Moshe B. Goldgraber

Pseudopolyps in ulcerative colitis.

Summary and ConclusionsThe variable appearance of pseudopolyps of the colon in chronic ulcerative colitis has been outlined. A change from one form to another in the life of pseudopolyps is likely to occur.The need for a thorough study of the usual type of adenomas in different portions of the colon at different stages is stressed, for better evaluation of the development of pseudopolyps.A hitherto unreported entity, “localized recurrent giant pseudopolyposis,” has been described.

SPECIFIC DISEASES SIMULATING NONSPECIFIC ULCERATIVE COLITIS (LYMPHOPATHIA VENEREUM, ACUTE VASCULITIS, SCLERODERMA AND SECONDARY AMYLOIDOSIS

Excerpt Nonspecific ulcerative colitis is an acute and chronic disease of the colon, of obscure etiology and pathogenesis.1The diagnosis is established on the basis of clinical symptoms, typical pr...

Disease of the liver in chronic ulcerative colitis

Abstract Parenchymal jaundice ranging in duration from fifteen to sixty days was observed during the evolution of ulcerative colitis in twenty-one of 720 patients (3 per cent). Chronic symptomatic hepatic disease occurred in eighteen of the 720 patients. In fifty autopsies of seventy fatal cases, fatty change was the most frequent hepatic lesion, being found in 50 per cent. Cirrhosis of the liver was found in 12 per cent of the necropsy cases of colitis as compared with 1 per cent each in two control groups. The types of cirrhosis noted were biliary (both obstructive and nonobstructive), portal and postnecrotic. There were two instances of carcinoma of the biliary ducts. It is concluded that the hepatic disease of patients with ulcerative colitis is basically similar to that found in other patients. The true incidence of chronic viral hepatitis probably will not be known until adequate diagnostic methods are available. Biliary cirrhosis was surprisingly frequent.

The Histopathology of Chronic Ulcerative Colitis and its Pathogenic Implications

Summary A group of 124 patients with ulcerative colitis, who had colon surgery, an autopsy, or both, was studied. Review of clinical data and of proctoscopic, roentgenologic, and histopathologic findings revealed frequent lack -of correlation between them. A segment of bowel, although normal grossly by inspection or x-ray examination, may reveal disease when examined microscopically. Ulceration and pseudopolyp formation were the most constant histologic features. Cryptitis could not account for the mechanism of the ulcerative process. Other features observed in a large proportion of cases were granuloma formation, giant cells, and tissue eosinophilia. Their possible relation to the presence of a hyperimmune mechanism in the bowel wall is discussed. Vascular thrombosis, lymphatic dilation, and perivascular infiltrates were present frequently. Similar features are associated with hypersensitive states in the experimental animal. Acute vasculitis was present in only 1 case; it does not seem to play a role in the mechanism of ulceration in ulcerative colitis. Endothelial desquamation, observed in 3 cases, could not account for either thrombosis or ulceration. No information was obtained concerning the role of changes of the homogenous ground substance or of the number and activity of mast cells—both requiring special techniques and special studies. No suggestion could be found in our material of defective cellular regeneration. Adenomas and carcinomas were present in 26 and 19 per cent of the cases, respectively.

Generalized scleroderma associated with chronic ulcerative colitis.

Abstract A case of generalized scleroderma associated with the clinical syndrome of non-specific ulcerative colitis is presented. The diagnosis was difficult to establish clinically and pathologically. The clinical course was characterized by a spectrum of collagen diseases that included systemic lupus erythematosus, rheumatic fever, rheumatoid arthritis, dermatomyositis and scleroderma. The patient received 11,000 units of ACTH, 48,000 mg. of hydrocortisone and 162,000 mg. of cortisone over a period of five years without significantly influencing the relentless course of the disease. The following complications of steroid medication developed: Cushings syndrome and adrenal cortical atrophy, steroid psychosis, peptic ulcer and osteoporotic fractures of the vertebrae and humerus.

Carcinoma of colon complicating ulcerative colitis

Summary and ConclusionsThere were ten additional patients in whom ulcerative colitis was complicated by cancer of the colon. A total of 33 patients with carcinoma of the colon among approximately 1,200 patients with ulcerative colitis have been identified. Seven of the ten are dead. The average age when cancer appeared was 44 years and malignancy was diagnosed after an average duration of ulcerative colitis of 17 years. The distribution of carcinoma was more diffuse throughout the colon in ulcerative colitis than that in the case ofordinary cancer of the large bowel. The neoplasia frequently was multifocal, presented variable histopathologic characteristics, and involved new sites in the colon after removal of the initial tumor. Involvement of lymph nodes was present in most cases, but it did not exclude the possibility of prolonged periods of survival.

Chronic Idiopathic Jaundice: A Case Report

Summary A 23-year-old mestizo from a tropical region of Peru, afflicted from early childhood with the Dubin-Johnson black liver syndrome, is described. The methylene blue test in conjunction with the duodenal drainage is suggested as a diagnostic aid. The pathognomonic appearance of the liver grossly and histologically is emphasized.

The response of esophageal cancer to irradiation: A serial cytologic study of two cases

Summary 1. Two esophageal cancer cases, one of epidermoid and the other of recurrent basal cell carcinoma, were followed by serial esophageal washings and cyt 2. Cellular radioresistance was evident throughout the radiation period. 3. The literature dealing with assessment of prognosis on the basis of cell studies during x-ray treatment was briefly reviewed. 4. Some problems for future studies were outlined.