Gall Bladder Polyps : A Paradigm Shift – Need for Reappraisal of Guidelines

Background : Gall Bladder Polyps are mucosal lesions that project from the Gall Bladder wall into the Gallbladder lumen. They form morphologically distinct lesion/s with internal characteristics different than that of neighboring structures as verified by microscopic examination. About 4-6% are picked up clinically, 2-12% in Cholecystectomy specimens and 4% on Ultrasound. Materias and Methods : A three calendar year retrospective single surgical unit study compromised of 1442 cholecystectomies performed for benign Gall Bladder Disease. The patient were subjected to Ultrasound of abdomen for diagnosis and routine clinic work up. The Gall Bladders Harboring Polyps were examined grossly for site ,number, and microscopy for histological details. Results : In a total number of 40 cases of Gall Bladder Polyp, females outnumbered males. This series spreads over age groups of 3rd decade - 9th decade, most of the patients were seen in 6th decade of life. Youngest patients were 27 years old and oldest one was 85 years old. Incidentally, none of the old patients had evidence of malignancy on histopathology in their Gall Badder Polyp, only 2% were necessitated for a pre-operative diagnosis of Gall Bladder Polyps alone. Rest required it for presence of Gallstones with or without Polyp. None of >10mm size showed any malignant change on histopathological examination. On the Contrary, among the polypoid lesions <10mm size, one polypid lesion (7mm) showed a malignant change (Carcinoma in situ) Conclusion : A predictive model for neoplastic potential of Gall Bladder Polyp may support clinical decision to achieve an ideal therapeutic outcome. Hence a need for reappraisal of management guidelines.

Caracterización clínico-histológica de pacientes con cáncer esofágico del Hospital Nacional "Guido Valadares", Timor Oriental

RESUMEN Introducción: El cáncer de esófago es una enfermedad descrita desde hace 2 000 años y en la actualidad ocupa el octavo lugar en incidencia a nivel mundial. Objetivo: Describir las características clínico-histológicas de los pacientes con cáncer esofágico del Hospital Nacional "Guido Valadares" de Timor Oriental. Método: Se realizó un estudio observacional-descriptivo y retrospectivo en 106 personas con diagnóstico endoscópico e histológico de cánceres esofágicos atendidos en la Unidad de Endoscopia del servicio de Gastroenterología de dicha institución, desde junio de 2016 hasta mayo de 2021. Se analizaron variables como: grupo etario, sexo y otros factores de riesgo (manifestaciones clínicas, tiempo de comienzo de los síntomas, localización, tipo endoscópico y tipo histológico). Resultados: El cáncer de esófago fue más frecuente en hombres de 60 y más años de edad (65,1 %). El tabaquismo y la ingestión de alcohol fueron los factores de riesgo predominantes con el 64,2 % y 57,5 %, respectivamente. La mayoría de los casos se diagnosticaron entre los 3 y 6 meses del inicio de los síntomas, la disfagia el principal motivo de consulta (98,1 %). Desde el punto de vista endoscópico predominó el tipo polipoide o vegetante localizados en el tercio medio esofágico (45,3 %), constituyendo el carcinoma de células escamosas el tipo histológico más frecuente. Conclusiones: El estudio de las características clínico-histológicas de los pacientes con cáncer esofágico permite un adecuado enfoque diagnóstico de esta enfermedad, así como el desarrollo de acciones de salud preventivas sobre los principales factores de riesgo identificados.

