Osseous metaplasia in a tubular adenoma of the colon

An 85 year old woman presented with a one month history of change in her bowel habits in the form of alternating diarrhoea and constipation. She also noted some rectal bleeding. Flexible sigmoidoscopy revealed a 1.5 cm polyp 30 cm from the anus. The polyp was removed during the sigmoidoscopy by electrocautery and sent for histological examination. The polyp was a tubular adenoma with mild dysplasia. The adenoma contained numerous foci of metaplastic bone. These consisted of irregular islands of mineralised osteoid bone rimmed by a layer of scattered osteoblasts. This is the first case of osseous metaplasia in a tubular adenoma of the colon to be reported.     

Osseous metaplasia in renal cell carcinoma: report of a rare case

Focal calcifications are frequently seen in renal masses including renal cell carcinoma (RCC). Osseous metaplasia, on the other hand, is a rare finding in RCC. We report a case of RCC with radiological evidence of speckled calcification that showed osseous metaplasia on histopathological examination. The clinical and pathologic differential diagnosis for this tumor is discussed along with a review of the literature on this unusual phenomenon.     

Case report: Osseous metaplasia of the endometrium: a rare cause of infertility and its hysteroscopic management

This case report presents a very rare and long-standing causeof infertility, osseous metaplasia of the endometrium, and describesits successful management by hysteroscopy. A woman with a historyof induced abortion 12 years ago, failed to conceive from thattime on. The infertility work-up was unrevealing except forthe presence of intracavitary calcification on ultrasonography.After diagnostic hysteroscopy, solid bony spicules coveringthe posterior wall of the endometrial cavity were removed bywire loop resectoscope. Histology established the diagnosisof osseous metaplasia of the endometrium. The patient conceivedin her second spontaneous cycle and has an ongoing pregnancyat the time of writing. Hysteroscopy was an effective meansof extracting this heterotopic tissue, thereby re-establishingfertility even after a long period of infertility.     

Adenocarcinoma arising in a traditional serrated adenoma of the rectosigmoid colon with osseous metaplasia

Within the gastrointestinal tract, osseous metaplasia is an extremely rare phenomenon. It has only recently been described within a traditional serrated adenoma. Serrated colorectal carcinoma is the end point of the serrated neoplasia pathway. Left sided lesions typically arise from traditional serrated adenomas and represent only 8% of colorectal carcinomas. Herein reported is a case of colorectal adenocarcinoma arising from a traditional serrated adenoma with the rare occurrence of osseous metaplasia within the adenoma. The significance of the finding is discussed.     

Tubular adenoma with focal squamous metaplasia of the ascending colon

A case of tubular adenoma with focal squamous metaplasia of the ascending colon in a 66-year-old male is reported. The tumor was a pedunculated polyp with a size of 1.5 X 1.4 X 0.9 cm. Histologically, the tumor showed tubular adenoma with moderate to severe atypia, was accompanied by focal squamous metaplasia. It is thought that squamous epithelial polyp may be derived from colonic adenoma with squamous metaplasia, and that the malignant change of colonic adenoma with squamous metaplasia may lead to squamous cell carcinoma, adenosquamous carcinoma, and mucoepidermoid carcinoma. Only seven cases of colonic adenoma with squamous metaplasia have been reported previously in the literature, and it is yet necessary to discuss the histogenesis, significance, and natural history of colonic adenoma with squamous metaplasia.     

Allergy-related proctocolitis in infants: diagnostic usefulness of rectal biopsy

To evaluate the diagnostic utility of rectal mucosal biopsies in infants with proctocolitis, we compared the clinical and histologic features of an allergy-related group (N = 36) with those of normal (N = 12) and inflammatory (N = 8) controls. Clinical features were nondiscriminatory among the three groups of patients, except for an increased absolute peripheral eosinophil count in the allergic group. Similarly, morphologic evidence of proctitis (cryptitis and crypt abscesses) and small or moderate numbers of eosinophils (less than or equal to 60 per ten high power fields) in the lamina propria of the biopsies did not discriminate among the three groups. However, large numbers of eosinophils (greater than 60 per ten high power fields) and eosinophils located in the muscularis mucosae or as the predominant cell in crypt abscesses were significantly associated with allergy-related disease. No histologic features of chronic colitis were noted in the allergy-related group. Thus, in tandem with the remainder of the clinical data, rectal mucosal biopsy is a useful adjunct in the diagnosis of allergic proctocolitis.     

Mucosal metaplasia in the appendix

Metaplastic foci do not appear to have been previously described in the mucosa of the appendix. Eight examples are reported, two of which were found in a series of 100 consecutive appendicectomies.     

Osseous fragility in Marshall-Smith syndrome

Marshall-Smith syndrome is characterized by accelerated osseous maturation, craniofacial anomalies, failure to thrive, psychomotor delay, hypotonia, pulmonary dysfunction, and limited life expectancy. We describe a 7-year-old girl who, in addition to meeting these criteria for Marshall-Smith syndrome, had multiple fractures and skeletal anomalies. The purpose of this report is to draw attention to Marshall-Smith syndrome as one of the skeletal dysplasias characterized by osseous fragility.