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Endoscopic Biopsy (endoscopic + biopsy)
Selected AbstractsTreatment of an osteoblastic osteosarcoma in an aged geldingEQUINE VETERINARY EDUCATION, Issue 4 2010T. Springer Summary A 27-year-old Thoroughbred gelding was examined for a right nasal mass visible inside the right nares. Airflow through the right nostril was absent. Endoscopy and radiography revealed the mass to occupy the entire right nasal passage. Nasal biopsies were inconclusive, so en bloc resection was performed. A diagnosis of an incompletely resected osteoblastic osteosarcoma was made. Endoscopic biopsies performed 4 weeks post surgery revealed osteosarcoma cells present in the caudal right nasal cavity. Metastatic disease was not present in mandibular lymph node aspirates or on thoracic radiographs. The right nasal passage was irradiated with 12 treatments over the course of 4 weeks. Comfort and quality of life were excellent during treatment and no adverse side effects were noted. Endoscopy and follow-up biopsies at 1, 2, 4, 12 and 14 months post radiation therapy have not found any evidence of regrowth of the osteosarcoma. [source] Fundal gastritis as a potential cause of reflux oesophagitisDISEASES OF THE ESOPHAGUS, Issue 1 2000M. Newton The transient lower oesophageal sphincter relaxations which allow reflux may be due to altered afferent pathways from the fundus. We aimed to determine whether fundal inflammation is the underlying cause. Two endoscopic biopsies were taken from each of the gastric antrum and fundus in 25 asymptomatic controls with a normal endoscopy (median age 54 range 13,83 years), and 33 patients with erosive oesophagitis (median age 52, 11,78 years). No patient had taken acid suppression therapy or antibiotics for at least 1 month. Sections were stained with haematoxylin and eosin and Giemsa stain and examined in a blinded fashion by one pathologist for the presence of gastritis (Sydney classification) and Helicobacter pylori. Chronic gastritis was common in both groups, but was usually mild. In Helicobacter pylori -negative subjects, there was significantly less chronic gastritis in the antrum and the fundus in oesophagitis patients than in controls (p < 0.05). When present, gastric atrophy was usually antral and mild in severity. There was no difference in the incidence of gastric atrophy in patients with oesophagitis compared with controls (24% compared with 40%; p > 0.05). Chronic gastritis is not more common in patients with oesophagitis, and is unlikely to play a part in the pathogenesis of this disease. [source] Oro-facial granulomatosis: Crohn's disease or a new inflammatory bowel disease?INFLAMMATORY BOWEL DISEASES, Issue 9 2005FRCP, Jeremy Sanderson MD Abstract Background: Oro-facial granulomatosis (OFG) is a rare chronic inflammatory disorder presenting characteristically with lip swelling but also affecting gingivae, buccal mucosa, floor of mouth, and a number of other sites in the oral cavity. Histologically, OFG resembles Crohn's disease (CD), and a number of patients with CD have oral involvement identical to OFG. However, the exact relationship between OFG and CD remains unknown. Methods: Thirty-five patients with OFG and no gut symptoms were identified from a combined oral medicine/gastroenterology clinic. All underwent a standardized assessment of the oral cavity and oral mucosal biopsy to characterize the number of sites affected and the type of inflammation involved. Hematological and biochemical parameters were also recorded. All 35 patients underwent ileocolonoscopy and biopsy to assess the presence of coexistent intestinal inflammation. Results: Ileal or colonic abnormalities were detected in 19/35 (54%) cases. From gut biopsies, granulomas were present in 13/19 cases (64%). An intestinal abnormality was significantly more likely if the age of OFG onset was less than 30 years (P = 0.01). Those with more severe oral inflammation were also more likely to have intestinal inflammation (P = 0.025), and there was also a correlation between the histologic severity of oral inflammation and the histologic severity of gut inflammation (P = 0.047). No relationship was found between any blood parameter and intestinal involvement. Conclusions: Endoscopic and histologic intestinal abnormalities are common in patients with OFG with no gastrointestinal symptoms. Younger patients with OFG are more likely to have concomitant intestinal involvement. In these patients, granulomas are more frequent in endoscopic biopsies than reported in patients with documented CD. OFG with associated intestinal inflammation may represent a separate entity in which granulomatous inflammation occurs throughout the gastrointestinal tract in response to an unknown antigen or