1/40. Multiple hyperplastic inflammatory polyps complicating quiescent ulcerative colitis.A patient with well-controlled and currently asymptomatic ulcerative colitis had II unusually large polypoid lesions in his colon demonstrated by barium enema X-ray examination and colonoscopy. Previous histological descriptions of inflammatory polyps did not adequately describe their morphology, and the term "hyperplastic inflammatory polyp" is suggested.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
2/40. Dysplasia-associated polypoid mucosal lesion in a pelvic pouch after restorative proctocolectomy for ulcerative colitis.A 32-year-old man with ulcerative colitis had a colectomy for toxic colitis. Later, a rectal mucosectomy was performed along with the creation of a pelvic pouch. In 1998, approximately 10 years after this staged restorative proctocolectomy was completed, endoscopic examination of the pelvic pouch detected a small mucosal polypoid mass lesion. Although the lesion had the macroscopic appearance of an inflammatory polyp, microscopic sections of the resected lesion revealed dysplastic changes. Endoscopic polypectomy was performed to remove the lesion, and further histological surveillance examinations of the pelvic pouch have not detected additional dysplastic mucosal changes.- - - - - - - - - - ranking = 1.2keywords = colitis (Clic here for more details about this article) |
3/40. carcinoembryonic antigen: clinical and historical aspects.To further define and determine the usefulness of CEA, 1100 CEA determinations have been made over the past two years at The ohio State University hospitals on patients with a variety of malignant and nonmalignant conditions. Correlation of CEA titers with history and clinical course has yielded interesting results not only in cancers of entodermally derived tissues, for which CEA has become an established adjunct in management, but also in certain other neoplasms and inflammatory states. The current total of 225 preoperative CEA determinations in colorectal carcinomas shows an 81% incidence of elevation, with postoperative titers remaining elevated in patients having only palliative surgery but falling to the negative zone after curative procedures. An excellent correlation exists between CEA levels and grade of tumor (more poorly differentiated tumors showing lower titers). Left-side colon lesions show significantly higher titers than right-side lesions. CEA values have been shown to be elevated in 90% of pancreatic carcinomas studied, in 60% of metastatic breast cancers, and in 35% of other tumors (ovary, head and neck, bladder, kidney, and prostate cancers). CEA levels in 35 ulcerative colitis patients show elevation during exacerbations (51%). During remissions titers fall toward normal, although in 31% still remaining greater than 2.5 ng/ml. In the six colectomies performed, CEA levels all fell into the negative zone postoperatively. Forty percent of adenomatous polyps showed elevated CEA titers (range 2.5-10.0) that dropped following polypectomy to the negative zone. Preoperative and postoperative CEA determinations are important in assessing the effectiveness of surgery. Serial CEA determinations are important in the follow-up period and in evaluation of the other modes of therapy (e.g., chemotherapy). These determinations of tumor antigenicity give the physician added prognostic insight into the behavior of the tumor growth. Rectal examination with guaiac determinations, sigmoidoscopy, cytology, barium enema, and a good clinical evaluation remain the primary tools for detecting colorectal disease. However, in the high-risk patient suspicious of developing cancer, CEA determinations as well as colonoscopy are now being used increasingly and provide additional highly valuable tools in the physician's armamentarium.- - - - - - - - - - ranking = 0.2keywords = colitis (Clic here for more details about this article) |
4/40. Intramural barium in ischemic colitis: a new radiographic finding.Two cases of ischemic colitis are presented, demonstrating a new radiographic finding of intramural dissection of barium. Colonoscopic findings were compatible with that diagnosis. Deep, discrete ulcerations were observed during the healing process. Both patients recovered and prolonged retention of the intramural barium was seen.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
