PubMed · 7971630
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L Kreel, D Scullion. 1994. Triple pathology.. https://doi.org/10.1136/pgmj.70.827.646
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Second only to lung cancer in mortality, colon cancer is amenable to cure if detected early. Because fecal occult blood testing and flexible sigmoidoscopy are effective individually but have limitations, both are now recommended for screening. However, after successful polyp removal, surveillance colonoscopy does not need to be performed as often as previously thought.
The controversy surrounding the value of performing screening barium enema in patients with inguinal hernia persists. It was Myers & Zollinger who, in 1942, reviewed 200 consecutive cases of inguinal hernia and noted that 18%; of patients complained of gastrointestinal symptoms. Of these, two cases of adenocarcinoma were discovered on further evaluation. Subsequently, many authors have reported a low diagnostic yield of barium enema in patients with inguinal hernia unless specific colonic symptoms were present. We present a case in which this investigation was indicated, but led to irreducibility.
Villous adenoma of the ampulla of Vater is a rare but distinct pathologic entity. We studied seven brush cytology specimens from four patients with this unusual lesion all of whom had surgical pathologic confirmation and clinical follow-up. The distinguishing cytologic appearance includes the presence of slender, elongate columnar cells arranged singly or in small sheets and clusters. Long, thin, basally oriented nuclei occupy about one third of the cell and have fine, granular chromatin with one or more nucleoli. Although brushings of villous adenoma of the ampullary region may reveal a relatively benign but distinctive morphologic pattern, the aggressive nature of these lesions has been well documented, including those in our patients.