antigens. [source] Increasing cyclooxygenase-2 (cox-2) gene expression in the progression of Barrett's esophagus to adenocarcinoma correlates with that of Bcl-2INTERNATIONAL JOURNAL OF CANCER, Issue 4 2006Daisuke Shimizu Abstract Previous studies from our laboratory and others have suggested that increased expression of cox-2 is important in the genesis of esophageal adenocarcinoma. In vitro studies suggest that cox-2 regulates expression of the anti-apoptotic protein bcl-2, thus possibly accounting for reduced apoptosis in carcinogenesis. The aim of this study was to investigate the relationship of these 2 genes in the development of Barrett's-associated adenocarcinoma. Histologic sections from endoscopic biopsies or esophagectomy specimens were classified as non-dysplastic Barrett's (n = 30), intraepithelial neoplasia (n = 12) and adenocarcinoma (n = 48). The desired tissue was isolated by laser capture microdissection and expression levels of cox-2 and bcl-2 were measured by quantitative real-time PCR (Taqman®). Gene expression levels were compared to samples of the distal esophageal squamous epithelium (n = 55) and reflux-esophagitis (n = 25), without Barrett's or cancer. Expression of both bcl-2 and cox-2 were increased in non-dysplastic Barrett's (p = 0.0077, p = 0.0037), intraepithelial neoplasia (p = 0.0053, p = 0.0220) and adenocarcinoma (p < 0.0001, p < 0.0001) compared to squamous epithelium or reflux-esophagitis. Furthermore, there is a significant correlation between these two genes, especially in carcinoma (p < 0.0001). © 2006 Wiley-Liss, Inc. [source] Epidermal growth factor receptor mutations in needle biopsy/aspiration samples predict response to gefitinib therapy and survival of patients with advanced nonsmall cell lung cancerINTERNATIONAL JOURNAL OF CANCER, Issue 4 2006Jin-Yuan Shih Abstract Recently, mutations in the epidermal growth factor receptor (EGFR) gene in nonsmall cell lung cancer (NSCLC) patients were reported to correlate with gefitinib response. Less than 30% of NSCLC patients are surgically resectable; however, molecular analysis has to rely on nonsurgical diagnostic tissue samples. The objective of this study is to investigate EGFR mutation analysis on needle biopsy/aspiration samples and its correlations with gefitinib response and patients' survival. EGFR mutation was assessed from DNA of 63 paraffin-embedded small needle biopsy/aspiration specimens from 62 patients with NSCLC treated with gefitinib. The peripheral blood lymphocyte DNA of the patients was sequenced to verify the EGFR mutation. EGFR mutations were found in 47% of 62 patients (60% of 20 CT-guided biopsies, 44% of 18 ultrasound-guided biopsies, 31% of 16 endoscopic biopsies and 44% of 9 effusion cell blocks). EGFR mutations were frequently present in females (p = 0.006) and never smokers (p = 0.04). Patients with EGFR mutations had a significantly better response rate compared to that of the nonmutation group (p < 0.001). Multivariate analysis showed that EGFR mutation (p < 0.001) and PS 0,1 (p = 0.02) were independently associated with a better response rate. Cox regression analysis showed that EGFR mutation was the independent prognostic factor for progression-free survival (p = 0.008) and overall survival (p = 0.03). In conclusion, EGFR mutation analysis is feasible in needle biopsy/aspiration paraffin-fixed specimens. EGFR mutation is an independent predictor of gefitinib response and survival in patients of advanced NSCLC treated by gefitinib. © 2005 Wiley-Liss, Inc. [source] Detection of Chlamydia pneumoniae by polymerase chain reaction,enzyme immunoassay in intestinal mucosal biopsies from patients with inflammatory bowel disease and controlsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2002Wangxue Chen Abstract Background and Aim : It has been suggested that Chlamydia is an organism that may have the potential to cause inflammatory bowel disease (IBD) in susceptible individuals. Chlamydia pneumoniae has emerged as an important human pathogen in the last decade. The objective of the present study was to investigate the frequency of the presence of C. pneumoniae DNA in intestinal biopsies from patients with IBD and from non-IBD controls. Methods : The DNA was extracted from 222 colonoscopic biopsies, which were obtained from 11 patients with Crohn's disease (CD), 18 patients with ulcerative colitis (UC) and from 37 non-IBD control patients. The presence of the C. pneumoniae omp1 gene and C. trachomatis 16S rRNA gene was determined using a rapid and sensitive polymerase chain reaction-enzyme immunoassay (PCR-EIA). Results : The C. pneumoniae -specific DNA was detected in 32 (14.4%) of 222 endoscopic biopsies. Among them, C. pneumoniae DNA were found in nine of 42 (21.4%) biopsies from patients with