Endoscopic enucleation of large esophageal leiomyomas.

摘要

In 1838, Mathias Schleiden, a German botanist, coined the term amyloid to describe the normal amylaceous constituent of plants. In 1854, Rudolf Virchow used the term amyloid when describing its reaction with iodine and sulfuric acid, which, at the time, was a marker for starch. He subsequently adopted the term to describe an abnormal extracellular material that is seen in the liver during autopsy. Indeed, amyloidosis is characterized by the extracellular tissue deposition of an abnormal protein. Six types of amyloidosis are recognized: primary (associated with monoclonal light chains in serum and/or urine), secondary (associated with a variety of inflammatory, infectious, and neoplastic diseases), hemodialysis-related, hereditary, senile, and localized. In the Gi tract, whether as part of a systemic or localized process, amyloid may involve the blood vessels and manifest with ischemic necrosis; the mucosa with resultant bleeding, malabsorption, and diarrhea; or the muscles with subsequent dysmotility, intestinal obstruction, and constipation. Another rare manifestation is amyloid polyposis in which the amyloid, mainly in the submucosa of the small intestine and colon, forms filiform, sessile, or polypoid lesions mainly in the submucosa of the small intestine or colon. Despite the multiplicity of cause and manifestations, all amyloid is composed of 3 component parts: a fibrillar protein, a nonfibrillar glycoprotein, and glycosoaminoglycans. It is the amyloid fibrils, however, that are responsible for the Congo red and apple-green birefringence seen under polarized light microscopy that is the histochemical hallmark of the disease. The history of the name Congo red is, to me, of great interest. In 1885, the term Congo red was introduced in Berlin at the Berlin West Africa Conference as the name for the first direct textile dye. At that time, European newspapers were filled with exciting stories of the exotic Congo River basin in Central Africaa hot new geopolitica...