Enteropathy in malignant disease

Malignancy, weight loss, and the small intestinal mucosa

The mucosal architecture and mucosal dynamics of the small bowel have been studied in patients with malignant disease not of the gastrointestinal tract but associated with severe weight loss. Mucosal changes in malignant disease are demonstrated by stereomicroscopy, mucosal architectural measurement, and decreased lactose utilization. Measurement of the epithelial DNA loss rate indicates, in association with mucosal measurement, that the architectural changes are caused by a hypoplasia of the epithelium. Similar findings are demonstrated in patients with profound weight loss due to other non-malignant wasting diseases. Although mucosal changes undoubtedly occur in malignant disease, the changes are not specific for malignancy and the concept of ;cancer enteropathy' is not tenable. It is suggested that mucosal changes are the effect of and not the cause of cachexia.

Vitamin B 12 malabsorption after cobalt teletherapy for carcinoma of the bladder

After cobalt teletherapy for carcinoma of the bladder, eight out of 14 consecutively admitted patients were shown to have malabsorption of vitamin B(12), though none had developed a megaloblastic anaemia. Despite lack of symptoms this group of patients is at risk after radiotherapy.

Massive renal adenoma associated with intestinal malabsorption

A 43-year-old woman with evidence of intestinal malabsorption and a renal tumour was found to have a 2220-g. renal adenoma which showed no evidence of malignancy despite its size and known duration. The association of a benign renal tumour with jejunal villous atrophy and intestinal malabsorption is discussed.

Staining method for the examination of the small intestinal villous pattern in necropsy material

A new technique for the rapid identification of villous structure in postmortem material is described. It has been used with success for over a year and has proved superior in the authors' hands to previously described methods.