Lymphangiomatous Lesions of the Gastrointestinal Tract. A Clinicopathologic Study and Comparison Between Adults and Children
|
|
- Whitney Floyd
- 6 years ago
- Views:
Transcription
1 AJCP / Original Article Lymphangiomatous Lesions of the Gastrointestinal Tract A Clinicopathologic Study and Comparison Between Adults and Children Margaret E. Lawless, MD, Kelly A. Lloyd, MD, Paul E. Swanson, MD, Melissa P. Upton, MD, and Matthew M. Yeh, MD, PhD From the Department of Pathology, University of Washington School of Medicine, Seattle. Key Words: Lymphangioma; Lymphangiectasia; Gastrointestinal tract; Adults; Children Am J Clin Pathol October 2015;144: ABSTRACT Objectives: Lymphangiomatous lesions involving the gastrointestinal (GI) tract remain incompletely characterized, and their clinical and histopathologic features have not been systematically evaluated. The distinction between a primary lymphatic malformation (lymphangioma) and a dilation of existing lymphatics (lymphangiectasia) is of clinical significance, since lymphangiectasia may occur in the setting of lymphatic obstruction due to an unsampled malignancy. We describe clinical and morphologic features of lymphangiomas of the GI tract in adult and pediatric populations and contrast them with lymphangiectasia. Methods: We performed a retrospective review of adult and pediatric lymphangiomas and lymphangiectasia involving the GI tract. Results: Thirty-six cases of lymphangioma and lymphangiectasia were retrieved, and clinical presentation and histologic features were compared. Lymphangiomas had distinct clinical presentations in adults and children, with adult lesions being more frequently asymptomatic and more frequently involving the superficial mucosal layers of the GI tract. Microscopically, lymphangiomas mostly consisted of confluent dilated spaces with a smooth muscle component. This appearance differed from lymphangiectasia, which lacked a complete distinct endothelial or smooth muscle lining and diffusely involved the mucosa and submucosa. Conclusions: Morphologic features of GI tract lymphangiomas can be reliably distinguished from lymphangiectasia by clinical and pathologic characteristics. Lymphangiomas are benign tumors formed by dilated lymphatic channels that occur most commonly in the head and neck or axillary region. 1-3 Gastrointestinal involvement, once thought to be rare, 4,5 is now more frequently recognized as increasing numbers of patients undergo endoscopic evaluations of the gastrointestinal tract. The prevailing histogenetic hypothesis is that lymphangiomas represent benign congenital malformations of lymphatic vasculature that form mass lesions that may enlarge and become obscured by inflammation or reactive changes. 6,7 By endoscopic examination, these lesions typically present as small incidental polyps; however, some of these tumors present as mass lesions capable of causing bowel obstruction, abdominal pain, and gastrointestinal bleeding Because of their intra-abdominal location, they may remain undetected until adulthood. In contrast, intestinal lymphangiectasia is defined as dilation of existing mucosal, submucosal, or subserosal lymphatics within the gastrointestinal tract. 13 In adults, it can be seen in association with Waldenström macroglobulinemia, sarcoidosis, mass-forming intestinal malignancy, and other inflammatory conditions, and it may result in protein-losing enteropathy or occult gastrointestinal bleeding However, lymphangiectasia is most frequently asymptomatic and has been reported as an incidental finding in 1.9% of adult patients undergoing endoscopy 17 and may be transient. 18 Morphologic criteria to distinguish lymphangiomas from intestinal lymphangiectasias have not been previously defined, and although clinical characteristics (such as concurrent medical conditions and endoscopic appearance) may point toward a particular diagnosis, the histologic features of lymphangiomas and intestinal lymphangiectasia in adult Am J Clin Pathol 2015;144:
2 Lawless et al / Lymphangiomatous Lesions of the GI Tract Table 1 Pediatric Lymphangiomas: Clinical and Histologic Characteristics Age Sex Primary Site Clinical Presentation Size, cm Confluent vs 4 mo M Jejunum Incidental lesion in small bowel resection for necrotizing enterocolitis mo M Mesentery Vomiting, bowel obstruction 3 Confluent 1.5 y F Jejunum Small bowel obstruction 12.4 Confluent 3 y F Jejunum Chronic abdominal pain 7.5 Confluent 4 y M Mesentery Acute abdominal pain 3.5 Confluent 4 y F Mesentery Acute abdominal pain 1.2 Confluent 5 y M Jejunum Palpable abdominal mass 2.7 Confluent 5 y F Mesentery Acute abdominal pain 12.4 Confluent 5 y F Retroperitoneal Acute abdominal pain 7 Confluent 6 y M Retroperitoneal Acute abdominal pain 6.2 Confluent 7 y M Mesentery Acute abdominal pain 11 Confluent 12 y F Mesentery Palpable abdominal mass 1.2 % of positive findings, present;, absent. Table 2 Adult Lymphangiomas: Clinical and Histologic Characteristics Age, y Sex Primary Site Clinical Presentation Endoscopic Appearance 38 M GE junction Longstanding history of GE reflux, melena Irregular z-line, mucosal erythema 41 F Jejunum Abdominal pain and bloating 1 year Submucosal mass 54 M Proximal stomach Incidental lesion in resection for esophageal adenocarcinoma NA 54 F Jejunum Melena Polyp 55 F Ileocecal valve Positive fecal occult blood test Polyp 61 F Jejunum Incidental subserosal small bowel nodule discovered during NA exploratory laparotomy 63 F Sigmoid colon Screening colonoscopy Polyp 71 M Duodenum Abdominal pain Polypoid pink-tan mass 78 M Ileocecal valve Screening colonoscopy Polyp 79 F Duodenum Small bowel obstruction/ileus Submucosal mass % of positive findings GE, gastroesophageal; NA, not available;, present;, absent. and pediatric populations have yet to be contrasted in detail. Furthermore, most of the studies to date describing the clinicopathologic features of intra-abdominal lymphangiomas have been limited to cases requiring surgical resection and thus have not included smaller incidental or endoscopically detected lesions. The aim of this study is to define the clinical and morphologic characteristics of gastrointestinal tract lymphangiomas within adult and pediatric cohorts based on a more broadly inclusive set of surgically and endoscopically evaluated lesions and contrast those morphologic features with intestinal lymphangiectasia. the abdomen and included portions of the gastrointestinal tract. Clinical data (age, sex, significant medical history, presenting symptoms), endoscopic findings, and histologic features were compiled and reviewed. The diagnoses of lymphangioma and lymphangiectasia were rendered using previously described morphologic descriptions 1,2 and were correlated with clinical history and relevant follow-up. This study was performed in compliance with relevant and institutional guidelines. Results Materials and Methods We conducted a retrospective review at the University of Washington Medical Center and Seattle Children s Hospital to identify cases of lymphangioma or lymphangiectasias diagnosed between 1982 and 2012 that involved Demographics and Clinical Characteristics The demographic and clinical attributes of all cases are summarized in Table 1, Table 2, and Table 3. A total of 36 specimens were identified, including 12 pediatric lymphangiomas (all resections), 10 adult lymphangiomas (four 564 Am J Clin Pathol 2015;144:
3 AJCP / Original Article Submucosal Mucosal Complete Endothelial Lining Smooth Muscle Component Lymphoid Tissue Foam Cells Intraluminal Proteinaceous Fluid Size, cm Confluent vs Submucosal Mucosal Complete Endothelial Lining Smooth Muscle Component Lymphoid Tissue Foam Cells Confluent 0.5 Confluent 1.1 Confluent 0.7 Confluent 0.5 Confluent 0.6 Confluent 0.4 Confluent 0.2 Confluent 1.2 Confluent Intraluminal Proteinaceous Fluid resections and six biopsy specimens), and 14 adult lymphangiectasias (all biopsy specimens). Sex distribution was equal in the pediatric lymphangioma group (male/female, 6:6), whereas females predominated in the adult lymphangioma and lymphangiectasia groups (male/female, 4:6 and 4:10, respectively). The median patient ages for pediatric lymphangiomas, adult lymphangiomas, and adult lymphangiectasia were 4.5 (range, ) years, 58 (range, 38-79) years, and 58 (range, 40-89) years, respectively. Pediatric lymphangiomas were most commonly discovered in previously healthy children, with the exception of one patient who underwent a small bowel resection for necrotizing enterocolitis. The most common presentation was acute abdominal pain (n = 6). Less commonly, children had bowel obstruction (n = 2) or a palpable abdominal mass and/or increasing abdominal girth (n = 2). Adult lymphangiomas were most commonly discovered incidentally during procedures performed for other indications, including colonoscopy for gross or occult gastrointestinal bleeding (n = 3) and screening colonoscopy (n = 2). A minority of adult patients experienced symptoms that could be attributed to their lymphangiomas (n = 2); one patient had a 1-year history of abdominal pain and bloating, and one experienced acute abdominal pain due to small bowel obstruction by the lymphangioma. Adult patients with lymphangiectasia had a variety of symptoms prior to endoscopic investigation. Seven patients had separate lesions in the proximity of the sampled mucosa that could plausibly result in secondary lymphangiectasia due to lymphatic obstruction; malignancy was identified in two of these cases. One patient carried a diagnosis of Waldenström disease and had experienced large-volume diarrhea. This patient had a serum albumin level of 1.6 g/dl (reference, g/dl), and white villi were observed throughout the ileum on lower endoscopy. Lymphangiectasia was identified on screening colonoscopy in two patients who were otherwise healthy and had no significant findings on subsequent colonoscopy. Am J Clin Pathol 2015;144:
4 Lawless et al / Lymphangiomatous Lesions of the GI Tract Table 3 Lymphangiectasia: Clinical and Histologic Characteristics Age, y Sex Primary Site Clinical Presentation Endoscopic Appearance 40 F Terminal ileum Large-volume diarrhea White villi 45 M Rectum Bright red blood per rectum Diminutive polyp 52 F Ileocecal valve Screening colonoscopy Polyp 52 F Rectum Screening colonoscopy Polyp 54 F Duodenum Constipation Luminal narrowing 55 F Duodenum Postprandial vomiting Flattened folds 58 F Duodenum Diarrhea White plaque 58 M Jejunum Dyspepsia White plaque 60 F Jejunum Anemia White plaque with prominent folds 65 M Duodenum Anemia Dilated lacteals 71 F Duodenum Anemia Two diminutive polyps 73 M Duodenum Nausea and vomiting Abrupt narrowing 74 F Jejunum Nausea and vomiting Polyp 89 F Jejunum Anemia Yellowish nodules (<4 mm) % of positive findings, present;, absent. The mean size of pediatric lymphangiomas was 5.7 (median, 4.85; range, ) cm, and primary sites were mesentery (n = 6), small bowel (n = 4), or retroperitoneum (n = 2). The mean size of adult lymphangiomas was 0.8 (median, 0.55; range, ) cm, and primary sites were small bowel (n = 7), stomach (n = 2), and sigmoid colon (n = 1), typically appearing as polypoid mucosal or submucosal lesions on endoscopy. Pediatric lymphangiomas were significantly larger than their adult counterparts (P =.003). Lymphangiectasia was identified in the small bowel (n = 12) and rectosigmoid colon (n = 2) and most often appeared as whitish plaques on endoscopy, although there were five instances when the endoscopic appearance was polypoid. Microscopic Features A number of microscopic features were evaluated and are highlighted in Tables 1, 2, and 3. The distribution of lymphatic channels within the mucosal and/or submucosal compartments was recorded. The lymphatic spaces were further characterized as either diffuse, widely spaced proliferations or confluent, discrete masses. Half of pediatric lymphangiomas occupied the submucosa, and only one involved the mucosa. Adult lymphangiomas did not have a characteristic pattern of distribution. of both mucosa and submucosa was seen almost uniformly in all cases of lymphangiectasia, with one exception of a polypoid lesion at the anal verge that was confined to the mucosa. All adult and pediatric lymphangiomas contained anastomosing dilated spaces with complete endothelial lining and at least partial investment by smooth muscle. In contrast, cases of lymphangiectasias generally lacked a complete endothelial lining or smooth muscle component, and lymphatic spaces were more widely spaced throughout the mucosa and submucosa. When Image 1 Pediatric lymphangioma: large submucosal space lined by flat endothelial lining and smooth muscle with associated lymphoid tissue, intraluminal proteinaceous fluid, and foam cells (H&E, 10). visualized, the endothelium was relatively thin and attenuated compared with that of lymphangiomas. Prominent lymphoid tissue Image 1 was associated with the lymphatic spaces in all cases of pediatric lymphangioma but was absent in all cases of lymphangiectasia and all but two of the adult lymphangiomas. Intraluminal proteinaceous fluid was seen in all cases of adult lymphangioma Image 2 and most cases of lymphangiectasia Image 3 and pediatric lymphangioma. Foam cells were present within lymphatic channels only in pediatric lymphangiomas (Image 1). Generally, foam cells were few in number and observed at the periphery of intact lymphatic spaces, accompanied by 566 Am J Clin Pathol 2015;144:
