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Pancreatic lymphangioma:two case reports from an institutional experience with a rare entity and review of literature

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Journal of pancreatology 2022年第2期5卷 98-109页

作者： Alfonso Tan-Garcia Ser Yee Lee Jen San Wong Thomas W.T.Ho Keng Sin Ng Kiat Hon Tony Lim Division of Pathology Department of Anatomical PathologySingapore General HospitalSingapore Surgical Associates Mount Elizabeth Medical CentreSingapore Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore hepatobiliary and Pancreatic Surgery Centre Mount Elizabeth Medical CentreSingapore Digestive Surgical Oncology Department of Diagnostic Imaging Mount Alvernia HospitalSingapore

Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic lesions.As such,pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised lesion.We present 2 cases of pancreatic lymphangioma,determine its prevalence at our institution and perform a detailed review of published literature since 2010.Case 1 is a 36-year-old male and case 2 is a 35-year-old female,both of which presented with abdominal pain.These were the only cases of pancreatic lymphangiomas reported at our institution since 2010.We reviewed 69 cases of pancreatic lymphangiomas from 52 publications.It affects predominantly females with a median age of 43 and such patients typically present with abdominal pain(58.8%)or are asymptomatic(27.9%).The median size is 8.6 cm,the most common location is the head of pancreas and the most common imaging finding is that of a multilocular cyst.Majority of patients underwent surgical resection(69.6%).Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid,elevated fluid triglyceride levels(15/16 cases)and numerous lymphocytes on cytology.The majority of patients with elevated fluid triglyceride levels(13/15 cases)were managed conservatively.Pancreatic lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical,radiological,biochemical and cytological features,allowing greater confidence in the selection of patients who can be managed conservatively.

关键词： Case report Cystic Diagnostic features Literature review Lymphangioma management Pancreas Prevalence

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Risk factors for bile leakage after hepatectomy

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hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 12-13页

作者： Benjamin Struecker Andreas Andreou Igor M Sauer Johann Pratschke Daniel Seehofer General Visceraland Transplantation SurgeryCharité-Universitaetsmedizin BerlinCampus Virchow Clinic

In the current issue, Panaro et al presented a retro- spective single-center study on 411 hepatectomies for benign and malignant liver tumors. After exclusion of hilar cholangiocarcinomas and hepatectomies with simultaneous biliary or pancreatic resection, risk factors for postoperative bile leakage were analyzed. Progress in preoperative assessment （e.g. modern imaging studies, liver function tests）, liver preconditioning （e.g. portal vein embolization）, improving perioperative care, and advances in surgical techniques （e.g. two stage hepatec- tomies, liver partition with portal vein ligation for staged hepatectomy） enable curative resections even for advanced hepatic malignancies with reasonable mortality rates and constantly improving oncological outcomes.

关键词： Risk factors for bile leakage after hepatectomy

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ALPPS versus portal vein embolization for hepatitis B virus-associated hepatocellular carcinoma: a delicate balance between volume and morbidity

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hepatobiliary Surgery and Nutrition 2023年第2期12卷 284-286页

作者： Victor Lopez-Lopez Kohei Miura Asuncion Lopez-Conesa Roberto Brusadin Alvaro Navarro Ricardo Robles-Campos Department of General Visceral and Transplantation SurgeryClinic and University Hospital Virgen de La ArrixacaIMIB-ARRIXACAEl PalmarMurciaSpain Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental SciencesNiigataJapan

We have read with great interest the recent study published by Li et al.,entitled“Associating liver partition and portal vein ligation for staged hepatectomy versus sequential transarterial chemoembolization and portal vein embolization in staged hepatectomy for HBV-related hepatocellular carcinoma:a randomized comparative study”(1).

