Case of a Large Pedunculated Biliary Cholesterol Polyp With Osseous Metaplasia

Abstract Background The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Methods This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037). Conclusions Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.

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Imaging of endometrial osseous metaplasia—an uncommon but treatable cause of infertility

Middle East Fertility Society Journal ◽

10.1186/s43043-020-00045-0 ◽

2020 ◽

Vol 25 (1) ◽

Author(s):

Abdul Haseeb Wani ◽

Arshed Hussain Parry ◽

Imza Feroz ◽

Majid Jehangir ◽

Masarat Rashid

Keyword(s):

Inflammatory Cells ◽

Osseous Metaplasia ◽

Dystrophic Calcification ◽

Non Invasive ◽

Dilatation And Curettage ◽

Clinical Scenarios ◽

Uncommon Condition ◽

Urinary Tuberculosis ◽

Hypointense Signal ◽

Metaplastic Ossification

Abstract Background Endometrial osseous metaplasia (EOM) is an uncommon condition characterised by metaplastic transformation of endometrial tissue into osteoblasts (mature or immature bone in the endometrium). Etiopathogenesis of EOM is explained by multiple putative mechanisms like dystrophic calcification, metaplastic ossification, retained foetal bones after abortions and genito-urinary tuberculosis. EOM has varied clinical presentation ranging from patient being asymptomatic to secondary infertility. Although hysteroscopy is the gold standard for its diagnosis and treatment, non-invasive imaging comprising chiefly of ultrasonography (USG) is increasingly becoming the mainstay of diagnosis. We aim to present the imaging findings in EOM to acquaint radiologists and gynaecologists with this condition to avert misdiagnosis of this uncommon yet treatable cause of infertility. Results Mean age of patients was 31.4 ± 5.4 (S.D) years. USG revealed linear or tubular densely echogenic endometrium with posterior acoustic shadowing in all the 14 patients. MRI in 3 patients revealed diffuse or patchy areas of T1W and T2W hypointense signal intensity with unilateral (n = 2) and bilateral (n = 1) ovarian cysts. One patient who underwent CT scan revealed dense endometrial calcification. Histopathologic examination (HPE) revealed lamellar (n = 6) or trabecular (n = 4) bone within endometrium (EOM) and inflammatory cells with calcification in four patients (calcific endometritis). Twelve patients conceived after dilatation and curettage within 15 months. Conclusion Familiarity with the imaging appearances of EOM is indispensable to clinch this diagnosis and avert misdiagnosis of this rare but potentially treatable cause of infertility. USG is usually sufficient for diagnosis. MRI and CT are only supplementary tools in difficult clinical scenarios.

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Evaluation of an isotope ratio method for measuring biliary cholesterol secretion.

The Journal of Lipid Research ◽

10.1016/s0022-2275(20)37930-x ◽

1983 ◽

Vol 24 (7) ◽

pp. 854-860

Author(s):

J R Crouse ◽

M D Wilson ◽

D S Weaver

Keyword(s):

Isotope Ratio ◽

Ratio Method ◽

Biliary Cholesterol ◽

Biliary Cholesterol Secretion ◽

Cholesterol Secretion

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GASTRIC CARCINOMA WITH OSSEOUS METAPLASIA IN A DOG

Archives of Veterinary Science ◽

10.5380/avs.v17i3.22798 ◽

2012 ◽

Vol 17 (3) ◽

Cited By ~ 1

Author(s):

Irina Ferraz Amorim ◽

Celia Lopes ◽

Rui M Gil da Costa ◽

Augusto MR Faustino ◽

Fatima Gartner ◽

...

Keyword(s):

Monoclonal Antibodies ◽

Epithelial Cells ◽

Gastric Carcinoma ◽

Heterotopic Ossification ◽

Bone Tissue ◽

Exploratory Laparotomy ◽

Osseous Metaplasia ◽

Mucin Production ◽

Positive Immunostaining ◽

Neoplastic Epithelial Cells

This report describes an unprecedented case of a gastric carcinoma with osseous metaplasia in a 8-year-old male standard poodle. An exploratory laparotomy revealed a firm yellowish nodular mass in the pyloric region. The lesion was surgically removed and submitted for current histological examination. Immunohistochemistry was performed employing monoclonal antibodies for pan-cytokeratin, vimentin, smooth muscular a-actin and BMP-2/4. The mass consisted in neoplastic proliferation of epithelial cells, arranged in a tubular or acinar pattern and supported by scirrhous stroma, with mucin production and multiple foci of heterotopic ossification. Neoplastic epithelial cells showed strong positive immunostaining for AE1/AE3 and BMP-2/4, although they were negative for both vimentin and a-actin. Histopathological findings suggested that the bone tissue may be primarily originated from neoplastic epithelial cells which directly circumscribe the osseous metaplasia foci.

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