5/40. Topical budesonide for treating giant rectal pseudopolyposis.Pseudopolyps are a frequent finding in the course of inflammatory bowel disease. They are non-neoplastic lesions resulting from a regenerative and healing process that leaves inflamed colonic mucosa in polypoid configuration. Data about their management is lacking. "Giant" pseudopolyps can be mistaken for adenocarcinomas and, as they rarely regress with medical management alone, a surgical resection is often required. A case ofgiantpseudopolyposis treated non-surgically, in a patient with concomitant ulcerative colitis and chronic hepatitis b, is reported, representing a co-morbidity complicating an eventual conservative treatment. The clinical implementation of topical budesonide was originally tested, resulting in clinical, endoscopic and histological remission. budesonide seems a promising therapy for IBD, particularly when a comorbidity with viral hepatitis exist.- - - - - - - - - - ranking = 0.2keywords = colitis (Clic here for more details about this article) |
6/40. Localized giant pseudopolyposis in ulcerative colitis.A case of localized giant pseudopolyposis in ulcertative colitis is discussed in which a mass effect mimicked tumor. The fulminant collection of pseudopolyps was palable in the epigastrium on physical exam and caused a partial obstruction to the retrograde flow of barium. Carcinoma is a worrisome possibility in ulcerative colitis, but localized giant pseudopolyposis may also present as a mass.- - - - - - - - - - ranking = 1.2keywords = colitis (Clic here for more details about this article) |
7/40. Invasive balantidiasis presented as chronic colitis and lung involvement.A unique case of chronic balantidiasis is described, presenting with chronic colitis and inflammatory polyposis of the rectum and sigmoid colon and an intrapulmonary mass. histology of the colonic polyps showed balantidium coli, and both aspergillus and balantidium coli were found in the aspirate of the pulmonary mass. The patient was treated with doxycycline HCl 100 mg/day for 10 days with complete clinical recovery and marked improvement of the endoscopic appearance of the colonic mucosa.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
8/40. Colonic metaplasia of ileostomies. Biological significance for ulcerative colitis patients following total colectomy.Two patients who had undergone proctocolectomy for ulcerative colitis developed lesions in their ileal stoma that appeared to be inflammatory polyps morphologically similar to those encountered in the large intestine of ulcerative colitis patients. One of these patients eventually developed mucinous adenocarcinoma in the ileal stoma. The ileal mucosa adjacent to the neoplasm had morphologic features of large-bowel mucosa and was richly populated by sulfomucin-containing goblet cells, which are characteristic of large-bowel mucosa. Sulfomucin-containing goblet cells were also found in the inflammatory lesions biopsied from the ileal stomas of both patients, as well as from the adenocarcinoma found in one patient. These findings support the hypothesis that colonic metaplasia can occur in ileal stomas of ulcerative colitis patients. Furthermore, the metaplastic colonic tissue is the site of origin of lesions typically found in ulcerative colitis. Colonic metaplasia occurring in ileal stoma should be recognized by pathologists as a clinical entity. When colonic metaplasia is identified in the ileal stoma of an ulcerative colitis patient, biopsy surveillance of stomal mucosa is recommended.- - - - - - - - - - ranking = 1.8keywords = colitis (Clic here for more details about this article) |
9/40. Jejunitis cystica profunda in a hamartomatous polyp. Report of a case.A patient with a history of abdominal discomfort and rectal bleeding was discovered to have two hamartomatous polyps, one of the jejunum and one of the colon. The former was associated with mucinous cysts at its base. The findings were similar to those described for colitis cystica profunda. This case is a rare example of cystica profunda disease of the small bowel. Uniquely, it was associated with a hamartomatous polyp.- - - - - - - - - - ranking = 0.2keywords = colitis (Clic here for more details about this article) |
10/40. Giant pseudopolyposis in granulomatous colitis.A case is described of an unusual combination of polypois and inflammatory bowel disease of a granulomatous type. A striking feature is the complexity of the polypoidal lesions. The relationship between these lesions and the granulomatous colitis which is probably a variant of Crohn's disease is discussed.- - - - - - - - - - ranking = 1keywords = colitis (Clic here for more details about this article) |
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