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PubMed1976

Fruit pit obstruction. "The propitious pit.".

Ingestion of fruit pit must be a frequent and innocuous phenomenon, judging from the expected frequency of such occurrences and the relative dearth of medical reports to the contrary. Reported here are four cases in which fruit pits of varied nature completed an otherwise incomplete intestinal obstruction. On of these was in the terminal ileum, with incomplete obstruction due to regional ileitis, in which the offending pit was seen radiologically but was not recognized as such. The other three were in the transverse colon, at the site of annular carcinomatous lesions. The completion of the obstruction by the fruit pits eventuated in earlier symptoms, diagnosis, and treatment. In one case, the fruit pits were multiple; in the remainder, they were single.

Aged↗
PubMed1982

A second look at colonoscopy: indications, failures, and costs.

Results of colonoscopy and colonoscopic polypectomy in 599 patients have been reviewed. Added experience has not decreased the number of failures--failure to examine the entire colon, polyps not retrieved for histological examination ("lost polyps"), undetected ("missed") lesions, and false-negative biopsy specimens. The incidence of invasive carcinoma in polyps measuring under 1 cm is less than 1%; polypectomy should be reserved for larger lesions or demonstrated growth of small polyps. Diagnostic colonoscopy in selected patients (those with persistent gross or occult rectal bleeding but normal results from sigmoidoscopic and barium enema studies) demonstrates a causative lesion in greater than 25% and detects a cancer in 5% to 10% of patients.

Biopsy↗
PubMed1985

Squamous cell carcinoma of the cecum.

Squamous cell carcinoma of the cecum above the peritoneal reflection has rarely been reported. The pathogenesis of squamous cell carcinoma of the cecum is speculative. A report of two cases and a review of the literature were undertaken to study the significant pathologic causative mechanism of this disease. A significant causative factor is trauma to the cecal wall followed by chronic irritation. The clinician should be alerted to the fact that operative trauma to the colon followed by chronic irritation or prolonged chronic infection may be one causative factor in squamous cell carcinoma of the colon.

Adult↗
PubMed1989

Experimental liver metastasis. Implications of clonal proclivity and organ specificity.

"Spontaneous" lung metastases develop in over 50% of the animals bearing subcutaneous isografts of WB-2054, a rat colon carcinoma. A metastatic variant has been developed by "Fidler" type in vivo selection, yielding 100% lung metastasis. In a five-week assay to test the organ specificity of this lung metastatic variant, however, "experimental" liver and lung metastases could be induced in 100% and 60% of animals on portal venous and intravenous injections, respectively. The results demonstrate selection of a metastatic variant from heterogeneous primary tumor, and suggest at least two interacting mechanisms: (1) mechanical (the anatomy of the blood-borne metastatic pathways) and (2) biologic (factors intrinsic to primary tumor subpopulations that can be selected for metastatic proclivity). In addition, liver metastases were successfully established from colon tumors induced by cecal wall injection of tumor cells. Such a spontaneous liver metastasis model will be useful to study the specific mechanisms involved during metastasis of colon cancer to the liver.

1,2-Dimethylhydrazine↗
PubMed1992

Racial differences in the anatomical distribution of colon cancer.

The objective of this study was to determine whether racial differences exist with regard to the anatomical distribution of adenocarcinoma of the colon. We conducted a retrospective study of consecutive patients with primary colon cancer seen during a 12-year period (1976 to 1987) identified by the Rush Tumor Registry. The setting was a large, tertiary-care, private medical center, located in the inner city of Chicago, Ill. A chi 2 unpaired Student's t test of association was performed to detect any statistically significant difference in the anatomical sites of distribution between blacks and whites. A statistically significant percentage of black patients had proximally located primary colon lesions compared with white patients. This observation was independent of the actual anatomical definition of right-sided or proximal colon lesions. These findings suggest that a significant percentage of black and white patients are less likely to be diagnosed with colon cancer at a more curable stage, when abiding by the current screening guidelines of the American Cancer Society and the National Cancer Institute. The impact is greater on black patients with adenocarcinoma of the colon.

Adenocarcinoma↗
PubMed1998

Differences in the diagnostic criteria used by Japanese and Western pathologists to diagnose colorectal carcinoma.

BACKGROUND: In view of the many studies of early stage colorectal carcinoma from Japan, it is essential to know whether the criteria for the histologic diagnosis of colorectal carcinoma are similar in Japan and Western countries. METHODS: Eight expert pathologists from Japan (4), North America (2), and Europe (2) individually reviewed microscope slides of 20 colorectal lesions from Japanese patients who had undergone endoscopic mucosal resection or surgery because early stage carcinoma and/or adenoma was suspected. The pathologists indicated the pathologic findings on which they based each diagnosis. RESULTS: For 11 slides that showed adenoma according to the Western pathologists with low grade dysplasia according to at least half of them, the Japanese diagnosed definite carcinoma with or without adenoma in 4 cases and adenoma in 5, and in 2 cases they were equally divided between a diagnosis of adenoma and carcinoma. For five slides showing adenoma with high grade dysplasia according to the Western pathologists, the Japanese diagnosed definite carcinoma with adenoma in three cases and adenoma in one, and in one case they were equally divided between a diagnosis of adenoma and carcinoma. For one case in which the Western pathologists were equally divided between a diagnosis of carcinoma and adenoma with high grade dysplasia, all the Japanese pathologists diagnosed definite carcinoma with or without adenoma. Three slides showed definite carcinoma with or without adenoma, according to both the Western and the Japanese pathologists. The presence of invasion was the most important diagnostic criterion of colorectal carcinoma for the Western pathologists, whereas for the Japanese the nuclear features and glandular structures were more important. CONCLUSIONS: In Japan, colorectal carcinoma is diagnosed on the basis of nuclear and structural criteria, even in cases considered by Western pathologists to be noninvasive lesions with low grade dysplasia. This diagnostic practice may contribute to the relatively high incidence of early stage colorectal carcinoma reported in Japan as compared with Western countries.

Adenoma↗