AIM: The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis (UC). The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role...AIM: The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis (UC). The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role of the appendix in the development of UC.METHODS: Colonoscopic biopsy specimens of the appendix, transverse colon, and rectum were obtained from 86 patients with UC: active pancotitis (A-Pan; n = 15),active left-sided colitis (A-Lt; n = 25), A-Lt with appendiceal involvement (A-Lt/Ap; n = 10), inactive pancolitis (I-Pan;n = 14), and inactive left-sided colitis (I-Lt; n = 22),and from controls. In the isolated mucosal T cells, the CD4/CD8 ratio and proportion of activated CD4+ T cells were investigated, and compared with controls.RESULTS: In the appendix, the CD4/CD8 ratio significantly increased in A-Lt and A-Lt/Ap. The ratio in the appendix also tended to increase in A-Pan. In the rectum, the ratio significantly increased in all UC groups. Tn the appendix,the proportion of CD4+CD69+ (early activation antigen)T cells significantly increased in all UC groups. Tn the rectum, the proportion of CD4+CD69+ T cells significantly increased only in A-Pan. The proportion of CD4+HLADR+ (mature activation antigen) T cells significantly increased only in the rectum of A-Pan, but not in the other areas of any groups.CONCLUSION: The increased CD4/CD8 ratio and predominant infiltration of CD4+CD69+ T cells in the appendix suggest that the appendix is a priming site in the development of UC.展开更多
AIM:To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit. METHODS: Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis ...AIM:To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit. METHODS: Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination. Liver function tests and clinical monitoring measurements were also recorded. RESULTS: Liver biochemistries were increased in the majority of patients before death. Histology of liver bi- opsy specimens showed portal inflammation in 73.3%, centrilobular necrosis in 80%, lobular inflammation in 66.7%, hepatocellular apoptosis in 66.6% and cholan- gitis/cholangiolitis in 20% of patients. Mixed hepatitic/ cholestatic type of liver injury was observed in 6/15 (40%) patients and hepatitc in 9/15 (60%). Steatosis was ob- served in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma. Among the histological features, the presence of portal inflammation in liver biopsy was as- sociated with increased hospitalization in the ICU prior death (P = 0.026). CONCLUSION: Features of hepatitis and steatosis arethe main histological findings in the liver in the majority of patients dying from sepsis.展开更多
Castleman's disease (CD) of the pancreas/peripancreas is extremely rare. The recently introduced, endoscopic ultrasonography (EUS)-guided trucut biopsy (TCB) is a useful diagnostic modality for obtaining tissue sa...Castleman's disease (CD) of the pancreas/peripancreas is extremely rare. The recently introduced, endoscopic ultrasonography (EUS)-guided trucut biopsy (TCB) is a useful diagnostic modality for obtaining tissue samples from peripancreatic lesions. However, its role in diagnosing CD remains unknown. We report a case of localized, peripancreatic, hyaline-vascular CD biopsied using EUS. The pathology results were initially interpreted as an extranodal, marginal-zone B-cell lymphoma. However, polymerase chain reaction (PCR) study for the IgH gene rearrangement revealed a polyclonal pattern. We also reviewed the relevant literature. To our knowledge, this is the first illustrated report on EUS-TCB findings of CD with its pathology results of EUS-TCB mimicked a B-cell lymphoma.展开更多
AIM: To evaluate the value of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas.METHODS: From January 1999 to October 2004, CT-guided core-needle biopsies were performed in 80 patient...AIM: To evaluate the value of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas.METHODS: From January 1999 to October 2004, CT-guided core-needle biopsies were performed in 80 patients with suspected malignant lymphoma. Biopsies were performed with an 18-20 G biopsy-cut (CR Bard, Inc., Covington, GA,USA) needle driven by a spring-loaded Bard biopsy gun.RESULTS: A definite diagnosis and accurate histological subtype were obtained in 61 patients with a success rate of 76.25% (61/80). Surgical sampling was performed in 19 patients (23.75%) with non-diagnostic core-needle biopsies. The success rate of CT-guided core-needle biopsy varied with the histopathologic subtypes in our group.The relatively high success rates of core-needle biopsy were noted in diffuse large B-cell non-Hodgkin's lymphoma (NHL, 88.89%) and peripheral T-cell NHL (90%). However,the success rates were relatively low in anaplastic large cell (T/null cell) lymphoma (ALCL, 44.44%) and Hodgkin's disease (HD, 28.57%) in our group.CONCLUSION: CT-guided core-needle biopsy is a reliable means of diagnosing and classifying malignant lymphomas,and can be widely applied in the management of patients with suspected malignant lymphoma.展开更多
