1/10. Familial adenomatous polyposis: a case report and histologic mucin study.adenocarcinoma arising at an ileostomy is uncommon, and only 29 cases have been reported in the literature. The case of a 54-year-old man who developed an adenocarcinoma at a Brooke ileostomy is reported. The ileostomy had been fashioned 21 years earlier after proctocolectomy for familial adenomatous polyposis (FAP). A wide local excision of the stoma was performed, and a new Brooke ileostomy was fashioned on the opposite side of the abdomen. Histopathologic examination revealed a well-differentiated adenocarcinoma with early invasion of the submucosa. On hematoxylin and eosin staining, the ileal mucosa adjacent to the tumor showed signs of colonic metaplasia, including loss of villous architecture and a reduced number of paneth cells. Mucin staining using the high iron diamine-alcian blue stain demonstrated a mixture of sulfomucin and sialomucin in the ileal mucosa near the tumor, confirming colonic metaplasia. ileostomy site carcinogenesis can be attributed to both the colonic metaplasia and the inherent nature of FAP or ulcerative colitis (UC), where colonic mucosa is susceptible to adenoma formation or dysplasia. Longstanding ileostomies in patients with FAP or UC should be followed to exclude the development of adenoma, dysplasia, or cancer.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/10. 131I-meta-iodobenzylguanidine in the management of metastatic midgut carcinoid tumors.The management of metastatic neuroendocrine tumors incorporates multimodal therapy with surgery, biotherapy, and chemotherapy. Tumor-targeted therapies using radiolabeled octreotide and metaiodobenzylguanidine (mIBG) represent a novel treatment approach. The aim of this study was to evaluate the effectiveness of 131I-mIBG in the treatment of metastatic midgut carcinoid tumors. survival outcomes were assessed for patients treated at two regional cancer centers and then compared. One center used 131I-mIBG routinely in the management of metastatic carcinoid tumors (center A), and the other did not use this modality (center B). Only patients with histologically proven metastatic carcinoid tumor shown, or thought most likely, to be of midgut origin were included in the study. During the period 1980 to 2002, a series of 58 patients from center A with metastatic carcinoid tumor arising from the midgut underwent multimodality therapy with the addition of 131I-mIBG. Their median age was 64 years. The median dose of 131I-mIBG administered was 6751 MBq, and there was an average of 2.8 treatments per patient. During the same period, 58 patients with metastatic carcinoid were treated at center B with similar multimodality therapy without the use of 131I-mIBG therapy. Their median age was 65 years. Survivals at 3 and 5 years were 77% and 63%, respectively (95% CI 47-75), for group A. The 3- and 5-year survivals for group B were 56% and 47% (95% CI 34-59), respectively. The mean follow-up was 6.6 years for group A and 5.0 years for group B. Although retrospective in nature, this study suggests that the addition of 131I-mIBG therapy to the treatment protocol of patients with metastatic midgut carcinoid tumors prolongs survival.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/10. Neuromesenchymal hamartoma of the small bowel.We present the case of a long small bowel stricture with pathological features similar to those described as "neuromuscular and vascular hamartoma," showing in addition extensive fatty submucosal infiltration and fibrous intramural nodules. In the controversy about the nature of this disorder, we consider it a separate entity. Taking into account that other mesenchymal tissues than the originally described can participate, we propose the alternative term of "neuromesenchymal hamartoma" of the small bowel.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/10. Solitary intestinal fibromatosis in the newborn. Rare cause of neonatal intestinal obstruction.We describe a case of solitary fibromatosis of the ileum in an infant. Intestinal fibromatosis is a rare cause of intestinal obstruction in the newborn. The disease is poorly characterized and has been rarely reported under this name. The differential diagnosis is discussed with particular attention to inflammatory fibroid polyps, neurofibromatosis, and sarcoma. Reasons of a theoretical and practical nature are outlined that recommend the term "solitary intestinal fibromatosis" as the most appropriate name for this disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/10. APUD system neoplasms in renal transplant patients.Apudomas are uncommon neoplasms composed of neuroendocrine cells. They include carcinoid tumors, islet cell tumors, and small cell lung carcinoma. We found six cases of apudomas in a series of 1028 renal transplants from three medical centers (0.58%). One of these had been reported in 1976. The cases included a carcinoid tumor of a Meckel's diverticulum discovered and