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Peripancreatic paraganglioma:Lesson from a round table

World Journal of Gastroenterology 2022年第21期28卷 2396-2402页

作者： Federica Petrelli Geri Fratini andrea Sbrozzi-Vanni andrea giusti Raffele Manta Claudio Vignali Gabriella Nesi andrea Amorosi andrea Cavazzana Marco Arganini Maria Raffaella Ambrosio Pathology Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Surgery Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Endoscopic Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Endoscopic Unit Santa Maria Misericordia HospitalPerugia 06122Italy Interventional Radiology Unit Azienda Sanitaria Toscana Nord OvestPisa 56121Italy Department of Health Sciences University of FlorenceFlorence 50139Italy Pathology Unit UniversitàMagna GraeciaCatanzaro 88100Italy

We described the case of a peripancreatic paraganglioma(PGL)misdiagnosed as pancreatic *** exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon *** enucleation of the mass was performed,preserving the pancreatic ***,a diagnosis of PGL was ***,two previously unreported mutations,one affecting the KDR gene in exon 7 and another on the JAK3 gene in exon 4 were *** mutations are known to be *** and cytologic findings were blindly reviewed by an expert panel of clinicians,radiologists,and pathologists to identify possible causes of the *** major issue was lack of evidence of a cleavage plane from the pancreas at imaging,which prompted radiologists to establish an intraparenchymal *** blinded revision shifted the diagnosis towards an extrapancreatic lesion,as the pancreatic parenchyma showed no structural alterations and no dislocation of the Wirsung *** post,the identified biases were the emergency setting of the radiologic examination and the very thin mesocolon sheet,which hindered clear definition of the lesion *** endoscopic ultrasonography diagnosis was confirmed,emphasizing the intrinsic limit of this technique in detecting large ***,pathologic review favored a diagnosis of PGL due to the morphological features and immonohistochemical *** months after tumor excision,the patient is asymptomatic with no disease relapse evident by either radiology or laboratory *** report strongly highlights the difficulties in rendering an accurate preoperative diagnosis of PGL.

关键词： Peripancreatic paraganglioma Pancreatic neuroendocrine tumor Solid pseudopapillary neoplasm S100 Succinate dehydrogenase subunit B gene and expression Fine needle biopsy

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Challenges in the differential diagnosis of hypercalcemia: A case of hypercalcemia with normal PTH level

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World Journal of Clinical Oncology 2012年第1期3卷 7-11页

作者： Francesca Pellicciotti andrea giusti Maria Carolina Gelli Salvatore Foderaro Alberto Ferrari Giulio Pioli Geriatric Unit Arcispedale Santa Maria Nuova Viale Risorgimento 80 42123 Reggio Emilia Italy Bone Clinic Department of Gerontology and Musculoskeletal Sciences Galliera Hospital Corso Mentana 10 16128 Genoa Italy Department of Pathology Arcispedale Santa Maria Nuova Viale Risorgimento 80 42123 Reggio Emi-lia Italy

The hypercalcemias are a common and heterogeneous group of disorders, ranging from the occasional detection of a high level of serum calcium to a life-treating condition. In a patient presenting with hypercalcemia, a differential diagnosis can be established easily by measuring serum calcium and parathyroid hormone(PTH) concentrations. We describe the case of an 83-year-old man presenting with a severe symptomatic hypercalcemia with high-normal PTH level due to the coexistence of primary hyperparathyroidism and malignancy-associated hypercalcemia. The presence of two conditions producing hypercalcemia was revealed only during inhospital stay and after the administration of an intravenous bisphosphonate, when the PTH concentration increased rapidly after bisphosphonate treatment with a decrease in serum calcium. The occurrence of twoconditions producing hypercalcemia is a rare event in the literature, and should be considered in the presence of an abnormally high serum calcium level associated with normal or high-normal PTH, in order to establish a correct diagnosis and appropriate interventions.