ABSTRACT Introduction: Esophageal cancer is a leading cause of cancer-related illness that has been described for two thousand years and currently set at the eighth place in incidence worldwide. Objective: To describe the clinical-histological features in patients with esophageal cancer at the Guido Valadares National Hospital in Timor-Leste. Method: An observational-descriptive and retrospective study was conducted in 106 patients with esophageal cancer related endoscopic and histological diagnosis. All of them attended in the Endoscopy Unit at the Gastroenterology service, from June 2016 to May 2021. Variables such as age group, sex and other risk factors like (clinical manifestations, the onset of symptom, location, endoscopic type and histological type) were analyzed. Results: Esophageal cancer was more frequent in male aged 60 and older (65.1%). Smoking and alcohol intake were the predominant risk factors (64.2% and 57.5%, respectively). Most of cases were diagnosed between 3 and 6 months after the onset of symptoms, with dysphagia as the main reason for consultation (98.1%). From the endoscopic point of view, polypoid mass or vegetating lesions found in the middle third of the esophagus predominated (45.3%), with squamous cell carcinoma as the most frequent histological type. Conclusions: Study of clinical-histological features in patients with esophageal cancer allows an adequate diagnostic approach to this illness, as well as the development of preventive health actions on the main risk factors identified.

RESUMO Introdução: O câncer de esôfago é uma doença descrita há 2.000 anos e atualmente ocupa o oitavo lugar em incidência mundial. Objetivo: Descrever as características clínico-histológicas dos pacientes com câncer de esôfago no Hospital Nacional "Guido Valadares" em Timor Leste. Método: Foi realizado um estudo observacional-descritivo e retrospectivo em 106 pessoas com diagnóstico endoscópico e histológico de câncer de esôfago atendidas na Unidade de Endoscopia do serviço de Gastroenterologia da referida instituição, no período de junho de 2016 a maio de 2021. Variáveis como: foram analisadas: faixa etária, sexo e outros fatores de risco (manifestações clínicas, tempo de início dos sintomas, localização, tipo endoscópico e tipo histológico). Resultados: O câncer de esôfago foi mais frequente em homens com 60 anos ou mais (65,1%). O tabagismo e o consumo de álcool foram os fatores de risco predominantes com 64,2% e 57,5%, respectivamente. A maioria dos casos foi diagnosticada entre 3 e 6 meses do início dos sintomas, sendo a disfagia o principal motivo de consulta (98,1%). Do ponto de vista endoscópico, predominou o tipo polipóide ou vegetativo localizado no terço médio do esôfago (45,3%), sendo o carcinoma espinocelular o tipo histológico mais frequente. Conclusões: O estudo das características clínico-histológicas de pacientes com câncer de esôfago permite uma adequada abordagem diagnóstica desta doença, bem como o desenvolvimento de ações preventivas de saúde sobre os principais fatores de risco identificados.

Differential diagnosis of gallbladder polypoid lesions by micro-flow imaging / 南方医科大学学报

OBJECTIVE@#To explore the value of micro-flow imaging (MFI) in evaluating blood flow characteristics and differential diagnosis of gallbladder polypoid lesions.@*METHODS@#We retrospectively analyzed the clinical data and ultrasound images of 73 patients with gallbladder polypoid lesions, including 24 patients with pathologically confirmed neoplastic polyps (n=24) and 49 with non-neoplastic polyps (n=49). All the patients underwent conventional ultrasound, MFI and contrast enhanced ultrasound (CEUS) before cholecystectomy. The blood flow characteristics of the lesions in color Doppler flow imaging (CDFI) and MFI were compared, and the consistency of the findings by these two modalities with those of CEUS were evaluated by weighted Kappa consistency test. The diagnostic performance of MFI for gallbladder polypoid lesions was assessed.@*RESULTS@#There were significant differences between MFI and CDFI in the evaluation of blood flow characteristics of gallbladder polypoid lesions (χ2=37.684, P < 0.001). MFI showed better performance than CDFI in displaying the blood flow characteristics of the polyps. The consistency in the findings was 0.118 between CDFI and CEUS and 0.816 between MFI and CEUS. The sensitivity, specificity and accuracy of MFI in distinguishing neoplastic polyps from non-neoplastic polyps were 75.00%, 93.88% and 87.67%, respectively.@*CONCLUSION@#MFI has a good consistency with CEUS in displaying the blood flow characteristics of gallbladder polypoid lesions and can accurately distinguish neoplastic polyps from non-neoplastic polyps, thus providing new ultrasound diagnostic evidence to support clinical decisions on optimal treatments of gallbladder polypoid lesions.

