bromochloroacetic-acid and Rectal-Diseases

Xanthomas of the colon appear to be rare lesions. Four cases are reported to bring wider attention to this entity.. Slides, reports and clinical notes from all cases coded as colonic or rectal xanthoma or xanthelasma during the period 1 January 1993 to 1 January 2000 were reviewed. The clinicopathological features are described and integrated into a review of nine previously reported cases.. The ages of the patients ranged from 51 to 62 years (2M, 2F). Three lesions were located in the sigmoid colon and one in the rectum. They were all incidental findings at colonoscopy. Grossly, they varied from cream to yellow papules/polyps, ranged in size from 1 to 4mm and were all solitary. Two patients had an associated rectosigmoid hyperplastic polyp. There were no associated cutaneous xanthomatous lesions. One patient was diabetic and the serum lipid levels were normal in all patients. Histologically, all cases consisted of aggregates of mucosal foamy macrophages but in one case there were also macrophages involving the muscularis mucosae. The macrophages were negative for mucin and cytokeratin but were positive for CD68.. Colonic xanthomas do not appear to be the cause of lower gastrointestinal symptoms and are an incidental colonoscopic finding as well as at times being seen in association with colonic polyps.

Topics: Antigens, CD; Antigens, Differentiation, Myelomonocytic; Colon; Colonic Diseases; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Mucins; Rectal Diseases; Rectum; Xanthomatosis

To investigate the frequency of endometriotic lesions and disseminated endometriotic-like cells in a series of incidentally removed lymph nodes (LNs) in patients with endometriosis.. Retrospective study.. University hospital endometriosis center.. Premenopausal patients underwent surgery because of endometriosis-associated symptoms.. Retrospective analysis of 108 coincidentally resected LNs of 24 patients with endometriosis. To identify endometriotic cells, immunohistochemical analysis of estrogen and progestogen receptor (ER-PR), CD10, and cytokeratin was performed.. The occurrence of endometriotic lesions (ER-PR, CD10, and cytokeratin positive) and disseminated endometriotic-like ER-PR-positive cells in LNs.. Deep infiltrating endometriosis was diagnosed in 23 of the 24 patients with incidentally removed LNs. In 8 of 24 (33.3%) patients with incidentally removed LNs, typical endometriotic lesions were detected. Disseminated ER-PR-positive cells were found in 17 of 24 patients (70.8%). Lymph node involvement correlated directly with the deep infiltrating endometriosis lesional size.. Estrogen receptor-progestogen receptor-positive endometriotic lesions and disseminated endometriotic-like cells frequently are detected in LNs of patients with deep infiltrating endometriosis and, therefore, might reflect "nonlocalized" disease. If clinical significance of such lesions were provided, adjuvant hormonal treatment could be considered as a possible additional mode of therapy.

Topics: Adult; Endometriosis; Female; Humans; Immunohistochemistry; Incidental Findings; Keratins; Lymph Nodes; Middle Aged; Neprilysin; Premenopause; Receptors, Estrogen; Receptors, Progesterone; Rectal Diseases; Retrospective Studies; Vaginal Diseases; Young Adult

Patients with solitary rectal ulcer syndrome (SRUS) frequently present with a mass that can be misinterpreted as cancer. In contrast, the occurrence and characteristics of SRUS-like histopathology produced by underlying malignancy have not been reported in detail. We report seven patients whose rectal mass that was induced by infiltrating carcinoma showed only histopathologic changes of SRUS on initial mucosal biopsy specimens. Carcinoma was evident in subsequent specimens after one to five repeat biopsies with delay in diagnosis from 1 week to 18 months in six patients. In one patient, infiltrating carcinoma was suggested on the first biopsy specimen by immunohistochemistry for cytokeratin. Three of the patients had primary rectal adenocarcinoma, two had metastatic carcinoma from stomach or ovary, and two had direct invasion of anal squamous cell carcinoma or prostatic adenocarcinoma. We conclude that the histopathology of SRUS may occasionally represent a characteristic but nonspecific mucosal reactive change to a deeper seated malignancy. The terminology "solitary rectal ulcer syndrome/mucosal prolapse changes" with a cautionary note may be useful for reporting biopsy results to emphasize the possibility of underlying primary or metastatic malignancy in the differential diagnosis.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Biopsy; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Proctoscopy; Prostate-Specific Antigen; Rectal Diseases; Rectal Neoplasms; Rectal Prolapse; Retrospective Studies; Ulcer

To compare histologically and stereologically the endometriotic nodule of the rectovaginal septum to peritoneal endometriosis.. Morphometric investigation, cytokeratin and vimentin content, and steroid receptor evaluation were performed on endometriotic tissue from the peritoneum (n = 52) and rectovaginal nodules (n = 68).. An academic teaching hospital.. Biopsies were taken from 120 patients undergoing a laparoscopy for infertility and/ or pelvic pain (52 from typical black peritoneal endometriotic implants and 68 from endometriotic nodule of the rectovaginal septum). None of the patients were treated.. Mitotic activity was found to be significantly different in peritoneal and rectovaginal endometriosis. The evaluation suggested that the stroma is not mandatory for the invasion of glandular epithelium in the rectovaginal nodule, which is, like a adenomyoma, a circumscribed nodular aggregate of smooth muscle and glandular elements. Cytokeratin and vimentin content as well as the estrogen receptor (ER) and P receptor (PR) content were significantly lower in both types of lesion when compared with eutopic endometrium. But vimentin immunoreactivity in epithelium, as well as the ER and PR content, were significantly lower in nodules when compared with black peritoneal lesions.. It is suggested that the rectovaginal endometriotic nodule is a different disease from peritoneal endometriosis and must be called rectovaginal adenomyosis or rectovaginal adenomyoma. Its histopathogenesis probably is not related to the implantation of regurgitated endometrial cells but to the metaplasia of Müllerian rests.

Topics: Adenomyoma; Biopsy; Diagnosis, Differential; Endometrial Neoplasms; Endometriosis; Endometrium; Epithelium; Female; Humans; Immunohistochemistry; Keratins; Mitosis; Peritoneal Diseases; Receptors, Estrogen; Receptors, Progesterone; Rectal Diseases; Vaginal Diseases; Vimentin