Squamous cell metaplasia of the rectum associated with a longstanding ulcerative colitis (clinical cases report)

INTRODUCTION: squamous cell metaplasia in the rectum is found in patients with longstanding inflammation or infectious lesions [1]. Colonoscopy plays a major role in the diagnostic of squamous cell metaplasia, especially with the use of Narrow Band Imaging (NBI) or Blue Light Imagining (BLI), which allows for targeted visualization of intraepithelial capillary loopspeculiar for the squamous epithelium [1,2]. The final conclusion cannot be reached without morphological diagnostics. We would like to show on two clinical cases of patients with a longstanding ulcerative colitis the occurrence of squamous cell metaplasia in the rectum. These areas of metaplasia may be the source of squamous cell cancer.CLINICAL CASES: a clinical cases of squamous cell metaplasia in the rectum in two patients with a longstanding ulcerative colitis (9 and 14 years) are presented. The total ulcerative colitis was verified in both patients by colonoscopy. Against the background of endoscopic remission, flat whitish areas of irregular shape, up to 3 cm in size, in the form of “tongues” of metaplastic epithelium with clear boundaries were found in the low rectum. When examined in a Narrow Band Imaging (NBI) and Blue Light Imagining (BLI), the microvascular pattern in the detected areas was identical in structure to the microvascular pattern of the squamous epithelium. The biopsies confirmed the presence of squamous cell epithelium.CONCLUSION: patients with a longstanding ulcerative colitis may have squamous cell metaplasia of the rectal mucosa, which can be detected by colonoscopy in white light. Using a Narrow Band Imaging (NBI) followed by a targeted biopsy allows the most accurate diagnosis to be established. Patients of this group require repeated colonoscopies using the above methods, since areas of metaplasia can be a source of squamous cell cancer of the rectum.

Squamous cell metaplasia of the rectum associated with a longstanding ulcerative colitis (clinical cases report)

INTRODUCTION: squamous cell metaplasia in the rectum is found in patients with longstanding inflammation or infectious lesions [1]. Colonoscopy plays a major role in the diagnostic of squamous cell metaplasia, especially with the use of Narrow Band Imaging (NBI) or Blue Light Imagining (BLI), which allows for targeted visualization of intraepithelial capillary loopspeculiar for the squamous epithelium [1,2]. The final conclusion cannot be reached without morphological diagnostics. We would like to show on two clinical cases of patients with a longstanding ulcerative colitis the occurrence of squamous cell metaplasia in the rectum. These areas of metaplasia may be the source of squamous cell cancer.CLINICAL CASES: a clinical cases of squamous cell metaplasia in the rectum in two patients with a longstanding ulcerative colitis (9 and 14 years) are presented. The total ulcerative colitis was verified in both patients by colonoscopy. Against the background of endoscopic remission, flat whitish areas of irregular shape, up to 3 cm in size, in the form of “tongues” of metaplastic epithelium with clear boundaries were found in the low rectum. When examined in a Narrow Band Imaging (NBI) and Blue Light Imagining (BLI), the microvascular pattern in the detected areas was identical in structure to the microvascular pattern of the squamous epithelium. The biopsies confirmed the presence of squamous cell epithelium.CONCLUSION: patients with a longstanding ulcerative colitis may have squamous cell metaplasia of the rectal mucosa, which can be detected by colonoscopy in white light. Using a Narrow Band Imaging (NBI) followed by a targeted biopsy allows the most accurate diagnosis to be established. Patients of this group require repeated colonoscopies using the above methods, since areas of metaplasia can be a source of squamous cell cancer of the rectum.

Squamous cell carcinoma of an eyelid in a horse: A case report

The aim of this report is to describe a clinical case of squamous cell carcinoma in an 18-year-old horse. This tumor is one of the most common superficial oncological problems in these animals. A lesion in the lateral corner of the eye was already observed about 10 years earlier, but due to the lack of significant growth or alarming symptoms, no diagnostics or treatment was implemented. A year before surgery, an episode of acute inflammation in the eye and a slight enlargement of the nodule occurred. Initially, an autoimmune origin of the lesion was assumed, but anti-inflammatory and bactericidal treatment did not lead to a significant improvement. As a result of sampling for histopathological examination, the tumor doubled its volume, so, given the inefficacy of the subsequent anti-inflammatory and antibiotic therapy, the horse was sent to the clinic. A convex, painful lesion partially covering the cornea was found on arrival. In view of the rapid growth of the tumor and its infiltration of surrounding tissues, a decision was made to carry out transpalpebral enucleation. The procedure was performed under general anesthesia and with an additional retrobulbar block. Because of significant tissue tensions and the risk of hematoma, an intermittent horizontal mattress suture was used. The area was secured with a compression dressing. The horse returned to sport, and no recurrence of the tumor was observed up to 7 months after surgery. Histopathological examination confirmed squamous cell metaplasia forming keratin pearls, characteristic of squamous cell carcinoma.

