检索结果-南通市图书馆

Cystic tumors of the pancreas: Opportunities and risks

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Pathophysiology 2015年第2期6卷 29-32页

作者： Marco Del Chiaro Caroline Verbeke Pancreatic Surgery Unit Division of Surgery Department of Clinical Science Intervention and Technology (CLINTEC) Karolinska Institute at Center for Digestive Diseases Karolinska University Hospital Department of Pathology Institute of Clinical Medicine University of Oslo Department of Pathology Karolinska Institute

Pancreatic cystic neoplasms(PCNs) are a high prevalence disease. It is estimated that about 20% of the general population is affected by PCNs. Some of those lesions can progress till cancer, while others behave in a benign fashion. In particular intraductal papillary mucinousneoplasms of the pancreas can be considered as the pancreatic analogon to colonic polyps. Treatment of these precursor lesions at an early stage can potentially reduce pancreas cancer mortality and introduce a new "era" of preemptive pancreatic surgery. However, only few of those lesions have an aggressive behavior. The accuracy of preoperative diagnosis, i.e., the distinction between the various PCNs is around 60%, and the ability to predict the future outcome is also less accurate. For this reason, a significant number of patients are currently over-treated with an unnecessary, high-risk surgery. Furthermore, the majority of patients with PCN are on life-long follow-up with imaging modality, which has huge cost implications for the Health Care System for limited benefits considering that a significant proportion of PCNs are or behave like benign lesions. The current guidelines for the diagnosis and management of PCNs are more based on expert opinion than on evidence. For all those reasons, the management of cystic tumors of the pancreas remains a controversial area of pancreatology. On one hand, the detection of PCNs and the surgical treatment of pre-cancerous neoplasms can be considered a big opportunity to reduce pancreatic cancer related mortality. On the other hand, PCNs are associated with a considerable risk of under- or over- treatment of patients and incur high costs for the Health Care System.

关键词： Pancreatic cystic neoplasms mucinous cystic neoplasia Preemptive pancreatic surgery Pancreas Intraductal papillary mucinous neoplasia

Endosonography in the diagnosis and management of pancreatic cysts

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2015年第3期7卷 213-223页

作者： Vivek Kadiyala Linda S Lee Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Harvard Medical School

Rapid advances in radiologic technology and increased cross-sectional imaging have led to a sharp rise in incidental discoveries of pancreatic cystic lesions. These cystic lesions include non-neoplastic cysts with no risk of malignancy, neoplastic non-mucinous serous cystadenomas with little or no risk of malignancy, as well as neoplastic mucinous cysts and solid pseudopapillary neoplasms both with varying riskof malignancy. Accurate diagnosis is imperative as management is guided by symptoms and risk of malignancy. Endoscopic ultrasound(EUS) allows high resolution evaluation of cyst morphology and precise guidance for fine needle aspiration(FNA) of cyst fluid for cytological, chemical and molecular analysis. Initially, clinical evaluation and radiologic imaging, preferably with magnetic resonance imaging of the pancreas and magnetic resonance cholangiopancreatography, are performed. In asymptomatic patients where diagnosis is unclear and malignant risk is indeterminate, EUSFNA should be used to confirm the presence or absence of high-risk features, differentiate mucinous from non-mucinous lesions, and diagnose malignancy. After analyzing the cyst fluid for viscosity, cyst fluid carcinoembryonic antigen, amylase, and cyst wall cytology should be obtained. DNA analysis may add useful information in diagnosing mucinous cysts when the previous studies are indeterminate. New molecular biomarkers are being investigated to improve diagnostic capabilities and management decisions in these challenging cystic lesions. Current guidelines recommend surgical pancreatic resection as the standard of care for symptomatic cysts and those with high-risk features associated with malignancy. EUSguided cyst ablation is a promising minimally invasive, relatively low-risk alternative to both surgery and surveillance.

关键词： Endoscopic ultrasound Pancreatic cyst Serous cystadenoma Intraductal papillary mucinousneoplasms mucinous cystic neoplasm Solid pseudopapillaryneoplasms diagnosis Management Ablation

Pancreatic Carcinoma with Prominent Mucin Production: A Clinicopathologic and Immunohistochemical Study of 9 Cases

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Pathology 2012年第2期2卷 15-20页

作者： Makoto Saito Hiroshi Nishihara Mishie Tanino Taichi Kimura Yoshihiro Matsuno Kazuo Nagashima Michio Shimizu Shinya Tanaka Department of Cancer Pathology Hokkaido University Graduate School of Medicine Sapporo Japan Department of Cancer Pathology Hokkaido University Graduate School of Medicine Sapporo Japan Department of Pathology Saitama Medical University Saitama Japan. Department of Surgical Pathology Hokkaido University Hospital Sapporo Japan Department of Translational Pathology Hokkaido University Graduate School of Medicine Sapporo Japan

