Sarcoma Of Intestine Research Articles

Diagnósticos histomorfológico e imunofenotípico de tumores estromais gastrointestinais e outros sarcomas que acometem o intestino de cães

Abstract In view of the morphological similarity between gastrointestinal stromal tumors (GIST) and other sarcomas of the intestine of dogs, the aim was to carry out the histomorphological and immunohistochemical diagnosis of these tumors, associating breed, sex and age, location and tumor invasion. 217 cases were evaluated by histopathology and 36 diagnosed by immunohistochemistry were included (24 GIST and 12 other intestinal sarcomas). Mixed breed dogs were the most diagnosed with GIST, mainly elderly females (9.5±2.2 years); in the other intestinal sarcomas, crossbreeds and Dachshunds, males and females, were equally affected. The cecum was the most affected by GISTs, with tumor invasion of the intestinal layers in all cases. The small intestine was the most affected by the other intestinal sarcomas, with invasion of the layers in most of these tumors. GISTs expressed markers such as CD117 and DOG-1, unlike other intestinal sarcomas. GIST and other intestinal sarcomas denoted histomorphological and immunophenotypic characteristics similar to histopathology, justifying the association of immunohistochemistry for the definitive diagnosis.

On the question of jejunum sarcomas

Intestinal sarcoma is a relatively rare disease. It occurs much less frequently than cancer. According to Mikulich, for example, there were only 5 sarcomas per 100 cases of bowel cancer (except recti). The intestine, in comparison with other organs, is also not often affected by sarcoma. According to Nagel's notes on 247 sl. sarcomas, intestinal sarcomas were observed in 3 cases (1%)- Surgical literature is not rich in works devoted to intestinal sarcomas. Korner and Furbank collected 175 sarcomas of the digestive tract before 1907, of which 65 were localized in the small intestine. Sreese in 1914 was able to take 99 sl. intestinal sarcomas. The Russian literature on the issue of intestinal sarcoma has the works of Bondarev, Favorsky, Peacemakers and Punin. Intestinal sarcoma is more common in men (80% according to Noorden) This disease is mainly observed at a young age, from 20 to 30 years (Peacemakers, Bondarev), 30-40 (Corner, Madelung). However, sarcomas also occur at an older age. Of all parts of the intestine, sarcoma is most often found in the small intestine. So Korner and Furbank mark 65 sarcomas of the small intestine, 20 sarcomas of the blind and 11 other parts of the colon. According to Liebman, out of 50 cases in 15 sl. localization was in the 12-digit, in 18 in the skinny, in 14 in the iliac and the rest in other parts of the digestive tract. According to Staemmler (1924), for 184 cases of sarcoma of the small intestine, localization in the jejunum is indicated in 44 cases.

PGI37 THRESHOLDS FOR MEANINGFUL CHANGE FOR THE EQ-5D VAS AND EORTC QLQ-C30 PHYSICAL AND ROLE FUNCTIONING SCALE IN GASTROINTESTIONAL-RELATED CANCERS

Interpretation of patient-reported outcome (PRO) measures for oncology efficacy trials requires an understanding of what constitutes meaningful change (minimal clinically important difference or MCID) for patients. We assessed the evidence base for MCIDs for the EQ-5D visual analogue scale (VAS) and the EORTC QLQ-C30 physical functioning (PF) and role functioning (RF) scales for use in gastrointestinal stromal tumor (GIST) efficacy trials. The VAS was selected because it is a patient-centered assessment of overall health. The PF and RF scales were chosen because they characterize GIST patients’ daily functioning. A targeted literature review was initially conducted within PubMed for methodologically-sound MCIDs for the VAS and the PF and RF for gastrointestinal (GI)-related cancers (e.g., GIST, colorectal, colon, rectal, stomach, gastrointestinal, gastric, or intestinal sarcomas or carcinomas). The search around MCID for VAS was subsequently expanded to include all cancers. No articles were identified that provided MCIDs for the VAS in GI-related cancers. When the review was expanded to all cancers, five articles were identified. One article provided an empirically derived MCID for the VAS (Pickard 2007) based upon cross-sectional anchors. These MCID estimates ranged from 7-8 points for anchor-based and 9-11 for distribution-based estimates. Of the 29 articles meeting search criteria, none provided de novo, empirically-derived MCIDs for the PF and RF scales in GI-related cancers. Where no MCID exists, heuristics may be helpful; the MCID for health-related quality-of-life is often found to be in the range of 0.3 – 0.5 times standard deviation of the baseline value (Norman et al., 2003). Even in the most used cancer-specific function scales, the MCID has rarely been established. Where no MCID exists, heuristics can be helpful.

