Numerous Polyps Research Articles

The influence of cold acclimation on the behavior of the plasma membrane following osmotic contraction of isolated protoplasts

Osmotic contraction of protoplasts isolated from cold acclimated leaves ofSecale cereale L. cv. Puma results in the formation of exocytotic extrusions of the plasma membrane. Numerous knobs or polyps were observed on the surface of the protoplasts with scanning electron microscopy. In thin sections, the extrusions were bounded by the plasma membrane with a densely osmiophilic interior. Cross-fracturing of the extrusions revealed aparticulate bodies within, a further indication that the interior of the extrusions was predominantly lipid material. Freeze-fracture of the plasma membrane suggests a possible source of this lipid material. Following osmotic contraction, the particle density on the plasma membrane protoplasmic face (PFp) increased, being reflected in both a substantial increase in paracrystalline arrays and an increase in the particle density in non-crystalline regions. This increase in particle density indicates that lipid material is preferentially lost from the plasma membrane during contraction. The density on the exoplasmic face (EFp) did not change. Together, these findings suggest that during hypertonic contraction of acclimated protoplasts, lipid material is preferentially subducted from the plasma membrane and sequestered into lipid bodies (the osmiophilic regions). The formation of lipid bodies and extrusions was readily reversible. Following osmotic expansion of acclimated protoplasts, the extrusions were retracted back into the plane of the plasma membrane.

Upper gastrointestinal polyps in Gardner's syndrome

Upper gastrointestinal polyps have been considered an uncommon finding in patients with Gardner's syndrome and familial polyposis coli. Investigators from Japan, however, have recently reported finding gastric and duodenal polyps in a high percentage of Japanese patients with these conditions. We endoscopically examined 11 affected members of the originally described Gardner's syndrome kindred to determine if upper gastrointestinal polyps also occurred in patients with Gardner's syndrome living in the United States. Six of the patients were found to have numerous small polyps of the gastric fundus and body. Polyp histology in 5 of the 6 patients was consistent with fundic gland hyperplasia. Biopsy specimens from the remaining patient demonstrated normal mucosa only. Another patient with no fundic polyps had a single antral polyp that was an adenoma. Eight patients exhibited small polyps of the duodenum. Biopsy specimens were obtained in 7 of the 8. All polyps biopsied were adenomas. The lerminal ileum was examined by endoscopy in 9 of the 11 study patients. All 9 had ileal polyps, but the polyps were adenomas in 6 patients and lymphoid aggregates in 3 patients. The results indicate that upper gastrointestinal polyps are a common pleiotropic manifestation of the genetic defect responsible for Gardner's syndrome.

Pathogenesis of colonic polyps in multiple juvenile polyposis:Report of a case associated with gastric polyps and carcinoma of the rectum

The pathogenesis of juvenile polyps of the colon was studied in a patient with multiple juvenile polyposis who underwent proctocolectomy for rectal carcinoma and antrectomy for associated polyps of the stomach. Numerous polyps up to 3 cm in diameter were present predominantly in the cecum and rectum, and in addition there was an adenocarcinoma in the rectum. Microscopically there were five categories of lesions: 1) Hyperplastic epithelial foci and small hyperplastic polyps; 2) Typical Juvenile polyps; 3) Juvenile polyps with focal adenomatous epithelium; 4) Adenomas; and 5) and adenocarcinoma. The five categories could represent a pathogenetic sequence, beginning with epithelial hyperplasia, leading to small hyperplastic polyps which become inflamed and enlarge, forming juvenile polyps. Focal adenomatous areas which develop in some juvenile polyps might give rise to adenomas and in turn lead to carcinoma. Although juvenile polyps are generally not considered to be premalignant lesions, this case demonstrates that neoplastic changes may occur in juvenile polyps in certain individuals, and raises the possibility that these may on occasion give rise to carcinoma.

Endobronchial Polyposis Secondary to Thermal Inhalational Injury

A 28-year-old man who sustained inhalational injury in a house fire developed symptoms of chronic cough and hemoptysis requiring bronchoscopy. Two months after the initial injury, numerous endobronchial polyps were found in the trachea and throughout the bronchial tree. His symptoms have subsequently improved over a six-month period while receiving steroid therapy. To our knowledge, this delayed complication of inhalational burn injury has not been previously reported.

