Dilated Glands Research Articles

Peribiliary Gland Dilatation in Cirrhosis: Relationship with Liver Failure and Stem Cell/Proliferation Markers.

Dilated peribiliary glands (PBG) in patients with cirrhosis are often an incidental finding although their significance and physiopathology remain unclear. We aimed to identify clinical factors associated with dilated PBG and to perform a detailed morphometric assessment of dilated PBG in cirrhotic patients undergoing liver transplantation (LT). All consecutive cirrhotic patients undergoing LT at our institution between October 2006 and October 2011 were assessed for inclusion. Ten non-cirrhotic patients were included as controls. We performed morphometrical assessment of PBG, assessed baseline clinical factors associated with dilated PBG, immunohistochemistry staining with CK-19, MiB-1 and EpCAM, and radiological assessment of all available cases. Seventy-one patients met the inclusion criteria, 24% had PBG dilatation of >1000µm. On multivariable analysis, MELD (OR 1.11 per unit increase in MELD, p=0.004) was the only significant factor associated with dilated PBG. Compared to PBG<1000µm, large PBG had a higher proportion of EpCAM-positive (69 vs. 28%, p<0.001) and MiB-1-positive lining cells (2.8 vs. 0.55%, p=0.036). Computed tomography and magnetic resonance imaging had high specificity but low sensitivity for the diagnosis of dilated PBG>1000µm (specificity 90-100%, sensitivity 25-29%). Dilated PBGs are a common finding in explants of cirrhotic subjects undergoing LT and are associated with liver failure although diagnostic performance of cross-sectional imaging is inconstant. The high number of proliferative and EpCAM-positive cells lining the PBG may suggest a role of PBG in organ repair during liver failure.

Morphological and Histological Effects of Radiofrequency and Laser (KTP and Nd:YAG) Treatment of the Inferior Turbinates in Animals.

The aim of this study was to evaluate the short and medium-term effects of radiofrequency (RF) and potassium titanyl phosphate (KTP) and neodymium-yttrium-aluminum garnet (Nd:YAG) laser treatment on the inferior turbinate mucosa in a porcine model. Following randomization, the inferior turbinates were treated either with RF submucosally or with the KTP or the Nd:YAG laser on the surface under videoendoscopic control. Tissue samples were taken at the end of postoperative weeks 1 and 6, and were evaluated macroscopically and histopathologically. Scanning electron microscopy was implemented to demonstrate the morphological changes in the respiratory epithelium. Six weeks following the RF procedure, the mucosa was intact in all cases, and the volume of the inferior turbinates was reduced in the majority of the cases. Although a volume reduction occurred in both laser groups, more complications associated with the healing procedure were noted. With hematoxylin and eosin and periodic acid-Schiff staining, intact epithelium, and submucosal glands remained after the RF procedures at the end of postoperative week 6. Following the KTP-laser intervention, necrotizing sialometaplasia and cartilage destruction occurred, and squamous metaplasia was also apparent in the Nd:YAG group. In both laser groups, dilated glands with excess mucus were seen. The scanning electron microscopic findings demonstrated that cilia were present in all cases. In conclusion, the medium-term macroscopic results were similar in all 3 groups, but the postoperative complications were less following the RF procedure. RF procedure is minimally invasive due to the submucosal intervention that leads to a painless, function preserving recovery.

First reports of esophageal adenocarcinoma with white globe appearance in Japanese and Caucasian patients

Background and study aims: Better endoscopic diagnosis in case of Barrett’s esophagus is still needed. White globe appearance (WGA) is a novel endoscopic marker for gastric adenocarcinoma, with high sensitivity for differentiating between gastric cancer/high-grade dysplasia and other lesions. We report 2 cases of esophageal adenocarcinoma with WGA. In Case 1, esophagogastroduodenoscopy (EGD) revealed a 10-mm esophageal adenocarcinoma in a 48-year-old Japanese woman with short-segment Barrett’s esophagus. A small (< 1 mm) white globular lesion, typical of WGA, was observed under the epithelium by magnifying narrow-band imaging. A dilated neoplastic gland with eosinophilic material and necrotic epithelial fragments was identified at the site of the WGA by histologic examination. In Case 2, EGD revealed a 5-mm esophageal adenocarcinoma in a 60-year-old Caucasian man with long-segment Barrett’s esophagus. A typical WGA was observed by magnifying narrow-band imaging and similar histologic findings were identified at the site of the WGA. WGA could be a reliable endoscopic finding for target biopsy in esophageal adenocarcinoma, if its specificity is as high as in gastric cancer. The clinical implications of WGA in patients with Barrett’s esophagus should be investigated further.

