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case_images: Endoscopic and pathological findings of a patient with Cronkhite-Canada syndrome. (a) Multiple reddish polyps and edematous adjacent mucosa are seen in the gastric body and antrum before the prednisolone (PSL) treatment (Top panel). Colonoscopy reveals multiple erythematous elevated lesions in the entire colon before the PSL treatment (middle panel). Regression of Cronkhite-Canada syndrome polyps was achieved after the PSL treatment. Type III advanced cancer was detected in the rectosigmoid colon (bottom panel). (b) Pathological examination results obtained from gastric and colonic elevated lesions reveal hamartomatous polyps with cystic dilatation of glands containing intraluminal mucin and infiltration of immune cells into the submucosa. Well-differentiated adenocarcinoma was detected in the rectal biopsy samples. Scale bar, 100 microm.
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case_images: Esophagogastroduodenoscopy revealed multiple reddish polyps and an edematous adjacent mucosa in the stomach (Figure 1a). Colonoscopy revealed multiple elevated erythematous lesions throughout the colon (Figure 1a). Pathological examination of the elevated gastric and colonic lesions revealed hamartomatous polyps with cystic dilatation of glands containing intraluminal mucin and infiltration of immune cells into the submucosa (Figure 1b). Regression of CCS polyps was observed in both the stomach and colon three months after PSL treatment (Figure 1a). Well-differentiated adenocarcinoma was detected in rectal biopsy samples (Figure 1b), and he underwent lower anterior resection for rectal cancer.
case_images: Cytokine analyses in a patient with Cronkhite-Canada syndrome. Colonic biopsy samples obtained before and after treatment with prednisolone (PSL) were subjected to quantitative reverse transcription polymerase chain reaction analyses. Messenger RNA (mRNA) expression of interleukin (IL)-1beta, IL-6, IL-10, interferon (IFN)-alpha4, and IL-10 was shown.
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case_images: IL-6, and tumor necrosis factor [TNF]-alpha; Figure 2). In contrast, interferon-alpha4 expression was increased after PSL treatment.
case_images: Fecal microbiota analyses in a patient with Cronkhite-Canada syndrome. Fecal samples obtained before and after treatment with prednisolone (PSL) were subjected to 16S ribosomal RNA sequencing. (a) Rarefaction analysis of alpha diversity in fecal samples before and after PSL treatment. (b) Relative abundance of fecal microbial composition at the species level before and after PSL treatment. *Species unidentified by sequence analyses.
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case_images: Unexpectedly, PSL treatment increased the microbial diversity in rarefaction analyses of alpha diversity (Figure 3a). A substantial reduction in the abundance of Bacteroides fragilis and Peptostreptococcus anaerobius was observed after PSL treatment (Figure 3b).