5 AJCP / Original Article vs Confluent Submucosal Mucosal Complete Endothelial Lining Smooth Muscle Lymphoid Tissue Foam Cells Intraluminal Proteinaceous Fluid Image 2 Adult lymphangioma: mucosal and submucosal collection of endothelial and smooth musclelined spaces containing intraluminal proteinaceous fluid (H&E, 4). Image 3 Lymphangiectasia: scattered dilated mucosal and submucosal spaces containing intraluminal proteinaceous fluid (H&E, 10). intraluminal proteinaceous fluid. Neutrophilic inflammation was not observed in any of the cases within the series. tract, the clinical presentations of gastrointestinal lesions are myriad, ranging from asymptomatic adenoma-like polypoid lesions to large obstructing masses.4-10,19-22 Accurate preoperative diagnosis of intra-abdominal lymphangioma is uncommon, particularly in adult patients,6,10,12 and the characteristics of smaller asymptomatic lesions in adults have not been well described in the literature. The diagnosis of lymphangioma is further complicated by histologic overlap with lymphangiectasia of the gastrointestinal mucosa. The latter is of particular clinical relevance to endoscopic mucosal biopsy interpretation when it is not immediately clear if the sampled tissue represents the primary lesion Discussion Lymphangiomas typically occur in the head and neck or axillary areas during childhood and are thought to represent congenital malformations of lymphatic spaces that form early in life.1-3 They may acquire secondary changes from inflammation, fibrosis, or obstruction of lymphatic spaces.6 Although they less commonly involve the gastrointestinal Am J Clin Pathol 2015;144:
6 Lawless et al / Lymphangiomatous Lesions of the GI Tract Image 4 Small bowel follow-through study with 5-cm lobular jejunal lymphangioma (arrows). Imaging courtesy of Joel E. Lichtenstein, MD, Department of Radiology, University of Washington. Image 5 Gross representation of focal 5-cm lymphangioma in the jejunum. (lymphangioma) or obstructive lymphangiectasia in the vicinity of an unsampled malignant neoplasm. The most reliable histologic features distinguishing lymphangioma from lymphangiectasia in this series were the presence of smooth muscle surrounding the lymphatic spaces and complete circumferential lining of spaces by endothelial-type cells. Most cases of lymphangiectasia lacked a complete endothelial lining and/or investing smooth muscle component. One of the classic histologic elements of lymphangioma (which reliably distinguishes it from other cystic neoplasms in the abdomen, including hemangioma and mesothelial cysts) is dense lymphoid aggregates. 1 While most of the pediatric lymphangiomas exhibited this pattern, it was present in only a minority of adult lymphangiomas. These findings suggest that these lesions are associated with a more exuberant immune reaction in the pediatric population, although the contribution of lesion size, mass effect, and continuity with the surrounding lymphatics should be considered. It is interesting that foam cells were unique to the pediatric population in this study (although others have described foam cells in adult lymphangiomas as well). 6 The clinical presentation of pediatric lymphangiomas differed from that of adult lymphangiomas with respect to size and distribution; pediatric lymphangiomas were significantly larger, more commonly involved mesentery, and most frequently presented with acute abdomen and bowel obstruction. Adult lymphangiomas were, for the most part, incidental mucosal polyps, although a case presenting as a mass lesion was included in this series Image 4 and Image 5. We recognize that there is an element of sampling bias, since children are not subjected to endoscopic cancer screening (minimizing opportunities for detection of incidental mucosal involvement), and clinical protocols for workup of gastrointestinal symptoms differ between children and adults. Nevertheless, the tendency for mesenteric lymphangiomas to be larger and present in childhood and smaller mucosal lymphangiomas to present in adulthood has been described previously. 12 Selected studies suggest that intraabdominal lymphangiomas predominate in males in pediatric patients, 5,8,23 while others note a female predominance in adult cohorts, 10 raising questions of true sex distribution in these lesions and whether lymphangiomas, like other cystic lesions such as hemangiomas and hepatic cysts, may exhibit growth in response to circulating estrogens. Although we did also observe a slight female predominance in the adult lymphangioma group, there was no significant relationship between tumor size and sex in either the pediatric or adult lymphangioma groups (P =.26 and.15, respectively). Recently, Handra-Luca and Montgomery 24 described an entity, hemangiolymphangioma, as a proliferation of varied vessel types (lymphatics, capillaries, veins); almost all were located in both the submucosa and the mucosa, whereas in our study, half of pediatric lymphangiomas occupied the submucosa and only one involved the mucosa. Adult lymphangiomas did not have a characteristic pattern of distribution. In our series, intraluminal proteinaceous fluid was seen in all cases of adult lymphangioma and most cases of lymphangiectasia and pediatric lymphangioma, which was not described by Handra-Luca and Montgomery. 24 Most of our lymphangioma 568 Am J Clin Pathol 2015;144:
7 AJCP / Original Article cases also consisted of confluent dilated spaces with a surrounding smooth muscle component and prominent lymphoid tissue, especially in the pediatric cases, but these were also not described by Handra-Luca and Montgomery. 24 Hemorrhage and thrombosis were noted in their article but not observed in our study. Based on these different findings, the lymphangiomas in our series do not appear similar to the hemangiolymphangiomas described by Handra-Luca and Montgomery, 24 suggesting they represent two different lesions. In conclusion, this series better characterizes lymphangiomas involving the gastrointestinal tract as discrete masses with anastomosing and distinct lymphatic spaces. In pediatric patients, lymphangiomas are mesentery based, are large, and present with obstruction, whereas in adult patients, they range from incidental polyps to mass lesions within the bowel. Histologically, pediatric and adult lymphangiomas are similar, consisting of dilated cystic spaces with associated smooth muscle and endothelial lining, although the presence of abundant lymphoid tissue and foam cells appears to distinguish pediatric from adult forms. Intestinal lymphangiectasia consists of more widely spaced mucosal and submucosal cystic spaces that lack both a smooth muscle and (to varying extents) a prominent endothelial lining. The distinction of lymphangiectasia from lymphangioma may be of significant clinical implication, since lymphangiectasia may indicate the presence of an unsampled mass lesion or concurrent medical condition that requires medical attention. Future studies, including immunohistochemistry, to further define the histologic differences between adult/pediatric lymphangiomas and intestinal lymphangiectasia are warranted. Corresponding author: Matthew M. Yeh, MD, PhD, Dept. of Pathology, University of Washington School of Medicine, 1959 NE Pacific St, NE140D, Box , Seattle, WA 98195; myeh@uw.edu. Acknowledgment: We thank Raj P. Kapur, MD, PhD, Seattle Children s Hospital and Department of Pathology, University of Washington, for his contribution of cases and critical comments in this manuscript. References 1. Weiss SW, Goldblum JR, Enzinger FM. Enzinger and Weiss s Soft Tissue Tumors. 