Immunohystochemical Study of the Intestinal Stromal Tumors in Dogs-7 Cases and Review of the Literature

Primary spindle cell neoplasms of the gastrointestinal system show considerable morphologic overlaps. Proper histological classification of these neoplasms using only the classical hematoxylin-eosin (HE) stained slides is often difficult and frequently a source of diagnosis error. Thus, the immunohistochemistry is an essential tool in the proper diagnosis and classification of such tumors.In this study we tested and standardised an immunohistochemical protocol used for the differentiation of primary intestinal sarcomas (nonangiogenic, nonlymphogenic intestinal sarcomas) in dogs. The paper also aimed to critically review the state of art in immunohistochemistry of intestinal spindle cell neoplasms currently used in dogs.Seven cases of primary intestinal spindle cell neoplasms were diagnosed and classified using a 6 antibody panel immunohistochemistry. Indirect immunohistochemistry staining for S100 protein, desmin, I±-SMA, CD34, c-Kit and GFAP was conducted using a Leica Bond-Max auto-immunostainer.Based on the immunoreactivity, five stromal tumours were classified as leiomyosarcomas, one fibrosarcoma and one an undifferentiated sarcoma.In most cases of intestinal sarcomas, the proper diagnosis requests the use of immunohistochemistry. The retrospective analysis of these tumours proved that at least in one case, the HE stain was not sufficient for the proper diagnosis and classification of the tumour.

Expression of the Receptor for Type I Insulin-like Growth Factor (IGF1R) in Gastrointestinal Stromal Tumors

A majority of gastrointestinal stromal tumors (GISTs) carry gain-of-function KIT or platelet-derived growth factor receptor α (PDGFRA) mutations. However, no mutational activation of KIT or PDGFRA has been identified in pediatric gastric GISTs, neurofibromatosis-1-associated GISTs, and a small subset of sporadic GISTs in adults [so-called wild-type (WT) GISTs]. Recently, pediatric gastric GISTs and some adult WT gastric GISTs have been found to have losses of the succinate dehydrogenase (SDH) complex, a Krebs cycle/electron transport chain interface protein, as seen by immunohistochemical loss of SDH subunit B (SDHB) expression. Moreover, recently, expression of the receptor for type I insulin-like growth factor (IGF1R) has been detected in pediatric and WT GISTs, although only a small number of cases have been analyzed. In this study, IGF1R expression was examined immunohistochemically in 1078 well-characterized GISTs representing different clinicogenetic categories and in 103 non-GIST gastrointestinal tumors. IGF1R expression was detected in 71/80 of SDH-deficient GISTs (SDHB-negative GISTs) but only in 9/625 (1%) of the SDHB-positive gastric GISTs. The latter often carried KIT or PDGFRA mutations and generally occurred in older patients. None of the 373 intestinal GISTs was IGF1R positive, whereas many primary intestinal sarcomas, including clear cell sarcomas, leiomyosarcomas, and undifferentiated sarcomas, were IGF1R positive. The consistent lack of IGF1R expression in intestinal GISTs should be considered an additional immunohistochemical marker in the differential diagnosis between GISTs and non-GIST sarcomas. Because inhibition of IGF1R signaling might become a therapeutic target in GISTs, screening for IGF1R expression may become important in the near future.

