Eicosanoids, including prostaglandins (PGs) and thromboxanes, are broadly bioactive lipid mediators and increase colon tumorigenesis possibly through chronic inflammatory mechanisms. Epidemiological and experimental data suggest that acetylsalicylic acid (ASA) helps prevent colorectal cancer (CRC), possibly through cyclooxygenase (COX)-mediated suppression of eicosanoid, particularly PGE, formation. Recent studies suggest that statins prevent CRC and improve survival after diagnosis. We identified patients on ASA and/or statin treatment undergoing routine colonoscopy and measured eicosanoid levels in colonic mucosa with targeted metabolomics technology (LC-MS/MS). ASA-treated individuals (n = 27) had significantly lower tissue eicosanoid levels of most COX-derived metabolites than untreated individuals (n = 31). In contrast, COX-derived lipid metabolites tended to be higher in patients with statin treatment (n = 7) as compared with those not receiving statins (n = 24). This effect was not discernible in subjects treated with ASA and statins (n = 11): Individuals treated with both drugs showed a pronounced suppression of COX-derived eicosanoids in colon tissue, even compared with subjects treated with ASA alone. Our data from a routine clinical setting support the hypothesis that ASA and statins could inhibit CRC development via lipid mediator modification. Further studies should directly investigate the effect of dual ASA and statin treatment on colon tumorigenesis in humans.

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Zusammenfassung Fokale Milzl?sionen sind sehr selten. Auch wenn bildgebende Verfahren wertvolle Hinweise zur Differenzierung der L?sionen liefern, ist eine sichere ?tiologische Zuordnung oft nicht m?glich. Wir berichten im vorliegenden Fall von einer endonosografisch gest?tzten Lymphknotenpunktion im Leberhilus mit Nachweis einer extrapulmonalen Sarkoidose bei einer jungen Patientin mit multiplen echoarmen Milzl?sionen. Ziel des vorliegenden Fallbeispiels ist es, einen kurzen ?berblick zu aktuellen Daten und Empfehlungen aus der Literatur bez?glich Differenzialdiagnosen fokaler Milzl?sionen und der extrapulmonalen Sarkoidose mit Milzbefall zu geben.

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