5th ed. Philadelphia, PA: Mosby Elsevier; Fenoglio-Preiser CM, Pascal RR, Perzin K. Tumors of the Intestines. Washington, DC: Armed Forces Institute of Pathology under the auspices of Universities Associated for Research and Education in Pathology; Alqahtani A, Nguyen LT, Flageole H, et al. 25 years experience with lymphangiomas in children. J Pediatr Surg. 1999;34: Girdwood TG, Philp LD. Lymphatic cysts of the colon. Gut. 1971;12: Steyaert H, Guitard J, Moscovici J, et al. Abdominal cystic lymphangioma in children: benign lesions that can have a proliferative course. J Pediatr Surg. 1996;31: Hornick JL, Fletcher CD. Intraabdominal cystic lymphangiomas obscured by marked superimposed reactive changes: clinicopathological analysis of a series. Hum Pathol. 2005;36: Mahle C, Schwartz M, Popek E, et al. Intra-abdominal lymphangiomas in children and adults: assessment of proliferative activity. Arch Pathol Lab Med. 1997;121: de Perrot M, Rostan O, Morel P, Le Coultre C. Abdominal lymphangioma in adults and children. Br J Surg. 1998;85: Rai P, Rao RN, Chakraborthy SB. Caecal lymphangioma: a rare cause of gastrointestinal blood loss. BMJ Case Rep doi: /bcr Goh BK, Tan YM, Ong HS, et al. Intra-abdominal and retroperitoneal lymphangiomas in pediatric and adult patients. World J Surg. 2005;29: Galifer RB, Pous JG, Juskiewenski S, et al. Intro-abdominal cystic lymphangiomas in childhood. Prog Pediatr Surg. 1978;11: Chung JH, Suh YL, Park IA, et al. A pathologic study of abdominal lymphangiomas. J Korean Med Sci. 1999;14: Sternberg SS, Mills SE, Carter D. Sternberg s Diagnostic Surgical Pathology. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; Freeman HJ, Nimmo M. Intestinal lymphangiectasia in adults. World J Gastrointest Oncol. 2011;3: Hasen J, Mustapha T, Schadlow AR. Protein-losing enteropathy caused by intestinal lymphangectasia. N Y State J Med. 1972;72: Pratz KW, Dingli D, Smyrk TC, et al. Intestinal lymphangiectasia with protein-losing enteropathy in Waldenstrom macroglobulinemia. Medicine (Baltimore). 2007;86: Kim JH, Bak YT, Kim JS, et al. Clinical significance of duodenal lymphangiectasia incidentally found during routine upper gastrointestinal endoscopy. Endoscopy. 2009;41: Femppel J, Lux G, Kaduk B, et al. Functional lymphangiectasia of the duodenal mucosa. Endoscopy. 1978;10: Chand EM, McNeely TW, Freant LJ. Pathologic quiz case: male with increasing abdominal girth. Pathologic diagnosis: multicystic intra-abdominal lymphangioma. Arch Pathol Lab Med. 2000;124: Henzel JH, Pories WJ, Burget DE, et al. Intra-abdominal lymphangiomata. Arch Surg. 1966;93: Ikura Y, Hashimoto T, Takamine Y, et al. Lymphangioma of the duodenum: report of a case. Surg Today. 1994;24: Seki H, Ueda T, Kasuya T, et al. Lymphangioma of the jejunum and mesentery presenting with acute abdomen in an adult. J Gastroenterol. 1998;33: Konen O, Rathaus V, Dlugy E, et al. Childhood abdominal cystic lymphangioma. Pediatr Radiol. 2002;32: Handra-Luca A, Montgomery E. Vascular malformations and hemangiolymphangiomas of the gastrointestinal tract: morphological features and clinical impact. Int J Clin Exp Pathol. 2011;4: Am J Clin Pathol 2015;144:
Abstracting Hematopoietic Neoplasms
CASE 1: LYMPHOMA PHYSICAL EXAMINATION 43yo male with a history of lower gastrointestinal bleeding and melena undergoing colonoscopy and biopsy to rule out neoplasm versus inflammation. Patient had no other
More informationAbdominal Cystic Lymphangioma in Children
Annals of Pediatric Surgery Vol 5, No 2, April 2009, PP 132-136 Original Article Abdominal Cystic Lymphangioma in Children Hisham Fayad Aly Department of Pediatric Surgery, Faculty of Medicine, Tanta University,
More informationIntraperitoneal cysts in infancy and childhood An overview and sonographic differentiation
Intraperitoneal cysts in infancy and childhood An overview and sonographic differentiation M. Mearadji International Foundation for Pediatric Imaging Aid Rotterdam, The Netherlands Intraperitoneal cysts
More informationReferences. GI Biopsies. What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD
What Should Pathologists Assistants Know About Gastrointestinal Histopathology? James M Crawford, MD, PhD jcrawford1@nshs.edu Executive Director and Senior Vice President for Laboratory Services North
More informationADULT INTUSSUSCEPTION SECONDARY TO LYMPHANGIOMA OF THE CECUM: A CASE REPORT
ADULT INTUSSUSCEPTION SECONDARY TO LYMPHANGIOMA OF THE CECUM: A CASE REPORT Chin-Fan Chen, 1 Chieh-Han Chuang, 2 Chien-Yu Lu, 3 Ching Hu, 4 Ting-Lu Kuo, 5 and Jan-Sing Hsieh 2,6 Departments of 1 Surgery,
More informationGASTRIC HETEROTOPIA IN THE ILEUM WITH ULCERATION AND CHRONIC BLEEDING
GASTROENTEROLOGY 66: 113-117, 1974 Copyright 1974 by The Williams & Wilkins Co. Vol. 66, No.1 Printed in U.S.A. CASE REPORTS GASTRIC HETEROTOPIA IN THE ILEUM WITH ULCERATION AND CHRONIC BLEEDING KARIM
More informationEDUCATIONAL CASES E1 & E2. Natasha Inglis 20/03/15
EDUCATIONAL CASES E1 & E2 Natasha Inglis 20/03/15 CASE E1 79 year old female Rectum. Altemeier operation Histology Superficial erosions and mucosal congestion volcano lesion and pseudomembrane formation
More informationSurveying the Colon; Polyps and Advances in Polypectomy
Surveying the Colon; Polyps and Advances in Polypectomy Educational Objectives Identify classifications of polyps Describe several types of polyps Verbalize rationale for polypectomy Identify risk factors
More informationDisorders of Cell Growth & Neoplasia. Histopathology Lab
Disorders of Cell Growth & Neoplasia Histopathology Lab Paul Hanna April 2010 Case #84 Clinical History: 5 yr-old, West Highland White terrier. skin mass from axillary region. has been present for the
More informationPreoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma
377 Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma Hiroaki Shiba a Yoshinobu Mitsuyama a Ken Hanyu a Kenji Ikeuchi b Hirotaka Hayashi c Katsuhiko Yanaga a a Department of
More informationUNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN
UNDERSTANDING X-RAYS: ABDOMINAL IMAGING THE ABDOMEN Radiology Enterprises radiologyenterprises@gmail.com www.radiologyenterprises.com STOMACH AND SMALL BOWEL STOMACH AND SMALL BOWEL Swallowed air is a
More informationFigure 1. Polypectomy specimen. Inset: Colonoscopy.
Case: A 69 year- old man with a history of gastrointestinal polyps presents with occult blood in the stool and iron deficiency anemia. He reports no weight loss, melena or hematochezia. Colonoscopy shows
More informationWorld Journal of Colorectal Surgery
World Journal of Colorectal Surgery Volume 6, Issue 5 2016 Article 4 Isolated Jejunal Crohn s Disease, A Diagnostic Dilemma Elise Biesboer BS Lacey Stelle MD Michelle M. Olson MD, MACM Paul Tender MD University
More informationImages In Gastroenterology
Images In Gastroenterology Thong-Ngam D, et al. THAI J GASTROENTEROL 2005 Vol. 6 No. 2 May - Aug. 2005 105 Imaging of Gastrointestinal Stromal Tumors Pornpim Fuangtharnthip, M.D. Narumol Hargroove, M.D.