AIM: To determine if Fourier-transform infrared (FT-IR)spectroscopy of endoscopic biopsies could accurately diagnose gastritis and malignancy.METHODS: A total of 123 gastroscopic samples, including 11 cases of cancero...AIM: To determine if Fourier-transform infrared (FT-IR)spectroscopy of endoscopic biopsies could accurately diagnose gastritis and malignancy.METHODS: A total of 123 gastroscopic samples, including 11 cases of cancerous tissues, 63 cases of chronic atrophic gastritis tissues, 47 cases of chronic superficial gastritis tissues and 2 cases of normal tissues, were obtained from the First Hospital of Xi'an Jiaotong University, China. A modified attenuated total reflectance (ATR) accessory was linked to a WQD-500 FT-IR spectrometer for spectral measurement followed by submission of the samples for pathologic analysis. The spectral characteristics for different types of gastroscopic tissues were summarized and correlated with the corresponding pathologic results.RESULTS: Distinct differences were observed in the FTIR spectra of normal, atrophic gastritis, superficial gastritis and malignant gastric tissues. The sensitivity of FT-IR for detection of gastric cancer, chronic atrophic gastritis and superficial gastritis was 90.9%, 82.5%, 91.5%, and specificity was 97.3%, 91.7%, 89.5% respectively.CONCLUSION: FT-IR spectroscopy can distinguish gastric inflammation from malignancy.展开更多
AIM:To evaluate the feasibility and utility of confocal laser endomicroscopy(CLE) in the description of normal gastrointestinal(GI) mucosa and in the diagnosis of GI disorders in children,in comparison to histology.ME...AIM:To evaluate the feasibility and utility of confocal laser endomicroscopy(CLE) in the description of normal gastrointestinal(GI) mucosa and in the diagnosis of GI disorders in children,in comparison to histology.METHODS:Forty-four patients(19 female) median age 10.9 years(range 0.7-16.6 years) with suspected or known GI pathology underwent esophago-gastro-duodenoscopy(OGD)(n = 36) and/or ileocolonoscopy(IC)(n = 31) with CLE using sodium fluorescein and acriflavine as contrast agents.Histological sections were compared with same site confocal images by two experienced pediatric and GI histopathologists and endoscopists,respectively.RESULTS:Duodenum and ileum were intubated in all but one patient undergoing OGD and IC.The median procedure time was 16.4 min(range 7-25 min) for OGD and 27.9 min(range 15-45 min) for IC.A total of 4798 confocal images were compared with 153 biopsies from the upper GI tract from 36 procedures,and 4661 confocal images were compared with 188 biopsies from the ileocolon from 31 procedures.Confocal images were comparable to conventional histology both in normal and in pathological conditions such as esophagitis,Helicobacter pylori gastritis,celiac disease,inflammatory bowel disease,colonic heterotopia,and graft versus host disease.CONCLUSION:CLE offers the prospect of targeting biopsies to abnormal mucosa,thereby increasing diagnostic yield,reducing the number of biopsies,decreasing the burden on the histopathological services,and reducing costs.展开更多
Liver biopsy is considered the most accurate means to estimate the necroinflammatory activity and the extent of fibrosis. However, histology evaluation is an invasive procedure associated with risk to the patient, ris...Liver biopsy is considered the most accurate means to estimate the necroinflammatory activity and the extent of fibrosis. However, histology evaluation is an invasive procedure associated with risk to the patient, risk of sampling error and diagnostic inconsistencies due to inter- and intra-observer error. On the basis of histological studies performed so far, chronic hepatitis C in children appears morphologically benign in the majority of cases. At the Pediatric Liver Unit of our university, a total of 67 children with chronic hepatitis C underwent liver biopsy. Liver biopsy was repeated 5.5 years after the initial histological evaluation in 21 children. On a total number of 88 liver biopsies, micronodular cirrhosis was detected only in one genotype 1b-infected obese child. Since liver histology investigation of a child with chronic hepatitis C has few chances to highlight severe lesions, we question how liver biopsy helps in the management of children with chronic hepatitis C.展开更多
TO THE EDITOR
We have read with interest the recent report by E Kayacetin and S Kayacetin of Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy[1] since we diagnosed the duodenal ulcer which penetrated ...TO THE EDITOR
We have read with interest the recent report by E Kayacetin and S Kayacetin of Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy[1] since we diagnosed the duodenal ulcer which penetrated into liver similarly. This is a rather unusual case because of the fifth case in the literature and responding to medical therapy.展开更多