removed prior to transplantation, with no evidence of recurrence 9 years later. A small cell lung carcinoma was discovered 40 months after renal transplantation, with a fatal outcome 6 months later. Four clinically occult apudomas were found at autopsy, including one gastric and one bronchial carcinoid tumor, one multicentric pancreatic islet cell neoplasm, and one case of multiple ileal carcinoids. With the exception of the small cell lung cancer, none of the apudomas was clinically significant, and none was associated with carcinoid or other paraneoplastic syndrome. These cases illustrate the difficulty of diagnosis of apudomas in patients with renal failure and the usually benign nature of these tumors despite the administration of potent immunosuppressive agents.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/10. To see or not to see, a difficult question in the ileocaecal region.A case is reported in which two diagnostic procedures were used to visualize colonic pathology, i.e. radiography and endoscopy. Neither of these methods led to the correct diagnosis. This case illustrates the need to combine and integrate the information obtained with the two methods, with respect to both the localization and the nature of the pathological process.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/10. Cancer in Crohn's disease--an 'occult' malignancy.The purpose of this case report of cancer complicating Crohn's disease is to highlight the occult nature of these tumours. From the literature it is apparent that the majority are only discovered by the pathologist. As many are inconspicuous even on macroscopic examination an improved method of dissection is suggested.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/10. Massive pulmonary deposition of rutile after titanium dioxide exposure: light-microscopical and physico-analytical methods in pigment identification.autopsy findings in a 55-year old man known to have been occupationally heavily exposed to titanium dioxide dust showed extensive pulmonary deposition of white pigment. By energy dispersive X-ray analysis (EDAX) and electron and x-ray diffraction, the pigment was identified as rutile. By ordinary transmitted light microscopy, deposits of the white crystalline titanium-dioxide could not be distinguished from anthracotic pigment present in the lung sections. By transmitted polarized and incident light microscopy, the different nature of the two types of pigment was immediately evident. Absence of inflammatory and fibrotic changes in the lungs in our case lends support to the view that rutile is biochemically inert.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/10. Composite glandular-carcinoid tumour of the terminal ileum.AIMS--To investigate a female patient with a tumour mass of the terminal ileum, to define the nature of the tumour, and to correlate its morphology and behaviour with similar types of tumours of the large intestine and stomach. methods--tissues obtained at colonoscopy, from hemicolectomy specimens, and from liver and peritoneal biopsy specimens were studied macroscopically, microscopically, histochemically, and immunohistochemically for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), neuron specific enolase (NSE), and S100 protein. RESULTS--Macroscopic examination showed a tumour of the terminal ileum protruding into the caecum. Microscopically the tumour showed two components, one adenoma with moderate dysplasia and the other carcinoid tumour. The adenomatous component stained positively for EMA and CEA and negatively for NSE. The carcinoid component stained positively for NSE and negatively for EMA and CEA. Histochemically the carcinoid area was argyrophil positive and argentaffin negative. Only the carcinoid had metastasised, to the liver, peritoneum, and the lymph nodes, at the time of diagnosis. CONCLUSION--The morphological, histochemical, and immunohistochemical findings confirm the diagnosis of a composite adenoma-carcinoid tumour of the terminal ileum.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/10. Ileal segmental gangrene caused by a metastatic mesenteric carcinoid.Malignant tumors of the small intestine are rare and their symptoms are discrete and of a chronic nature. At times they manifest as an acute abdomen, with high mortality. Carcinoid tumors represent one of the types of intestinal tumors, of the neuroendocrine line, more frequently located in the cecal appendix. In the small intestine, carcinoid tumors are most often located in the ileum. Carcinoid tumors produce several hormonal substances, some of which may induce symptoms such as the carcinoid syndrome. gangrene of the small intestine is a rare complication attributed to hormonal substances produced by the tumor which causes high mortality rates. We report, here, a case of ileal segmental gangrene with an excellent course.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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