Apocrine Hidrocystoma: A Rare Case Report

Hidrocystoma is a cystic tumor originating from a dilated sweat gland. The tumor is typically small and located predominantly on the face, particularly in the eyelid margins. They are two classical types of hidrocystomas i.e., Apocrine and Eccrine. Apocrine hidrocystomas are cystic lesions that arise from the apocrine secretory coil and Eccrine hidrocystomas represent retention cysts of the eccrine duct. Multiple apocrine hidrocystomas confined to the eyelids have been recognized as a feature of a new variant of ectodermal dysplasia. Here we present a rare case of Apocrine hidrocystoma of supraorbital area for which excisional biopsy of the lesion was performed. Histopathological evaluation proved the lesion was a unilocular cyst lined by a double-layered epithelium of the apocrine type. The purpose of this paper is to report the unique occurrence of a Supra orbital apocrine hidrocystoma which was clinically as a sebaceous cyst and to discuss its differential diagnosis with other more common supraorbital and face lesions.

Placenta Accreta and Placenta Increta: An Approach to Pathogenesis Based on the Trophoblastic Differentiation Pathway.

Morbid adherence remains a puzzling disease. This paper suggests that normal and morbidly adherent placentation may be viewed best in terms of trophoblastic stem cells and the mutually exclusive branches of the trophoblastic differentiation pathway-villous trophoblast (VT), interstitial and endovascular nonvillous trophoblast (NVT) at the implantation site, and a positional variation in the chorion. Based on cases of hysterectomies for morbid adherence seen over 30 years at a community hospital, analyzed with routine keratin stains, with actin and trichrome stains as indicated, and with attempts at ultrasonography-pathology correlation, we present selected observations. In true accreta, the site of morbid adherence was to dilated basal plate vessels infiltrated by endovascular NVT, with scant interstitial NVT, and normal myometrium. It appeared that excess blood flow into the placenta was due to excessively deep keratin-positive endovascular NVT that spread-independently of interstitial NVT-in an angiocentric fashion in both accreta and increta. Retroplacental abnormalities were due to myometrial destruction by interstitial NVT in increta, sometimes requiring actin stains for detection; and to an admixture of markedly dilated endometrial glands and vessels in true accreta, best appreciated with keratin stains. Variations of depth and extent in increta may be due to variations in myometrial tone, and in the protease-antiprotease balance. Morbidly adherent fetal membranes are described, and the role of caesarean section scars in incretas is addressed.

Estrogen Stimulates Homing of Endothelial Progenitor Cells to Endometriotic Lesions

The incorporation of endothelial progenitor cells (EPCs) into microvessels contributes to the vascularization of endometriotic lesions. Herein, we analyzed whether this vasculogenic process is regulated by estrogen. Estrogen- and vehicle-treated human EPCs were analyzed for migration and tube formation. Endometriotic lesions were induced in irradiated FVB/N mice, which were reconstituted with bone marrow from FVB/N-TgN (Tie2/green fluorescent protein) 287 Sato mice. The animals were treated with 100 μg/kg β-estradiol 17-valerate or vehicle (control) over 7 and 28 days. Lesion growth, cyst formation, homing of green fluorescent protein(+)/Tie2(+) EPCs, vascularization, cell proliferation, and apoptosis were analyzed by high-resolution ultrasonography, caliper measurements, histology, and immunohistochemistry. Numbers of blood circulating EPCs were assessed by flow cytometry. Invitro, estrogen-treated EPCs exhibited a higher migratory and tube-forming capacity when compared with controls. Invivo, numbers of circulating EPCs were not affected by estrogen. However, estrogen significantly increased the number of EPCs incorporated into the lesions' microvasculature, resulting in an improved early vascularization. Estrogen further stimulated the growth of lesions, which exhibited massively dilated glands with a flattened layer of stroma. This was mainly because of an increased glandular secretory activity, whereas cell proliferation and apoptosis were not markedly affected. These findings indicate that vasculogenesis in endometriotic lesions is dependent on estrogen, which adds a novel hormonally regulated mechanism to the complex pathophysiology of endometriosis.