基金Supported by the Grant-in-Aid for Scientific Research (C) from the Ministry of Culture and Science of Japan No. 16560645Grant-in-Aid for "Research for the Future" Program from The Japan Society for the Promotion of Science, No. JSPS-RFTF97I00201Supporting in Research Funds from The Japanese Foundation for Research and Promotion of Endoscopy, No. JFE-1997Shimidzu Immunology Foundation, 2000Tenri Foundation for Medical Research, 1997-2000Health and Labour Science Research Grants from the Japanese Ministry of Health, Labour and Welfare, and Research on Measures for Intractable Disease (Inflammatory Bowel Disease)a Grant from the "The 21st Century Center of Excellence (COE)" Program of the Ministry of Education, Culture, Sports, Science and Technology
文摘AIM: The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis (UC). The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role of the appendix in the development of UC.METHODS: Colonoscopic biopsy specimens of the appendix, transverse colon, and rectum were obtained from 86 patients with UC: active pancotitis (A-Pan; n = 15),active left-sided colitis (A-Lt; n = 25), A-Lt with appendiceal involvement (A-Lt/Ap; n = 10), inactive pancolitis (I-Pan;n = 14), and inactive left-sided colitis (I-Lt; n = 22),and from controls. In the isolated mucosal T cells, the CD4/CD8 ratio and proportion of activated CD4+ T cells were investigated, and compared with controls.RESULTS: In the appendix, the CD4/CD8 ratio significantly increased in A-Lt and A-Lt/Ap. The ratio in the appendix also tended to increase in A-Pan. In the rectum, the ratio significantly increased in all UC groups. Tn the appendix,the proportion of CD4+CD69+ (early activation antigen)T cells significantly increased in all UC groups. Tn the rectum, the proportion of CD4+CD69+ T cells significantly increased only in A-Pan. The proportion of CD4+HLADR+ (mature activation antigen) T cells significantly increased only in the rectum of A-Pan, but not in the other areas of any groups.CONCLUSION: The increased CD4/CD8 ratio and predominant infiltration of CD4+CD69+ T cells in the appendix suggest that the appendix is a priming site in the development of UC.
文摘AIM:To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit. METHODS: Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination. Liver function tests and clinical monitoring measurements were also recorded. RESULTS: Liver biochemistries were increased in the majority of patients before death. Histology of liver bi- opsy specimens showed portal inflammation in 73.3%, centrilobular necrosis in 80%, lobular inflammation in 66.7%, hepatocellular apoptosis in 66.6% and cholan- gitis/cholangiolitis in 20% of patients. Mixed hepatitic/ cholestatic type of liver injury was observed in 6/15 (40%) patients and hepatitc in 9/15 (60%). Steatosis was ob- served in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma. Among the histological features, the presence of portal inflammation in liver biopsy was as- sociated with increased hospitalization in the ICU prior death (P = 0.026). CONCLUSION: Features of hepatitis and steatosis arethe main histological findings in the liver in the majority of patients dying from sepsis.
文摘Castleman's disease (CD) of the pancreas/peripancreas is extremely rare. The recently introduced, endoscopic ultrasonography (EUS)-guided trucut biopsy (TCB) is a useful diagnostic modality for obtaining tissue samples from peripancreatic lesions. However, its role in diagnosing CD remains unknown. We report a case of localized, peripancreatic, hyaline-vascular CD biopsied using EUS. The pathology results were initially interpreted as an extranodal, marginal-zone B-cell lymphoma. However, polymerase chain reaction (PCR) study for the IgH gene rearrangement revealed a polyclonal pattern. We also reviewed the relevant literature. To our knowledge, this is the first illustrated report on EUS-TCB findings of CD with its pathology results of EUS-TCB mimicked a B-cell lymphoma.
文摘AIM: To evaluate the value of CT-guided core-needle biopsy in diagnosis and classification of malignant lymphomas.METHODS: From January 1999 to October 2004, CT-guided core-needle biopsies were performed in 80 patients with suspected malignant lymphoma. Biopsies were performed with an 18-20 G biopsy-cut (CR Bard, Inc., Covington, GA,USA) needle driven by a spring-loaded Bard biopsy gun.RESULTS: A definite diagnosis and accurate histological subtype were obtained in 61 patients with a success rate of 76.25% (61/80). Surgical sampling was performed in 19 patients (23.75%) with non-diagnostic core-needle biopsies. The success rate of CT-guided core-needle biopsy varied with the histopathologic subtypes in our group.The relatively high success rates of core-needle biopsy were noted in diffuse large B-cell non-Hodgkin's lymphoma (NHL, 88.89%) and peripheral T-cell NHL (90%). However,the success rates were relatively low in anaplastic large cell (T/null cell) lymphoma (ALCL, 44.44%) and Hodgkin's disease (HD, 28.57%) in our group.CONCLUSION: CT-guided core-needle biopsy is a reliable means of diagnosing and classifying malignant lymphomas,and can be widely applied in the management of patients with suspected malignant lymphoma.