Evaluation of whole-body cancer screening using 18F-2-deoxy-2-fluoro-d-glucose positron emission tomography: a preliminary report

(18)F-2-deoxy-2-fluoro-D-glucose positron emission tomography (FDG-PET) is a promising screening modality targeting whole body. However, the validity of PET cancer screening remains to be assessed. Even the screening accuracy for whole-body screening using FDG-PET has not been evaluated. In this study, we investigated the screening accuracy of PET cancer screening. A total of 2911 asymptomatic participants (1629 men and 1282 women, mean age 59.79 years) underwent both FDG-PET and other thorough examinations for multiple organs (gastrofiberscopy, total colonofiberscopy or barium enema, low-dose thin section computed tomography and sputum cytology, abdominal ultrasonography, an assay of prostate-specific antigen, mammography, mammary ultrasonography, Pap smear for the uterine cervix, and magnetic resonance imaging for the endometrium and ovaries) between February 2004 and January 2005, and followed sufficiently. The detection rate, sensitivity, specificity, and positive predictive value of FDG-PET were calculated using cancer data obtained from all examinations along with a 1 year follow-up. From among 2911 participants FDG-PET found 28 cancers, 129 cancers were PET negative. PET-positive cancers comprised seven colorectal cancers, four lung cancers, four thyroid cancers, three breast cancers, two gastric cancers, two prostate cancers, two small intestinal sarcomas (gastrointestinal stromal tumors), one malignant lymphoma, one head and neck malignancy (nasopharyngeal carcinoid tumor), one thymoma, and one hepatocellular carcinoma. PET-negative cancers included 22 gastric cancers and 20 prostate cancers that were essentially difficult to detect using FDG-PET. The overall detection rate, sensitivity, specificity, and positive predictive value were estimated to be 0.96%, 17.83%, 95.15%, and 11.20%, respectively. FDG-PET can detect a variety of cancers at an early stage as part of a whole-body screening modality. The detection rate of PET cancer screening was higher than that of other screening modalities, which had already shown evidence of efficacy. However, the sensitivity of PET cancer screening was lower than that of other thorough examinations performed at our institute. FDG-PET has some limitations, and cancer screening using only FDG-PET is likely to miss some cancers.

Inducement of canine gastric cancer by N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG).

Achievements in the experimental inducement of canine gastric cancer in Japan are reviewed. Canine gastric cancer was initially induced experimentally by the administration of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in drinking water. However, intestinal sarcoma caused death before the gastric cancer was detected. By giving an N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG)-soaked diet to dogs, we specifically induced gastric cancer and followed the process of carcinogenesis by X-ray, endoscopy, and biopsy. The initial macroscopic findings were areas of discoloration, with erosion or mucosal unevenness which became visible from approximately the 9th to 10th experimental months in mongrel dogs and around the 13th to 17th months in beagle dogs. The protruded type of cancer occurred in mongrel dogs early in the experimental period, while the less protruded but more ulcerated gastric cancer occurred in beagle dogs later. Histological examination of the autopsied stomachs 277, 395, 546 and 813 day in mongreal dogs and 804, 946, and 1591 day in beagle dogs revealed well differentiated, poorly differentiated, and undifferentiated adenocarcinoma. In animals with a lengthy survival (more than 600 days from the start of the experiment), metastases to lymph nodes, and, rarely, to liver, lung, bones, and other organs, were observed, as well as peritonitis carcinomatosa. Heterotransplantation of gastric cancer to nude mice succeeded to the fifth passage. Development of scirrhous cancer was induced in dogs by the combined use of ENNG and subcutaneous injection of gastrin, indicating that the experimentally induced canine gastric cancer resembled human gastric cancer. Although the induction of canine gastric cancer takes 2-3 years and the macroscopic type and time period differs among individual dogs, our results in the experimental induction of canine gastric cancer should be useful in various areas of research that require an animal model, such as genetic alteration during carcinogenesis, modulation of carcinogenesis, and prevention of gastric cancer.

Esophageal carcinoma in house musk shrews, Suncus murinus (Insectivora), induced by N-methyl-N'-nitro-N-nitrosoguanidine.

