Histogenesis of gastric foveolar metaplasia following duodenal ulcer: a definite reparative lineage of Brunner's gland

AIMS: We aimed to clarify the histogenesis of gastric metaplasia in the duodenal mucosa, particularly in association with a reparative lineage of Brunner's glands. METHODS AND RESULTS: Using immunohistochemical methods with recently developed antimucin monoclonal antibodies (mAbs) that distinguish foveolar and deep mucins of the gastric type, as well as mAb MIB-1, the histogenesis of gastric metaplasia was investigated in the duodenal wall of 20 surgically resected specimens. In duodenal ulcers extending into Brunner's glands with destruction of the muscularis mucosae, proliferating cells positive for MIB-1 were scattered in Brunner's glands. Interestingly, a group of proliferating cells was often seen next to the ulcerated surface. These cells were also positive for M1 (gastric-foveolar type mucin) but negative for M2 (deep gastric and Brunner glands' mucin). In regenerating ducts through granulation tissue, the proliferating cell zone was elongated, above which foveolar-type cells positive for M1 but negative for M2 were detected, indicating that the G-zone is newly established in Brunner's glands at the floor of an ulcer to produce gastric-foveolar cells. Subsequently, an organoid growth of the normal stomach mucosa is completed in the duodenum. CONCLUSIONS: This study indicates a possible histogenetic pathway of gastric metaplasia in close association with a reparative lineage of Brunner's glands, suggesting that the occurrence of the gastric-foveolar type epi-thelium is not a simple expansion of Brunner's duct but a true metaplasia.     

Morphological changes in the jejunum and ileum of rats after wide resection of the small intestine

Summary One third to one half of the medial portion of the small intestine was resected in white rats. The length of the remaining intestinal portion remained unchanged, but its diameter increased. The area of the intestinal mucous membrane of the operated rats in 10 days after the resection reached that of control rats. The structural reconstruction after the resection consisted in the hypertrophy of the villi and their increased number. These changes occurred in the jejunum and ileum and were retained for 2 months after the operation.Presented by Active Member of the AMN SSSR N. N. Zhukov-Verezhnikov     

Pyloric gland metaplasia/differentiation in multiple organ systems in a patient with Peutz-Jegher's syndrome

Peutz-Jegher's syndrome (PJS) involves multiple organ systems and the development of hamartomatous, metaplastic, or neoplastic lesions of different cell lineages. Among them, glandular lesions are the most common, but their properties are obscure. We report here a 53-year-old woman with PJS who developed multiple hamartomatous polyps in the jejunum and mucinous glandular lesions in multiple organ systems: glandular metaplasia in the urinary bladder; lobular endocervical glandular hyperplasia in the uterine cervix; mucinous metaplasia in the right fallopian tube; mucinous adenoma in the left ovary. Histological and immunohistochemical analyses disclosed that all of the intestinal and extra-intestinal lesions were associated with pyloric gland metaplasia/differentiation across the organ systems. In the general population, the organs described above rarely or infrequently show pyloric gland phenotype, to say nothing of trans-organ involvement. It is strongly suggested that commitment to pyloric gland metaplasia/differentiation is closely associated with PJS.     

Lipogranuloma with osseous metaplasia in the breast that developed after "Bu-Hwang" oriental medicine treatment

A lipogranuloma is an inflammatory reactive process associated with exogenous or endogenous lipids, and it's occurrence in the breast has rarely been reported. Osseous metaplasia, which is used to describe bone formation in abnormal locations, can develop from several conditions such as trauma or a tumor. However, few studies have reported benign breast lesions that have been seen as osseous metaplasia. We present a case of a benign calcified breast lesion that developed after a traumatic treatment process called "Bu-Hwang", and it was confirmed as a lipogranuloma with osseous metaplasia. To the best of our knowledge, this is the first reported case of a lipogranuloma with osseous metaplasia in the breast.     

Basaloid ductal carcinoma in situ arising in salivary gland metaplasia of the breast: a case report

Salivary gland metaplasia is a newly recognized, adenosis-like lesion which could not be classified according to known categories of adenosis of the breast. We report a case of basaloid ductal carcinoma in situ (DCIS) arising in a background of salivary gland metaplasia in a 49-year old woman who visited our hospital for a right breast mass. Breast ultrasonography showed a multi-lobulating mixed hypoechoic and isoechoic mass measuring 2.9 cm in size at the periareolar area. Histologically, the lesion showed a well-defined DCIS with basaloid tumor cells and central comedo-type necrosis surrounded by salivary gland metaplasia composed of glands or ducts not specific to the breast, ducts with cribriform proliferation of luminal epithelial cells, and ducts with varying degrees of proliferation of basaloid cells including solid nests of basaloid cells. Salivary gland metaplasia is a most unusual lesion of the breast characterized by salivary gland-type acini and ducts with various proliferations of luminal and basaloid cells, and accompanied by malignant tumor of basal cell type.     