Comparison of Ranibizumab and Conbercept combined with photodynamic therapy in the treatment of polypoid choroidal vascular disease / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effects of ranibizumab and conbercept combined with photodynamic therapy(PDT)on vision and hemorheology of polypoid choroidal vascular(PCV)lesions. <p>METHODS: Prospective research. A total of 120(120 eyes)PCV patients who were admitted to our hospital from 2017-02/2020-06 were enrolled and divided into 61 cases(61 eyes)in the ranibizumab combined with PDT treatment group according to the random number table. Conbercept combined with PDT treatment group of 59 patients(59 eyes), compared the intraocular pressure, best corrected visual acuity(BCVA), central retinal thickness(CRT), blood flow, and the incidence of complications within 3mo of follow-up between the two groups before and after treatment.<p>RESULTS: There was no difference in intraocular pressure, CRT, and BCVA at 1 and 3mo after treatment between the two groups(all <i>P</i>>0.05). The whole blood high shear viscosity and whole blood of the ranibizumab combined with PDT treatment group were 1 and 3mo after treatment. The low-shear viscosity was lower than the conbercept combined with PDT treatment group(all <i>P</i><0.05). At the same time, the complication rate in the ranibizumab combined with PDT treatment group during the follow-up period of 3mo was lower than that in the conbercept combined with PDT treatment group(3.3% <i>vs</i> 16.9%, <i>P</i><0.05). <p>CONCLUSION: The treatment of ranibizumab combined with PDT for patients with PCV disease is more conducive to hemorheological stability and reduces the incidence of complications.

MRI and Transvaginal Ultrasound Findings of Atypical Polypoid Adenomyoma: A Case Report / 中国医学科学杂志(英文版)

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.

Endometriosis polipoide: una variante de la endometriosis / Polypoid endometriosis: A variant of endometriosis

Resumen: ANTECEDENTES: La endometriosis polipoide describe una variante poco común de la endometriosis, con características histológicas que simulan un pólipo endometrial y posibilidad de transformación maligna. CASO CLÍNICO: Paciente de 46 años, acudió a consulta por dolor abdominal y sangrado uterino anormal. Los estudios de imagen revelaron una masa heterogénea de forma irregular, adyacente al ovario. Los análisis de sangre reportaron concentraciones elevadas de Ca-125 (75.2 U/mL). El tratamiento consistió en resección quirúrgica mediante laparotomía. El reporte de histopatología fue: endometriosis polipoide. Actualmente la paciente permanece en vigilancia médica, sin recidiva de la enfermedad. CONCLUSIONES: La endometriosis polipoide es una variante poco común de la endometriosis, con posibilidad de evolución maligna. Es importante conocer la enfermedad, con la finalidad de ofrecer el tratamiento adecuado.

Abstract: BACKGROUND: Polypoid endometriosis was first introduced in 1980. It was used to describe an uncommon variant of endometriosis with histological features simulating an endometrial polyp and may be at risk of malignant transformation. CLINICAL CASE: A 46-year-old female presented with lower abdominal pain and Abnormal uterine bleeding. Image studies revealed an irregular shaped, heterogeneous mass adjacent to the ovary. Blood tests showed an elevated CA-125 value (75.2 U/ml). Resection of the mass was performed by laparotomy and the definitive study of histopathology revealed polypoid endometriosis. Currently the patient continues in surveillance without disease recurrence. CONCLUSIONS: Polypoid endometriosis is an uncommon variant of endometriosis, with the possibility of malignant evolution. This rare form of disease should be known, in order to provide adequate treatment for the patient.

