Juvenile and Peutz-Jeghers polyps.
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Biomedical subjects
Publications and source records attributed to N M Gibbs.
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Eight cases of the rare undifferented carcinoma of the large intestine are described. The histological distinction between undifferentiated and poorly differentiated colonic adenocarcinoma and malignant carcinoid is discussed. It is concluded that undifferented carcinoma is a variant of adenocarcinoma which tends to grow to a large size before symptoms are produced but which nevertheless has a good prognosis when locally resectable. Five patients survived between 6 and 28 years, one is well 6 months after operation and two cases where local removal could not be achieved, died within a year.
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Ten cases of mucocele of the vermiform appendix are described. Eight cases were of mucinous cystadenoma of the appendix and six cases showed acute inflammation. Two of the six cases showed pseudoinvasion of the appendix and in a further case the appendix had perforated with extrusion of a misplaced neoplasm. Two cases were of mucinous cystadenocarcinoma and one of these was diagnosed as ;pseudomyxoma peritonei'. ;Pseudomyxoma peritonei' is a misnomer and is caused by dissemination of a mucinous cystadenocarcinoma within the peritoneal cavity. The special problems of histological diagnosis are discussed.
One thousand one hundred and thirty sera from hospital patients under investigation for autoimmune disease were tested for colon mucus antibody and tissue antibodies. The sera with a positive mucus antibody were retested against a panel of test colons of known blood group using IgG, IgA, and IgM antihuman globulin fluorescein isothiocyanate conjugate. It was found that there was a variation between the results obtained with different test colons. This was considered to be due to a system in tissues of mucus isoantigens produced by the goblet cells of the colon. Using this panel of test colons raised the percentage of mucus antibodies detected in cases of ulcerative colitis from 14 to 37%. The presence of the mucus antibody was found to be shortlived in some patients. The colon mucus antibody was also found in thyroid disease and chronic asthma and the reasons for this finding are discussed.
The incidence of argentaffin and Paneth cells in epithelial tumours of the large intestine was investigated. Argentaffin cells were found in adenomatous polyps, villus adenomas, polyposis coli, Peutz-Jehgers' polyps, juvenile polyposis, and adenocarcinomas. Paneth cells were not found in metaplastic or juvenile polyps. The crypt unit was destroyed in neoplasia and argentaffin and Paneth cells occurred either as a result of sequestration or were taking part in the neoplastic process. The crypt unit was retained in the disorders of epithelial growth. The identification of argentaffin and Paneth cells enabled the crypt to be defined and thus provided a useful, practical aid in the differentiation between neoplasms and disorders of epithelial growth.