关键词： Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) portal vein embolization(PVE) hepatocellular carcinoma(HCC) Hepatitis B

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AN IMMUNOHISTOCHEMICAL STUDY ON EXPRESSION OF CD44v6 PROTEIN IN HUMAN GALLBLADDER CARCINOMA

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Academic Journal of Xi'an Jiaotong University 2001年第2期13卷 98-100,106页

作者：张云锋王作仁杨春华刘永存 Department of hepatobiliary Surgery First Hosp. of Xi' an Jiaotong Univ. Xi' an 710061 China

Objective To investigate the clinical significances of CD44v6 protein expression in human gallbladder carcinoma(GBC).Methods The immunohistochemical technique was used to detect the CD44v6 protein expression in 40 cases of GBC,12 cases of chronic cholecystitis,6 cases of adenoma and 4 cases of adenomyomatous hyperplasia.Results The positive rate of CD44v6 expression in gallbladder carcinoma and benign lesions was 72.5% and 0%,respectively( P clinic staging,but there was no correlation among pathological types.Conclusion Detecting CD44v6 expression might be severed as an objective indicator for differential diagnosis,lymph node metastatic potency,tumor progress and prognosis in gallbladder carcinoma.

关键词： gallbladder neoplasm CD44v6 protein immunohistochemistry

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Combined transarterial chemoembolization and stereotactic body radiation therapy as a bridge therapy to liver transplant for hepatocellular carcinoma

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Hepatoma Research 2020年第8期6卷 36-45页

作者： Bui Quang Bieu Nguyen Dinh Chau Nguyen Xuan Kien Le Van Thanh Vu Van Quang Thai Doan Ky Nguyen Tien Thinh Mai Hong Bang Department of Radiation Oncology and Radiosurgery Military Central Hospital 108Hanoi 100000Vietnam Department of hepatobiliary and Pancreatic Surgery Military Central Hospital 108Hanoi 100000Vietnam Department of Gastroenterology and hepatobiliary Military Central Hospital 108Hanoi 100000Vietnam.

Liver transplant(LT)is the curative treatment for patients with hepatocellular carcinoma(HCC).Bridge therapies are local treatments given to patients on the LT waitlist,to prevent tumor progression and to reduce the dropout rate.Case presentation:We reported a 40-year-old man diagnosed with Barcenola-clinic Liver Cancer BCLC intermediate stage HCC and Child-Pugh A5 hepatitis B virus cirrhosis who underwent combined bridge therapies to LT.Firstly,the patient received transarterial chemoembolization(TACE)for two times and showed a partial response.Then he underwent stereotactic body radiation therapy(SBRT)with a total dose of 45 Gy in 3 fractions.Three months later,the tumor size and serum protein induced by Vitamin K absence or antagonists-II,alpha fetoprotein levels decreased gradually.In June 2019 a suitable donor was found and his LT was successfully performed.Conclusion:We propose that a combination of TACE and SBRT was feasible as bridge therapy for HCC patients on the LT waitlist.

关键词： Transarterial chemoembolization stereotactic body radiation therapy bridge therapy hepatocellular carcinoma liver transplant

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Preoperative defining system for pancreatic head cancer considering surgical resection

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World Journal of Gastroenterology 2016年第26期22卷 6076-6082页

作者： Seok Jeong Yang Ho Kyoung Hwang Chang Moo Kang Woo Jung Lee Department of Surgery Ulsan University Hospital University of Ulsan College of Medicine Department of hepatobiliary and Pancreatic Surgery Yonsei University College of Medicine Pancreaticobiliary Cancer clinic Yonsei Cancer Center Institute of Gastroenterology Yonsei Severance Hospital

