Cases reported "Hyperplasia"

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1/16. Atypical ductal hyperplasia of the pancreas associated with a stricture of the main pancreatic duct.

    Atypical ductal hyperplasia of the pancreas is thought to be a precancerous lesion. We report a case of atypical ductal hyperplasia associated with a stricture of the main pancreatic duct. A 70-year-old man was admitted to our hospital because of abdominal pain with an elevated serum pancreatic isoamylase level. Endoscopic retrograde cholangiopancreatography disclosed a stricture of the main pancreatic duct in the body of the pancreas. Cytological evaluation of endoscopic brushings suggested adenocarcinoma. Distal pancreatectomy was performed. Microscopic examination of the stenotic pancreatic duct showed a hyperplastic epithelium without atypia. Atypical hyperplasia, however, was found in the distal portion of the main pancreatic duct in close proximity to the stricture. Atypical hyperplasia extended along the main pancreatic duct into the ductal branches of the pancreatic tail. In contrast to the vast majority of patients with atypical hyperplasia, the atypical hyperplasia seen in the present patient had no histological features suggestive of intraductal extension of the invasive carcinoma or intraductal papillary-mucinous tumor, thus representing a sporadic precancerous lesion, and it may have been equivalent to carcinoma in situ. Pancreatic duct stricture and the resultant stasis of the pancreatic juice may have promoted the atypical changes in the ductal cells upstream of the stricture.
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ranking = 1
keywords = precancerous
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2/16. A case of intraductal papillary adenocarcinoma of the pancreas associated with mass forming chronic pancreatitis.

    A case of intraductal papillary adenocarcinoma of the pancreas associated with mass forming chronic pancreatitis without calcifications is described. Pancreatolithiasis, or calcified pancreas, is recognized as a high risk factor for pancreatic cancer. However, epidemiologic studies have found that carcinoma of the pancreas associated with chronic pancreatitis was rare. The question is whether chronic pancreatitis without calcifications is actually a precancerous background lesion or not. This case suggests that hyperplasia of the pancreatic ductal epithelium may be a precancerous lesion for pancreatic cancer in some patients with chronic pancreatitis.
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ranking = 1
keywords = precancerous
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3/16. A case report of hepatocellular carcinoma within adenomatous hyperplasia: is adenomatous hyperplasia a precancerous lesion or not?

    It is controversial whether adenomatous hyperplasia (AH) of the liver progresses to hepatocellular carcinoma. We experienced two hepatic lesions in a patient (73-yr-old male) with cirrhotic liver. One was diagnosed as HCC and the other was AH including a small HCC histologically. To investigate cell kinetics and the ploidy pattern of these lesions, Feulgen dna-cytofluorometry analysis was performed. The result of this analysis suggested that AH developed into extremely well-differentiated HCC composed of mononuclear diploid cells at first and then was further transformed into clear cell type HCC composed of mononuclear tetraploid cells. The development of human HCC, at least in cirrhotic liver, may therefore be a multi-step process.
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ranking = 2
keywords = precancerous
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4/16. Selective necrosis of encapsulated malignant lesion within atypical adenomatous hyperplasia of the liver following transarterial embolization. A report of two autopsy cases.

    We report here the morphology of two nodules of atypical adenomatous hyperplasia (AH), a preneoplastic or early developmental stage of hepatocellular carcinoma (HCC), with a fibrously encapsulated malignant lesion occurring in two cirrhotic livers. The two patients had been treated for HCC by transarterial embolization. At autopsy, HCC nodules and several AH nodules were found in each case. Microscopically, two of the several AH nodules contained malignant lesions that showed selective coagulative necrosis: the hepatocytes of the nonmalignant parts of the two AH nodules were viable. The malignant lesions within the atypical AH nodules were surrounded with a fibrous capsule, and the majority of HCC nodules were necrotic; AH nodules themselves, except for malignant lesions, were viable. This suggests to us that there are differences in blood supply between the malignant lesions and surrounding tissue of atypical AH: malignant lesions within atypical AH may be supplied mainly by arterial blood, whereas nonmalignant areas of atypical AH may be dually supplied by both arterial and portal blood. Alternatively, it may be that the malignant lesions in atypical AH are more susceptible to hypoxia caused by transarterial embolization.
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ranking = 21.124931383989
keywords = preneoplastic
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5/16. An autopsy case of metastatic foci of hepatocellular carcinoma in adenomatous hyperplasias of the liver.

    Adenomatous hyperplasia of the liver is known as a preneoplastic or early developmental stage of hepatocellular carcinoma, in which overt malignant foci occasionally develop. We have recently experienced an autopsy case (a 70-year-old male) of liver cirrhosis with hepatocellular carcinoma and two nodules of adenomatous hyperplasia. The latter two nodules contained several microscopic foci of moderately differentiated hepatocellular carcinoma. There were a number of tumor microemboli in portal vein branches within areas of adenomatous hyperplasia in addition to areas surrounding cirrhotic liver, some of which grew into the parenchyma of adenomatous hyperplasia and cirrhotic regenerative nodules. These findings and the fact that adenomatous hyperplasia contained portal tracts including portal venous branches, suggest that malignant foci in adenomatous hyperplasia contained portal tracts including represent metastases from hepatocellular carcinoma in other parts of the liver via the intrahepatic portal venous system.
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ranking = 21.124931383989
keywords = preneoplastic
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6/16. The histogenetic origin of cervical mesonephric hyperplasia and mesonephric adenocarcinoma of the uterine cervix studied with immunohistochemical methods.

