The pigment of melanosis coli: a lectin histochemical study.

BACKGROUND: The compositional nature of the pigment of melanosis coli is essentially unknown. Previous histochemical studies suggested that this pigment has certain similarities with lipofuscin (i.e., age-dependent pigment) and ceroids (i.e., pathologically derived pigments) and that it may contain, therefore, polymerized glycolipids and glycoproteins. However, the saccharide composition of this pigment was never explored by lectin histochemical procedures, which was the main object of this study. METHODS: Colonoscopic biopsy specimens from eight patients with melanosis coli and from three normal control subjects were studied by fluorescent microscopy and by standard and lectin histochemistry. The number of apoptoses in the lining colonic epithelium was also evaluated histologically. RESULTS: Apoptotic bodies were significantly more numerous in patients with melanosis coil than in control subjects. The pigment that accumulates in macrophages of the lamina propia showed autofluorescence, sudanophilia, acid-fastness, and positiveness to PAS and Schmorl's reactions, all of which are common to lipofuscin and ceroids, plus an intense argentaffin reaction abolished by bleaching, indicative of a melanic substance. Lectin histochemistry showed, in decreasing order of frequency, the presence of alpha-D-mannose, sialic acid, beta-D-galactose (lactose), gal-beta-(1-3)acetyl-galactosamine, alpha-D-galactose, and alpha-L-fucose, but no terminal alpha-D-acetyl-galactosaminyl residues. CONCLUSIONS: The significant increase of apoptotic bodies in the lining colonic epithelium indicated that this type of cell death is not due to the natural programmed cell renewal, but to the action of laxatives. Because the autofluorescent pigment of melanosis coli contains melanin (as well as glycoconjugates) and is not dependent on age but on the use of anthranoid laxatives, it should be categorized as a "melanized ceroid." The lectin affinities of this pigment indicated that it contains a substantial number of saccharide residues almost similar to those found in the ceroid pigment of human aortic atheromas. These findings and considerations on the metabolism and pharmacokinetics of anthranoids suggested that the apoptotic epithelial cells, rather than the laxatives, may be the source of the pigment saccharides, whereas the precursors of the melanic substance may be derived from the anthranoids.

Biopsia peroral por succión del intestino delgado dirigida bajo control endoscópico / Peroral suction biopsy of the small intestine directed under endoscopic control

Con el objeto de evaluar el procedimiento de biopsia-succión de la mucosa del intestino delgado dirigida bajo control endoscópico, fueron estudiados 47 pacientes. Sobre un total de 121 muestras obtenidos resultaron adecuadas para diagnóstico 114 muestras (94,2%). Este procedimiento resultó ser efectivo, rápido y seguro para el estudio de la patología de la mucosa yeyunal (AU)

Biopsia peroral por succión del intestino delgado dirigida bajo control endoscópico / Peroral suction biopsy of the small intestine directed under endoscopic control

Con el objeto de evaluar el procedimiento de biopsia-succión de la mucosa del intestino delgado dirigida bajo control endoscópico, fueron estudiados 47 pacientes. Sobre un total de 121 muestras obtenidos resultaron adecuadas para diagnóstico 114 muestras (94,2%). Este procedimiento resultó ser efectivo, rápido y seguro para el estudio de la patología de la mucosa yeyunal

[Peroral suction biopsy of the small intestine directed under endoscopic monitoring]. / Biopsia peroral por succión del intestino delgado dirigida bajo control endoscópico.

The technical difficulties of the procedures for jejunal biopsy are a waste of time. In the present paper we consider the suction biopsy of small bowel with the Olympus equipment, under endoscopic control. We studied 47 patients, mean age 46 years old (range 22-70) with clinical suggestion of malabsorption. In all patients, we tried to obtain 3 samples, in 31 (66%) we obtained the 3, in 8 (17%) we obtained 2 and in 2 (4.2%) no samples. With this procedure we had 121 samples; from these 114 (94.2%) were useful for diagnosis. We had no complications. The small bowel biopsy with Olympus system was fast, sure and effective.

Biopsia peroral por succión del intestino delgado dirigida bajo control endoscópico. / [Peroral suction biopsy of the small intestine directed under endoscopic monitoring]

The technical difficulties of the procedures for jejunal biopsy are a waste of time. In the present paper we consider the suction biopsy of small bowel with the Olympus equipment, under endoscopic control. We studied 47 patients, mean age 46 years old (range 22-70) with clinical suggestion of malabsorption. In all patients, we tried to obtain 3 samples, in 31 (66

) we obtained the 3, in 8 (17

) we obtained 2 and in 2 (4.2

) no samples. With this procedure we had 121 samples; from these 114 (94.2

) were useful for diagnosis. We had no complications. The small bowel biopsy with Olympus system was fast, sure and effective.

[Lymphomatous polyposis of the digestive tract]. / Poliposis linfomatosa del tubo digestivo.

A case of multiple lymphomatous polyposis of the gastrointestinal tract is presented. The recent literature on this type of lymphoma is reviewed. Also summarized are the clinical findings, diagnostic procedures, current methods of treatment and prognosis of these patients. Diarrhea upon admission, lead us to a complete work up finally to the correct diagnosis. The lack of symptoms of this patient was in contrast with most of the cases reviewed, so the diagnosis was mainly based on the endoscopic findings (colonoscopy and esofago-gastro-duodenoscopy). It is emphasized the importance of repeated biopsies in case of negative ones, as it occurs in this patient, in which an endoscopic "polypectomy" from the recto-sigmoid area, provided enough material to the pathologist, for the diagnosis, after several "non-diagnostic" biopsies taken previously. Finally the therapy for this entity is updated, with special reference to quemotherapy and a list of drugs combination is given.

Poliposis linfomatosa del tubo digestivo. / Lymphomatous polyposis of the digestive tract

Se presenta un caso de poliposis multiple linfomatosa del tubo gastrointestinal. Se revisa la literatura y los hallazgos clinicos, procedimientos diagnosticos incluyendo endoscopia y el tratamiento y pronostico de estos pacientes

Poliposis linfomatosa del tubo digestivo. / Lymphomatous polyposis of the digestive tract

Se presenta un caso de poliposis multiple linfomatosa del tubo gastrointestinal. Se revisa la literatura y los hallazgos clinicos, procedimientos diagnosticos incluyendo endoscopia y el tratamiento y pronostico de estos pacientes

Poliposis linfomatosa del tubo digestivo. / [Lymphomatous polyposis of the digestive tract]

A case of multiple lymphomatous polyposis of the gastrointestinal tract is presented. The recent literature on this type of lymphoma is reviewed. Also summarized are the clinical findings, diagnostic procedures, current methods of treatment and prognosis of these patients. Diarrhea upon admission, lead us to a complete work up finally to the correct diagnosis. The lack of symptoms of this patient was in contrast with most of the cases reviewed, so the diagnosis was mainly based on the endoscopic findings (colonoscopy and esofago-gastro-duodenoscopy). It is emphasized the importance of repeated biopsies in case of negative ones, as it occurs in this patient, in which an endoscopic [quot ]polypectomy[quot ] from the recto-sigmoid area, provided enough material to the pathologist, for the diagnosis, after several [quot ]non-diagnostic[quot ] biopsies taken previously. Finally the therapy for this entity is updated, with special reference to quemotherapy and a list of drugs combination is given.