Female 6-week-old shrews were given a solution of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) at a concentration of 50 micrograms/ml or 100 micrograms/ml in the drinking water. All 11 shrews receiving 100 micrograms/ml MNNG died 8-13 days after the beginning of carcinogen administration and 6 of the 20 shrews receiving 50 micrograms/ml MNNG died after 10-54 days. When animals were between 43 and 54 weeks of age, multiple esophageal lesions were evoked in all 14 that had received 50 micrograms/ml MNNG for 30 weeks. All shrews developed a protruding, ulcerative, or superficial type of squamous-cell carcinoma of the esophagus, accompanied by papillomas. Local invasion was seen in squamous-cell carcinoma but no distant metastasis was noted. None of the 5 control shrews developed any esophageal abnormality. No gastric adenocarcinoma, intestinal sarcoma, or other tumors were induced with MNNG. It can be concluded that MNNG has a carcinogenic effect on shrew esophageal epithelium.

A clinicopathologic and immunohistochemical study of gastrointestinal stromal tumors

The clinicopathologic and immunohistochemical features in 120 cases of gastrointestinal stromal tumor (GIST) were reviewed. Excluding 24 cases of gastric schwannoma, 96 cases of GIST consisting of 62 benign tumors and 34 sarcoma (low grade, 17; high grade, 17), with 9 cases arising in the esophagus, 57 in the stomach, 28 in the small intestine, and 2 in the colon, were studied. All esophagus and colon tumors were benign and resembled a conventional leiomyoma histologically. However, the gastric and small intestine benign tumors mostly showed histologic features of cellular or epithelioid leiomyoma. Immunohistochemically, desmin caused a positive reaction in all esophagus and colon tumors, but only 26% of gastric and small intestine tumors. However, muscle-specific actin (HHF35) caused a positive reaction in most GIST (92%). The 10-year survival rates of the patients with gastric sarcoma and those with intestinal sarcoma were 74% and 17%, respectively. These results showed that histologic and immunohistochemical features were distinctly different, depending on the location in the gastrointestinal tract; that most GIST, excluding schwannoma, had smooth muscle differentiation; and that sarcomas had a more favorable prognosis when they occurred in the stomach rather than the intestine.

Classic articles in colonic and rectal surgery. Johann von Mikulicz-Radecki 1850-1905.

Johann von Mikulicz-Radecki was born in Cernowicz, then a part of Austria, now Rumania, on May 16, 1850. He was educated at Herrmannstadt and earned his way through the University by giving piano lessons and playing the organ. He achieved the degree of Doctor of Medicine at Vienna in 1875 and became an assistant to Billroth. At the age of 32 he became the Director and Professor of Surgery at Krakow, Poland. While there he performed the first esophageal resection and introduced lateral pharyngotomy in excising malignant tumors of the tonsillar region. In 1887 he became Director of the Clinic and Professor of Surgery in Konigsburg. At the age of 40 (1890), he became Professor of Surgery at Breslau, a position which he held until his death. Professor Mikulicz was known for his work on many surgical subjects. His name has been used eponymously in varied conditions and applications--these include Mikulicz cells, disease, drain, line, mask, ointment, and at least ten operations. In 1902 he described his two-stage resection for tumors of the intestine, which was published one year later. He died in Breslau on June 14, 1905, of carcinoma of the stomach.

