The Diagnosis and Differential Diagnosis of Umteral Fibroepithelial Polyps

OBJECTIVE To study the clinical pathologic characteristics and differential diagnosis of ureteral fibroepithelial polyps. METHODS One case of ureteral fibroepithelial polyps was studied by clinical data analysis and light microscopy. RESULTS The tumor was located in the lower ureter. Histologically, the polyp was composed of expanded blood vessels and fibrous connective tissue under normal or proliferous transitional epithelium. CONCLUSION Benign ureteral fibroepithelial polyps are extremely rare, recognition of it＇s precise histological features can facilitate its correct diagnosis.     

Clinicopathologic Features of Colorectal Polyps in Shahid Beheshti University of Medical Sciences (SBMU)

Aim: This study was designed to report epidemiologic findings of polyps in Iranian patients, and predict histology of polyp regarding to demographic and colonoscopic findings. Background: Classification of colorectal polyps had been revised in the past two decades and there is a need for polyp categorization in the Iranian Health System. Patients and methods: In this retrospective study, the medical records of patients with colonoscopic diagnosis of polyp in pathology departments of SBMU affiliated teaching hospitals were reviewed. Patient’s slides evaluated and demographics findings were assessed. The anatomical location, macroscopic appearance including size and histological assessment of all polyps were recorded. Results: From total number of 1106 polyps (detected in 862 patients), adenomatous polyps (638 [57.7%]) were the most prevalent findings, followed by colon mucosal tag (184[16.6%]), hyperplastic and serrated polyps (122[11%]), inflammatory polyps (110[9.9%]), hamartomatous (21[1.9%]), and malignant lesions (13[1.2%]). Multivariate logistic regression showed age (each one year increasing age; odds ratio [OR] = 1.026, 95%confidence interval [CI] = 1.016–1.036, p < 0.0001), location of polyp (right colon; OR = 1.905, 95%CI = 1.366–2.656, p < 0.0001), and polyp size of 5-10 mm (OR = 1.662, 95%CI = 1.214–2.276, p = 0.002), and polyp size of >10 mm (OR = 2.778, 95%CI = 1.750–4.411, p< 0.0001) were independently associated with neoplastic polyps. Also, polyp size of >10 mm (OR= 2.613, 95%CI= 1.083-6.307, p=0.033), tubulovillous pattern of polyp (OR= 3.508, 95%CI= 1.666-7.387, p=0.001) and villous pattern of polyp (OR= 10.444, 95%CI= 4.211-25.905, p     

Nasal polyps: a clinical, histopathological and radiological profile

Objective

Comparison of clinical, radiological & histopathological profile in nasal polyps.

Material & method

A prospective randomized study conducted on 50 patients of nasal polyps (diagnosed clinically or radiologically) from July 2003 to December 2005 selected from the inpatient department of Otorhinolaryngology, Dayanand Medical College & Hospital, Ludhiana.

Results

The results show that 70% of the clinical findings were consistent with radiological findings. However in rest 30% of cases, a difference of opinion was seen in non neoplastic and neoplastic lesions. The diagnosis of allergic fungal or allergic non fungal can only be established on histopathology.

Conclusion

It is concluded that for proper evaluation of nasal polyps clinical, radiological and histopathological evaluation should be done in all the patients, where radiology provides a road map to the endoscopic surgeons and warns of any existing or impending complications. Histopathology always gives a confirmatory diagnosis.     

Prevalence and Characteristics of Colorectal Polyps in Symptomatic and Asymptomatic Iranian Patients Undergoing Colonoscopy from 2009-2013

Background: Colorectal cancer is the third most common type of cancer in males and the second in femalesin Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor forcolorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. Aim: The object of thisstudy was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients andto investigate the variation between our populations with other populations. Materials and Methods: A total of167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013and specimens were taken through polypectomy and transferred to pathology. All data in patient files includingpathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of< 0.05 was considered significant. Results: Mean age of participants was 57±15. Some 84 were females (50.3%)and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) werein females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%)with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followedby 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, databeing missing in two cases. Conclusions: Recto sigmoid was site of most of the polyps. The most prevalent typeof lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70(31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screeningplans to prevent further healthcare problems with colorectal cancer in the Iranian population.     

