1/6. Gastrointestinal toxicity of 5-FU and 5-FUDR: radiographic findings.The authors describe two patients who suffered gastrointestinal toxicity after receiving chemotherapy for unresectable lesions in the liver that metastasized from colonic carcinoma. One patient had severe ileitis caused by intravenous administration of 5-fluorouracil; the other had severe duodenitis caused by infusion of 5-floxuridine into the hepatic artery by an implanted pump. The type of toxicity that occurred was directly related to the route of administration of these chemotherapeutic agents. Cessation of the chemotherapy led to a dramatic clinical response in these patients.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/6. Crohn's disease of the duodenum complicated by adenocarcinoma.patients with Crohn's disease of the small bowel or the colon are at risk for development of cancer within their chronically inflamed intestinal loops. We present here the first reported case of malignant degeneration of duodenal mucosa involved by Crohn's disease. The clinical observations as well as radiographic and endoscopic features of this unusual complication are described.- - - - - - - - - - ranking = 4keywords = carcinoma (Clic here for more details about this article) |
3/6. Multiple gastric tumors--Crohn's disease.A case of multiple, histologically in part differing gastric tumors and granulomatous inflammation in the upper gastrointestinal tract and terminal ileum in the same patient is presented. The differential diagnosis of granulomatous inflammation and a possible association between Crohn's disease and carcinoma is discussed.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
4/6. Carcinoma of the biliary tree complicating Crohn's disease.A patient with long-standing Crohn's disease who subsequently developed carcinoma of the biliary tree is described. biliary tract neoplasia may represent another extraintestinal complication of Crohn's disease, but its frequency of association is probably less than that of ulcerative colitis.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
5/6. Coeliac disease with histological features of peptic duodenitis: value of assessment of intraepithelial lymphocytes.AIMS--To determine if a clinically important polymorphonuclear leucocyte infiltrate and surface gastric epithelial metaplasia occur in the second part of the duodenum in coeliac disease; to evaluate the utility of these morphological criteria in the differential diagnosis of coeliac disease and peptic duodenitis. methods--49 mucosal biopsy specimens of the second part of the duodenum reported as showing inflammation were reviewed. Sections were prepared with haematoxylin and eosin, periodic acid Schiff, and Warthin-Starry stains. Clinical presentation, outcome, and immunological investigations were assessed. RESULTS--Four cases confirmed as coeliac disease on clinical and immunological grounds showed acute inflammation and surface epithelial gastric metaplasia. Increased intraepithelial lymphocytes (IELs) were found in each of the four. CONCLUSIONS--Clinically important polymorphonuclear leucocyte infiltration and surface epithelial gastric metaplasia may occur in the duodenal mucosa in coeliac disease and should not be used as diagnostic features to exclude the diagnosis of coeliac disease in the absence of confirmatory clinical and immunological information.- - - - - - - - - - ranking = 269.25080094803keywords = intraepithelial (Clic here for more details about this article) |
6/6. Peptic duodenitis--does it exist in the second part of the duodenum?AIM: To re-evaluate all patients diagnosed histologically as having peptic duodenitis who had known endomysial antibody (EMA) test results to find out whether they would still be classified as peptic duodenitis on histological analysis and to review their subsequent clinical course. methods: All mucosal biopsy specimens of the second part of the duodenum which were reported as showing features of peptic duodenitis and on which a serum EMA test had been done between January 1990 and January 1995 were reviewed. The number of intraepithelial lymphocytes (IELs) per 500 epithelial cells was also counted. The cases were re-assigned to one of three clinical categories: normal, coeliac disease or peptic duodenitis. Clinical details were reviewed for any cases where the re-assigned diagnosis and the EMA test result did not correlate. RESULTS: Of the 24 cases, 21 showed a correlation between morphology and immunology-that is, if the biopsy specimen was characteristic of coeliac disease, the EMA was positive and if the biopsy specimen was normal or characteristic of peptic duodenitis, the EMA was negative. Three cases had a negative correlation: two had a positive EMA test but a biopsy diagnosis of peptic duodenitis and one had a normal duodenal biopsy specimen with a positive EMA test. On review of their clinical details, two of the three patients were diagnosed with coeliac disease and the other with silent coeliac disease. EMA test results and IEL counts correlated with the final diagnosis in all cases. CONCLUSIONS: The diagnosis of peptic duodenitis on biopsy specimens of the second part of the duodenum was not substantiated in 92% of cases. On review of 24 cases, a histological diagnosis of peptic duodenitis was reached in four. In difficult cases, the histological appearances should be correlated with the EMA test result and the IEL count. Correlation of this kind should leave no cases of coeliac disease undiagnosed.- - - - - - - - - - ranking = 53.850160189607keywords = intraepithelial (Clic here for more details about this article) |