Six cases of primary gastric and intestinal sarcoma

Six cases of primary gastric and intestinal sarcoma

Sarcomas of the Small Intestine and Reference to Their Radiosensitivity

One dealing with oncology is impressed by the marked infrequence of tumors of the small intestine. Among 986 tumors of the gastro-intestinal tract, Raiford (1) found only 88 (9 per cent) in the small intestine, 14 of which were in the jejunum. Heimann (2) found only 20 malignant neoplasms of the small intestine in 7,005 cases of cancer of the alimentary tract, excluding the mouth. Gidro (3), in his recent paper, reviewed the necropsy records of several Austrian, German, and Hungarian hospitals and found 47 cases of sarcoma of the intestine among 73,524 necropsies, of which 65 per cent were located in the small intestine. Feldman (4) collected 58 cases of sarcoma of the small intestine from 104,621 necropsy reports of five authors. Only eight tumors of the small intestine were found in our 2,252 necropsies and 20,603 surgical specimens, while 75 neoplasms of the stomach and 108 neoplasms of the colon, including the cecum and rectum, were reported. The classification of these eight small-intestinal neoplasms is as follows: 3 leiomyoma; 1 leiomyosarcoma; 3 lymphosarcomas, and 1 carcinoma. The cause of the relative infrequence of newgrowths of the small intestine is easily understood when a study is made of its special function, which necessitates much less irritation, both physical and chemical, than those of the remaining parts of the alimentary canal. The food particles traverse the esophagus and stomach in a more or less hard state and enter the small intestine as a soft semi-fluid material. The content of the colon becomes harder in consistency because of inspissation of water and has almost lost its soft fluid consistency upon reaching the rectum, where the fecal material is harder and much more irritating to the delicate mucous membrane of the colon and rectum. The reaction of the small intestine is alkaline which is much less irritating than the acid gastric juice. The colon wall is exposed to the irritating effect of bacterial toxins which are also normally absent in the small intestine. The food is stored for hours in the stomach and colon, but passes through the small intestine more rapidly, so that the physical and chemical effects and the other irritations caused by direct contact on the mucous membrane are diminished in the small intestine as compared to the stomach and colon. The small intestine develops from the primitive gut, like the other parts of the alimentary canal, so the intrinsic, histogenic factors of neoplasms are equal in the entire gastro-intestinal tract. However, the extrinsic factors—constant chemical and traumatic irritations—are so minimized, as compared with the mouth, esophagus, stomach, and colon, that the possibility of developing a neoplasm in the small intestine is extremely rare. Histologically, the sarcomas of the small intestine are classified as fibro-, lyrnpho-, leiomyo-, and miscellaneous sarcomas.

Primary lymphosarcoma of the intestine

YMPHOSARCOMA of the intestine L is rare. NothnageIl reviewed 21,358 autopsies performed at the Genera1 HospitaI in Vienna from 1882 to 1893 and found onIy g cases of Iymphosarcoma of the intestine. To this series he added one of his own cases of Iymphosarcoma of the smaI1 intestine concurrent with tubercuIosis of the intestine. Libman2 in his survey did not uncover a singIe case of intestina1 sarcoma in the BerIin PathoIogicaI Institute from 1859 to 1875. From the coIIected Iiterature, however, he amassed 5g cases of primary sarcoma of the smaI1 intestine. SmoIer3 in 1898 reported onIy 13 cases of Iymphosarcoma of the intestine among 13,036 autopsies performed at the Prague PathoIogicaI Institute. Up to 1913 Crowther4 coIIected from the Iiterature Ig 1 cases of sarcoma of the smaI1 intestine, 48 of which were Iymphosarcomas. Warthin in 1915 found onIy 2 cases of Iymphosarcoma of the intestine among 2000 maIignant neopIasms in the young examined at the PathoIogicaI Laboratories of the University of Michigan. The Iiterature up to IgIg contained 249 cases of primary Iymphosarcoma of the intestine, as reviewed by Graves,6 who added 3 of his own. In an anaIysis of 54,000 autopsy records in the German and Austrian hospitaIs, StaemmIer’ in 1923 found 33 cases of sarcoma of the intestine, an incidence of 0.06 per cent. Fishers in 1925 reviewed the records of the RoyaI Price AIfred HospitaI in Sydney, AustraIia for the fifteen years, Ig Io-1925, and uncovered onIy 5 cases of sarcoma in a series of 265 cases of maIignant disease of the smaI1 and Iarge intestine, excIuding the rectum. In 1928 VerceIIattig reported 7 cases of sarcoma of the intestine in 14,585 autopsies. UIIman and Abeshouse’O in 1932 coIIected 125 cases of Iympho-