Uterine Adenosarcoma.

Müllerian adenosarcoma is an uncommon biphasic tumor composed of malignant stromal and benign epithelial components. Morphologically, adenosarcoma is characterized by a broad leaflike architecture, reminiscent of phyllodes tumors of the breast. Periglandular cuffing of the stromal cells around the compressed or cystically dilated glands is characteristic. The mesenchymal component is typically a low-grade spindle cell sarcoma, whereas the epithelial counterpart is commonly endometrioid with frequent squamous or mucinous metaplasia and may, in some circumstances, show mild to moderate atypia. In all cases, it is important to assess for the presence of sarcomatous overgrowth and myometrial invasion, which are the prognostic factors. In this brief review, we present the clinical, histopathologic, and immunohistochemical features of adenosarcoma, as well as updates on the molecular biology of this neoplasm.

Hysteroscopic Patterns in Women on Treatment With Ulipristal Acetate 5 mg/day: A Preliminary Study

Study ObjectiveTo describe the hysteroscopic findings in women on treatment with ulipristal acetate (UPA) and to define the most common hysteroscopic patterns related to the treatment and compare them with the histologic findings. DesignPreliminary study. SettingOB-GYN and Gynecology Oncology Clinic, Military Medical Institute, Ministry of Defense, Warsaw, Poland, and Obstetrics and Gynecology Department, University of Bari, Italy. PatientsSeventy-four premenopausal patients complaining of abnormal uterine bleeding due to uterine myomas and on treatment with UPA 5 mg/day for at least 30 days. InterventionsWomen received transvaginal sonography (TVS) and then office hysteroscopy and visually guided endometrial biopsies. Video hysteroscopies were recorded in digital format. Pictures were evaluated by 2 authors off-line and compared with histologic results. Measurements and Main ResultsHysteroscopic aspects and classification of progesterone receptor modulator–associated endometrial changes were measured. The most common hysteroscopic finding was the combination of a flat subtle epithelium with small glandular openings; large isolated or confluent cysts in the stroma, giving the surface a floating aspect at fluid distention; and well-evident subendometrial vascular network with a “chicken-wire” vascular pattern (44.6%). This finding accounted for 82% of cases with endometrial thickness > 10 mm at TVS. Histology confirmed a combination of epithelial secretory (vacuoles) and hypotrophic effects (small and dilated glands), whereas at stromal level the combination of cysts, dense stroma, and vascular wall thickening was found. At 3 months follow-up echographic, hysteroscopic, and histologic endometrial patterns were normal in all patients. ConclusionsIn most women on UPA and with thickened endometrium at TVS, the hysteroscopy showed benign and characteristics aspects related to the ambivalent effects of UPA on progesterone receptor. These alterations took place just after 1 month of treatment but disappeared within 3 months of stopping treatment.