CD, nine of 59 (15.3%) biopsies from patients with UC, and 14 out of 122 (11.4%) biopsies from non-IBD control patients, respectively. Moreover, the percentage of patients with at least one biopsy positive for C. pneumoniae was higher, although not statistically significant, in CD (36.4%) and UC patients (38.9%) compared to non-IBD controls (16.2%). In contrast, C. trachomatis DNA was detected in only two of 222 (0.9%) biopsy samples. Conclusion : The C. pneumoniae DNA was detected in the intestine of both patients with IBD and in non-IBD control patients, probably reflecting the high prevalence of this organism in the environment. The moderate yield of positive biopsies in our IBD patients and the fact that the detection rate of C. pneumoniae DNA was similar in endoscopic biopsies from IBD patients and non-IBD controls does not support a direct role for this organism in the pathogenesis of IBD. © 2002 Blackwell Publishing Asia Pty Ltd [source] Antiplatelet agents and bleeding time after endoscopic biopsy of the gastric antrum in Japanese patientsDIGESTIVE ENDOSCOPY, Issue 3 2010Takatsugu Yamamoto No abstract is available for this article. [source] Endoscopically managed superficial carcinoma overlying esophageal lipomaDIGESTIVE ENDOSCOPY, Issue 1 2004Shinsuke Usui The occurrence of superficial carcinoma over a benign tumor of the esophagus is considered to be rare. Only a few reports have been reported and all of them were treated surgically. We now report one case of superficial carcinoma overlying an esophageal lipoma that was successfully resected endoscopically. The patient was a 61-year-old man who had no symptoms. A submucosal tumor was found at the thoracic esophagus by upper gastrointestinal endoscopy. The top of the tumor was slightly depressed with mild redness and its surface was irregular. This depressed lesion was not stained by iodine. Histological examination of endoscopic biopsy revealed squamous cell carcinoma. To completely remove this tumor in a single fragment, we used an insulation-tipped electrosurgical knife. An en bloc resection of the tumor was completed without complications. [source] Colonic perforation after endoscopic biopsy of a submucosal tumor: successful conservative treatmentDIGESTIVE ENDOSCOPY, Issue 4 2002Kuang-I. Colonoscopy is a powerful diagnostic and therapeutic procedure with a recognized risk of complications ranging from perforation to hemorrhage and septicemia. Perhaps the most dangerous complication associated with this procedure is bowel perforation. Although some colonic perforations can be treated medically, prompt surgery is generally preferred to minimize morbidity and mortality. We present a case of colonic perforation resulting from bite biopsy followed by mucosal resection of a submucosal tumor. Perforation occurred in a delayed manner despite prophylactic closure of the mucosal defect by the replacement of endoclips. The patient recovered spontaneously after antibiotic treatment and reduction of oral intake. We carried out successful conservative medical treatment of a minor iatrogenically induced bowel perforation without operation. [source] Helicobacter Pylori and Precancerous Gastric LesionsDIGESTIVE ENDOSCOPY, Issue 3 2000Pham Quang Cu Background: To determine the relationship between Helicobacter pylori (H. pylori) infection and the precancerous gastric lesions: atrophic gastritis (AG) and intestinal metaplasia (IM) and dysplasia. Methods: A total of 347 dyspeptic patients, including 141 H. pylori -positive patients and 206 H. pylori -negative patients, were studied alongside age- and sex-matched controls. The patients underwent gastroscopy and endoscopic biopsy for detection of H. pylori, and histological examinations. Helicobacter pylori was detected by a urease test (CLO; Delta West; Bentley, Australia), by histology (H&E stain, Giemsa) and by serology (BioSig; BioMeditech, NJ, USA). Atrophic gastritis, IM and dysplasia were detected by histological examination (Giemsa, H&E stain). Results: There is a higher rate of atrophic gastritis in H. pylori -positive than in H. pylori -negative patients (46 vs 13.5%, odds ratio (OR) = 5.4; P < 0.01). Gastritis in H. pylori -positive patients also has a higher rate of activity than in H. pylori -negative patients. The rate of IM is higher in H. pylori -positive patients than in H. pylori -negative patients (35 vs 11%; OR = 4.3; P < 0.01). Metaplasia is more often diffuse in H. pylori -positive than in H. pylori -negative patients. Dysplasia is more common in H. pylori -positive than in H. pylori -negative patients (12 and 3.8%; OR = 3.3; P < 0.01). Conclusions: This study supports the suggestion of a relationship between H. pylori infection and precancerous gastric lesions. Wherever H. pylori is present, the