| Three
cases of Solitary Peutz-Jeghers-type hamartomatous polyp in the
duodenum.World
J Gastroenterol. 2008 Feb 14; 14(6): 944-7.
A solitary
Peutz-Jeghers-type hamartomatous polyp in the duodenum is rare, and
few reports have described its characteristic endoscopic features. We
describe three cases of solitary Peutz-Jeghers-type hamartomatous
polyp and their endoscopic findings in detail. The polyp in all of our
three cases showed an irregularly lobular or nodular surface, whereas
adenomas often show a regularly nodular or granular surface. The color
of the polyp was whitish in all of our cases. In the present cases,
close observation by endoscopy revealed that the solitary
Peutz-Jeghers-type hamartomatous polyps looked whitish because of the
presence of diffusely scattered white spots on the surface of the
polyps. Duodenal polyps that exhibit the aforementioned endoscopic
characteristics may be diagnosed as Peutz-Jeghers-type hamartomatous
polyps and treated by polypectomy because of the malignant potential.
Breast cancer, ovarian gonadoblastoma and cervical cancer in a patient
with Peutz-Jeghers Syndrome.Arch Gynecol
Obstet. 2008 Jan 12.
BACKGROUND:
Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant disorder
characterized by gastrointestinal hamartomatous polyps and
mucocutaneous pigmentation. Patients with PJS have increased risk for
gastrointestinal, breast, and female genital tract cancers. CASE:
Multiple genital tract cancers in a 34-year-old woman with PJS are
described. The patient, who was admitted to our department with severe
vaginal bleeding, was performed right salpingo-oophorectomy because of
pure gonadoblastoma in 1996. In 2003, concomitant to cervical
carcinoma, breast cancer was diagnosed. Patient underwent left
modified radical mastectomy due to the invasive papillary carcinoma.
The patient received six cycles combination chemotherapy and radiation
therapy because of stage IIIB cervical cancer. CONCLUSION(S): This is
the first case report presenting PJS associated with multiple genital
tract tumors including ovarian gonadoblastoma in literature. The
clinical significance of these tumors in PJS patients has been
reviewed.
E-book - History of
Medicine with special reference to India |
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|
Pathology of the Intestinal Polyp (Peutz
- Jeghers Polyp)
Visit: GI Path Online
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| Do
sporadic Peutz-Jeghers polyps exist? Experience of a large teaching
hospital.Am
J Surg Pathol. 2007 Aug;31(8):1209-14.
Most types of
sporadic gastrointestinal (GI) polyps vastly outnumber their
syndromic counterparts. In contrast, the incidence of sporadic
Peutz-Jeghers polyps (PJP) is unknown. We examined all potential PJP
seen at our hospital over a 22-year (y) period to assess the
incidence of sporadic PJP. The pathology database of a large
hospital was searched for "Peutz-Jeghers polyp(s)," yielding 121
polyps from 38 patients. The polyps were reviewed by 3 pathologists
to confirm the diagnosis. Clinical information to confirm or refute
a diagnosis of Peutz-Jeghers syndrome (PJS) was collected. Of the
102 polyps included after histologic review, 94 polyps arose in
patients meeting the World Health Organization criteria for PJS.
These PJS polyps were eliminated from further analysis. Clinical
information was obtained for the remaining 8 patients with potential
"sporadic" PJP (1 to 50 y; mean=14 y; median=4 y). Of the 8
potential sporadic PJP, only 3 polyps from 3 patients had
unequivocal PJP histologic features, all from the small intestine.
All 3 patients had clinical histories suggesting syndromic PJP
although they did not meet World Health Organization criteria, that
is, 2 developed pancreatic cancer, 1 had bilateral "ovarian cystic
masses" and a glomus tympanicum tumor, and 1 had strong family
history of GI malignancies. The 5 remaining patients each had a
colonic polyp with features suggestive, but not definitely
diagnostic of, PJP. In these cases, prolapse lesions could not be
excluded. One patient had a history of high-grade dysplasia in a
tubulovillous adenoma in the colon at 53 years, but no family cancer
history. Another had a family GI cancer history. Another had a
history of pituitary adenoma at age 39, and the last had ductal
breast carcinoma diagnosed 4 years before the discovery of the
polyp. Our findings suggest that if sporadic PJP exist, they are
extremely rare. Moreover, our data suggest that individuals with a
single PJP may have a cumulative lifetime risk of cancer similar to
those with the syndrome. |
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March 2008
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