MUC5B、Villin、P53在胆囊黏膜幽门腺化生、肠上皮化生及胆囊腺癌中的表达及意义

目的：通过观察MUC5B、Villin、P53蛋白在胆囊黏膜幽门腺化生、肠上皮化生及胆囊腺癌的表达,探讨胆囊黏膜两种化生与胆囊腺癌发生的关系。方法：收集2013年1月至2015年1月兰州市第二人民医院病理科诊断的胆囊黏膜幽门腺化生40例、肠上皮化生40例及胆囊腺癌40例,采用免疫组化方法检测MUC5B、Villin、P53在胆囊黏膜幽门腺化生、肠上皮化生及胆囊腺癌的表达。结果：MUC5B在胆囊黏膜幽门腺化生、肠上皮化生、胆囊腺癌的阳性表达率分别为95.00%(38/40)、75.00%(30/40)、27.50%(11/40);Villin在三组中的阳性表达率分别为0.00%(0/40)、87.50%(35/40)、22.50%(9/40);P53在三组中的阳性表达率分别为2.50%(1/40)、7.50%(3/40)、80.00%(32/40)。各组间比较MUC5B在幽门腺及肠上皮化生的阳性表达率明显高于胆囊腺癌,差异有统计学意义(χ2=42.754,P=0.001);Villin在肠上皮化生的阳性表达率明显高于幽门腺化生及胆囊腺癌,差异有统计学意义(χ2=71.124, P=0.001);P53在胆囊腺癌中的阳性表达率明显高于幽门腺及肠上皮化生,差异有统计学意义(χ2=71.667,P=0.001)。MUC5B、Villin在幽门腺化生、肠上皮化生及胆囊腺癌的阳性表达率递减;P53在幽门腺化生、肠上皮化生及胆囊腺癌的阳性表达率递增。结论：幽门腺及肠上皮化生可能参与了胆囊腺癌的发生。     

Regeneration of the thyroid gland in dogs after resection

In experiments on 44 dogs after removal of one lobe of the thyroid gland or one complete lobe and two-thirds of the other, no increase in weight of the residual part of the gland was observed. Restoration of thyroid function took place through hypertrophy of the thyroid epithelium in the residual gland, brought about by hyperplasia of the intracellular structures.Department of Pathological Anatomy, Blagoveshchensk Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR A. P. Avtsyn.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 81, No. 1, pp. 64–65, Janyary, 1976.     

The external secretory activity of the pancreas after wide resection of the proximal division of the small intestine

Summary Experimental material presented was obtained on 2 dogs with a fistula according to Bakuradze and on one animal with the pancreatic duct exteriorized according to Pavlov. After the establishment of the normal secretion in response to the main food stimuli (100 gm of meat and 200 ml of milk) the dogs were subjected to an extensive resection (65–70%, 155–190 cm) of the superior portions of the small intestine. As shown, secretion in response to 100 gm of meat was considerably increased in all the 3 dogs; the concentration of the enzymes (amylase and trypsin) per 1 ml of the juice remained almost unchanged, varying within the range of preoperative values. However, the total amount of the enzyme units is markedly increased in connection with the increased amount of the juice. Secretion in response to 200 ml of milk was reduced in 2 dogs and increased in one. The concentration of the enzymes remained within the range of the initial values. The data obtained demonstrated that extensive intestinal resection caused mainly an increased pancreatic juice secretion in response to food stimuli, which could be regarded as a compensatory phenomenon.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 53, No. 4, pp. 57–60, April, 1962     

Adenomyoma of the small intestine: report of two cases and review of the literature

Adenomyoma of the small intestine is a rare tumor-like lesion composed of exocrine-type ducts and hypertrophic smooth muscle. We describe two cases of adenomyoma of the small intestine. One was an ileal adenomyoma that presented with intussusception occurring in a 7-month-old boy. The other was a jejunal adenomyoma found incidentally in a 63-year-old man with colon cancer. Histologically, the lesions composed of benign ducts and bundles of smooth muscle. The second case was detected on contrast-enhanced computed tomography scan as a small enhancing polypoid mass. We review the previous literature of adenomyoma of the small intestine.     