Pancreatic carcinoma occasionally associated with prominent mucin production and this type of tumor designated as PCM (pancreatic carcinoma with prominent mucin production) was diagnosed depends on subjective estimation of the amount of mucous area, and there has been no report on a quantitative evaluation of the amount of mucinous area in the tumor. To examine the feature of PCM, we analyzed 9 cases of PCM among 243 cases of pancreas carcinoma and evaluated the amount of mucin by imaging analysis. Morphologically, 5 cases were classified as intradactal papillary mucinous neoplasms (IPMN)-derived PCM and 4 cases were as ductal adenocarcinoma (DA)-derived PCM. Mucous composition was found to be more than 50% in all IPMN-derived PCM cases, and that was 40% - 50% in DA-derived PCM cases with one exception. IPMN-derived PCM cases showed expansive growth with pancreatic duct dilatation filled with mucin, while DA-derived PCM cases possessed mucin infiltration into interstitial tissue. Immunohisto-chemically, three of 4 DA-derived PCM cases were MUC1(–)/MUC2(+), and the results of expressions for p16 and Dpc4 suggesting that DA-derived PCM was similar to IPMN-derived PCM rather than ordinary DA. Survival rate of DA-derived PCM cases was lower than that of IPMN-derived PCM cases. We advocate that DA-derived PCM may constitute a borderline group between IPMN and ordinary DA.

关键词： Pancreatic Carcinoma with Prominent Mucin Production (PCM) mucinous Non-Cystic Carcinoma (MNCC) Intraductal Papillary mucinous Neoplasm (IPMN) Ductal Adenocarcinoma (DA) Immunohistochemistry

Evaluation of diagnostic cytology via endoscopic naso-pancreatic drainage for pancreatic tumor

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2014年第8期6卷 366-372页

作者： Tomoyuki Iwata Katsuya Kitamura Akira Yamamiya Yu Ishii Yoshiki Sato Tomohiro Nomoto Akitoshi Ikegami Hitoshi Yoshida Division of Gastroenterology Department of Medicine Showa University School of Medicine Shinagawa-ku Tokyo 142-8666 Japan

AIM: To evaluate the usefulness of cytology of the pancreatic juice obtained via the endoscopic naso-pancreatic drainage tube(ENPD-C).METHODS: ENPD was performed in cases where a diagnosis could not be made other than by using en-doscopic retrograde cholangiopancreatography and in cases of pancreatic neoplasms or cystic tumors, includ-ing intraductal papillary mucinous neoplasm(IPMN) suspected to have malignant potential. 35 patients(21 males and 14 females) underwent ENPD between January 2007 and June 2013. The pancreatic duct was imaged and the procedure continued in one of ENPD-C or ENPD-C plus brush cytology(ENPD-BC). We checked the cytology result and the final ***: The mean patient age was 69 years(range, 48-86 years). ENPD-C was performed in 24 cases andENPD-C plus brush cytology(ENPD-BC) in 11 cases. The ENPD tube was inserted for an average of 3.5 d. The final diagnosis was confirmed on the basis of the resected specimen in 18 cases and of follow-up findings at least 6 mo after ENPD in the 18 inoperable cases. Malignancy was diagnosed in 21 cases and 14 patients were diagnosed as having a benign condition. The ratios of class Ⅴ/Ⅳ:Ⅲ:Ⅱ/Ⅰ?findings were 7:7:7 in malignant cases and 0:3:11 in benign cases. The sensitivity and specificity for all patients were 33.3% and 100%, re-spectively. The cytology-positive rate was 37.5%(6/16) for pancreatic cancer. For IPMN cases, the sensitivity and specificity were 33% and 100%, ***: Sensitivity may be further increased by adding brush cytology. Although we can diagnosis cancer in cases of a positive result, the accuracy of ENPD-C remains unsatisfactory.

关键词： Endoscopic naso-pancreatic drainage Pancreatic juice Cytology Pancreatic cancer Intraductal papillary mucinous neoplasm

Misleading New Entity in Tumors of Kidney: A Case Report and Literature Review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Urology 2012年第4期2卷 219-222页

作者： El Fatemi Hinde Hammas Nawal Hafid Imane Tazi Fadl Elfassi Jamal Amarti Afaf Department of Pathology Hassan II Teaching Hospital Fez Morocco Department of Urology Hassan II Teaching Hospital Fez Morocco

Introduction: mucinous tubular and spindle cell carcinomas (MTSCC's) are recently described rare type of renal cell carcinoma (RCC). They may have morphological similarities to papillary RCC (papRCC) and in our case to carcinoma collecting ducts of Bellini. Case report: We report a rare case of renal tumor, mucinous tubular and spindle cell carcinoma in a 56-year-old woman. The tumor, located in the left kidney, was well circumscribed. MTSCC's are characterized by small, elongated tubules lined by cuboidal cells and/or cords of spindled cells separated by pale mucinous stroma. Discussion: MTSCC is a rare type of renal cell carcinoma. Pathologists should be aware of the histological spectrum of MTSCCs to ensure an accurate diagnosis. Careful attention to the presence of a spindle cell population may be helpful in the differential diagnosis in tumors with predominant compact tubular growth.