Comparison of the efficacy of two Conbercept regimens in the treatment of polypoid choroidal angiopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the efficacy of two conbercept regimens in the treatment of polypoid choroidal angiopathy.<p>METHODS: Twenty-one patients with polypoidal choroidal vasculopathy who met the inclusion criteria and were treated in our hospital were randomly divided into two groups. The group A(9 patients and 9 eyes)was treated with 3+Q12W scheme, namely, 0.5mg conbercept ophthalmic injection was intravitreally injected every 4wk for 3 consecutive times, and then 1 time every 12wk. In the group B(12 patients and 12 eyes), 3+TAE scheme was carried out, that is 0.5mg conbercept ophthalmic injection was intravitreally injected every 4wks for 3 consecutive times. The time of next injection was determined according to the evaluation results of each visit. The interval to the next visit/treatment was ≥ 4wk and ≤ 12wk. The best corrected visual acuity(BCVA), central retinal thickness(CRT)and the frequency of injection were compared between the two groups at 12 and 48wk after treatment, respectively.<p>RESULTS: BCVA of the group A was 74.78±11.23 letters and 74.67±13.94 letters at 12 and 48wk after treatment, which increased by 7.00±4.21 letters and 6.89±4.48 letters at the baseline before treatment, respectively. BCVA in the group B was 77.83±5.46 letters and 77.58±8.59 letters respectively at 12 and 48wk after treatment, which were 8.75±7.54 letters and 8.50±5.60 letters higher than the baseline before treatment. At the 12 and 48wk after injection, the average CRT in the group A was 276.33±44.34μm and 240.56±40.11μm, respectively, which were 43.22±42.21μm and 79.00±53.64μm lower than the baseline before treatment. At the 12 and 48wk after injection, the average CRT in the group B was 271.58±63.08μm and 241.00±43.91 μm, which were 57.42±45.33μm and 88.00±61.16μm lower than the baseline before treatment, respectively. The average times of intravitreal injection of conbercept were 6.00±0.00 and 7.75±1.14 times in the 3+Q12W group and the 3+TAE group, respectively.<p>CONCLUSION: Two different regimens of conbercept could reduce the CRT and improve the visual acuity of the patients with polypoidal choroidal vasculopathy. And the times of intravitreal injection in the 3+Q12W administration group were less than those in the3+TAE administration group.

Detection of serum cytokines and analysis of risk factors in patients with polypoid choroidal vasculopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the changes of serum cytokines in patients with polypoid chorioretinopathy and analyze its risk factors. <p>METHODS: Select 50 cases of PCV patients in our hospital from December 2018 to May 2019 served as observation group, 50 cases of senile cataract patients who want to undergo cataract surgery served as control group. The levels of inflammatory factors and angiogenic factors were compared between the two groups, and the general clinical data were analyzed by single factor and logistic regression. <p>RESULTS: The levels of IL-8, MCP-1, VEGF and PEDF in the observation group were significantly higher than those in the control group(<i>P</i><0.01). The results of ANOVA showed that there was significant difference between smoking history and hypertension between the two groups(<i>P</i><0.05); Logistic regression analysis showed that the increased levels of IL-8, MCP-1, VEGF, PEDF, smoking history and hypertension were independent risk factors for PCV. <p>CONCLUSION: The serum levels of IL-8, MCP-1, VEGF and PEDF in PCV patients were all increased abnormally, which was closely related to smoking history and hypertension.

Differential diagnosis of benign and malignant gallbladder polypoid lesions with maximum diameter ≥1 cm based on CT radiomics / 中国医学影像技术

Objective: To explore the value of radiomics based on CT in differential diagnosis of benign and malignant polypoid lesions of the gallbladder (PLG). Methods: Totally 145 patients with PLG ≥1 cm who underwent abdominal enhanced CT examination and confirmed by pathology were collected. Among them, benign PLG was found in 82 cases, while malignant ones were detected in 63 cases. The patients were randomly divided into training set and test set. 3D ROIs of portal vein phase CT images were manually segmented using ITK-SNAP software. AK software was introduced to extract high-dimensional radiomics features. Then Lasso regression was used to reduce the dimension of the features. Logistic regression model was established and tested with R language software. Finally, the diagnostic performance of the model was evaluated with ROC. Results: Seven features related to benign and malignant identification of gallbladder polyps were obtained. The optimal threshold based on training set was 0.370. After the model was established, the threshold was used for test set with accuracy was 0.886, the specificity and sensitivity was 0.880 and 0.895, respectively, and AUC was 0.924. Conclusion: CT radiomics can effectively identify benign and malignant PLG with the maximum diameter ≥1 cm.

