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Research Interests: Gastroenterology, Medicine, Humans, Liver Cirrhosis, Alcoholism, and 10 moreFemale, Pubmed, Male, Etiology, Aged, Middle Aged, Adult, Cirrhosis, Cholelithiasis, and Cholecystitis
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Research Interests: Adolescent, Medicine, Sarcoidosis, Humans, Intestinal Mucosa, and 7 moreFemale, Pubmed, Male, Lung Diseases, Jejunum, Middle Aged, and Adult
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The authors report a case of primary malignant meningioma of meninges in the right frontal area with metastases to meninges in the right temporal area and left atrial endocardium and with emboli composed of malignant cells in the vessels... more
The authors report a case of primary malignant meningioma of meninges in the right frontal area with metastases to meninges in the right temporal area and left atrial endocardium and with emboli composed of malignant cells in the vessels of the myocardium, spleen, liver, lungs and pancreas in a 49-year-old woman after commissurotomy performed for rheumatic valvular heart disease.
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A woman with Peutz-Jeghers syndrome is reported in whom malignant transformation was found in a polyp of the small intestine. The patient was operated on for occlusion of the small intestine. A tumour of the jejunum was disclosed and... more
A woman with Peutz-Jeghers syndrome is reported in whom malignant transformation was found in a polyp of the small intestine. The patient was operated on for occlusion of the small intestine. A tumour of the jejunum was disclosed and histological examination revealed, besides typical structure of a Peutz-Jeghers polyp, also severe carcinomatous dysplasia with beginning invasion of the submucosa. The modern strategy of management of Peutz-Jeghers polyps is discussed.
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The etiology and pathogenesis of esophageal squamous cell papillomas (ESCP), rare benign tumors of human esophagus, are still controversial. Chronic mucosal irritation and infection with human papillomaviruses (HPV) are two proposed... more
The etiology and pathogenesis of esophageal squamous cell papillomas (ESCP), rare benign tumors of human esophagus, are still controversial. Chronic mucosal irritation and infection with human papillomaviruses (HPV) are two proposed etiologies. To investigate these hypotheses, we screened 29 ESCPs from 28 patients originating from Slovenia and Poland for HPV infection using in situ hybridization (ISH) and polymerase chain reaction (PCR). No evidence of HPV DNA was found using ISH. By PCR, the presence of HPV DNA was detected in only one lesion using two different HPV L1 consensus primer sets. The restriction fragment analyses of PCR product showed patterns unique to HPV type 6. All other ESCPs were successfully amplified only with internal control human beta-globin primers. Our results show that HPV DNA is not frequently detectable in ESCPs, even when highly sensitive methods like PCR are used and that other pathogenetic mechanisms are more important in the etiology of ESCPs.
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This paper is a presentation of the unusual case of a 61-yr-old woman operated on for multiple gastric cancers. Two of the cancers were found in the hyperplastic polyps and one in the adenoma. Apart from cancers that arose from these... more
This paper is a presentation of the unusual case of a 61-yr-old woman operated on for multiple gastric cancers. Two of the cancers were found in the hyperplastic polyps and one in the adenoma. Apart from cancers that arose from these polyps, there were four separate polypoid or flat gastric carcinomas and three other hyperplastic polyps with no signs of malignancy, in this case. The presentation is followed by a detailed discussion focusing on the possible development of carcinoma in gastric hyperplastic polyps in view of the data from the literature.
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ABSTRACT Primary sclerosing cholangitis is a rare, cholestatic liver disease, most commonly affecting young men. The association of primary sclerosing cholangitis with other autoimmune disorders, although rare, indicates a genetic... more
ABSTRACT Primary sclerosing cholangitis is a rare, cholestatic liver disease, most commonly affecting young men. The association of primary sclerosing cholangitis with other autoimmune disorders, although rare, indicates a genetic predisposition for this disease. We describe, for the first time, the association of primary sclerosing cholangitis, ulcerative colitis and coeliac disease in two sisters. Ulcerative colitis was mild and preceded liver disease in both patients. There were no symptoms of coeliac disease, and its silent form was diagnosed on the basis of serological tests. Both patients carried HLA molecules DR3 and DQ2. Although HLA DR4 was not found, there was a rapid progression of liver disease to cirrhosis and cholangiocarcinoma in one patient. The familial occurrence of primary sclerosing cholangitis, ulcerative colitis and coeliac disease supports the hypothesis of genetic predisposition for these diseases.