基金Supported by the National Natural Science Foundation of China, No. 30371604 and State Key Project of China, No. 2002CCA01900
文摘AIM: To determine if Fourier-transform infrared (FT-IR)spectroscopy of endoscopic biopsies could accurately diagnose gastritis and malignancy.METHODS: A total of 123 gastroscopic samples, including 11 cases of cancerous tissues, 63 cases of chronic atrophic gastritis tissues, 47 cases of chronic superficial gastritis tissues and 2 cases of normal tissues, were obtained from the First Hospital of Xi'an Jiaotong University, China. A modified attenuated total reflectance (ATR) accessory was linked to a WQD-500 FT-IR spectrometer for spectral measurement followed by submission of the samples for pathologic analysis. The spectral characteristics for different types of gastroscopic tissues were summarized and correlated with the corresponding pathologic results.RESULTS: Distinct differences were observed in the FTIR spectra of normal, atrophic gastritis, superficial gastritis and malignant gastric tissues. The sensitivity of FT-IR for detection of gastric cancer, chronic atrophic gastritis and superficial gastritis was 90.9%, 82.5%, 91.5%, and specificity was 97.3%, 91.7%, 89.5% respectively.CONCLUSION: FT-IR spectroscopy can distinguish gastric inflammation from malignancy.
基金Supported by Peel Research Foundation and Yorkshire Cancer ResearchThe Egyptian Cultural Bureau
文摘AIM:To evaluate the feasibility and utility of confocal laser endomicroscopy(CLE) in the description of normal gastrointestinal(GI) mucosa and in the diagnosis of GI disorders in children,in comparison to histology.METHODS:Forty-four patients(19 female) median age 10.9 years(range 0.7-16.6 years) with suspected or known GI pathology underwent esophago-gastro-duodenoscopy(OGD)(n = 36) and/or ileocolonoscopy(IC)(n = 31) with CLE using sodium fluorescein and acriflavine as contrast agents.Histological sections were compared with same site confocal images by two experienced pediatric and GI histopathologists and endoscopists,respectively.RESULTS:Duodenum and ileum were intubated in all but one patient undergoing OGD and IC.The median procedure time was 16.4 min(range 7-25 min) for OGD and 27.9 min(range 15-45 min) for IC.A total of 4798 confocal images were compared with 153 biopsies from the upper GI tract from 36 procedures,and 4661 confocal images were compared with 188 biopsies from the ileocolon from 31 procedures.Confocal images were comparable to conventional histology both in normal and in pathological conditions such as esophagitis,Helicobacter pylori gastritis,celiac disease,inflammatory bowel disease,colonic heterotopia,and graft versus host disease.CONCLUSION:CLE offers the prospect of targeting biopsies to abnormal mucosa,thereby increasing diagnostic yield,reducing the number of biopsies,decreasing the burden on the histopathological services,and reducing costs.
文摘Liver biopsy is considered the most accurate means to estimate the necroinflammatory activity and the extent of fibrosis. However, histology evaluation is an invasive procedure associated with risk to the patient, risk of sampling error and diagnostic inconsistencies due to inter- and intra-observer error. On the basis of histological studies performed so far, chronic hepatitis C in children appears morphologically benign in the majority of cases. At the Pediatric Liver Unit of our university, a total of 67 children with chronic hepatitis C underwent liver biopsy. Liver biopsy was repeated 5.5 years after the initial histological evaluation in 21 children. On a total number of 88 liver biopsies, micronodular cirrhosis was detected only in one genotype 1b-infected obese child. Since liver histology investigation of a child with chronic hepatitis C has few chances to highlight severe lesions, we question how liver biopsy helps in the management of children with chronic hepatitis C.
文摘TO THE EDITOR
We have read with interest the recent report by E Kayacetin and S Kayacetin of Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy[1] since we diagnosed the duodenal ulcer which penetrated into liver similarly. This is a rather unusual case because of the fifth case in the literature and responding to medical therapy.
