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Original Article
- Melanosis Coli: Relation to Apoptosis in Pathogenesis.
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Sun Hee Sung, Hea Soo Koo, Woon Sup Han
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Korean J Pathol. 1996;30(7):570-575.
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Abstract
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- Melanosis coli is characterized by a dark brownish discoloration of the colonic mucosa. Its pathogenesis is still unknown. Recently it was proposed that the apoptosis of mucosal epithelium due to habitual use of laxatives play an important role for induction of melanosis coli. We studied clinicopathologic aspects of 12 cases of melanosis coli and analysed the histochemical and immunohistochemical characteristics of them. Results are as follows. : Mean patient's age was 53.5, and the male:female ratio was 4:8.
Nine patients had a history of constipation, and all of these had administrated various kinds of laxatives. The severity of discoloration was correlated with the duration of constipation and age. There was no difference of anatomical distribution in colon. Other remarkable mucosal lesions were not accompanied. On pathologic examination, all cases showed frequent yellow-brown pigment laden cells in lamina propria. These pigments were positive for periodic acid Schiff stains, Fontana Masson stains, and Victoria blue stains, however they were negative for prussian blue stain.
On immunohistochemical stainings pigmented cells were positive for CD68, and negative for S-100 protein and neuron specific enolase. These results indicate that they are macrophages. On ultrastructural examination pigmented cytoplasms were filled with variable sized electron dense granules including irregulary round deformed membranous structures, lipid vacuoles. Apoptosis of mucosal epithelium was noted in 5 cases. These findings suggest that apoptosis is the significant pathologic process in the progression of some cases of melanosis coli.
Case Reports
- Primary Malignant Melanoma of the Esophagus: A case report.
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Lee So Maeng, Kyoung Mee Kim, Eun Jung Lee, Anhi Lee, Sang In Shim
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Korean J Pathol. 1998;32(9):694-696.
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Abstract
- This report presents an unusual case of primary malignant melanoma in the midesophagus. The patient was a 36-year-old woman presenting with dysphagia and odynophagia. The resected esophagus and proximal stomach showed a dark purple large polypoid mass, measuring 6.0 3.3 2.0 cm, with a diffuse tan pigmentation of surrounding mucosa in the mid-esophagus and two small daughter nodules, up to 1.2 0.3 cm, in the lower esophagus near the gastro-esophageal junction. A microscopic examination revealed a malignant melanoma of epithelioid cell type confined to mucosa and submucosa with a diffuse melanosis. Cytoplasmic immunoreactivity for HMB 45 and S-100 protein were noted. An electron microscopic examination revealed large, loosely cohesive variable shaped cells with a few cytoplasmic premelanosomes.
- Melanosis Duodeni.
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Sun Hoo Park, So Yeon Park, Yong Il Kim, Woo Ho Kim
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Korean J Pathol. 1998;32(12):1089-1091.
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Abstract
- Melanosis duodeni is an uncommon pathologic condition characterized by diffuse small black spots on the first and second portions of the duodenum. It occurs predominantly in elderly patients and is linked to chronic renal failure, use of antihypertensive drug and oral iron supplementation, and/or presence of gastric hemorrhage. We report a case of melanosis duodeni in a 60-year-old woman diagnosed with hypertension 20 years ago and chronic renal failure 6 years ago. She has taken antihypertensive drugs for many years. On endoscopy, speckled black pigmentation of duodenal mucosa was detected. Microscopically, this duodenal lesions showed numerous coarse pigments in macrophages confined within the lamina propria. By ultrastructural study, macrophages contained electron-dense granules admixed with lipofuscin-like material in residual bodies.
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