Adenomatous and carcinomatous changes within hyperplastic colonic epithelium

Hyperplastic colonic polyps are benign, nonneoplastic proliferations; unlike tubular and villous adenomas, they do not predispose the patient to colonic cancer. Theoretically, these hyperplastic polyps, like normal colonic epithelium, should be able to undergo adenomatous transformation and possibly develop into cancer. In this report, we discuss an unusual case of a patient with numerous hyperplastic polyps, in which adenomatous changes occurred and cancer developed. We also discuss the significance of these changes as they relate to the polyp-cancer sequence.

Juvenile colonic polyposis with villous adenoma and retroperitoneal fibrosis

A 25-year-old Nigerian black woman was found to have polyps involving the rectum, rectosigmoid, and sigmoid colon on air-contrast barium-enema examination. Resection of a segment of sigmoid colon revealed numerous polyps that were predominantly of the juvenile type, in keeping with the diagnosis of juvenile polyposis of the colon. This case is unusual because of the coexistence of retroperitoneal fibrosis with juvenile polyposis of the colon. In addition, one of the colonic polyps was a villous adenoma. The implications these findings are discussed in relation to polyposis syndromes reported previously.

Splenic Rupture Following Colonoscopy

To the Editor.— With the advent of the fiberoptic colonoscope, colonoscopy has been used more widely as a diagnostic and therapeutic procedure. Colonoscopic polypectomy has almost replaced the transabdominal polypectomy and has substantially reduced the mortality and the morbidity. Reported complications are primarily those of perforation and hemorrhage at the site of polypectomy. Rare complications include tear of the mesentery and injury to other intraabdominal viscera during manipulation of the colonoscope. We recently encountered the following case of unrecognized rupture of the spleen following colonoscopy. Report of a Case.— A 53-year-old woman who had a prior history of numerous colonic polyps was brought to the emergency room with a history of left upper quadrant pain radiating to the left shoulder. The pain started following an outpatient colonoscopic examination performed three days previously. The colonoscope was advanced to 50 cm. There was some difficulty in advancing the colonoscope through the sigmoid

Hereditary polypoid diseases of the gastrointestinal tract: A working classification

Almost all published cases of hereditary intestinal polypoid diseases can be meaningfully classified into a relatively few distinct syndromes including familial polyposis of the colon, Peutz-Jeghers syndrome, and juvenile polyposis. Familial polyposis is characterized by the development of numerous adenomatous polyps of the colon and subsequent development of colorectal carcinoma in nearly all patients. Extracolonic manifestations are common but do not influence the premalignant nature of this syndrome. Peutz-Jeghers syndrome is identifiable by a combination of circumoral melanin pigmentation and hamartomatous polyps. These polypoid lesions have an unusually wide distribution and may occur in the respiratory, gastrointestinal, or genitourinary tract. There is a small but definite increased incidence of gastrointestinal cancer in these patients. Juvenile polyposis presents a more variable spectrum. In one form there is extensive intestinal involvement leading to diarrhea, inanition, and increased susceptibility to infection. Another form is limited to the colon and easily confused with familial polyposis. With the third form, there is involvement of the stomach, intestines, and colon, which makes it easily mistaken for the Peutz-Jeghers syndrome.

Fine Structure of the Anthocodium of Renilla Mulleri

Renilla mulleri is a colonial marine coelenterate commonly called a sea pansy. Its body consists of a distal reniform shaped rachis bearing numerous secondary polyps which are restricted to the superior surface and a single proximal peduncle devoid of polyps. The secondary polyps illustrate the dimorphic nature of the colony by establishing a division of labor among zooids for feeding and circulation. The latter is accomplished by numerous clusters of tentacle-less zooids, which serve as pumps driving water into the colony, called siphonozooids. Water passes from the colony through a single exhalant siphonozooid. The feeding and/or reproductive polyps are called autozooids. These polyps are typically alcyonarian in that they possess eight hollow pinnate tentacles with eight single complete mesenteries. All polyps are embedded in a common tissue mass, the coenenchyme. The anthocodium, the only portion of the autozooid which projects above the coenenchyme, is the subject of this paper.

Gastric polyps. Histologic types and their relationship to gastric carcinoma.