关键词： Bisphosphonates Hypercalcemia Malignancy-associated hypercalcemia Parathyroid hormone Primary hyperparathyroidism

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Deep endometriosis with pericolic lymph node involvement: A case report and literature review

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World Journal of Gastroenterology 2014年第21期20卷 6675-6679页

作者： andrea Cacciato Insilla Monnalisa Granai Grazia Gallippi Patrizia giusti Sabina giusti Simone Guadagni Luca Morelli Daniela Campani Department of Surgical Pathology University Hospital of Pisa56124 PisaItaly Department of Diagnostic Radiology University Hospital of Pisa56124 PisaItaly Department of General Surgery University Hospital of Pisa56124 PisaItaly

Deep infiltrating endometriosis is an often-painful disorder affecting women during their reproductive years that usually involves the structures of the pelvis and frequently the gastrointestinal *** present the case of a 37-year-old female patient with an endometrial growth on the sigmoid colon wall causing pain,diarrhea and the presence of blood in the *** histology of the removed specimen also revealed the involvement of the utero-vesical fold,the recto-vaginal septum and a pericolic lymph node,which are all quite uncommon *** identify the endometrial cells,we performed immunohistochemical staining for CD10and the estrogen and progesterone receptors.

关键词： Deep infiltrating endometriosis Gastrointestinal t

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Clinical epidemiology of chronic viral hepatitis B:A Tuscany real-world large-scale cohort study

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World Journal of Hepatology 2018年第5期10卷 409-416页

作者： Cristina Stasi Caterina Silvestri Roberto Berni Maurizia Rossana Brunetto Anna Linda Zignego Cristina Orsini Stefano Milani Liana Ricciardi andrea De Luca Pierluigi Blanc Cesira Nencioni Donatella Aquilini Alessandro Bartoloni Giampaolo Bresci Santino Marchi Franco Filipponi Piero Colombatto Paolo Forte andrea Galli Sauro Luchi Silvia Chigiotti Alessandro Nerli Giampaolo Corti Rodolfo Sacco Paola Carrai Angelo Ricchiuti Massimo giusti Paolo Almi andrea Cozzi Silvia Carloppi Giacomo Laffi Fabio Voller Francesco Cipriani Observatory of Epidemiology Regional Health Agency of TuscanyFlorence 50141Italy Center for Systemic Manifestations of Hepatitis Viruses(MaSVE) Internal Medicine and Liver UnitDepartment of Experimental and Clinical MedicineCareggi University HospitalFlorence 50134Italy Web Solutions Data Visualization and Scientific DocumentationRegional Health Agency of TuscanyFlorence 50141Italy Hepatology Unit Department of Clinical and Experimental MedicineUniversity Hospital of PisaPisa 56100Italy Gastroenterology Research Unit Department of Experimental and Clinical Biomedical Sciences“Mario Serio”Careggi University HospitalFlorence 50134Italy Infectious Disease Unit Hospital of LuccaLucca 55100Italy Infectious Diseases Unit Department of Medical BiotechnologiesSiena University HospitalSiena 53100Italy Infectious Disease Unit “S.Maria Annunziata”HospitalPonte a Niccheri 50012Italy Infectious Disease Unit Hospital of GrossetoGrosseto 58100Italy Infectious Disease Unit Hospital of PratoPrato 59100Italy Infectious and Tropical Diseases Unit Department of Experimental and Clinical MedicineCareggi University HospitalFlorence 50134Italy Gastroenterology and Metabolic Disorders Department of SurgeryCisanello University HospitalPisa 56100Italy Gastroenterology Unit Department of Translational Research and New Technologies in Medicine and SurgeryCisanello University Hospital of PisaPisa 56100Italy Liver Surgery and Transplantation Unit Department of Surgical PathologyMedicineMolecular and Critical AreaCisanello University HospitalPisa 56100Italy Internal Medicine Unit “San Jacopo”HospitalPistoia 51100Italy Infectious Diseases and Hepatology Unit Department of Internal and Specialized MedicineUniversity Hospital of SienaSiena 53100Italy Gastroenterology Unit San Giuseppe HospitalEmpoli 50053Italy Internal Medicine and Liver Unit Department of Experimental and Clinical MedicineCareggi University HospitalFlorence 50135Italy Department of Prevention Central Tuscany Local UnitFlorence 5

AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care *** This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults.

关键词： Hepatitis B virus infection Liver fibrosis Cirrhosis Public health Epidemiology

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