Villous adenoma

The level of ras oncogene protein product p21 (L6) was evaluated in specimens of normal human colonic mucosa, hyperplastic polyps, tubular adenomas, villous adenomas, and the epithelium from a case of ulcerative colitis. Differences in p21 values among all classes of polyps were significant (hyperplastic polyps had values less than tubular adenoma values, which were less than villous adenoma... 

Vomiting, nasogastric suctioning, and chloride (secretory) diarrhea (villous adenoma or laxative abuse)... 

Features include muscle weakness and cramps, paraesthesia, nausea, vomiting, constipation, abdominal pain, polyuria, polydipsia, depression, confusion and psychosis. Hypokalaemia may cause brady/tachyarrhythmias, hypotension, respiratory failure, ileus and altered mental state. It also increases the toxicity of cardiac glycosides. There are several associated disease states (e.g. diarrhoea, vomiting, renal tubular acidosis types I and II, hypomagnesaemia, Conn s syndrome, Cushing s disease, Gitelman s syndrome, villous adenoma, pyloric stenosis, intestinal fistulae). 

Prolonged vomiting or nasogastric suction Pyloric or upper duodenal obstruction Prolonged or abusive diuretic therapy (loop diuretics) Villous adenoma Posthypercapnic state... 

Gastrointestinal disorders Vomiting Gastric drainage Villous adenoma of the colon Chloride diarrhea Diuretic therapy... 

Another recently proposed classification system, which pertains mainly to adenoma in the EHBDs, divides them into two categories on the basis of the predominant cytologic features columnar-cell and cuboidal-cell types." This is analogous to the villous/intestinal and pancreatobiliary subsets of pancreatic IPMNs, respectively. ... 

Urethral and periurethral gland adenocarcinoma (female) Villous adenoma and adenocarcinoma of the bladder Extramammary Paget disease of the male external genitalia Pleomorphic adenoma of the salivary glands (male) Carcinoma of the salivary glands (male)... 

Lane Z, Hansel DE, Epstein JI. Immunohistochemical expression of prostatic antigens in adenocarcinoma and villous adenoma of the urinary bladder. Am J Surg Pathol. 2008 32 1322. 

A nodule of the liver was incidentally noted during left colectomy for a large villous adenoma in a 74-year-old man (Mondou and Gnepp 1989). Microscopic examination disclosed a granuloma of the liver containing numerous Enterobius vermicularis ova and a cross-section of the nematode. 

Villous adenomas are also found in the duodenum and appear as sessile, carpet-like lesions with an irregular and whitish surface. They may show substantial lateral spread (Fig. 3.52) and, taking into consideration their high risk for malignancy, this indicates that they are not suitable for endoscopic removal. 

Fig. 9.17. a Intraluminal villous adenoma. CECT shows a soft-tissue polypoid mass with a small pedicle, arising from the medial aspect of the descending duodenum, with no mural thickening or extraduodenal disease, b Malignant villous tumor of the duodenum. Note the extensive carpetlike lesion involving most of the inferior duodenal flexure as well as the liver metastasis (c)... 

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