More informationFundic Gland Polyposis in Patients Without Familial Adenomatosis Coli: Its Incidence and Clinical Features
GASTROENTEROLOGY 1984;86;1437-42 ALIMENTARY TRACT Fundic Gland Polyposis in Patients Without Familial Adenomatosis Coli: Its Incidence and Clinical Features MITSUO IIDA, TSUNEYOSHI YAO, HIDENOBU WATANABE,
More informationChief Complaint. Retroperitoneal cystic mass incidentally found at health examination center.
Personal Information Age: 34 y/o Sex: female Past history: major systemic medical history(-) surgical history(-), family history(-) Denied food or drug allergy Chief Complaint Retroperitoneal cystic mass
More informationPathology of Intestinal Obstruction. Dr. M. Madhavan, MBBS., MD., MIAC, Professor of Pathology Saveetha Medical College
Pathology of Intestinal Obstruction Dr. M. Madhavan, MBBS., MD., MIAC, Professor of Pathology Saveetha Medical College Pathology of Intestinal Obstruction Objectives list the causes of intestinal obstruction
More information59 yo male with past medical history of prostate carcinoma, presented with upper abdominal pain
December 2016 59 yo male with past medical history of prostate carcinoma, presented with upper abdominal pain Contributed by: Divya Sharma, MD. Fellow, Gastrointestinal Pathology, Department of Pathology
More informationDiffuse vascular malformation of large intestine clinically and radiologically misdiagnosed as ulcerative colitis
Journal of Surgical Case Reports, 2017;2, 1 5 doi: 10.1093/jscr/rjx016 Case Report CASE REPORT Diffuse vascular malformation of large intestine clinically and radiologically misdiagnosed as ulcerative
More informationTools of the Gastroenterologist: Introduction to GI Endoscopy
Tools of the Gastroenterologist: Introduction to GI Endoscopy Objectives Endoscopy Upper endoscopy Colonoscopy Endoscopic retrograde cholangiopancreatography (ERCP) Endoscopic ultrasound (EUS) Endoscopic
More informationGastroenterology Tutorial
Gastroenterology Tutorial Gastritis Poorly defined term that refers to inflammation of the stomach. Infection with H. pylori is the most common cause of gastritis. Most patients remain asymptomatic Some
More informationDIGESTIVE TRACT ESOPHAGUS
DIGESTIVE TRACT From the lower esophagus to the lower rectum four fundamental layers comprise the wall of the digestive tube: mucosa, submucosa, muscularis propria (externa), and adventitia or serosa (see
More information11/21/13 CEA: 1.7 WNL
Case Scenario 1 A 70 year-old white male presented to his primary care physician with a recent history of rectal bleeding. He was referred for imaging and a colonoscopy and was found to have adenocarcinoma.
More informationWorld Journal of Colorectal Surgery
World Journal of Colorectal Surgery Volume 3, Issue 4 2013 Article 3 Sigmoidorectal Intussusception Presenting as Prolapse Per Anus in an Adult Venugopal Hg Hasmukh B. Vora Mahendra S. Bhavsar SMT.NHL
More informationClinical Management of Obscure- Overt Gastrointestinal Bleeding. Presented by Dr. 張瀚文
Clinical Management of Obscure- Overt Gastrointestinal Bleeding Presented by Dr. 張瀚文 Definition Obscure: : hard to understand; not clear. Overt: : public; not secret. Occult: : hidden from the knowledge
More informationUncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception
Case Report Uncommon conditions in surgical oncology: acute abdomen caused by ileocolic intussusception Karl Mrak Department of Surgery, Brothers of Mercy Hospital, St. Veit, Glan, Austria Correspondence
More informationHyperplastische Polyps Innocent bystanders?
Hyperplastische Polyps Innocent bystanders?? K. Geboes P th l i h O tl dk d Pathologische Ontleedkunde, KULeuven Content Historical Classification Relation Hyperplastic polyps carcinoma The concept cept
More informationWendy L Frankel. Chair and Distinguished Professor
1 Wendy L Frankel Chair and Distinguished Professor Case 1 59 y/o woman Abdominal pain No personal or family history of cancer History of colon polyps Colonoscopy Polypoid rectosigmoid mass Biopsy 3 4
More informationSupplementary Online Content
Supplementary Online Content Tran AH, Ngor EWM, Wu BU. Surveillance colonoscopy in elderly patients: a retrospective cohort study. JAMA Intern Med. Published online August 11, 2014. doi:10.1001/jamainternmed.2014.3746
More informationA rare presentation of a mesenteric venolymphatic malformation with spontaneous hemorrhage in a newborn infant: A case report
www.edoriumjournals.com CASE REPORT PEER REVIEWED OPEN ACCESS A rare presentation of a mesenteric venolymphatic malformation with spontaneous hemorrhage in a newborn infant: A case report Alaa Mahmoud,
More informationLymphangioma of the small bowel mesentery: A case report and review of the literature
Online Submissions: http://www.wjgnet.com/esps/ wjg@wjgnet.com doi:10.3748/wjg.v18.i43.6328 World J Gastroenterol 2012 November 21; 18(43): 6328-6332 ISSN 1007-9327 (print) ISSN 2219-2840 (online) 2012
More informationColon Cancer , The Patient Education Institute, Inc. oc Last reviewed: 05/17/2017 1
Colon Cancer Introduction Colon cancer is fairly common. About 1 in 15 people develop colon cancer. Colon cancer can be a life threatening condition that affects the large intestine. However, if it is
More informationColo-Colonic Intussusception Caused by a Submucosal Lipoma
168 Colo-Colonic Intussusception Caused by a Submucosal Lipoma Case Report and Review of the Literature B.A. Twigt S.K. Nagesser D.J.A. Sonneveld Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands
More informationSAMs Guidelines DEVELOPING SELF-ASSESSMENT MODULES TEST QUESTIONS. Ver. #
SAMs Guidelines DEVELOPING SELF-ASSESSMENT MODULES TEST Ver. #5-02.12.17 GUIDELINES FOR DEVELOPING SELF-ASSESSMENT MODULES TEST The USCAP is accredited by the American Board of Pathology (ABP) to offer
More informationColonic Polyp. Najmeh Aletaha. MD
Colonic Polyp Najmeh Aletaha. MD 1 Polyps & classification 2 Colorectal cancer risk factors 3 Pathogenesis 4 Surveillance polyp of the colon refers to a protuberance into the lumen above the surrounding
More information1. Esophageal diverticulum located above the upper esophageal sphincter is called