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Research Interests: Medicine, Humans, Female, Pubmed, Aged, and 4 moreNeurilemmoma, Mediastinum, Mediastinal neoplasms, and Schwannoma
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Research Interests: Adolescent, Medicine, Humans, Intestinal Mucosa, Female, and 7 morePubmed, Male, Aged, Middle Aged, Adult, Small Intestine, and Intestinal diseases
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The formation of carcinoma in the hyperplastic gastric polyp is extremely rare. This paper presents two cases of carcinomas which developed in hyperplastic polyps of the stomach in a 39‐year‐old man and an 82‐year‐old man. The problem of... more
The formation of carcinoma in the hyperplastic gastric polyp is extremely rare. This paper presents two cases of carcinomas which developed in hyperplastic polyps of the stomach in a 39‐year‐old man and an 82‐year‐old man. The problem of malignant transformation of gastric hyperplastic polyps is stressed and discussed in the light of data in the literature.
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Research Interests: Gastroenterology, Medicine, Humans, Pubmed, Male, and 4 moreGiardiasis, Middle Aged, Antibody, and Small Intestine
... of Gastroenterology, Medical Center of Postgraduate Education, Warsaw, Poland (25 blocks). The study spanned a period of 13 years, from 1981 to 1993. ... Eur J Biochem 1986;159:529-34. 13. Baas 10, Mulder JWR, Offerhaus JA, Vogelstein... more
... of Gastroenterology, Medical Center of Postgraduate Education, Warsaw, Poland (25 blocks). The study spanned a period of 13 years, from 1981 to 1993. ... Eur J Biochem 1986;159:529-34. 13. Baas 10, Mulder JWR, Offerhaus JA, Vogelstein B, Hamilton SR. ...
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Serrated polyps of the colorectum are heterogeneous lesions, a subset of which is now regarded as the precursor of colorectal cancer with DNA microsatellite instability. The serrated pathway encompassing hyperplastic aberrant crypt foci,... more
Serrated polyps of the colorectum are heterogeneous lesions, a subset of which is now regarded as the precursor of colorectal cancer with DNA microsatellite instability. The serrated pathway encompassing hyperplastic aberrant crypt foci, hyperplastic polyps, sessile serrated polyps (adenomas), mixed polyps, and traditional serrated adenomas, with a meticulous review of their up-to-date histological classifications, is presented. Some remarks concerning genetics of serrated polyps and the mechanism leading to carcinoma development are also included.
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In western and northern but not southern Europe, the prevalence of coeliac disease among patients with primary biliary cirrhosis (PBC) is higher than in the general population. We analysed the prevalence of coeliac disease among patients... more
In western and northern but not southern Europe, the prevalence of coeliac disease among patients with primary biliary cirrhosis (PBC) is higher than in the general population. We analysed the prevalence of coeliac disease among patients with PBC in Poland, a central European country. In 115 patients with PBC, immunoglobulin A (IgA) antibodies against guinea-pig tissue transglutaminase (tTGA), monkey endomysium (EMA) and gliadin (AGA) were determined. In patients positive for tTGA and/or EMA, the DNA typing of HLA-DQB gene and small-bowel biopsy were performed. IgA EMA was found in one patient with PBC (0.9%, 95% CI 0-2.5%). tTGA was detected in seven patients (6%, 95% CI 1.8-10.3%). Small-bowel biopsy showed flat mucosa in one subject, who was EMA positive/tTGA negative/AGA negative, and normal histology in four tTGA-positive/EMA-negative patients. In the latter four patients, the positive tTGA result was caused by IgA reactivity to proteins other than transglutaminase. Prevalence of coeliac disease in our 115 patients with PBC was 0.9% (95% CI 0-1.9%). In one patient with silent coeliac disease presenting with the HLA-DQ2 allele, introduction of a gluten-free diet was followed by improvement in liver function tests, improvement in histology of the distal duodenum, and disappearance of EMA. Our results from Poland do not confirm a high prevalence of coeliac disease in PBC patients. Guinea-pig liver transglutaminase immunolinked assay cannot be used as a screening test for coeliac disease in PBC patients. A gluten-free diet may be helpful in restoration of liver function in patients with such an association.
