Stomach cancer metastasizing into a solitary adenomatous colonic polyp

A 69-year-old man with known diffuse type gastric stump carcinoma was found at autopsy to have widely disseminated metastasis of this cancer. Metastasis also occurred in the adenomatous polyp of the cecum. This is the third report, to our knowledge, in the literature and the first Hungarian publication of a metastasis to an adenomatous polyp of the colon.     

结肠息肉患者的临床病理及内镜检查分析

目的:探讨对结肠息肉患者的病理特征、临床表现、病发部位及其内镜下的特点,分析当中的相关因素.方法:对应用电子结肠镜发现的210例结肠息肉患者资料做回顾性分析,根据检查结果,对其在年龄、临床表现、病理特征、发生部位以及内镜资料进行探讨分析.结果:210例结肠息肉患者中,男性为120例,女性90例,发病年龄集中在40～69岁,共计161例,占比率为76.67％.其中息肉发生部位以直肠较多,占比率为32.79％,乙状结肠为30.70％,降结肠为15.81％,横结肠为7.44％,升结肠为6.98％,盲肠为6.28％,病理类型中腺瘤性息肉为主,占比率为54.42％.结论:结肠息肉主要发生于40～69岁年龄段,其主要的临床表现有大便性状改变、便血以及腹痛、腹胀等,分布的部位主要在横结肠、乙状结肠及直肠,为预防结肠息肉进一步癌变的发生,早期的诊断及其治疗措施是十分重要的.     

Gastric and colonic sarcoidosis. A case report

Sarcoidosis is a disseminated disease defined by the presence of non-caseous granulomas. Digestive localizations are rare and the stomach is the mostly affected. The diagnosis is frequently difficult. We report the case of a digestive (gastric and colic) and hepatic sarcoidosis in a 38-year old woman. The clinical and endoscopic findings initially suggested linitis plastica. Subsequently the discovery of gastric granulomas led to the diagnosis of sarcoidosis. Coloscopy and abdominal scan were performed discovering a colic, hepatic and splenic localizations which were asymptomatic.     

Removal of sessile recidive rectal polyp with endoscopic submucosal dissection. Case report and review of the literature

With the development of flexible endoscopy, removal of the large sessile polyps and superficial malignant tumors that do not exceed the layer muscular mucosa has become today's major challenge. Earlier in various types of mucosectomy performed with such indication it was difficult to control the depth and the lateral margin of the resection surface. Tumors larger than 20 mm could only be removed with the application of the piecemeal technique. PATIENT AND METHOD: 64-year-old female patient's large sessile polyp had been removed earlier with piecemeal technique followed by mucosectomy. On the area of these interventions a recidiv adenoma was found and for this reason endoscopic submucosal dissection was applied. RESULT: The procedure took 55 minutes, and only small volume of bleeding was detected during the intervention. The postoperative period was uneventful, one day later the patient left the hospital. Vertical and lateral resection surface were free of tumor histologically. CONCLUSION: The endoscopic submucosal dissection is suitable for the removal of the large sessile polyp, which could not be successfully removed with earlier techniques.     

结肠息肉的虚拟可视化检查系统

根据GPGPU原理,用虚拟内窥镜、虚拟展平和虚拟切开并结合虚拟外翻技术,设计了一种用于快速辅助结肠息肉检查的诊断系统。实验结果表明,该系统的各种虚拟可视化方法能够清晰准确地显示结肠内壁表面,能提供实时的人机交互操作,可以应用于快速高效的人体胃肠道早期癌症和息肉的检查。     

Amyloidosis induced colonic stricture. The first symptom of myeloma multiplex. A case report

Systemic amyloidosis often involves the gastrointestinal tract and usually presents as ulceration or polypoid lesions. However, annular stricture of the colon due to amyloidosis is very rare. Amyloidosis develops in appr. 10% of multiple myeloma patients with lambda light chain production, it is usually type AL and not a presenting symptom. CASE REPORT: A 73-year-old female patient appeared at our hospital with anaemia, abdominal pain and haematochesia. Colonoscopy revealed a circular narrowing of the sigmoid colon suggesting malignancy. The patient underwent sigmoid resection and rectosigmoideal anastomosis was prepared to relieve mechanical obstruction. Surprisingly the histological finding from the resected specimen was amyloidosis. Subcutaneous fat tissue biopsy established the diagnosis of systemic AA amyloidosis. Immunoelectrophoresis revealed an elevated gamma-globulin fraction with IgG lambda monoclonal component, as well as a different lambda light chain. Therefore bone marrow biopsy was carried out which confirmed the diagnosis of multiple myeloma. DISCUSSION: Our case is a rare example of the extraordinary tumor-mimicking colon amyloidosis that led to the diagnosis of multiple myeloma. Beside haematological treatment, strict follow-up of the colon process and reconsideration of surgical therapy or endoscopic stenting is of great importance.