits on the polyp were found, consistent with a hyperplastic gland pattern. From these results, we diagnosed inverted hyperplastic polyp of the colon by colonoscopy.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
6/14. Inflammatory myoglandular polyp: a rare cause of hematochezia.Inflammatory myoglandular polyp is characterized by inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle, and hyperplastic glands with variable cystic change. The etiology is obscure. Mucous diarrhea, tenesmus, and hematochezia are main symptoms. We hereby report an 80-year-old man with diagnosis of inflammatory myoglandular polyp.- - - - - - - - - - ranking = 3.5keywords = gland (Clic here for more details about this article) |
7/14. Cronkhite-canada syndrome associated with colon carcinoma and adenomatous changes in C-C polyps.A 73-yr-old man with the clinical features of Cronkhite-canada syndrome developed colonic carcinoma. Radiologic and endoscopic examination revealed numerous polyps involving the stomach and large intestine. Histologic examination of the biopsied polyps revealed polypoidal lesions covered by a single layer of normal columnar mucus-secreting epithelial cells. The stroma of each polyp was composed of well-vascularized edematous lamina propria containing inflammatory cells and glands of variable sizes. Some of the glands were cystically dilated and lined by a single layer of mucin-secreting epithelial cells. These polyps were reminiscent of "juvenile polyps" or retention polyps. Some of these polyps also showed definite adenomatous changes at the surface epithelium. In addition, a large cecal tubulovillous adenoma with foci of well-differentiated adenocarcinoma was noted, indicating that adenomatous and carcinomatous epithelial changes can occur in otherwise nonneoplastic polyposis of the Cronkhite-canada syndrome as seen in the present case.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/14. Composite glandular-carcinoid tumors of the colon and rectum. Report of two cases.Composite glandular-carcinoid tumors of the large bowel are rare. We describe two cases that appeared to be at a relatively early stage in their development. Each of these cases was a composite colorectal adenoma-carcinoid--an entity that has not previously been described. There was no evidence of inflammatory bowel disease (IBD) in either of these cases; and a review of the literature on composite adenocarcinoma-carcinoid neoplasms of the colon and rectum revealed only two cases that arose in a background of IBD. Thus, despite the association of IBD, especially long-standing ulcerative colitis, with epithelial dysplasia and mucosal endocrine cell hyperplasia, respectively, we believe that other factors more significant than IBD may be operative in the genesis of composite glandular-carcinoid tumors of the large bowel. Further documentation of these tumors is needed in order to better appreciate their clinicopathologic manifestations and associations.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
9/14. Management of endoscopically removed malignant colon polyps.The medical records of 87 patients with 89 malignant colorectal polyps removed endoscopically between 1971 and 1983 were reviewed retrospectively. Fifty-five polyps contained carcinoma-in-situ. Four polyps had "pseudo-invasion" by displaced mucosal glands. Thirty polyps contained invasive carcinoma. No patients with carcinoma-in-situ or "pseudo-invasion" had either local residual disease or metastatic disease at the time of colectomy or which was detected during subsequent follow-up. Four patients (14%) with invasive cancer would have been inadequately treated by polypectomy alone, since one had residual disease at the polypectomy site, one had nodal metastases, one had liver metastases at the time of colectomy, and one subsequently developed liver metastases. Three histologic criteria correctly predicted all four cases where residual or recurrent disease was present: involvement of the polypectomy resection margin, lymphatic invasion within the polyp, and poorly differentiated histology. Polyp size, histology (villous adenoma, adenomatous polyp, or villo-adenomatous polyp), or anatomic location did not identify those patients who warranted further therapy. We conclude that polypectomy alone is adequate treatment for polyps containing carcinoma-in-situ. Polypectomy alone is also adequate treatment for most polyps containing invasive carcinoma. However, patients with lymphatic involvement within the polyp, poorly differentiated cancer, or resection margin involvement should probably undergo colectomy.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
10/14. Cronkhite-canada syndrome associated with a rectal cancer and adenomatous changes in colonic polyps.A 52-year-old man with the clinical features of Cronkhite-canada syndrome developed rectal cancer. Radiologic and endoscopic examinations revealed gastrointestinal polyposis. Histologic examination of the biopsied polyps showed cystic dilatation of glands with an inflammatory stroma. A later biopsy from a rectal polyp proved to be an adenocarcinoma. The totally resected colon and upper rectum had an ulcerated rectal cancer and numerous polyps; most of the polyps showed histological changes typical of the syndrome. Only three polyps had adenomatous changes at their surfaces. Adenomatous and carcinomatous changes of epithelia can occur in non-neoplastic polyposis of Cronkhite-canada syndrome from which presumably a carcinoma can develop, as in the present case.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
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