AIM: To provide appropriate treatment, it is crucial to share the clinical status of pancreas head cancer among multidisciplinary treatment members. METHODS: A retrospective analysis of the medical records of 113 patients who underwent surgery for pancreas head cancer from January 2008 to December 2012 was performed. We developed preoperative defining system of pancreatic head cancer by describing "resectability- tumor location- vascular relationship- adjacent organ involvement- preoperative CA19-9(initial bilirubin level)- vascular anomaly". The oncologic correlations with this reporting system were evaluated.RESULTS: Among 113 patients, there were 75 patients(66.4%) with resectable, 34 patients(30.1%) with borderline resectable, and 4 patients(3.5%) with locally advanced pancreatic cancer. Mean disease-free survival was 24.8 mo(95%CI: 19.6-30.1) with a 5-year diseasefree survival rate of 13.5%. Pretreatment tumor size ≥ 2.4 cm [Exp(B) = 3.608, 95%CI: 1.512-8.609, P = 0.044] and radiologic vascular invasion [Exp(B) = 5.553, 95%CI: 2.269-14.589, P = 0.002] were independent predictive factors for neoadjuvant treatment. Borderline resectability [Exp(B) = 0.222, P = 0.008], pancreatichead cancer involving the pancreatic neck [Exp(B) = 9.461, P = 0.001] and arterial invasion [Exp(B) = 6.208, P = 0.010], and adjusted CA19-9 ≥ 50 [Exp(B) = 1.972 P = 0.019] were identified as prognostic clinical factors to predict tumor recurrence. CONCLUSION: The suggested preoperative defining system can help with designing treatment plans and also predict oncologic outcomes.

关键词： Preoperative defining system Pancreas head cancer Borderline resectable Adjusted CA19-9 Neoadjuvant

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The potential molecular mechanism of overexpression of uPA, IL-8, MMP-7 and MMP-9 induced by TRAIL in pancreatic cancer cell

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hepatobiliary & Pancreatic Diseases International 2008年第2期7卷 201-209页

作者： Anna Trauzold Christian Rder Holger Kalthoff Molecular Oncology Research Laboratory Clinic for General and Thoracic Surgery Christian-Albrechts-University 24105 Kiel Germany

BACKGROUND: TNF-related apoptosis-inducing ligand (TRAIL) is a death ligand of the TNF-superfamily that has been implicated in inducing apoptosis in some tumor cells. The purpose of this study was to find out if TRAIL could induce the expression of uPA, IL-8, MMP-7 and MMP-9. and to explore the corresponding potential signaling transduction pathway in pancreatic cancer cells. METHODS: Colo357wt, Panc89 and PancTu I cell lines were stimulated by TRAIL (100 ng/ml). Crystal violet cell vitality assay was used to check the sensitivity to TRAIL-induced apoptosis. Real-time RT-PCR tested the expression of uPA, IL-8, MMP-7 and MMP-9. RESULTS: TRAIL can stimulate the expression of uPA, IL-8, MMP-7 and MMP-9 in pancreatic cancer cell lines, especially in Colo357wt. The members of caspases, MEK1/2, PKC, and NF-kappa B are involved in TRAIL-induced expression of uPA, IL-8, MMP-7 and MMP-9. Furthermore, caspases play a different role in Colo357wt, Panc89 and PancTu I. CONCLUSIONS: TRAIL-treatment may result in the enhancement of invasion involving the signaling pathways of caspases, MEK1/2, PKC and NF-kappa B, in pancreatic cancer cells. It points to the necessity to carefully evaluate in vivo side effects of TRAIL.

关键词： TRAIL molecular mechanism pancreatic neoplasms

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The challenge of hepatic vein reconstruction in surgical oncology

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hepatobiliary Surgery and Nutrition 2022年第3期11卷 473-476页

作者： Víctor Lopez-Lopez David Ferreras Dilmurodjon Eshmuminov Roberto Brusadin Ricardo Robles-Campos Department of General Visceral and Transplantation SurgeryClinic and University Hospital Virgen de La ArrixacaIMIB-ARRIXACAEl PalmarMurciaSpain Department of Surgery and Transplantation Swiss Hepato-Pancreato-Biliary(HPB)CenterUniversity Hospital ZurichZurichSwitzerland

In the liver surgical oncology,a complete resection of the primary or metastatic liver tumors remains the main objective.If the tumor invades the hepatic vein or the inferior vena cava(IVC)a curative resection becomes challenging.However,recent advances in intraoperative hemodynamic management together with the refinement of the surgical technique acquired by complex liver surgery and transplantation have allowed to perform hepatic vein or vena cava resection for curation with low morbidity and mortality.