胃肠道炎性纤维性息肉的病理诊断分析

目的　探讨病理对胃肠道炎性纤维性息肉 (IFP)的诊断及其价值。方法　观察 5例IFP临床、病理学特点及免疫组织化学(ABC)标记。结果　 5例均表现为胃肠道粘膜下息肉样肿块 ,向腔内突出炎性生长 ,病变由小的薄壁血管周围环绕具有长的胞浆突起的梭形细胞构成 ,这些细胞在较大的血管周围呈洋葱皮排列。有慢性炎细胞浸润 ,常以嗜酸细胞为主 ,ABC结果病变组织为纤维及肌纤维母细胞标记。Vimentin( 5 / 5 )、SMA( 3/ 5 )。结论　确诊胃肠炎性纤维性息肉诊断首选病理。     

结直肠锯齿状病变病理诊断及鉴别诊断

结直肠癌是最常见及致死率最高的癌症之一,其发生机制有两个主要通路:即经典的“腺瘤-腺癌”通路和锯齿状通路。锯齿状通路因其独特的分子病理学改变,而被认为是独立于经典的“腺瘤-腺癌”通路之外的结直肠癌发生路径。Longacre和Fenoglia Preiser于1990年对大肠“混合性增生性腺瘤样息肉”(mixed hyperplastic adenomatous polyps,MHAP)进行重新评估,并首次使用“锯齿状腺瘤”(serrated adenoma,SA)来定义此类病变。锯齿状病变的组织学分类及致癌的分子机制已部分阐明。然而,在实际工作中,病理医生,特别是年轻的病理医生对锯齿状病变分类及诊断仍存困惑。本文拟就锯齿状病变的分类、临床病理学特征、诊断及鉴别诊断要点进行讨论。     

原发性输尿管癌的诊断与治疗(附27例报道)

目的:提高原发性输尿管癌的诊治水平.方法:分析27例原发性输尿管癌的临床特点、诊断、治疗及预后.结果:首发症状以内眼血尿最常见.B超为首选影像学检查方法,静脉尿路造影、逆行肾盂输尿管造影、膀胱镜检查是最重要的诊断方法.27例获得随访,5年生存率为42.2%.结论:原发性输尿管癌的预后与肿瘤的分期、分级密切相关.早期诊断与合理治疗是提高患者生存率的关键.     

老年大肠复合性息肉临床研究

目的提高对老年大肠复合性息肉的认识。方法在２２１例老年大肠息肉患者中发现复合性息肉２６例,观察复合性息肉的临床病理特点。结果老年大肠复合性息肉并非少见,检出率为１１．８％,多位于直、乙状结肠,占３８．７％,以炎性息肉和腺瘤并存者居多,占８９％,恶变率２６．９％,多肠段息肉检出复合性息肉率高,为２１．３％（Ｐ＜０．０５）;年龄以７０～７９岁检出率最高,为２６．３％（Ｐ＜０．０５）;其检出率与数目、性别无关（Ｐ＞０．０５）。结论要重视老年复合性息肉,对多发性息肉要尽可能做多个息肉病理检查,提高其诊断率。     

巨大食管息肉一例报告(英文)

目的食管息肉是一种少见的疾病。我们报道一例巨大食管息肉病例,该病人有吞咽困难和呕血的症状。我们完善各项检查后,肯定肿块是食管平滑肌瘤。在胸部探查中,我们发现为食管息肉并予以切除。术后病理报告食管巨大纤维血管息肉伴粘液变。外科医师应该意识到这种少见疾病的存在。     

巨大食管息肉一例报告

目的食管息肉是一种少见的疾病。我们报道一例巨大食管息肉病例，该病人有吞咽困难和呕血的症状。我们完善各项检查后，肯定肿块是食管平滑肌瘤。在胸部探查中，我们发现为食管息肉并予以切除。术后病理报告食管巨大纤维血管息肉伴粘液变。外科医师应该意识到这种少见疾病的存在。     

巨大食管息肉一例报告

目的食管息肉是一种少见的疾病。我们报道一例巨大食管息肉病例,该病人有吞咽困难和呕血的症状。我们完善各项检查后,肯定肿块是食管平滑肌瘤。在胸部探查中,我们发现为食管息肉并予以切除。术后病理报告食管巨大纤维血管息肉伴粘液变。外科医师应该意识到这种少见疾病的存在。     