Consequences of Vitamin A Deficiency: Immunoglobulin Dysregulation, Squamous Cell Metaplasia, Infectious Disease, and Death

Vitamin A is an important regulator of immune protection, but it is often overlooked in studies of infectious disease. Vitamin A binds an array of nuclear receptors (e.g., retinoic acid receptor, peroxisome proliferator-activated receptor, retinoid X receptor) and influences the barrier and immune cells responsible for pathogen control. Children and adults in developed and developing countries are often vitamin A-deficient or insufficient, characteristics associated with poor health outcomes. To gain a better understanding of the protective mechanisms influenced by vitamin A, we examined immune factors and epithelial barriers in vitamin A deficient (VAD) mice, vitamin D deficient (VDD) mice, double deficient (VAD+VDD) mice, and mice on a vitamin-replete diet (controls). Some mice received insults, including intraperitoneal injections with complete and incomplete Freund’s adjuvant (emulsified with PBS alone or with DNA + Fus-1 peptide) or intranasal inoculations with Sendai virus (SeV). Both before and after insults, the VAD and VAD+VDD mice exhibited abnormal serum immunoglobulin isotypes (e.g., elevated IgG2b levels, particularly in males) and cytokine/chemokine patterns (e.g., elevated eotaxin). Even without insult, when the VAD and VAD+VDD mice reached 3–6 months of age, they frequently exhibited opportunistic ascending bacterial urinary tract infections. There were high frequencies of nephropathy (squamous cell hyperplasia of the renal urothelium, renal scarring, and ascending pyelonephritis) and death in the VAD and VAD+VDD mice. When younger VAD mice were infected with SeV, the predominant lesion was squamous cell metaplasia of respiratory epithelium in lungs and bronchioles. Results highlight a critical role for vitamin A in the maintenance of healthy immune responses, epithelial cell integrity, and pathogen control.

Immature Squamous Metaplasia of Esophageal Glands Associated with Squamous Cell Carcinoma: Case Report

Background: Esophageal immature squamous metaplasia is poorly reported in the literature. This entity can, however, be misinterpreted as high grade dysplasia or invasive squamous cell carcinoma and hence represent a potential pitfall. Case presentation: Histopathological examination of a superficial esoophageal lesion removed by endoscopic submucosal dissection revealed a squamous cell carcinoma associated with immature squamous cell metaplasia arising from esophageal glands. Immunohistochemical stainings allowed to distinguish malignant from metaplastic cells.Conclusions: Immunohistochemistry for Ber-EP4 is helpful in making the distinction between esophageal squamous cell carcinoma and immature squamous metaplasia. This can avoid overstaging and overtreatment, especially in early esophageal cancer.

Tracheal stenosis in a Holstein cow

ABSTRACT: Tracheal stenosis, also known as “Honker syndrome”, is characterized by tracheal edema and hemorrhage, leading to partial obstruction of the lumen; therefore, death. Its etiology is not yet well elucidated. A 3-year-old Holstein cow, with a history of dyspnea, and a large amount of reddish foam flowing from the mouth and nose, had died after 10 minutes of clinical signs. Macroscopic examination revealed focally extensive hemorrhage and clot organization in tracheal mucosa extending to the submucosa, surrounded by well-differentiated fibrous connective tissue. In adjacent mucosa was observed moderate multifocal inflammatory infiltrate composed by lymphocytes and plasma cells, as well as moderate squamous cell metaplasia. The bacterial culture showed growth of contaminant and environmental bacteria and the RT-PCR to detect Herpesvirus 1 (BoHV-1) and 5 (BoHV-5) was negative. To the author’s knowledge, this is the first report of tracheal stenosis in South America, as well as the first report of this condition described in a Holstein cow.

Radiation-Induced Rhinitis: Cytological and Olfactory Changes

Background Oral mucositis is a well-known adverse event of radiotherapy (RT) for head and neck cancer (HNC). Its nasal counterpart, the radiation-induced rhinitis, is poorly studied and considered in clinical practice. Objective The aim of this observational study was to evaluate acute cytological and olfactory alterations during RT and their correlation with RT doses. Methods Ten patients who underwent RT for HNC, excluding tumors of the nasal cavities, were evaluated with nasal scraping for cytological examination, Sniffin’ Sticks test for olfactory assessment, and Nasal Obstruction Symptom Evaluation scale. The examinations were performed before (T0), at mid-course (T1), and at the end (T2) of RT. They were repeated 1 and 3 months after RT (T3 and T4). Mean dose (Dmean) and near maximum dose (D2%) to nasal cavities and inferior turbinates were used for correlation analyses. Results Radiation-induced rhinitis was present in 70% of patients at T2, and it was still observed in 40% of cases after 3 months. Although olfactory function remained within the normal range at the evaluated times, a significant decrease in odor threshold and discrimination was observed during RT, which returned to baseline levels after RT. Nasal cytology showed a radiation-induced rhinitis with neutrophils and sometimes bacteria. Mucous and squamous cell metaplasia appeared in 10% of patients. Dmean and D2% to inferior turbinates were associated to neutrophilic rhinitis at T2, and D2% to inferior turbinates was correlated to mucous cell metaplasia at T2. Conclusions RT for HNC induces acute rhinitis that may persist after the completion of treatment and can affect patient’s quality of life. Nasal cytology can help to choose the best treatment on an individual basis.