Test Bank for Robbins Basic Pathology 9th Edition by Kumar Link full download: http://testbankair.com/download/test-bank-for-robbins-basic-pathology-9thedition-by-kumar/ Chapter 14: Oral Cavity and Gastrointestinal
More informationGRANULOMATOUS COLITIS: SIGNIFICANCE OF INVOLVEMENT OF THE TERMINAL ILEUM
GASTROENTEROLOGY 64: 1071-1076, 1973 Copyright 1973 by The Williams & Wilkins Co. Vol. 64, No.6 Printed in U.S.A. GRANULOMATOUS COLITIS: SIGNIFICANCE OF INVOLVEMENT OF THE TERMINAL ILEUM JAMES A. NELSON,
More informationDepartment of Surgery, Aizu Central Hospital, Fukushima
Case Reports Resection of Asynchronous Quadruple Advanced Colonic Carcinomas Followed by Reconstruction with Ileal Interposition between the Transverse Colon and Rectum Sho Mineta 1, Kimiyoshi Shimanuki
More informationIntraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma
Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma Authors: R. Revert Espí, Y. Fernandez Nuñez, I. Carbonell, D. P. Gómez valencia,
More informationCross-sectional Imaging of Neuroendocrine Tumors of the Gastrointestinal Tract
Cross-sectional Imaging of Neuroendocrine Tumors of the Gastrointestinal Tract Eric J. May 1, Shannon P. Sheedy 1, Joel G. Fletcher 1, Mark J. Truty 2, Thomas C. Smyrk 3, Jeff L. Fidler 1 1. Radiology,
More informationBurkitt s Lymphoma of the Abdomen: The Northern California Kaiser Permanente Experience
ISPUB.COM The Internet Journal of Surgery Volume 18 Number 2 Burkitt s Lymphoma of the Abdomen: The Northern California Kaiser Permanente Experience J McClenathan Citation J McClenathan. Burkitt s Lymphoma
More informationA Case of Giant Mesenteric Cyst Originating from the Small Intestine
Showa Univ J Med Sci 27 2, 125 129, June 2015 Case Report A Case of Giant Mesenteric Cyst Originating from the Small Intestine Takahiro UMEMOTO 1, Tetsuji WAKABAYASHI 1, Nobuyuki OHIKE 2, Ryuichi SEKINE
More informationINVESTIGATIONS OF GASTROINTESTINAL DISEAS
INVESTIGATIONS OF GASTROINTESTINAL DISEAS Lecture 1 and 2 دز اسماعيل داود فرع الطب كلية طب الموصل Radiological tests of structure (imaging) Plain X-ray: May shows soft tissue outlines like liver, spleen,
More informationGastroenterology. Certification Examination Blueprint. Purpose of the exam
Gastroenterology Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the certified gastroenterologist
More informationcolorectal cancer Colorectal cancer hereditary sporadic Familial 1/12/2018
colorectal cancer Adenocarcinoma of the colon and rectum is the third most common site of new cancer cases and deaths in men (following prostate and lung or bronchus cancer) and women (following breast
More informationENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID
ENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID Manoop S. Bhutani, MD, FASGE, FACG, FACP, AGAF, Doctor Honoris Causa Professor of Medicine Eminent Scientist of the Year 2008, World
More informationAbstracting Upper GI Cancer Incidence and Treatment Data Quiz 1 Multiple Primary and Histologies Case 1 Final Pathology:
Abstracting Upper GI Cancer Incidence and Treatment Data Quiz 1 Multiple Primary and Histologies Case 1 A 74 year old male with a history of GERD presents complaining of dysphagia. An esophagogastroduodenoscopy
More informationGASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint
GASTROENTEROLOGY Maintenance of Certification (MOC) Examination Blueprint ABIM invites diplomates to help develop the Gastroenterology MOC exam blueprint Based on feedback from physicians that MOC assessments
More informationPatient underwent hemicolectomy: 7 x 4.5 cm intusscepted segment of ileum in colon - mucosal
Extranodal Lymphomas Rena Buckstein Odette Cancer Center Case: JT 69 yo male COO software company PMHx: basal cell back, cholesterol Presents to ER with severe abdominal pain, bloody diarrhea x 2d In ER
More informationIntussuception due to gastrointestinal stromal tumor with neural differentiation in a patient with. Von Recklinghausen Neurofibromatosis,
Turkish Journal of Cancer Vol 31/ No.4 /2001 Intussuception due to gastrointestinal stromal tumor with neural differentiation in a patient with Von Recklinghausen Neurofibromatosis (NF-1): A case report
More informationד"ר דוד ירדני המכון לגסטרואנטרולוגיה ומחלות כבד מרכז רפואי סורוקה
ד"ר דוד ירדני המכון לגסטרואנטרולוגיה ומחלות כבד מרכז רפואי סורוקה Presentaion: S.A is 38 years old. Referred for rectal bleeding investigation. Describes several occasions of bleeding and abdominal pain.
More informationmalignant polyp Daily Challenges in Digestive Endoscopy for Endoscopists and Endoscopy Nurses BSGIE Annual Meeting 18/09/2014 Mechelen
Plan Incidental finding of a malignant polyp 1. What is a polyp malignant? 2. Role of the pathologist and the endoscopist 3. Quantitative and qualitative risk assessment 4. How to decide what to do? Hubert
More informationCT Evaluation of Bowel Wall Thickening. Dr: Adel El Badrawy; M.D. Lecturer of Radio Diagnosis Faculty of Medicine Mansoura University.
CT Evaluation of Bowel Wall Thickening By Dr: Adel El Badrawy; M.D. Lecturer of Radio Diagnosis Faculty of Medicine Mansoura University. The CT findings of bowel wall thickening includes 1 Degree of thickening.
More informationThe focus of this week s lab will be pathology of the gastrointestinal and hepatobiliary systems.
GASTROINTESTINAL AND HEPATOBILIARY SYSTEMS The focus of this week s lab will be pathology of the gastrointestinal and hepatobiliary systems. GASTROINTESTINAL SYSTEM AND HEPATOBILIARY SYSTEM We will examine
More informationPatologia sistematica V Gastroenterologia Prof. Stefano Fiorucci. Colon polyps. Colorectal cancer
Patologia sistematica V Gastroenterologia Prof. Stefano Fiorucci Colon polyps Colorectal cancer Harrison s Principles of Internal Medicine 18 Ed. 2012 Colorectal cancer 70% Colorectal cancer CRC and colon
More informationThe Digestive System Laboratory
The Digestive System Laboratory 1 The Digestive Tract The alimentary canal is a continuous tube stretching from the mouth to the anus. Liver Gallbladder Small intestine Anus Parotid, sublingual, and submaxillary
More informationCase Scenario 1. The patient has now completed his neoadjuvant chemoradiation and has been cleared for surgery.