Eyelid Apocrine Hidrocystomas in a Cat

Background: Eyelid apocrine hidrocystoma (AH) is a benign cystic lesion originating from the glands of Moll. These eyelid lesions are rare in cats and there are few cases reported in the literature. The aetiopathogenesis of AH is unknown and the lesion has been interpreted either as proliferative adenomatous tumour or as retention cyst. Defnitive diagnosisrequires biopsy with microscopic examination. Treatment options for eyelid AH include surgical excision, drainage through aspiration, cryosurgery with liquid nitrogen and chemical ablation. The aim is to report a case of bilateral multiple AH of the eyelids in a cat that was successfully treated with surgical excision.Case: A 5-year-old male Himalayan cat was referred to the Ophthalmology Section in the Veterinary Clinics Hospital of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil with a history of pigmented masses in both eyes that had been progressively enlarging over a 1-year period. Ophthalmic examination revealed two cysts on themedial canthus at the eyelid margin in both eyes. In the left eye was observed mild blepharospasm and lacrimation. Cysts were soft, smooth, round and flled with a dark brownish pigment. The remainder of the ophthalmic examination was unremarkable. Surgical excision of the cysts was indicated with a safety margin. The surgical procedure was performedunder inhalation anaesthesia using an operating microscope. A V-shaped, full-thickness excision of the eyelid containing the cyst was performed. The eyelids were closed with two layers of sutures. No complications were noted during surgery. Microscopic examination revealed cystic dilatation of the sweat glands with a large amount of eosinophilic secretion. EyelidAH was diagnosed based on the results to confrm the diagnosis. The cat recovered and was discharged the following day. The postoperative treatment involved the administration of tramadol (2 mg/kg, PO, q 12 h) daily for 3 days. After surgery, the cat had no signs of ocular discomfort. After three years, no recurrence has been observed.Discussion: AH is a benign tumour derived from Moll’s glands. The exact aetiology of AH is unknown. A breed-specifc predisposition among Persian cats has been suggested. In the present case, the ophthalmic examination revealed periocular masses brownish to black, round, soft, and fluid-flled. Multiple pigmented nodules involving the skin of the lower eyelids were observed. In the current case, the cat was of the Himalayan breed and was 5 years old with multiple AH in both eyelids. In terms of clinical features, this case was similar to previous ones reporting eyelid AH in cats. Normally, a defnitive diagnosis is confrmed through histopathology after excisional biopsy. In the current case, diagnose was made on the basis of the clinical fndings, history, and results of histological examination. Treatment options for eyelid AH include surgical excision, aspiration, cryosurgery and chemical ablation with trichloroacetic acid. Surgical removal of the cysts was performed in the current case. Histopathologic examination revealed cystic dilatation of the sweat gland with large amount of eosinophilic secretion. The sutures were removed one week after surgery. Periodic evaluations were conducted and there were no signs of recurrence after three years. In the present case, surgical excision was effective in the treatment of eyelid AH in a cat.Keywords: lid, cystic adenomas, feline.

Cronkhite-Canada Syndrome: A Rare Cause of Chronic Diarrhoea in a Young Man.

A young Indian man presented with nine-month history of chronic diarrhea, occasionally mixed with blood and intermittent colicky abdominal pain. He also complained of generalized body swelling for the last three months. On examination, he had diffuse hyperpigmentation of the skin and dystrophic nail changes. Upper and lower gastrointestinal endoscopy revealed multiple sessile polyps in the stomach, small bowel, and colon and rectum. Biopsy of polyps showed adenomatous changes with stromal edema and dilated glands. Cronkhite-Canada syndrome (CCS) was diagnosed and treated with glucocorticoids and enteral nutritional supplementation. There was an associated small intestinal bacterial overgrowth (SIBO) and stool was positive for clostridium difficile toxin. After 12 weeks of treatment, the patient achieved remission. Close correlation with clinical findings, including pertinent ectodermal abnormalities, endoscopic studies, and careful examination of biopsies will ensure a timely and correct diagnosis of CCS.

Effects on the equine endometrium of cervical occlusion after insemination

Cervical patency is considered to be important for uterine drainage after mating or artificial insemination (AI), and failure to relax or premature tightening of the cervix can lead to persistent endometritis. This study investigated the hypothesis that cervical occlusion after AI increases accumulation of fluid, polymorphonuclear leukocytes (PMNs), and cytokines in the uterine lumen. Endometrial swabs were obtained from 29 normal cyclic mares during the first, third, and fifth estrus and biopsies during the first and fifth estrus. All mares were inseminated during the second and fourth estrus. In either the second or fourth estrus, a clamped catheter was inserted into the uterus immediately after AI. Accumulation of intrauterine fluid was evaluated by transrectal ultrasonography at 0, 6, 25, and 48 hours. Fluid was drained from the catheter at either 25 hours (TxA) or 6 and 25 hours after AI (TxB). In the control estrus (TxC, no catheters), fluid was obtained by a tampon at 25 hours after AI. The uteri were then lavaged with Ringer's solution, after which the catheters were withdrawn. Sequences of treatments in the second and fourth estrus were A followed by C, C followed by A, B followed by C, and C followed by B in groups AC, CA, BC, and CB, respectively. Five mares lost their catheters and were excluded from the study. Scores for total inflammation, gland dilation, and lymphatic lacunae in the uterine biopsies did not differ significantly between groups or estrous periods. In contrast, periglandular fibrosis scores increased in all groups during the experiment. At 25 hours after AI in the second estrus, the mares with the catheters had larger accumulations of fluid (P < 0.05) and higher concentrations and total numbers of PMNs in uterine fluid (P < 0.05) than the mares without catheters. In the fourth estrus, the total number of PMNs was lower in TxB than in TxA at 25 hours (P < 0.05). Concentrations of PMNs in TxC were 10 times higher in the fourth estrus than the second. Within mare groups AC and BC, total numbers of PMNs in treatment C (fourth estrus) were as high as in TxA and B (second estrus). Expression of IL-1β, IL-6, IL-10 and TNF-α, analyzed by Western blotting, did not differ significantly between the treatments or estrous periods. It is concluded that a closed cervix after insemination results in pronounced inflammation of the mare's endometrium. Furthermore, this kind of severe insult may lead to permanent pathologic changes in the endometrium, including fibrosis.