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Research Interests: Adolescent, Medicine, Endoscopy, Humans, Pubmed, and 4 moreAged, Middle Aged, Adult, and Colonic Neoplasms
Research Interests: Gastroenterology, Adolescent, Medicine, Humans, Child, and 9 moreFemale, Pubmed, Male, Colonoscopy, Aged, Middle Aged, Adult, Adenoma, and Child preschool
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Research Interests: Adolescent, Medicine, General Surgery, Humans, Child, and 6 moreFemale, Pubmed, Male, Colonoscopy, Colectomy, and Child preschool
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Research Interests: Molecular Biology, Gastroenterology, Biology, Medicine, Gene expression, and 15 moreLevels of selection, Humans, Genetic Testing, Female, Male, Comparative Analysis, Genotype, Dysplasia, Esophagus, Genetic variation, Disease Progression, Boundary Value Problems, Genetic Markers, Gene expression profiling, and Esophagoscopy
A case of giant diffuse filiform polyposis of the entire colon with pathological features of Crohn's disease in a 30-year-old man is presented. The most important aspects and difficulties with differential diagnosis of filiform... more
A case of giant diffuse filiform polyposis of the entire colon with pathological features of Crohn's disease in a 30-year-old man is presented. The most important aspects and difficulties with differential diagnosis of filiform polyposis are discussed.
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Eighty-four colorectal polyps of up to 3.3 cm in diameter were removed with the diathermy snare during 48 colonoscopies on 42 children, aged 2 to 18 years (mean, 7.4 years). Most polyps were juvenile and the majority were located in the... more
Eighty-four colorectal polyps of up to 3.3 cm in diameter were removed with the diathermy snare during 48 colonoscopies on 42 children, aged 2 to 18 years (mean, 7.4 years). Most polyps were juvenile and the majority were located in the sigmoid colon (55%) or rectum (37%). No complications related to medication, colonoscopy, or snare polypectomy were observed. The two presenting symptoms, rectal bleeding and anemia, disappeared soon after polypectomy in all but one patient with adenomatous polyposis coli, subsequently operated upon. Follow-up examinations, including total colonoscopy, performed 4 months to 7 years (mean, 25 months) later did not reveal abnormalities in any of the 37 children whose previously removed polyps were juvenile. The authors conclude that endoscopic snare polypectomy is an effective and safe treatment for colorectal polyps in the pediatric age group.
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Objectives: To compare the malignant potential of hyperplastic polyps and adenomas in relation to different histological classifications and to try to follow the natural history of the BEGP-carcinoma sequence. Methods: During a 13-yr... more
Objectives: To compare the malignant potential of hyperplastic polyps and adenomas in relation to different histological classifications and to try to follow the natural history of the BEGP-carcinoma sequence. Methods: During a 13-yr period (1981-1993), 811 BEGP were discovered in 432 patients in consecutive esophagogastroscopic examinations in our department. Adequate endoscopic biopsies or polypectomy specimens were histologically diagnosed as hyperplastic polyp in 751 (92.6%) and adenoma in 60 (7.4%) of the lesions, according to WHO classification. Hyperplastic lesions were further divided into two subgroups: 268 were polypoid foveolar hyperplasia (FH) and 483 were typical hyperplastic polyps (HP), according to Elster's classification. Special attention was paid to focal malignancy at the first examination or malignant transformation of BEGP during follow-up. Ninety-six patients with 220 BEGP were followed for 1-11 yr, with an average of 2 yr and 8 months. Results: According to Elster's classification, there were 10/483 (2.1%) HP and 6/60 (10.0%) adenomas with focal carcinoma. Moreover, in 19/265 patients (7.1%) with HP and in 4/30 patients (13.3%) with adenomas, carcinoma was found elsewhere in the stomach. During our follow-up, 5/131 HP showed different steps of histological transformation: focal intestinal metaplasia in two, focal dysplasia in one, and focal carcinoma in two of them, which is 1.6%, 0.8%, and 1.6%, respectively. In 1/23 adenomas, focal carcinoma developed after 1 yr of observation (4.3%). Separate gastric carcinomas developed outside polyps during follow-up in 2/58 (3.5%) patients with hyperplastic polyps only. None of those with FH had focal carcinoma either at primary biopsy or during long-term observation. All proportions concerning gradual transformation of hyperplastic polyps classified as only one group according to WHO were lower. Conclusions: In contrast to hitherto existing opinions, our results give support to the idea that gastric HP, like adenomas, are susceptible to malignant transformation. It seems sensible to separate a subgroup of FH from HP, since FH have no malignant potential until they change their histology to HP. The treatment of FH and HP as one group is the main reason why the malignant potential of hyperplastic polyps is still underestimated.