Clinical effect of low frequency ultrasound combined with high frequency ultrasound in the diagnosis of gallbladder polypoid lesions / 中国综合临床

Objective To explore the clinical effect of low frequency ultrasound combined with high frequency ultrasound in the diagnosis of polypoid lesions of gallbladder,and to provide reference for clinical diagnosis. Methods From January 2013 to January 2017,87 patients with gallbladder polypoid lesions in Hankou Hospital were selected as the subjects,all the patients were checked by low frequency ultrasound and high frequency ultrasound,the results were compared with postoperative pathological findings. The diagnostic effect were compared between the low frequency ultrasound and low frequency ultrasound combined with high frequency ultrasound,and the consistency between the two inspection methods and postoperative pathological results was analyzed. Results The postoperative pathological report showed that among the 87 patients,59 cases ( 67. 82%) had gallbladder polyp, 6 cases ( 6. 90%) had adenomyosis, 10 cases ( 11. 49%) had gallbladder adenoma, 12 ( 13. 79%) had small nodular gallbladder cancer, 65 ( 86. 67%) had benign polypoid lesions,73 (97. 33%) had low frequency ultrasound combined with high frequency ultrasound. The accuracy of combined high-frequency ultrasound in the diagnosis of benign gallbladder polypoid lesions was significantly higher than that of low frequency ultrasound (χ2＝5. 797,P＜0. 05); the specificity and positive predictive value of combined low frequency ultrasound and high frequency ultrasound in the diagnosis of benign gallbladder polypoid lesions were significantly higher than those of low frequency ultrasound(90. 00%and 41. 18%,97. 33% and 86. 67%) . The difference was statistically significant ( χ2 ＝6. 217, 5. 797, P＝0. 013,0. 016). Conclusion Compared with low frequency ultrasound,low frequency ultrasound combined with high frequency ultrasound improves the differential diagnosis effect of gallbladder polypoid lesions,which is worthy of clinical attention.

Expression of IL-8 and its receptor in aqueous humor of patients with polypoid choroidal vasculopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the levels of interleukin-8, interleukin-8 receptor 1, 2(CXCR1, CXCR2)in aqueous humor of polypoid choroidal vasculopathy(PCV)and their clinical significance.<p>METHODS: Totally 67 patients with PCV in our hospital were selected as PCV group, and another 50 patients with cataract were selected as control group, fluorescence quantitative PCR(QPCR)was used to detect the expression of IL-8, CXCR1 and CXCR2 mRNAs in aqueous humor of two groups, the best corrected visual acuity(BCVA)of all subjects were measured by the international standard visual acuity chart, optical coherence tomography(OCT)was used to detect foveal retinal thickness(CMT), the receiver operating characteristic curve(ROC)was created to analyze the predictive values of IL-8, CXCR1 and CXCR2 in the occurrence of PCV. Multivariate Logistic regression analysis was used to assess the risk factors for PCV.<p>RESULTS: Compared with the control group, the expression of IL-8, CXCR1 and CXCR2 mRNA increased in group PCV. BCVA in PCV group decreased and CMT increased(<i>P</i><0.05). IL-8, CXCR1 and CXCR2 were significantly positively correlated with BCVA(<i>r</i>=0.438, 0.346, 0.385, all <i>P</i><0.05), IL-8, CXCR1 and CXCR2 were positively correlated with CMT(<i>r</i>=0.378, 0.606, 0.357, all <i>P</i><0.05). Logistic multivariate regression analysis showed that IL-8, CXCR1, CXCR2, BCVA and CMT were the risk factors of PCV. The AUC of IL-8, CXCR1 and CXCR2 for PCV diagnosis was 0.882, 0.860 and 0.812.<p>CONCLUSION: The expression of IL-8, CXCR1 and CXCR2 in PCV aqueous humor were all increased, which was not only related to BCVA and CMT in patients, but also related to the occurrence of PCV, and it may become a potential predictor of PCV.

