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Isolated pancreatic tuberculosis masquerading as pancreatic cancer

Gastroenterology Report 2014年第2期2卷 154-157页

作者： George S.Zacharia Rajany Antony Sandesh Kolassery Thazhath M.Ramachandran Medical Gastroenterology Government Medical College CalicutIndia

Isolated pancreatic tuberculosis(TB)remains a rarity despite the high incidence of tuberculosis in many of the African and Asian countries.Presentation as discrete pancreatic mass often masquerades as pancreatic neoplasm and diagnosis may require histology.Extra-hepatic portal hypertension due to splenic vein thrombosis complicating pancreatic TB has been reported in the literature.We report here a case of isolated pancreatic TB with pancreatic head mass mimicking neoplasm with extra-hepatic portal hypertension.The possibility of TB should be considered in the list of differential diagnoses of pancreatic mass and an endoscopic,ultrasound-guided biopsy might help to clinch the diagnosis of this potentially curable disease.

关键词： pancreatic tuberculosis pancreatic cancer endoscopic ultrasonography

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Accessory Spleen Presenting as a Submucosal Lesion on Stomach Wall after Splenectomy

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Chinese Medical Journal 2018年第7期131卷 869-870页

作者： Ya-Ting Shen Chun-Hua Zhou Wen Tang Wei Wu Guang-Qiang Chen Duan-Min Hu Department of Gastroenterology The Second Affiliated Hospital of Soochow University Suzhou Jiangsu 215000 China Radiology Center The Second Affiliated Hospital of Soochow University Suzhou Jiangsu 215000 China

To the Editor： Gastric submucosal lesions are easily misdiagnosed as submucosal tumors （SMTs） or oppression, and these patients may go through endoscopic resection or surgeries. For submucosal lesions in the gastric fundus, with echotexture same as the spleen and extragastric under endoscopic ultrasound （EUS） examination, especially in patients with the history of splenectomy, accessory spleen should be suspected. It is a challenge for EUS operators. This report presented two cases diagnosed as accessary spleen by EUS and CT for the purpose of avoiding unnecessary treatment.

关键词： endoscopic ultrasonography

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文献中最早获得诊断的胃丛状血管黏液样肌纤维母细胞瘤

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Gastroenterology Report 2018年第4期6卷 313-316,I0003页

作者： Xi Li Shuangqing Li Shenghua Xiong Zhujun Wang Hu Zhang Department of General Practice West China Hospital of Sichuan UniversityChengduSichuanChina Department of Pathology West China Hospital of Sichuan UniversityChengduSichuanChina Department of Gastroenterology West China Hospital of Sichuan UniversityChengduSichuanChina

Plexiformangiomyxoid myofibroblastic tumor(PAMT)is a rare gastric mesenchymal entity with a peculiar plexiform pattern,bland spindle cells and myxoid stroma rich in arborizing blood vessels.Here we report a 44-year-old Chinese woman with PAMT.Initially she was admitted for removal of a gastric antral‘polyp’found on a routine examination 5 months previously.Our gastroscopy showed a 0.80.8cm polyp-like mass in the antrum which protruded into the lumen.endoscopic submucosal dissection(ESD)was performed to remove this mass en bloc.The specimen was carefully examined by pathologists,and the correct diagnosis of PAMT was finally made.The tumor in this case depicted typical histopathological and immunohistochemical features of gastric PAMT.This PAMT was not only the smallest on endoscopic examination in the literature but also—unlike the already reported PAMTs—exhibited a focal hyperechogenic lesion on endoscopic ultrasonography(EUS).This information highlights its value on how to identify a PAMT at its early stage.

关键词： plexiform angiomyxoid myofibroblastic tumor diagnosis endoscopic ultrasonography gastrointestinal stromal tumors

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内镜超声引导下针芯活检诊断胰腺原发性鳞状细胞癌

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Gastroenterology Report 2017年第1期5卷 72-74,I0003页

作者： Amir Kashani Melissa Kahn Laith H.Jamil Division of Gastroenterology Cedars-Sinai Medical CenterLos AngelesUSA Department of Pathology and Laboratory Medicine Cedars-Sinai Medical CenterLos AngelesUSA

Primary squamous cell carcinoma(SCC)of the pancreas is a particularly rare entity.Diagnosis of this tumor is tentatively made after ruling out metastatic SCC from another primary site and adenosquamous carcinoma(ASC)of the pancreas.Here we discuss the case of a 76-year-old woman who was found to have a solitary pancreatic lesion and multiple hepatic lesions.Results of computed tomography-guided biopsy of the liver lesions were consistent with a metastatic carcinoma displaying squamous differentiation;therefore,an endoscopic ultrasound(EUS)-guided core-needle biopsy(CNB)of the pancreatic mass was performed.Meticulous histopathological examination of the pancreatic specimen at multiple levels revealed moderately well-differentiated SCC with no glandular component.An extensive metastatic work-up did not reveal an extra-pancreatic origin for this SCC;hence,a diagnosis of primary SCC of the pancreas was established.To our knowledge,this is the first report of the diagnosis of a primary SCC of the pancreas using EUS-guided CNB.We believe that CNB has a diagnostic yield equivalent to that of fine-needle aspiration for recognizing pancreatic adenocarcinoma;however,when cytological examinations reveal atypical squamous epithelial cells suggestive of malignancy,CNB may provide a better tissue specimen,from which to determine the presence of a glandular component.Such an assessment will differentiate pancreatic SCC from ASC.

关键词： squamous cell carcinoma pancreatic neoplasms endoscopic ultrasonography core needle biopsy

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