Origins of the Leeds Castle Polyposis Group

Familial juvenile polyposis (JP) is an uncommon genetic disorder that, if untreated, can lead to gastrointestinal cancer. To evaluate familial JP prevalence, phenotypic manifestations, causative mutations, treatment and compliance for diagnosis and follow-up in our registry. Since 1993 our familial JP patients were registered, followed-up before and/or after surgery and their families encouraged to have mutation analysis, endoscopic screening and treatment. Ten pedigrees were identified, all Jewish, but only one was Ashkenazi, six were Sepharadi and three were Oriental; the only mutation found was BMPR1A in two of six pedigrees examined. Of 139 first-degree relatives at risk for JP, 62 (45%) had JP or cancer; 56 (40.3%) were available for follow-up and 35 entered the registry. Of these, 71% reported rectal bleeding, 40% had <20 colonic polyps, 31% had 20–100 polyps; 2 had >100 gastric polyps. Cancer occurred in 22.9% (6 colonic, 2 gastric) before familial JP diagnosis or during follow-up elsewhere or non-compliance for follow-up; however, 1 gastric cancer developed during our treatment. In 46% the initial clinical-pathological diagnosis was incorrect. Compliance for evaluation and follow-up of pedigree members and individual familial JP patients was inadequate in 20% and 26%, respectively. Familial JP does not occur in the Israeli Ashkenazi Jewish population at the expected proportion; it is often misdiagnosed and is inadequately recognized in Israeli non-Jews. Mutations were identified in only a minority of pedigrees despite comprehensive screening. The inadequate compliance for screening and follow-up needs to be addressed by educating the public, health care workers and health insurances.     

Helicobacter Pylori Associated Gastritis Increases Risk of Colorectal Polyps: a Hospital Based-Cross-Sectional Study in Nakhon Ratchasima Province,Northeastern Thailand

Background: Colorectal polyps are common in Thailand, particularly in the northeastern region. The present study aimed to determine any correlation between Helicobacter pylori-associated gastritis and colorectal polyps in the Thai population. Materials and Methods: A total of 303 patients undergoing esophagogastroduodenoscopy with colonoscopy for investigation of chronic abdominal pain participated in this study from November 2014 to October 2015. A diagnosis of Helicobacter pylori associated gastritis was made if the bacteria were seen on histopathological examination and a rapid urease test was positive. Colorectal polyps were confirmed by histological examination of colorectal biopsies. Patient demographic data were analyzed for correlations. Results: The prevalence of colorectal polyps was 77 (25.4%), lesions being found more frequently in Helicobacter pylori infected patients than non-infected subjects [38.4% vs. 12.5%; Odds Ratio (OR) (95% CI): 2.26 (1.32 - 3.86), p < 0.01]. Patients with Helicobacter pylori - associated gastritis were at high risk of having adenomas featuring dysplasia [OR (95% CI): 1.15 (1.16 - 7.99); P = 0.02]. There was no varaition in location of polyps, age group, sex and gastric lesions with respect to Helicobacter pylori status. Conclusions: This study showed that Helicobacter pylori associated gastritis is associated with an increased risk of colorectal polyps, especially adenomas with dysplasia in the Thai population. Patients with Helicobacter pylori-associated gastritis may benefit from concurrent colonoscopy for diagnosis of colorectal polyps as a preventive and early treatment for colorectal cancer.     

Intermittent gastric outlet obstruction caused by a prolapsing antral gastric polyp

Most gastric polyps have an asymptomatic presentation and are an incidental finding on upper endoscopy. Symptomatic presentations can range from an ulcerated polyp leading to anemia and occult bleed to complete gastric outlet obstruction. We report a case of an 89-year-old woman who presented with postprandial nausea and early satiety. Her upper endoscopy revealed a 2 cm pedunculated hyperplastic polyp arising from the antrum of the stomach which was seen prolapsing into the pylorus causing intermittent gastric outlet obstruction. In the present report, we statistically analyzed 39 prolapsing gastric polyps previously reported in the English literature and demonstrate the current utility of monopolar snare polypectomy in establishing a histological diagnosis while offering simultaneous treatment. Additionally, we review the literature for the management of all hyperplastic gastric polyps in relation to advancements in digestive endoscopy.     

原发性输尿管恶性肿瘤的诊断与治疗(附30例报告)

目的提高原发性输尿管恶性肿瘤的诊治水平。方法结合文献对1974年～1999年收治的30例原发性输尿管恶性肿瘤的临床特点、诊断、治疗及预后进行回顾性分析并进行讨论。结果30例中26例行手术治疗,术后均经病理证实。首发症状以肉眼血尿最常见,尿路造影(IVU)、B超、膀胱镜、逆性输尿管肾盂造影、CT及输尿管镜检查是主要的诊断方法,术前诊断符合率93.3%(28/30)。结论术前联合应用B超、尿路造影(IVU)、逆性输尿管肾盂造影、膀胱镜及CT,MRI等检查方法可提高原发性输尿管恶性肿瘤的正确诊断率,其中以逆行输尿管肾盂造影的诊断符合率最高。肾-输尿管全长及膀胱袖状切除术仍是其经典术式,且其预后主要取决于肿瘤之分期。     

Vaginal polyps with pseudosarcomatous features. A clinicopathologic study of seven cases

Seven cases of vaginal polyps with atypical stromal cells were investigated. Three of the cases were classified as vaginal rhabdomyoma and four as fibroepithelial polyps with atypical stromal cells. All of the patients were adult women with minor or no symptoms. None of the tumor recurred or metastasized. The recognition of the vaginal polyps with bizarre stromal cells is important in order to avoid misdiagnosis of sarcoma, particularly botryoid rhabdomyosarcoma.     

