José Luiz Borges

Restaging of colorectal cancer based on the identification of lymph node micrometastases through immunoperoxidase staining of CEA and cytokeratins.

The present study was performed to identify tumor cells in lymph nodes from colorectal adenocarcinomas considered free of disease by the classic hematoxylin-eosin stain, based on the detection of the carcinoembryonic antigen (CEA) and cytokeratins in neoplastic epithelial cells. For this purpose, 603 lymph nodes from 46 lesions were stained by the peroxidase-antiperoxidase technique. Tumor cells were detected in 22 nodes from 12 patients, mainly in the subcapsular sinuses, permitting a restaging of these patients into two groups: those now considered to have metastatic disease and those free of metastases. However, the 5-year follow-up showed no statistical differences in survival between the two groups.

Laparoscopic treatment of intestinal intussusception in the Peutz-Jeghers syndrome: case report and review of the literature.

The hamartomatous polyps of Peutz-Jeghers Syndrome (PJS) can cause repeated episodes of rectal bleeding and intestinal subocclusion. Laparoscopic treatment of intussusception is rarely reported and must be considered for this clinical condition. We described a 35-year-old male with PJS who presented with rectal bleeding and abdominal pain. One duodenal polyp and two others in the jejunum, which caused intussusception, were visualized on preoperative investigation. Polyps were identified by laparoscopy and removed extracorporeally through enterotomies. All lesions were hamartomas. The patient was discharged on the third postoperative day and has been asymptomatic for more than 2 years. Laparoscopy allows an adequate access to explore and treat small bowel polyps and avoid the classic laparotomy.

7112 Colonoscopic aspects of cytomegalovirus colitis in aids patients.

OBJECTIVES Diarrhea in AIDS patients is one of the most important and disabling symptom, and often decreases their quality of life. Cytomegalovirus colitis is among the principal causes of this sympton, and colonoscopy is the gold standard examination to diagnose it. The objetive of this study is to define the main endoscopic findings in AIDS patients with CMV colitis. PATIENTS AND METHODS On two hundred forty five colonoscopies perfomed in AIDS patients, over a ten year period, sixty two examinationts in fifty one patients diagnosed cytomegalovirus colitis. Full length colonocopy with ileum intubation and multiple biopsies of all segments examined were always attempted. All diagnoses were confirmed by histologic and inmunohistochemical studies. RESULTS Total colonoscopy was possible in 97,5% of these examinations, and ileum intubation was achieved in 87,2% of them. A heterogeneous ulcerative pattern was present in 82% of these cases and in 50% of then only the proximal segments were affected. The cytomegalovirus was also found in one patient with normal mucosa on total endoscopic examination. In 10% of these exams another infectious agent was observed. CONCLUSION We may conclude that full length colonoscopy with ileum intubation and multiple biopsies of all segments, even if they are endoscopically normal, has always to be attempted in all cases of AIDS patients with diarrhea.