Polypoid endometriosis of post vaginal fornix: utility of MRI imaging of pelvis with diffusion weighted imaging for diagnosis

Polypoid endometriosis is an uncommon variant of endometriosis which can mimic malignancy due to its presentation as masses. We present a case of polypoid endometriosis which simulated cervical malignancy both on clinical examination and on computed tomography (CT) scanning and discuss how magnetic resonance (MR) imaging, in particular Diffusion Weighted Imaging (DWI), can help to distinguish this condition from true malignancy and avoid invasive surgery.

The polypoid ganglioneuroma associated with hyperplastic polyposis

No abstract available.

Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a Healthy Population

PURPOSE: To determine the prevalence of and investigate the risk factors for gallbladder (GB) polypoid lesions in a healthy population. MATERIALS AND METHODS: A total of 23827 subjects who underwent abdominal ultrasonography in conjunction with health screening examinations were retrospectively analyzed. The prevalence of risk factors for GB polypoid lesions were evaluated. In addition, risk factors according to the number of polypoid lesions and the presence of stones with polypoid lesions were investigated. To analyze these risk factors, a control group was established with a 1:2 ratio matched for age and sex. RESULTS: The prevalence of GB polypoid lesions was identified as 9.96%. On multivariate analysis, chronic hepatitis B infection (CHB) and the presence of metabolic syndrome (MS) were risk factors for GB polypoid lesions. CHB and MS were also significant independent risk factors for multiple GB polypoid lesions when compared with solitary GB polypoid lesions. In addition, gastric Helicobacter pylori infection and MS were significant risk factors for GB polypoid lesions with stones when compared with GB polypoid lesions without stones. CONCLUSION: The prevalence of GB polypoid lesions in a healthy Korean population was 9.96%. Patients with CHB and MS need to be carefully examined for such lesions.

Polypoid Spitz Nevus: Aided by Dermoscopic Examination / 대한피부과학회지

Spitz nevus is a benign melanocytic nevus, common in children or young adults, and it has histological features that are confused with those of malignant melanoma. Polypoid Spitz nevus is the benign counterpart of polypoid malignant melanoma. A 22-year-old woman presented with a solitary 1.5×1.5 cm-sized firm polypoid erythematous nodule on the left thigh. On dermoscopy, pink to yellowish lagoons intermingled by white fibrous septa were found but milky red globules or irregular linear vessels were not found. Therefore, melanoma almost could be ruled out cautiously. Histopathology showed symmetrical, well-circumscribed, polypoid architecture with predominant dermal nests of spindle cells. Immunohistochemically, the nevus cells were strongly positive for S-100 protein and negative for HMB-45. Thus, the diagnosis of polypoid Spitz nevus was made. Herein, we report a case of polypoid Spitz nevus that was differentiated from polypoid melanoma by histopathologic and dermoscopic findings.

Clinicopathological study of ten cases with polypoid endometriosis / 临床与实验病理学杂志

Purpose Polypoid endometriosis is an uncommon and distinctive variant of endometriosis, and its detailed histopathological features have been investigated and analysed. Methods A retrospective analysis was performed in 10 cases with polypoid endometrio-sis by comparing clinical data, histopathologic and immunohistochemical changes. Results The patients were 27 to 54 years ( mean 39. 4 years) of age. The most common clinical presentations were a pelvic mass. The intraoperative findings suggested a neoplasm. Sites of involvement in order of frequency included ovary, uterine serosa and cervix. Polypoid, pink, gray or tan masses ranged up to 9 cm in maximal dimension. On microscopic examination, the polypoid masses were composed of an admixture of endometriotic glands and stroma. Most commonly glandular architectural patterns were simple hyperplasia. Tubal epithelial metaplasia was common. The stroma was fibrous, resembling to some extent the stroma of the endometrial polyp and atypical stromal cells can be seen. Nine cases were associated with usual endometriosis. Follow-up data in nine patients indicated that all of patients were alive without evidence of re-sidual disease. The main lesion in the differential diagnosis is a mullerian adenosarcoma. Conclusion Polypoid endometriosis is a rare manifestation of endometriosis, and probably is overgrowth of local ectopic endometrium based on endometriosis. Understanding of such lesions is avoided misdiagnosing for other benign or malignant tumors on clincal, intraoperative or pathologic assesment, and influ-ences the clinical treatment.