Morphologic characterization of hamartomatous gastrointestinal polyps in Cowden syndrome, Peutz-Jeghers syndrome, and juvenile polyposis syndrome

The morphologic features of the gastrointestinal polyps in hamartomatous polyposis syndromes are poorly defined. Our aim was to better characterize the gastrointestinal hamartomas in these syndromes. A blinded review was performed regarding many histologic features for every polyp. The study included 15 Cowden syndrome, 13 Peutz-Jeghers (PJS), 12 juvenile polyposis (JuvPS) patients, and 32 cases of sporadic hamartomatous polyps. A total of 375 polyps were examined. Cowden syndrome polyps were characteristically colonic, sessile, small, without surface erosion, and showing mildly inflamed fibrotic lamina propria with smooth muscle proliferation and lymphoid follicles. They showed the least degree of cystic glands and had no thick mucin. Uncommon but specific features were ganglion cells and nerve fibers within the lamina propria and mucosal fat. PJS polyps were typically of small or large bowel origin, often exophytic, seldom eroded, with inflamed edematous and fibrotic lamina propria and dilated cystic glands filled with often thick mucin. All PJS polyps showed smooth muscle proliferation, frequently widespread. The polyps of JuvPS were typically colonic, large, exophytic, eroded, with strikingly edematous, fibrotic markedly inflamed lamina propria, cystic glands filled with frequently thick mucin, and the least degree of smooth muscle proliferation. Nonsyndromic hamartomatous polyps were similar to JuvPS polyps; however, they were more often colonic, were smaller, showed more widespread smooth muscle proliferation, and were less likely to contain thick mucin. In conclusion, we were able to define the characteristic hamartomatous polyp for each hamartomatous polyposis syndrome. Awareness to these features may aid in the diagnosis of these rare syndromes.

Morbid adherence of the placenta-a disease of nonvillous trophoblast?

Morbid adherence of the placenta-a disease of nonvillous trophoblast?

Gastric Polyps—To Worry or Not?

