1/11. Percutaneous transhepatic cholangiography. Problems in interpretation.The patient who presents with jaundice, regardless of the etiology, cannot be adequately examined by a gallbladder series and intravenous cholangiography. Clinical evaluation aided by laboratory analysis will not always differentiate between primary liver parenchymal disease and biliary tract obstruction. Percutaneous transhepatic cholangiography, when successfully performed, answers the question of whether the jaundice is due to primary liver parenchymal disease or due to biliary tract obstruction. The point to emphasize is that under no circumstances is it appropriate to presume any information if the biliary system is not entered and visualized successfully. The proper interpretation of the level of block can fall prey to the mistake of incomplete aspiration of the thick, inspissated bile in the obstructed biliary tree before injection of contrast material. The problem will be worsened by a peripheral entrance into the biliary system rather than a more central one. Gastrointestinal series should always be available to aid in identifying pathology at the entrace of the common bile duct into the duodenum. Lastly, identifying the etiology at the site of the block will require additional procedures. Selective visceral angiography has contributed greatly in this area. During the 20 years of clinical usage of percutaneous transhepatic cholangiography, we feel it has become the single examination capable of preventing unnecessary exploration of the jaundiced patient with primary liver parenchymal disease and the most useful potential source of practical information if laparotomy is necessary to correct biliary tract obstruction.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/11. granular cell tumor of the biliary tree. A report of two cases and a review of the literature.Granular cell tumors are relatively uncommon soft tissue tumors usually presenting in the skin and subcutaneous tissues or tongue, although many sites have been described. Two cases arising in the extrahepatic biliary tree are described, and the previously reported cases of this rare presentation are reviewed. These tumors may mimic sclerosing cholangitis and cholangiocarcinoma clinically, and occasionally histologically, in this relatively young group of patients. The histogenesis appears to be related to schwann cells as in granular cell tumors of other sites, evidenced by histologic, immunohistochemical, and electron microscopic findings. Granular cell tumors, albeit rare, should be considered in the differential diagnosis of biliary tract disease in young patients, particularly black women, and are curable by surgical excision.- - - - - - - - - - ranking = 5keywords = tree (Clic here for more details about this article) |
3/11. Granular cell myoblastoma of the biliary tree.A granular cell myoblastoma of the common bile duct is described which caused episodes of jaundice in a young woman. Histological examination demonstrated a close association of the tumour with nerve fibres, tending to support the theory of origin from schwann cells. The lesion is benign and after excision carries an excellent prognosis.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
4/11. Granular cell myoblastoma of the bronchus. Case report and literature review.A case of multiple granular cell myoblastomas of the tracheobronchial tree is presented. The patient is well 32 months following endobronchial removal. Only 46 cases of solitary and two cases of multiple lesions of the tracheobronchial tree have been described in the literature. These lesions occur with equal frequency in men and women; at a median age of 38 years; more frequently on the right than on the left; and most commonly with cough as the presenting symptom. Most patients have been treated with major surgical resections, but conservative endobronchial removal may be effective therapy.- - - - - - - - - - ranking = 2keywords = tree (Clic here for more details about this article) |
5/11. Multicentric endobronchial granular cell myoblastoma.Granular cell myoblastoma (GCM) is a rare benign neoplasm involving the tracheobronchial tree. It is believed to arise from the Schwann cell. Four cases of tracheobronchial GCM, all of which were multicentric, are presented and a conservative therapeutic approach is suggested.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/11. Primary endobronchial granular cell myoblastoma.Granular cell myoblastoma is a common lesion of uncertain histogenesis. It commonly affects the tongue, breast, and subcutaneous tissues. However, its occurrence in the tracheobronchial tree is rare. Although generally a benign lesion, isolated malignant granular cell myoblastoma as well as its coexistence with other primary bronchogenic carcinomas has been documented. In spite of recent anecdotal reports advocating endoscopic removal of this lesion, we believe definitive surgical excision is a more rational choice of treatment.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/11. Biliary granular cell tumor: a little-known curable bile duct neoplasm of young people.Two granular cell tumors of the biliary tree are described, one in a 37-year-old black woman with obstructive jaundice and the other in a 26-year-old white woman with abdominal pain. These are rare soft tissue tumors that have an excellent prognosis when surgically excised. Almost all reported cases have been in young women, the majority of whom have been black. Because granular cell tumors of the biliary tract are uniformly resectable and curable, they should be considered and distinguished from cholangiocarcinoma or localized sclerosing cholangitis, particularly if the patient is young, female, and black.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/11. granular cell tumor of the trachea.Granular cell tumors are rare neoplasms that arise in different regions of the body. Their cell of origin is still debated among many pathologists, but recent authors consider them to be neurogenic. These tumors are believed to be benign; however, local recurrences after excision and multifocality arouse suspicions for malignancy. In the head and neck, granular cell tumors occur most frequently in the tongue. In the laryngotracheobronchial tree, most tumors reported have been in the larynx and the next most in the bronchi. Only six cases of true tracheal occurrences have been reported previously; two additional cases are reported in this paper. The literature of the cell of origin of these tumors is reviewed, the different theories are presented, and diagnosis, treatment, and follow-up are discussed.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
9/11. Respiratory obstruction caused by a multicentric granular cell tumor of the laryngotracheobronchial tree.An unusual case of acute respiratory obstruction caused by multicentric granular cell tumors of the laryngotracheobronchial tree is presented. The patient also had granular cell tumors in the tongue, vulva, and chest wall. Multiplicity of the lesions in the left lung and recurrent episodes of intercurrent pulmonary infections necessitated left pneumonectomy. The extreme rarity of such a clinical circumstance is illustrated by a review of the literature. Salient clinical and pathological features of the tumor are briefly discussed.- - - - - - - - - - ranking = 5keywords = tree (Clic here for more details about this article) |
10/11. Multiple granular cel tumors of the gallbladder and biliary tree. Report of a case.Granular cell tumors are benign lesions that usually appear in the skin, oral activity, and mucous membrane. Occasionally, they will appear in visceral organs, and cause signs and symptoms similar to those of other organ-related diseases. We studied a patient with granular cell tumors of the common bile duct whose clinical appearance mimicked that of cholecystitis with cholelithiasis. Recognition of granular cell tumors on frozen section will allow surgical resection with probable cure.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
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