Polypoid Arteriovenous Malformation Presenting with Jejunojejunal Intussusceptions in an Adult

Jejunal polypoid arteriovenous malformations (AVMs) and jejunojejunal intussusceptions are both rare. Here, we present the case of a 61-year-old woman who suffered intermittent episodes of abdominal pain over the course of 13 years. A computed tomography scan of her abdomen and pelvis revealed a distal jejunojejunal intussusception. A suspected low density mass was observed at the tip of the intussusception. Treatment comprised laparoscopic small bowel resection with end-to-end jejunostomy. The final diagnosis was a polypoid AVM measuring 5x3.5x3 cm. We suggest that polypoid AVM should be considered as a differential diagnosis in patients presenting with small intestinal neoplasms.

Analysis of gallbladder polypoid lesion size as an indication of the risk of gallbladder cancer

BACKGROUNDS/AIMS: Recent advances in ultrasonography have contributed to the early detection of gallbladder cancer. We attempted to predict the progression of the disease by comparing the sizes of polypoid lesions, and we suggest that the size of the lesion would be a useful guideline to determine an appropriate primary surgical approach for polypoid lesions of the gallbladder. METHODS: We have retrospectively analyzed 253 patients that, during the operation period from January 2009 to December 2011, had had ultrasonographically detected gallbladder polypoid lesions, and who underwent cholecystectomy at Ulsan university hospital. We have analyzed the demographic data of the patients, the preoperative size of polypoid lesions, and pathologic findings. RESULTS: Of a total of 253 patients, 235 patients had benign lesions, and 18 patients had malignant lesions. Among the malignant polyp patients, 11 had pT1 cancer, 6 had pT2 cancer, and 1 had pT3 cancer. The average size of polypoid lesions was 9.1+/-3.1 mm and that of malignant lesions was 28.2+/-16.4 mm. The receiver operating characteristic (ROC) curve of the benign and malignant groups shows that 14.5 mm is the optimal point of prediction of the malignancy. Of a total of 18 patients of GB cancer, 11 had pT1 and the average size of their polypoid lesions was 20.5+/-5.8 mm 7 had pT2 with a size of 39.1+/-20.7 mm. ROC curve analysis of the pT1 and pT2 groups shows that 27 mm would be the optimal point to predict T2 and above cancer. CONCLUSIONS: In the case of an early cancer, curative treatment can be achieved through a simple and minimally invasive laparoscopic cholecystectomy. We attempted to predict early cancer occurrence among polypoid lesions of the gallbladder using the simplest standard, size. Although there are some limitations, size can be a simple and easy way to evaluate polypoid lesions of the gallbladder.

Research progress in the preoperative diagnosis of polypoid lesions of the gallbladder / 中华肝胆外科杂志

The diagnosis of polypoid lesions of the gallbladder plays a key role in the selection of treatment methods.However we still lack of effective means to exclude the malignant transformation currently.It is believed that lesions,whose diameter more than 10 mm,tend to be malignant.In addition,multiple imagings and related risk factors can also bring us some valuable tips.This article summarizes the current research progress related to the differential diagnosis of the disease,hoping to provide help for the clinicians in the timing of operation for such disease.

Polypoid Basal Cell Carcinoma Mimicking Soft Fibroma / 대한피부과학회지

Basal cell carcinoma (BCC) is the most common malignant tumor of the skin and usually seen on hair-bearing skin that is frequently exposed to the sun, especially on the face. Polypoid BCC, which is thought to be a new variant, is distinguished from other histologic types by having a stalk and by restriction of the tumor aggregation to the pedunculated zone. We report a case of polypoid BCC in a 73-year old man who had a skin-colored pedunculated papule in the perianal area mimicking soft fibroma.