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Research Interests: Medicine, Humans, Female, Pubmed, Male, and 8 moreFollow-up studies, Colonoscopy, Aged, Middle Aged, Adult, Time Factors, Adenoma, and Intraoperative Care
Research Interests: Medicine, Endoscopy, General Surgery, Humans, Pancreas, and 5 moreFemale, Clinical Sciences, Adult, choristoma, and Rectum
The aim of this analysis was to retrospectively review video recordings of malignant polyps... more
The aim of this analysis was to retrospectively review video recordings of malignant polyps <10 mm in search for suspicious macroscopic features in white light endoscopy. Database entries and recordings of screening colonoscopies from a single tertiary referral center between June 2009 and December 2012 were reviewed. Malignant polyps <10 mm were analyzed. The recordings were reviewed by two expert endoscopists in search for suspicious morphological features: irregular contours, central depression, contact bleeding, shape deformity, central depression, chicken skin sign, circumscribed area with abnormal vascular and/or surface pattern. Then, six experienced endoscopists watched the recordings in search of listed features. Next, video recordings of these malignant polyps were mixed with randomly drawn video recordings of 20 non-malignant polyps matched by size and reviewed by 14 blinded endoscopists to assess the sensitivity and specificity for the diagnosis of malignant polyps. Five of the 8651 (0.06%) subjects who underwent screening colonoscopy during the study period were diagnosed with a malignant polyp <10 mm. Only one of them was ad hoc identified by performing endoscopist as suspicious. On recordings review performed by the experts, each of the four remaining polyps presented at least one suspicious macroscopic feature. Presence of these features was confirmed by experienced endoscopists. The sensitivity and specificity for the diagnosis of malignant polyp were 73.21% and 85.35%, respectively, if at least two suspicious macroscopic features defined malignant polyp. On careful white light endoscopy examination small malignant colorectal polyps show suspicious macroscopic features, which were frequently unrecognized by examining endoscopists.
Research Interests: Radiology, Immunohistochemistry, Medicine, Endoscopy, Humans, and 13 moreFemale, Male, Colonoscopy, Clinical Sciences, Neoplasm Invasiveness, Retrospective Studies, Sensitivity and Specificity, Reference Values, Video Recording, Case Control Studies, Cohort Studies, Neoplasm staging, and Colonic Neoplasms
Coloscopy is the most accurate method of evaluation of the whole large bowel. The main indications for this examination are doubtful radiological changes in the colon and unexplained intestinal symptoms, bleeding in the first place.... more
Coloscopy is the most accurate method of evaluation of the whole large bowel. The main indications for this examination are doubtful radiological changes in the colon and unexplained intestinal symptoms, bleeding in the first place. Coloscopy plays also an important role in the differential diagnosis of colitis and in the oncological follow-up of patients after polypectomy or with long-standing ulcerative colitis. The therapeutic use of coloscopy includes removal of polyps and foreign bodies, control of bleeding, and laser photocoagulation of neoplasmatic lesions. Since 1973 in the Department of Gastroenterology of the Postgraduate Medical Center 2360 diagnostic coloscopies were carried out in 1838 patients. The most frequent diagnoses were polyps (34%) and large bowel cancer (12%). Various forms of colitis were diagnosed in 7% of patients, and all other diseases jointly in 11% of cases. In 36% of patients the large bowel showed no changes, in spite of undoubtful indications for coloscopy. Many of these patients were spared explorative laparotomy. By means of diathermic loop 808 colorectal polyps were removed in 421 patients. Rare complications of this procedure were bleedings (1.5%) and peritoneal irritation symptoms without perforation (0.25%). Adeneomas prevailed among polyps. Seventeen patients with invasive cancer in adenoma were treated successfully only endoscopically.
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UNLABELLED Chronic gastritis (CG) was diagnosed in 38 of 130 children with abdominal pain treated between 1980-1982. After eleven years, 20 of the 38 patients with CG were re-examined clinically and gastroscopically. Six gastric biopsies... more
UNLABELLED Chronic gastritis (CG) was diagnosed in 38 of 130 children with abdominal pain treated between 1980-1982. After eleven years, 20 of the 38 patients with CG were re-examined clinically and gastroscopically. Six gastric biopsies for hitopathological examination and two for CLO tests in each patient were taken. In 13 of 20 additional staining for H. pylori was done in the biopsy specimens take 11 years ago. In 95% (19 of 20) patients, CG and H. pylori infection were found. Thirteen of them (all examined) had already been infected with HP in childhood. Gastritis had progressed or remained unchanged in 90% (17 of 19) patients in the corpus and in 75% (15 of 20) in the antrum. All 6 patients who had duodenal ulcers (DU) in childhood had recurrences of DU. Thirty-one percent (4/13) of patients with persisting CG that had no ulcers previously, now had DU or erosions. All 19 patients with CG and HP infection received triple therapy. In 6 of 7 those regression or disappearance of C...