Case Scenario 1 July 10, 2010 A 67-year-old male with squamous cell carcinoma of the mid thoracic esophagus presents for surgical resection. The patient has completed preoperative chemoradiation. This
More informationKids Like to Break the Rules: Gastrointestinal Pathology in Children
Kids Like to Break the Rules: Gastrointestinal Pathology in Children Jeffrey Goldsmith MD Director of Surgical Pathology, Beth Israel Deaconess Medical Center; Consultant in Gastrointestinal Pathology,
More informationCase Report A Rare Case of Mucinous Adenocarcinoma of the Colon Presenting as Ileoileal Intussusception in an Adult
Case Reports in Medicine Volume 2012, Article ID 340947, 4 pages doi:10.1155/2012/340947 Case Report A Rare Case of Mucinous Adenocarcinoma of the Colon Presenting as Ileoileal Intussusception in an Adult
More informationScholars Journal of Applied Medical Sciences (SJAMS)
Scholars Journal of Applied Medical Sciences (SJAMS) Abbreviated Key Title: Sch. J. App. Med. Sci. Scholars Academic and Scientific Publisher A Unit of Scholars Academic and Scientific Society, India www.saspublisher.com
More informationEvaluation of Serosal Nerves in Hirschsprung Disease
Evaluation of Serosal Nerves in Hirschsprung Disease Mudassira and Anwar ul Haque Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad. Introduction: For the diagnosis of Hirschsprung
More informationDifferentiation Between Ileocecal Tuberculosis and Crohn s Disease using a Combination of Clinical, Endoscopic and Histological Characteristics
38 Original Article Differentiation Between Ileocecal Tuberculosis and Crohn s Disease using a Combination of Clinical, Endoscopic and Histological Characteristics Anuchapreeda S Leelakusolvong S Charatcharoenwitthaya
More informationPage 1. Is the Risk This High? Dysplasia in the IBD Patient. Dysplasia in the Non IBD Patient. Increased Risk of CRC in Ulcerative Colitis
Screening for Colorectal Neoplasia in Inflammatory Bowel Disease Francis A. Farraye MD, MSc Clinical Director, Section of Gastroenterology Co-Director, Center for Digestive Disorders Boston Medical Center
More informationRadiologic and Endoscopic Diagnosis of Duodenal angioma
Acta Radiologica ISSN: 0284-1851 (Print) 1600-0455 (Online) Journal homepage: https://www.tandfonline.com/loi/iard20 Radiologic and Endoscopic Diagnosis of Duodenal angioma Branko Plavšić & B. Jereb-Prović
More informationRADIATION INDUCED SMALL BOWEL DISEASE. Dr Mnguni Supervisor: Dr Lohlun Radiation Oncology
RADIATION INDUCED SMALL BOWEL DISEASE Dr Mnguni Supervisor: Dr Lohlun Radiation Oncology INTRODUCTION Radiation therapy is not regularly indicated in the treatment of small bowel disease. Reasons are complex
More informationManagement of pt1 polyps. Maria Pellise
Management of pt1 polyps Maria Pellise Early colorectal cancer Malignant polyp Screening programmes SM Invasive adenocar cinoma Advances in diagnostic & therapeutic endoscopy pt1 polyps 0.75 5.6% of large-bowel
More informationCase history: Figure 1. H&E, 5x. Figure 2. H&E, 20x.
1 Case history: A 49 year-old female presented with a 5 year history of chronic anal fissure. The patient s past medical history is otherwise unremarkable. On digital rectal examination there was a very
More informationA rare cause of abdominal pain and gastrointestinal bleeding: Colonic lipoma causing intussusception
www.edoriumjournals.com CLINICAL IMAGES PEER REVIEWED OPEN ACCESS A rare cause of abdominal pain and gastrointestinal bleeding: Colonic lipoma causing intussusception Daniela Ferreira, Marta Salgado, Isabel
More informationCase Report. A Surgical Case of Venous Aneurysm of the Cephalic Vein. with Unique Clinicopathological Findings for Venous Dissection
Case Report A Surgical Case of Venous Aneurysm of the Cephalic Vein with Unique Clinicopathological Findings for Venous Dissection Takashi Kobata, 1 Sohsuke Yamada, 2,3* Ken-ichi Mizutani, 2 Nozomu Kurose,
More informationEndoscopic Mucosal Resection (EMR) & Endoscopic Submucosal Dissection (ESD)
Endoscopic Mucosal Resection (EMR) & Endoscopic Submucosal Dissection (ESD) Minimally Invasive Polyp Removal IE-02700-Understanding EMR and ESD Brochure_R3.indd 1 Occasionally, a polyp that infiltrates
More informationPeutz Jegher's Syndrome (Gastro-intestinal Polyposis) and Its Complications
Peutz Jegher's Syndrome (Gastro-intestinal Polyposis) and Its Complications Pages with reference to book, From 154 To 155 Zakiuddin G. Oonwala, Sina Aziz ( Department of Surgery, Dow Medical College and
More informationAdult Intussusception
Bahrain Medical Bulletin, Vol. 27, No. 3, September 2005 Adult Intussusception Suhair Alsaad, MBCHB, CABS, FRCSI* Mariam Al-Muftah, MBCHB** Objectives: Adult intussusception is a rare entity. We present
More informationQuality Measures In Colonoscopy: Why Should I Care?
Quality Measures In Colonoscopy: Why Should I Care? David Greenwald, MD, FASGE Professor of Clinical Medicine Albert Einstein College of Medicine Montefiore Medical Center Bronx, New York ACG/ASGE Best
More informationVIII. 9. FDG-PET for Diagnosis of an Advanced Jejunal Adenocarcinoma with Distant Metastases, Compared with Gallium Scintigraphy
CYRIC Annual Report 2003 VIII. 9. FDG-PET for Diagnosis of an Advanced Jejunal Adenocarcinoma with Distant Metastases, Compared with Gallium Scintigraphy Yamaura G., Yoshioka T., Yamaguchi K. *, Fukuda
More informationEndoscopic Detection and Removal of Recto-sigmoid Myomatous (Leiomyoma) Tumour
Article ID: ISSN 2046-1690 Endoscopic Detection and Removal of Recto-sigmoid Myomatous (Leiomyoma) Tumour Author(s):Mr. Sridhar Dharamavaram, Dr. Ritu Kamra, Dr. Anu Priya, Mr. Rajiva Ranjan Das Corresponding
More informationActa Med. Okayama Vol. 70, No. 2. Iwamuro et al.
140 Iwamuro et al. cta Med. Okayama Vol. 70, No. 2 emission tomography (PET) scanning showed tracer uptake in the spleen and iliac bone as well as in the swollen lymph nodes. There were no abnormalities
More informationCase History B Female patient 1970 Clinical History : crampy abdominal pain and episodes of bloody diarrhea Surgical treatment
Case History B-1325945 Female patient 1970 Clinical History : crampy abdominal pain and episodes of bloody diarrhea Surgical treatment Case History B-1325945 Pathology Submucosa & Muscularis Endometriosis
More informationGastrointestinal Tract. Anatomy of GI Tract. Anatomy of GI Tract. (Effective February 2007) (1%-5%)
Gastrointestinal Tract (Effective February 2007) (1%-5%) Anatomy of GI Tract Esophagus bulls-eye or target EG junction seen on sagittal scan posterior to left lobe of liver and anterior to aorta Anatomy
More informationGross appearance of peritoneal cysts. They have a thin, translucent wall and contain a clear fluid.