关键词： Renal Carcinoma mucinous Tubular and Spindle Cell Carcinoma CD10 Immunohistochemistry

MALIGNANT TRANSFORMATION OF HOST STROMA CELLS INDUCED BY TRANSPLANTATION OF HUMAN RECTAL ADENOCARCINOMA IN NUDE MICE

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Science Bulletin 1988年第1期33卷 80-83页

作者：高天祥周利华张卫国 Central Laboratory of Electron Microscopy Shandong Medical University Jinan

A human rectal adenocarcinoma was propagated subcutaneously in BALB/c nude mice. After cultivation of the xenograft from nude mice in vitro, malignant transformation of host fibroblast cells was unexpectedly observed. This result suggests that the transformation was possibly induced by transplanted human tumor cells and the xenograft/nude mice system might serve as a useful model for the study of the mechanisms of malignant transformation in general.

关键词： nude rectal adenocarcinoma cultivation mucinous stroma malignancy possibly murine neoplastic

Potential Use of Ultrasonic Cavitation Threshold to Non-Invasively Differentiate Cystic Masses

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Open Journal of Radiology 2014年第4期4卷 329-338页

作者： Brian E. O’Neill Ellen Chang Nam Yu Department of Translational Imaging Houston Methodist Research Institute Houston USA

Objectives: To demonstrate in vitro that changes in ultrasound cavitation threshold might be used for non-invasively distinguishing high viscosity mucinous fluid from low viscosity serous fluid in cystic masses, based on the facts that cavitation threshold increases with increasing viscosity and that cavitation microbubbles are observable with diagnostic ultrasound. Methods: An in vitro model of a cyst was designed using dilutions of ultrasonic gel, and the cavitation threshold of this model was determined using focused and unfocused ultrasound for bubble initiation and clinical ultrasound b-scan for detection. Results: Viscosities of dilutions between 0% and 30% gel were had viscosities measuring between 1.05 ± 0.08 cP and 6600 ± 875 cP. Inertial cavitation in the latter was determined to require an order of magnitude greater intensity, at 1 MHz and 100% duty cycle, than the former (>2.2 W/cm2 vs. mucinous cysts and just 22% of serous cysts. The remaining 78% of patients presenting with serous cysts would be positively identified by detection of bubbles, and would be spared an unnecessary biopsy. Conclusions: The cavitation threshold may be used non-invasively to distinguish between high viscosity and low viscosity fluids in cysts and reduce biopsies on serous cysts.

关键词： Fluid Viscosity Cavitation Threshold mucinous Cyst Serous Cysts

Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2010年第10期2卷 349-351页

作者： Masaya Uesato Yoshihiro Nabeya Shinichi Miyazaki Taito Aoki Takashi Akai Kiyohiko Shuto Tohru Tanizawa Masaru Miyazaki Hisahiro Matsubara Department of Frontier Surgery Chiba University Graduate School of MedicineChiba 260-8677Japan Makuhari Gastrointestinal Clinic Chiba 262-0033Japan Department of Pathology Chiba University HospitalChiba 260-8677Japan Department of General Surgery Chiba University Graduate School of MedicineChiba 260-8677Japan

We report on a case of a 74 year old man who was diagnosed with a recurrence of non-invasive carcinoma of intraductal papillary mucinous neoplasm (non-invasive IPMN) by postoperative gastroscopy (GS). A pylorus preserving pancreatico duodenectomy for IPMN in the pancreatic head was performed. A histopathological study revealed non-invasive adenocarcinoma. At first,the local recurrence of the tumor around the superior mesenteric artery circumference was diagnosed and disappeared with gemcitabine. Later,the GS showed the elevated lesion with mucin hypersecretion in the remnant stomach. The lesion had a central dip and a fistula common to the pancreas was confirmed on fisterography. We diagnosed a recurrence of IPMN and administered chemotherapy again. However,he died of his original illness. There are no reports of postoperative recurrence of IPMN checked by GS. It should be remembered that the elevated lesion of the remnant stomach is considered as one of the recurrent patterns of IPMN.

关键词： Intraductal papillary mucinous neoplasm Recurrence Fistula Stomach Endoscopy

Choice of skin incision for a massive ovarian cyst

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Obstetrics and Gynecology 2013年第7期3卷 10-11页

作者： H. Annamraju R. Rehman E. Opara Department of Obstetrics and Gynaecology Wexham Park Hospital Slough UK

We present a case of a very large ovarian cyst extending up to the patient’s xiphisternum, which was managed through a Pfannensteil incision. The cyst was excised without any spill of fluid, using a5 mmlaparoscopic port under suction, through a Pfannensteil incision. By this method, the operating time and the post-operative in-patient stay were reduced. Also, as our patient had a very high BMI, the associated morbidity was significantly reduced.

关键词： Ovarian mucinous Cystadenoma Laproscopy Pfannensteil Incision Obesity