A 15-year-old white boy underwent upper endoscopy for persistent dyspepsia for which he had been receiving a proton pump inhibitor (PPI) (lansoprazole) for several years. The esophagus and duodenum were visually and histologically normal. Small, sessile polyps were seen on the gastric body (Fig. 1A). Biopsies of the gastric mucosa were normal; the polyps showed dilatation and hyperplasia of oxyntic glands (Fig. 1B) consistent with fundic gland polyps secondary to PPI therapy.FIGURE 1: Endoscopic (A) and histological (B) findings of fundic gland hyperplasia caused by long-term use of a protein pump inhibitor.Gastric polyps may be found at endoscopy as a spontaneous benign condition, part of an adenomatous polyp syndrome (familial adenomatous polyposis [FAP]), part of a hamartomatous polyp syndrome (juvenile polyposis syndrome, Peutz-Jegher syndrome, and PTEN hamartoma syndrome), or a result of medication (PPIs). Although patient history is important for developing a differential diagnosis of gastric polyps, diagnosis is confirmed by histological findings. Fundic gland polyps (FGPs) are seen in 2% to 12% of patients with no PPI exposure, 26% to 36% of patients on long-term (>12 months) PPI therapy, and in up to 81% of adults and 51% of children with FAP (1–5). FGPs are characterized by cystically dilated and irregularly budded fundic glands, which are lined by normal parietal cells, chief cells, or mucous neck cells. FGPs in FAP (Fig. 2A) are distinguished by foveolar dysplasia and may develop adenomatous transformation (Fig. 2B). Incipient hamartomatous polyps can mimic FGP endoscopically. These polyps are characterized by an edematous lamina propria with inflammatory cells and cystically dilated glands lined by cuboidal to columnar epithelium with reactive changes; Peutz-Jegher polyps are differentiated by arborization of smooth muscle.FIGURE 2: Endoscopic (A) and histological (B) findings of gastric polyps in a patient with familial adenomatous polyposis.FGPs in FAP carry a risk of malignant transformation necessitating surveillance endoscopy. Consensus as to when to initiate surveillance does not exist; recommendations are included at the time of initial colonoscopy or around age 20 years. Interval of surveillance endoscopy for gastric FAP is every 1 to 3 years (5,6). Although there is no need to worry about malignancy related to PPI-induced FGPs, long-term use (>5 years) of PPIs has been associated with osteopenia and osteoporosis-related fractures. Conflicting data are found regarding the role of PPIs in predisposing to small bowel bacterial overgrowth. The patient was informed of the risks of long-term PPI use, received dietary counseling; the PPI was discontinued and an H2-receptor antagonist started. No further surveillance was performed as the polyps regress with cessation of PPIs.

Detection of buried Barrett’s glands after radiofrequency ablation with volumetric laser endomicroscopy

The prevalence and clinical relevance of buried Barrett's glands (BB) after radiofrequency ablation (RFA) in Barrett's esophagus (BE) are debated. Recent optical coherence tomography studies demonstrated a high prevalence of BBs. Direct histological correlation, however, has been lacking. Volumetric laser endomicroscopy (VLE) is a second-generation optical coherence tomography system capable of scanning a large surface of the esophageal wall layers with low-power microscopy resolution. The aim was to evaluate whether post-RFA subsquamous glandular structures (SGSs), detected with VLE, actually correspond to BBs by pursuing direct histological correlation with VLE images. In vivo VLE was performed to detect SGSs in patients with endoscopic regression of BE post-RFA. A second in vivo VLE scan was performed to confirm correct delineation of the SGSs. After endoscopic resection, the specimens were imaged ex vivo with VLE. Extensive histological sectioning of SGS areas was performed, and all histology slides were evaluated by an expert BE pathologist. Seventeen patients underwent successful in vivo VLE (histological diagnosis before endoscopic treatment: early adenocarcinoma in 8 patients and high-grade dysplasia in 9). In 4 of 17 patients, no SGSs were identified during VLE, and a random resection was performed. In the remaining 13 patients (76%), VLE detected SGS areas, which were all confirmed on a second in vivo VLE scan and subsequently resected. Most SGSs identified by VLE corresponded to normal histological structures (eg, dilated glands and blood vessels). However, 1 area containing BBs was found on histology. No specific VLE features to distinguish between BBs and normal SGSs were identified. VLE is able to detect subsquamous esophageal structures. One area showed BBs beneath endoscopically normal-appearing neosquamous epithelium; however, most post-RFA SGSs identified by VLE correspond to normal histological structures. ( NTR4056.).

Histological Effects of Smokeless Tobacco on the Endometrial Glands of the Orally Treated Female Swiss Albino Rats

Tobacco use is the leading cause of mortality all over the world. Smokeless tobacco contains higher quantities of nicotine than most cigarettes. Over the past few decades the use of tobacco among women of reproductive ages has increased. Exposure to the toxins present in the tobacco interferes with the endometrial receptivity, endometrial angiogenesis and uterine blood flow.Material and Methods: 30 adult female Swiss albino rats were randomly selected. They were divided into three groups (n=10 each). Group A was kept as control. Experimental groups B and C consisted of rats which were given 5 % and 10% of smokeless tobacco in their feed respectively. Feed and water were given ad libitum. On 31stday the animals were sacrificed. Uterus of all the animals were removed and weighed. The tissues were processed for histological examination under light microscopy using H and E and Trichrome stains.Results: A significant decrease in the weight of the uterus was observed (P value &lt;= 0.001). The histological changes in the uterus of experimental groups revealed severe cystically dilated sub mucosal glands. Endometrial glands also showed marked atrophy (P value &lt;= 0.001).Conclusion: From this study it can be concluded that the smokeless form of tobacco causes adverse effects on the endometrium of the female Swiss albino rats. Long term use of this form of tobacco may lead to adverse reproductive outcomes or other pathological conditions of uterus.