关键词： surgical hepatic mortality

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Identification of portal vein tumor thrombus with an independent clonal origin in hepatocellular carcinoma via multi-omics data analysis

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Cancer Biology & Medicine 2019年第1期16卷 147-156页

作者： Shupeng Liu Zaixin Zhou Yin Jia Jie Xue Zhiyong Liu Kai Cheng Shuqun Cheng Shanrong Liu clinical Research Center Changhai Hospital Second Military Medical University Department of Laboratory Diagnostics Changhai Hospital Second Military Medical University Department of Hepatic Surgery VI Eastern Hepatobiliary Surgery Hospital Second Military Medical University

Objective: Multiple mechanisms underlying the development of portal vein tumor thrombus(PVTT) in hepatocellular carcinoma(HCC) have been reported recently. However, the origins of PVTT remain unknown. Increasing multi-omics data on PVTTs in HCCs have made it possible to investigate whether PVTTs originate from the corresponding primary tumors(Ts).Methods: The clonal relationship between PVTTs and their corresponding primary Ts was investigated using datasets deposited in public databases. One DNA copy number variations dataset and three gene expression datasets were downloaded for the analyses.Clonality analysis was performed to investigate the clonal relationship between PVTTs and Ts from an individual patient.Differential gene expression analysis was applied to investigate the gene expression profiles of PVTTs and Ts.Results: One out of 19 PVTTs had no clonal relationship with its corresponding T, whereas the others did. The PVTTs with independent clonal origin showed different gene expression and enrichment in biological processes from the primary Ts. Based on the unique gene expression profiles, a gene signature including 24 genes was used to identify pairs of PVTTs and primary Ts without any clonal relationship. Validation in three datasets showed that these types of pairs of PVTTs and Ts can be identified by the 24-gene signature.Conclusions: Our findings show a direct evidence for PVTT origin and consolidate the heterogeneity of PVTTs observed in clinic.The results suggest that PVTT investigation at a molecular level is clinically necessary for diagnosis and treatment.

关键词： Hepatocellular carcinoma portal vein tumor thrombus clonal origin copy number variation bioinformatics

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hepatobiliary manifestations of ulcerative colitis:an example of gut–liver crosstalk

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Gastroenterology Report 2014年第3期2卷 193-200页

作者： Udayakumar Navaneethan Department of Gastroenterology/Hepatology Digestive Disease InstituteThe Cleveland Clinic FoundationClevelandOhioUSA

The interaction between inflammatory bowel disease(IBD)and hepatobiliary manifestations represents a classic example of liver–gut crosstalk.The importance of liver–gut crosstalk in IBD is demonstrated in the pathogenesis and outcome of primary sclerosing cholangitis(PSC)in IBD patients.Immunoglobulin G4-associated cholangitis(IAC),which has recently been described in UC patients,may also illustrate the significance of gut–liver interaction in these patients.Presence of these hepatobiliary manifestations influences the outcome of associated IBD,in particular ulcerative colitis(UC),and vice versa.The pathogenesis of PSC is postulated to be related to gut inflammation in IBD that results in inflammation in the portal tracts(the‘leaky gut’).Enterohepatic circulation of lymphocytes from the gut to the liver is also of potential relevance to PSC pathogenesis and outcomes.The presence of PSC and gut inflammation in IBD influences the course and outcomes of both diseases.Further research is required,to understand the mutual effect of liver–gut crosstalk in the outcomes of UC patients,and highlights the importance of an interdisciplinary approach—involving gastroenterologists,hepatologists,advanced endoscopists and liver transplant surgeons—in the management of these patients.

关键词： primary sclerosing cholangitis restorative proctocolectomy ulcerative colitis liver transplantation

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