precancerous lesions are more common and more severe. [source] Long-term outcome of endoscopic biopsy and subsequent nephroureterectomy for upper urinary tract tumorINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2001Shigeru Minowada Abstract Background: Upper urinary tract tumors can be biopsied using a flexible ureterorenoscope. This study examined retrospectively possible adverse effects of this procedure on patient outcome. Methods: The study subjects consisted of 16 consecutive patients with renal pelvic tumor (n = 13) and upper ureteral tumor (n = 3). All subjects underwent endoscopic biopsy of their tumor and subsequent total nephroureterectomy between 1989 and 1995. The follow-up period ranged from 4.1 to 9.5 (mean 5.2) years. Results: The overall 5-year survival rate was 87.0%, being 100% in 12 patients with tumors of grade 1 or 2. In contrast, of four patients with grade 3 tumor, three (75%) developed systemic lymphogenous and/or multiple lung metastases within 1 year postoperatively. Conclusions: The excellent patient outcomes deny any adverse effect of endoscopic biopsy on patients with grade 1 or 2 tumor. However, the endoscopic procedure should be performed prudently when a high grade tumor is suspected. [source] Endoscopic investigation of the internal organs of a 15th-century child mummy from Yangju, KoreaJOURNAL OF ANATOMY, Issue 5 2006Seok Bae Kim Abstract Our previous reports on medieval mummies in Korea have provided information on their preservation status. Because invasive techniques cannot easily be applied when investigating such mummies, the need for non-invasive techniques incurring minimal damage has increased among researchers. Therefore, we wished to confirm whether endoscopy, which has been used in non-invasive and minimally invasive studies of mummies around the world, is an effective tool for study of Korean mummies as well. In conducting an endoscopic investigation on a 15th-century child mummy, we found that well-preserved internal organs remained within the thoracic, abdominal and cranial cavities. The internal organs , including the brain, spinal cord, lung, muscles, liver, heart, intestine, diaphragm and mesentery , were easily investigated by endoscopy. Even the stool of the mummy, which accidentally leaked into the abdominal cavity during an endoscopic biopsy, was clearly observed. In addition, unusual nodules were found on the surface of the intestines and liver. Our current study therefore showed that endoscopic observation could provide an invaluable tool for the palaeo-pathological study of Korean mummies. This technique will continue to be used in the study of medieval mummy cases in the future. [source] Predictors for squamous re-epithelialization of Barrett's esophagus after endoscopic biopsyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 6 2007Yuji Amano Abstract Background and Aim:, Acid suppressive therapy has been reported to regress Barrett's esophagus. However, it is still controversial as to whether all Barrett's esophagus patients respond to this therapy. The factors that might facilitate newly developed squamous re-epithelialization after biopsy excision of Barrett's mucosa were evaluated to identity individuals who may favorably respond to the regression therapy. Methods:, Two hundred and forty-seven biopsy sites from 185 patients with Barrett's esophagus were examined by endoscopy to investigate possible squamous re-epithelialization of Barrett's mucosa after endoscopic biopsy. Before endoscopic examination, all participants were requested to answer questionnaires concerning sociodemographic characteristics, lifestyle habits and drugs usage. The mucin phenotype, Cdx2 expression, cyclooxygenase-2 expression, cellular proliferation and apoptosis of Barrett's mucosa were immunohistochemically investigated in the biopsy samples taken from Barrett's esophagus. The influence of these factors on the newly developed squamous re-epithelialization of Barrett's mucosa after endoscopic biopsy excision was evaluated. Results:, By multivariate analysis, the independent factors that favored squamous re-epithelialization were the gastric mucin predominant phenotype of Barrett's mucosa and the absence of Cdx2 protein expression. In Barrett's mucosa with the gastric predominant mucin phenotype, proton pump inhibitor administration, the absence of reflux esophagitis and a low proliferating cell nuclear antigen index were found to be independent predictors for squamous re-epithelialization. Conclusions:, The absence of the intestinal predominant mucin phenotype was a positive predictor for newly developed squamous re-epithelialization at the site of biopsy of Barrett's mucosa. Only Barrett's esophagus with the gastric predominant mucin phenotype may predict