Su1720 Intra- and Inter- Observer Reproducibility in Detection of “White Globe Appearance”: a Novel Marker for Diagnosing Early Gastric Cancer Using Magnifying Endoscopy With Narrow-Band Imaging

Magnifying endoscopy with narrow-band imaging (M-NBI) is useful for the diagnosis of gastric mucosal lesions. However, diagnosing early gastric cancer (EC) can often be difficult, even with the aid of M-NBI. Recently we reported that a “white globe appearance” (WGA) could be a novel endoscopic marker, specific for EC (Doyama H et al. Endoscopy International Open, in press). The WGA is a small, white lesion with a globular shape underneath the gastric epithelium that can be clearly visualized with M-NBI and corresponds to pathological findings for intraglandular necrotic debris within markedly dilated neoplastic glands.

Mo1556 Novel Gastric Gastric Mucosal Changes Induced by Use of Pproton Pump Inhibitor

Use of proton pump inhibitor (PPI) is associated with parietal cell protrusions and oxyntic gland dilatations. It is generally accepted that PPI use develops fundic gland polyps by its effect on parietal cells. However, we often detect endoscopically two interesting mucosal changes in the patients with PPI use such as cobblestone like mucosa (CSM) and cracked mucosa (CM) of fundic gland area. The aim of this study was to clarify the relationship between PPI use and these mucosal changes.

Mucous gland adenoma of a segment bronchus - Case report

BackgroundMucous gland adenoma of the bronchus is a rare benign epithelial tumor. The majority arises from the submucosal seromucous glands and ducts of the proximal airways. In bronchus biopsy specimen it might be difficult to distinguish mucous gland adenomas from low-grade malignant tumors, such as carcinoids, mucoepidermoid carcinomas, or adenoid cystic carcinomas. Complete tumor resection serves for both definite diagnosis and potential curative treatment.CaseA non smoking man of 78 years suffered from cough, dyspnea and recently from hemoptysis. Fiberoptic bronchoscopy revealed a polypoid, well-circumscribed mass in the right posterior segmental bronchus. A bronchoscopic tumor excision was performed.Histology and immunohistochemistry (IHC)The tumor displayed with exuberant dilated cystic glands lined by columnar, cuboidal or flattened mucus secreting cells. IHC was positive for EMA, CKAE1/AE3, and negative for TTF1.ConclusionUncommon benign bronchus adenomas should be taken into account in addition to the common malignant lung carcinomas with endobronchial growth pattern. Endoscopic tumor excision of bronchus adenomas is indicated for potential curative treatment, especially in patients of higher age.

Effect of mercuric chloride on terrestrial slug Semperula maculata and histopathology of reproductive organs: a comprehensive study

Since the last few decades, terrestrial diversity is found to be under stress due to the contamination by various chemicals and gases of aquatic and agricultural media. The bioaccumulation of these compounds at certain concentrations in different tissues produces histopathological changes leading to behavioral changes in target animals. This study focused on terrestrial molluscan slug, Semperula maculata, against lethal concentrations of mercury chloride (HgCl2). Bioaccumulation of Hg was highest in ovotestis, while lowest in the molluscan penis. Histopathological changes were observed in the cellular arrangement of reproductive organs. Alterations in the penis and the dart gland included dilated unicellular, multicellular glands, and muscular dystrophy, dilated peripheral glandular cells, respectively; dilation being maximal in the prostate gland. Ovotestis showed depleted number of gametocytes. Vacoulized pre-vitellogenic oocytes with early vitellogenic oocytes were noted under light microscopy. Mercury produced toxicity on secretory functions and lowered the rate of reproduction in animals. Evidence indicates that Hg produced gamete degeneration, impacted reproductive capacity and survival of this species in the ecosystem.