Sebaceous gland metaplasia in cardiac-type mucosa of the oesophago-gastric junction

The first case of sebaceous gland metaplasia arising in cardiac-type mucosa of the oesophago-gastric junction of 71-year-old man is reported. Within cardiac glands, small nests composed of clear cells closely resembling sebaceous glands of the skin were found. Immunohistochemically, the cell nests stained positively for a monoclonal antibody 115D8 against milk-fat globule membrane (MAM-6). These cells were sometimes covered by cylindrical cells positive for foveolar-type mucin of the stomach (M1), and basal marginal cells of these nests expressed high molecular weight cytokeratins (34BE12). This study documents a new type of metaplasia of the gastric mucosa.     

The absorptive function of the small intestine after subtotal resection of the stomach

Summary The author describes the effect of partial resection of the stomach on the absorptive ability of the small intestine. Experiments were performed on dogs by 2 methods. The dynamics of glucose absorption were studied in normal conditions and at various time periods after resection of the stomach. Experiments were conducted by the administration of glucose into the digestive tract and subsequent study of the glycemic curve. The absorption function of the fasting small intestine was examined in 4 dogs with the isolated section of the superior portion of the small intestine by Thiry's and Thiry-Vella's methods. 0.5–1% glucose and water were given as test meals. Experiments conducted by the first method demonstrated that after stomach resection, the blood sugar level (before meals) and the character of glycemic curve show considerable changes, but the changes are different in these two dogs. Experiments carried out on isolated intestinal sections show that as a result of stomach resection, the glucose absorption decreases during the first month after the operation, then rises and stays within the normal limits. The dogs were observed for from 3 months to 11/2 years. Absorption of water is greatly increased after resection and remains in this condition for a long time. The absorption of glucose and water, as well as the blood sugar level and the character of glycemic curve, depends on the general condition of the animal after stomach resection.Presented by Active Member AMN SSSR V. N. Chernigovskii     

Histopathological differences in the development of small intestinal metaplasia between antrum and body of stomach

This study used mucin immunohistochemistry to investigate differences in the properties of intestinal metaplasia between the antrum and body of the stomach in 28 resected specimens. Intestinal metaplasia was classified as: (1) small intestinal metaplasia (SIM) with a tubule, including CD10-positive brush border on a background of MUC5AC-/ HGM-negative cells; or (2) goblet cell metaplasia (GCM) with MUC2-positive and CD10-negative cells. In the antrum, frequencies of SIM and GCM were nearly equal irrespective of metaplasia grade. Frequency and length of remnant pyloric gland for SIM were significantly greater in the antrum than in the body. In the proliferative zone, there existed a lower level in SIM than in non-intestinalized tubules. These findings suggest that the proliferative zone shifts from the neck zone toward the bottom of the tubule during the SIM process in the antrum. In the body, however, the grade of SIM grade was significantly higher than that of GCM. The proliferative zone was located higher in the fundic gland, pseudopyloric gland and SIM, in that order. Almost all remnant pyloric glands for SIM were negative for pepsinogen I. These facts indicate that SIM in the body originates in a proliferative zone that shifted downward to an area near the bottom of the tubule, with atrophic pyloric glands originating from pseudopyloric gland metaplasia.     

The absorptive function of the digestive apparatus after partial resection of the small intestine

Summary Experiments were conducted on 4 dogs with isolated portions of the superior or inferior portion of the small intestine according to Thiery. A study was made of the absorption of 1 percent glucose solution and water (observations—41/2 to 11 months) at various periods following resection of the superior or inferior half of the small intestine. All the experimental animals, irrespective of resected superior or inferior portion of the small intestine, were in a satisfactory condition for a long period after the operation this being confirmed by the indices weight and appetite as well as by data of coprologic examination. Studies of glucose and water absorption in various portions of the small intestine, revealed no essential difference in the rate of absorption in the intestine in resection of its various. Experimental results show that water absorption increased after the resection both of the superior and inferior portions of the small intestine, whereas glucose absorption changed but insignificantly.(Presented by Active Member AMN SSSR V. V. Parin) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 53, No. 4, pp. 61–64, April, 1962     

The secretory function of the small intestine in dogs after resection of the stomach

Summary Data concerning the secretory and enzyme-secretory function of the small intestine after resection of 2/3 of the stomach in dogs was studied. The amount of the intestinal juice in periodical secretion, the ratio of the fluid to the solid part and the content of the 5 enzymes-enterokinase, basicphosphatase, erepsin, lipase and amylase—were examined.It was demonstrated that there is a tendency to increased enzymatic activity of the intestinal juice after partial removal of the stomach. The most considerable increase was exhibited by phosphotase and enterokinase. The increase was more pronounced in the dogs, the general condition of which, after the operation, was good.It is believed that the main increase of the activity occurring in the enzymes which take part in the protein cleavage is in direct relationship with the acute disturbance of the process of protein digestion in the upper part of the digestive tract and is, therefore, compensatory in character.Presented by Active Member Acad. Med. Sci. USSR, V. N. Chernigovskii