Gross appearance of peritoneal cysts. They have a thin, translucent wall and contain a clear fluid. So-called multicystic benign mesothelioma. A, Gross appearance. So-called multicystic benign mesothelioma.
More informationThe Usefulness of Capsule Endoscopy
The Usefulness of Capsule Endoscopy David J. Hass, MD, FACG Assistant Clinical Professor of Medicine Yale University School of Medicine Gastroenterology Center of Connecticut Obscure Gastrointestinal Bleeding
More information8. The polyp in the illustration can be described as (circle all that apply) a. Exophytic b. Pedunculated c. Sessile d. Frank
Quiz 1 Overview 1. Beginning with the cecum, which is the correct sequence of colon subsites? a. Cecum, ascending, splenic flexure, transverse, hepatic flexure, descending, sigmoid. b. Cecum, ascending,
More informationAlberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines
Alberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines June 2013 ACRCSP Post Polypectomy Surveillance Guidelines - 2 TABLE OF CONTENTS Background... 3 Terms, Definitions
More informationVomiting in children: The good coordination between radiologists and pediatricians is the key to success
Vomiting in children: The good coordination between radiologists and pediatricians is the key to success C. Santos Montón 1, M. T. Garzon Guiteria 2, A. Hortal Benito-Sendín 1, K. El Karzazi 1, P. Sanchez
More informationClinical presentations of small bowel tumor
Original Research Article Clinical presentations of small bowel tumor Arige Subodh Kumar 1*, N L Eshwar Prasad 2, Avula Krishnaveni 3, Anuradha 4 1 In-charge Professor, Department of Plastic Surgery, Gandhi
More informationClinicopathological Characteristics of Superficial Type
Diagnostic and Therapeutic Endoscopy, 1995, Vol. 2, pp. 99-105 Reprints available directly from the publisher Photocopying permitted by license only (C) 1995 Harwood Academic Publishers GmbH Printed in
More informationEpidemiology and Treatment of Colonic Angiodysplasia; a Population-Based Study. Naomi G. Diggs, MD Lisa L. Strate, MD MPH March 2, 2010
Epidemiology and Treatment of Colonic Angiodysplasia; a Population-Based Study. Naomi G. Diggs, MD Lisa L. Strate, MD MPH March 2, 2010 Background Angiodysplasia is an important cause of occult and acute
More informationProposed Scoring System to Determine Small Bowel Mass Lesions Using Capsule Endoscopy
ORIGINAL ARTICLE Proposed Scoring System to Determine Small Bowel Mass Lesions Using Capsule Endoscopy Li-Rung Shyung, Shee-Chan Lin, Shou-Chuan Shih, Wen-Hsiung Chang,* Cheng-Hsin Chu, Tsang-En Wang Background/Purpose:
More informationTHE ORAL CAVITY
THE ORAL CAVITY WALL OF ABDOMEN (ANTERIOR) The paraumbilical vein drains into the portal vein and then through the liver. This is an important clinical connection. THE ABDOMINAL VISCERA The small
More informationFig. 1. Ileal and jejunal metastases from adenocarcinoma of the lung in 62-year-old male with a clinical history of bloody stool. A.
507 A B Fig. 1. Ileal and jejunal metastases from adenocarcinoma of the lung in 62-year-old male with a clinical history of bloody stool. A. An intraluminal polypoid mass (arrow) is seen in the dilated
More informationPolyps Adenomas Lipomas
30 Chapter 2 CT Colonography Chapter 2 Polyps Adenomas Lipomas Case 8 Case 9 Case 10 Case 11 Case 12 Case 13 Case 14 Case 15 Case 16 Case 17 Case 18 Pseudopolyp Polyp after intravenous administration of
More informationMultiple Polypoid Angiodysplasia with Obscure Overt Bleeding : A Case report. Jong Pil Im 1, Joo Sung Kim 1. Seoul, Republic of Korea
Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding : A Case report Jooyoung Lee 1, Sung Wook Hwang 1,2, Jihye Kim 1, Jinwoo Kang 1, Gyeong Hoon Kang 3, Kyu Joo Park 4, Jong Pil Im 1, Joo Sung
More informationAMSER Rad Path Case of the Month: December 2018
AMSER Rad Path Case of the Month: December 2018 Rectosigmoid Carcinoma Catherine McNulty, MS IV, Tulane University School of Medicine Dr. Matthew Hartman, M.D. Medical Student Radiology Director Dr. Matthew
More informationÓ Journal of Krishna Institute of Medical Sciences University 112
ISSN 2231-4261 CASE REPORT Large Pseudocyst of the Adrenal Gland: A Radiological Pathological Correlation 1* 1 2 1 1 Abhishek Dwivedi, Satveer Choudhary, Vikram Trehan, Narender Yadav, K. Leela Kanth 1
More informationEmergency MDCT in case of right lower quadrant pain
Emergency MDCT in case of right lower quadrant pain Poster No.: C-0563 Congress: ECR 2015 Type: Educational Exhibit Authors: M. Lisitskaya, V. Sinitsyn; Moscow/RU Keywords: Abdomen, Emergency, Gastrointestinal
More informationHASPI Medical Anatomy & Physiology 15a Lab Activity
HASPI Medical Anatomy & Physiology 15a Lab Activity Name(s): Period: Date: The Digestive System Digestion is an important process that involves breaking down food and drink into small molecules that can
More informationSmall intestine. Small intestine
General features Tubular organ longest part; 5-6 m most of chemical digestion absorption of nutrients reabsorption of H2O occurs. Two structural features; maximize the lumenal surface area villi microvilli
More informationESD for EGC with undifferentiated histology
ESD for EGC with undifferentiated histology Jun Haeng Lee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Biopsy: M/D adenocarcinoma ESD: SRC >>
More informationEndoscopic Submucosal Dissection ESD
Endoscopic Submucosal Dissection ESD Peter Draganov MD Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Florida Gastrointestinal Cancer Lesion that Can be Treated
More informationLarge Colorectal Adenomas An Approach to Pathologic Evaluation
Anatomic Pathology / LARGE COLORECTAL ADENOMAS AND PATHOLOGIC EVALUATION Large Colorectal Adenomas An Approach to Pathologic Evaluation Elizabeth D. Euscher, MD, 1 Theodore H. Niemann, MD, 1 Joel G. Lucas,
More informationA 50 year old female with no significant past medical history presented for a routine screening colonoscopy. The patient reported only symptoms of
A 50 year old female with no significant past medical history presented for a routine screening colonoscopy. The patient reported only symptoms of reflux. She had no family history of colorectal cancer
More information