a favorable response to acid suppressive therapy. [source] Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and CatsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010M.D. Willard Background: Prior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions. Hypothesis: Use of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia. Animals: Tissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries. Methods: Retrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2- and 4-point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while , statistics determined agreement between pathologists on histologic lesions. Results: There was poor agreement (,=,0.013 to 0.3) between pathologists, and institution of origin of slides had effect (,= 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4-point grading scale increased agreement between pathologists (maximum ,= 0.69 using 4-point scale versus maximum ,= 1.0 using 2-point scale). Significant association (P= .019, .04; 95% OR = 3.14,10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists. Conclusions and Clinical Importance: Substantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists. [source] Strongyloides Stercoralis Hyperinfection Transmitted by Liver Allograft in a Transplant RecipientAMERICAN JOURNAL OF TRANSPLANTATION, Issue 11 2009M. J. Rodriguez-Hernandez We describe a case of Strongyloides stercoralis hyperinfection in a liver allograft recipient 2.5 months after transplantation. The patient lives in Spain, which is not considered an endemic country for strongyloidiasis, and denied prior residence or travel to any known endemic area. The initial symptoms were fever and vomiting, and he subsequently developed a severe respiratory disease. An endoscopic biopsy of ulcerative lesions of the duodenum revealed massive mucosa infiltration by larvae and adult worms, which were also found in respiratory samples. The patient was successfully treated with combined therapy with albendazole and ivermectin. The strongyloides infection was transmitted by the liver allograft. The donor was from Ecuador and, retrospectively, his serum tested positive for S. stercoralis IgG antibodies. Additionally, the pancreas,left kidney allograft recipient from the same donor later developed an intestinal strongyloidiasis without hyperinfection syndrome. To our knowledge, this is the first confirmed case of S. stercoralis infection transmission from the same donor to two solid allograft recipients. [source] Awareness of glucose-6 phosphate-dehydrogenase deficiency in celiac diseaseACTA PAEDIATRICA, Issue 5 2010FO Hosnut Abstract Individuals with celiac disease (CD) are predisposed to a number of haematological abnormalities including anaemia secondary to malabsorption of iron, vitamin B12 or folate; anaemia of chronic disease and coagulopathy secondary to vitamin K deficiency. Correction of coagulopathy with vitamin K is necessary before endoscopic biopsy in patients with suspected CD. However, vitamin K causes haemolysis in glucose-6 phosphate-dehydrogenase deficiency. Conclusion:, When vitamin K administration becomes necessary for correction of coagulopathy in patients with CD; glucose-6 phosphate-dehydrogenase deficiency should be considered. [source] The immune recognition of gluten in coeliac diseaseCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2005R. Ciccocioppo Summary Coeliac disease, the most common intestinal disorder of western populations, is an autoimmune enteropathy caused by an abnormal immune response to dietary gluten peptides that occurs in genetically susceptible individuals carrying the HLA-DQ2 or -DQ8 haplotype. Despite the recent progresses in understanding the molecular mechanisms of mucosal lesions, it remains unknown how increased amounts of gluten peptides can enter the intestinal mucosa to initiate the inflammatory cascade. Current knowledge indicates that different gluten peptides are involved in the disease process in a different manner, some fragments being ,toxic' and others ,immunogenic'. Those defined as ,toxic' are able to induce mucosal damage either when added in culture to duodenal endoscopic biopsy or when administered in vivo, while those defined as ,immunogenic' are able to specifically stimulate HLA-DQ2- or DQ8-restricted T cell clones isolated from jejunal mucosa or peripheral blood of coeliac patients. These peptides are able to trigger two immunological pathways: one is thought to be a rapid effect on the epithelium that involves the innate immune response and the other represents the adaptive immune response involving CD4+ T cells in the lamina propria that recognize gluten epitopes processed and presented by antigen presenting cells. These findings are the subject of the present review. [source] | ||||||||||