In a study of the relationship between gastric polyps and carcinoma, a series of 97 cases of gastric polyps were studied histologically and follow-up information obtained. Thirty-five per cent of the total series of gastric polyps were found as incidental findings in stomachs with gastric carcinoma. Polyps were subdivided by gross appearance into single polyps, multiple discrete polyps, or gastric polyposis; no significant difference in association with carcinoma was found for these gross types. Polyps could be subdivided microscopically into hyperplastic and adenomatous types. Hyperplastic polyps were relatively more common (76%), and were randomly distributed in the stomach. Adenomatous polyps were usually antral in location and were histologically similar to the adenomatous polyps of the colon. Marked epithelial atypia (in-situ carcinoma) was seen only in polyps of the adenomatous type. Adenomatous polyps were associated with carcinoma more frequently than hyperplastic polyps—59% and 28%, respectively. Follow-up information on a total of 40 patients who underwent surgery for gastric polyps without associated carcinoma showed that 3 developed subsequent polyps and only one developed a polypoid carcinoma. The initial polyps in these cases were multiple, greater than 2 cm in size, and, in each case, at least one was of the adenomatous type. The subdivision of polyps into 2 histologic types revealed the close morphological and statistical relationship of the adenomatous type of gastric polyp to gastric carcinoma. This relationship is otherwise obscured by the presence of the more numerous hyperplastic polyps. In almost all circumstances, simple polypectomy with a rim of uninvolved adjacent mucosa is sufficient treatment.

A family with familial colonic polyposis and cancerization

I wish to present 1 family 2 sisters with familial colonic polyposis.Case 1 is a 25-year-old woman, complaining of diarrhea with massive blood coagula. She was found to have diffuse colonic polyposis with rectal cancer and was performed total colectomy. Her father had died of rectal cancer. Her eldest sister, that is, case 2 was also found by laparatomy to have diffuse colonic polyposis with sigmoid cancer. Her youngest sister was found by sigmoidscopy to have rectal polyposis (3 polyps were found in the rectum). So, I can say to have a family of familial colonic polyposis.In order to determine whether there was a presence of precancerous lesions, a patho-histological study of all polyps was carried out on the numerous polyps of the colon and rectum of case 1. These results were as follows:1) The total number of polyps was 920 and they were pathohistologically all sessil adenomatous polyps except for one which was pedunculated.2) These polyps were classified into five groups according to their degree of malignancy from atypia 0, atypia 1, atypia 2, atypia 3 and cancer. The result was atypia 0-260 (28.2 %), atypia 1-234 (25.4 %), atypia 2-256 (27.8 %), atypia 3-137 (14.9 %) and cancer-33 polyps (3.6 %).3) The highest incidence of site for malignant polyps was found in the order of descending colon, sigmoid colon, rectum, rectosigmoid, and transverse colon.4) Most of the malignant polyps were large in size, but 75 polyps (8.1 %) were less than 2 mm. in diameter.5) The polyps were equally distributed among the colon.Cass 2 is a sister of case 1. She was also founb to have colonic polyposis with sigmoid cancer. Only sigmoidectomy was carried out and 42 polyps surrounding a sigmoid cancer were removed. None of 42 polyps were cancerous, but 18 of them were of the atypia 2 type.The electron microscopic findings of a few of case 2 patient's polyps showed slight atypia such as gathering of chromatin, irregularly shaped nucleolus, and very few microvilli. There were relatively few Goblet Cells in the polyps. The findings of another one showed a more severe degree of malignacy such as almost no microvilli and slightly increased in number of endoplasma reticulum.

Generalized Juvenile Gastrointestinal Polyposis

Generalized juvenile gastrointestinal polyposis was recognized in 3 members of a kindred. This hereditary syndrome is characterized by the development of numerous juvenile polyps of the stomach, small intestine, colon, or rectum in various combinations. Juvenile type polyps may be present at birth or become manifest later as a developmental abnormality. These polyps may produce acute or chronic gastrointestinal blood loss and repeated bouts of intussusception. Operative treatment should be conservative to preserve maximal gastrointestinal function since juvenile polyps are hamartomas and not premalignant. Generalized juvenile gastrointestinal polyposis appears to be a hereditary syndrome quite distinct from juvenile polyposis coli, familial (adenomatous) polyposis of the colon, and Peutz-Jeghers syndrome. A classification of hereditary polypoid diseases of the gastrointestinal tract is proposed, using the microscopic characteristics of the polyps per se as the basis for delineating the several distinct syndromes.