38例输尿管癌诊断与治疗的分析

目的：提高输尿管癌的早期诊断和治疗效果。方法：将我科１９７８～１９９８年收治的３８例输尿管癌作回顾分析。结果：术前经膀胱镜、逆行输尿管造影、尿脱落细胞、ＣＴ等检查确诊２９例,全组均行手术,包括肾、全长输尿管及部分膀胱切除２６例,肾、全输尿管及膀胱切除２例,输尿管节段切除吻合３例,部分输尿管及膀胱切除输尿管膀胱再植６例,肿瘤活检１例。随访２５例,其中１４例无瘤生存,１１例死亡。结论：膀胱镜、逆行输尿     

注气与注水肠镜下结直肠息肉的内镜形态与病理关系的比较

目的:比较注气与注水结肠镜下结直肠息肉的内镜形态特征与病理类型之间的关系。方法:选取2018年9月至2019年6月于福建省肿瘤医院在非放大内镜窄带成像(narrow-band imaging,NBI)模式下62例接受注气肠镜与53例注水肠镜检查发现的结直肠息肉进行观察,分析病变的血管形态及表面的结构,应用国际结直肠内镜分型(NICE)实时预测病理类型,并将NBI内镜诊断结果与病理组织学诊断结果进行分析,比较两组的敏感度、特异度、准确率以及扁平息肉(即巴黎分型0~Ⅱa型)的检出率。结果:注水组扁平状息肉检出率为44.64%,其中左半、右半结肠检出率分别为26.78%、17.86%;注气组为40.00%,左半、右半结肠检出率分别35.56%、4.44%;两组检查结果差异具有统计学意义(P<0.01)。NICE分型实时预测结直肠息肉病变总的敏感度、特异度、准确率分别为91.95%、96.61%、93.84%,其中注气组的分别为90.74%、97.27%、93.33%,注水组的分别为93.93%、95.65%、94.64%,并发现2例无蒂锯齿状腺瘤(sessile serrated adenoma,SSA),两组检查结果差异无统计学意义。结论:注气肠镜与注水肠镜预测结直肠息肉的病理类型准确性无显著性差异,但注水肠镜能提高右半结肠0~Ⅱa型息肉的检出。     

原发性输尿管癌(附26例报告)

目的　提高原发性输尿管癌的诊治水平。方法　对 1980年～ 2 0 0 1年收治的 2 6例原发性输尿管癌患者的诊断、治疗经验进行总结。结果　 2 4例行IVU ,6例示输尿管充盈缺损或狭窄。 2 2例膀胱镜检 ,3例见肿瘤自输尿管口脱出 ,5例患侧输尿管口喷血。 16例逆行肾盂造影 ,11例输尿管充盈缺损或狭窄。 2 1例获随访 ,时间 6个月～ 12年。 5年生存率为 42 9%。结论　肉眼血尿、腰痛为主要症状。逆行肾盂造影及膀胱镜检查为主要手段。肾输尿管全长及膀胱部分切除为主要术式。预后与肿瘤分期分级有关     

浅表宫颈阴道肌纤维母细胞瘤3例临床病理观察

目的：探讨浅表宫颈阴道肌纤维母细胞瘤（SCVM）的临床表现、组织病理学、免疫组化染色特点以及诊断。方法对3例（2例发生于阴道、1例发生于宫颈）SCVM 的病理学形态、免疫组化染色进行观察，并复习相关文献。结果本组3例患者中，2例发生于绝经后妇女，中位年龄53岁，临床均表现为阴道出血。大体上，肿物成类圆形，边界清晰，肿物大小平均为4.3 cm。镜下见肿物由相对一致的梭形和星形细胞组成，周边区肿瘤细胞成分相对稀疏，中心区肿瘤细胞相对密集，细胞之间可见纤细、致密的胶原纤维。免疫组化染色示：Vimentin、Desmin、CD34、ER 和 PR 阳性，SMA、S-100、CK 和 EMA 阴性。Masson 染色显示：肿瘤细胞呈红色，胶原纤维呈红色，纤维组织呈绿色。结论 SCVM 是一种起源于女性阴道和宫颈黏膜下浅表基质的良性间叶性肿瘤，比较罕见，易与纤维上皮性息肉，血管肌纤维母细胞瘤等混淆，明确诊断需结合病理学形态、免疫组化及临床资料。