    Forty-four cases of mesonephric hyperplasia (MH) and two adenocarcinomas arising from mesonephric remnants (MA) in the cervix were compared immunohistochemically with 10 embryonic and fetal mesonephric tissues. The mesonephric cells retained their pattern for intermediate filaments during ontogenesis, as well as in the mature, hyperplastic, and neoplastic states: they expressed cytokeratin 8, cytokeratin 13, and vimentin, the two latter in variable amounts. In embryonic mesonephric tissues, cytokeratin was absent, whereas the staining for vimentin was intense. Fetal mesonephric cells stained for cytokeratin 13 and vimentin, but that staining diminished as maturation progressed. All MH and MA expressed cytokeratin 8, whereas only 20-30% of the cells in MH and 10-20% of carcinomatous mesonephric cells showed positive reactions with anti-cytokeratin 13 and anti-vimentin. CEA was always negative in cells of mesonephric origin. We regard these results to be important, since the reactions with anti-CEA and anti-vimentin enable one to distinguish cervical adenocarcinomas of mesonephric origin from those of endocervical origin, the latter being CEA-positive and vimentin-negative. Clinical studies revealed that approximately 75% of the patients with MH had used oral contraceptives for several years, 46% had precancerous lesions of the cervix, and in 62% the cervical mucosa showed adenomatous microglandular hyperplasia. We believe that hyperplasia of mesonephric remnants in the cervix may occur more often in patients with disturbed hormonal balance. However, the lack of a control population does not enable us to advance this hypothesis with assurance.
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ranking = 0.5
keywords = precancerous
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7/16. A histopathological analysis of five cases of adenomatous hyperplasia containing minute hepatocellular carcinoma.

    We present five cases of adenomatous hyperplasia (AH) containing minute hepatocellular carcinoma (HCC) in cirrhotic liver. All the patients were Japanese, four males and one female, ranging in age from 60 to 80 years. Two of the specimens were obtained at surgery and the others at autopsy. The AH specimens ranged from 2.0 to 3.0 cm in diameter, and the maximum diameter of HCC foci in the AH was 2.0 cm. Histologically, apart from the HCC foci, the AH specimens showed intrinsic atypia, suggesting preneoplastic change. These features included an increase of both cellularity and the nucleo-cytoplasmic ratio, distortion of cord structure and pseudoacinar formation. All of the AH specimens contained typical portal triads. Details of diagnostic imaging were also obtained in four cases. The findings of the present study support the possibility that AH with intrinsic atypia is a preneoplastic lesion of HCC. The sequence of "adenomatous hyperplasia with intrinsic atypia-HCC foci" would thus represent part of the early phase of hepatocarcinogenesis in humans.
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ranking = 42.249862767978
keywords = preneoplastic
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8/16. Study of preneoplastic changes of liver cells by immunohistochemical and molecular hybridization techniques.

    The status of hepatitis b virus dna was investigated by in situ hybridization in multifocal areas of a noncancerous hepatitis b virus-associated cirrhosis. This liver exhibited a marked degree of dysplasia and adenomatous hyperplasia. The results of these studies were correlated with the histopathology and immunohistochemical stains for hepatitis B core and surface antigens. There was clear evidence of a marked reduction to absence of hepatitis B viral dna by in situ hybridization and absence of HBc and HBsAg in the foci of liver cell dysplasia and adenomatous hyperplasia. These results support the hypothesis that liver cell dysplasia and adenomatous hyperplasia are preneoplastic in nature.
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ranking = 105.62465691994
keywords = preneoplastic
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9/16. Emergence of malignant lesions within an adenomatous hyperplastic nodule in a cirrhotic liver. Observations in five cases.

    Five cases of an adenomatous hyperplastic nodule or a similar lesion resected from a cirrhotic liver in which early malignant foci were seen as small nodule-in-nodule lesions are described. These hyperplastic lesions were detected by imaging diagnosis in patients with nonalcoholic cirrhosis, mostly during routine clinical follow-up. In 2 patients, recurrence of hepatocellular carcinoma occurred 11 mo and 15 mo postresection. Thus, these nodule-in-nodule lesions in an adenomatous hyperplastic nodule seem to represent an early stage of hepatocarcinogenesis in humans. In nonalcoholic cirrhotic patients from japan and Southeast Asia, in whom hepatocellular carcinoma is endemic, an adenomatous hyperplastic nodule or a similar hyperplastic lesion that occurs in cirrhotic livers may be preneoplastic and already committed to malignant transformation.
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ranking = 21.124931383989
keywords = preneoplastic
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10/16. Enzyme pattern and marker antigens in nodular "regenerative" hyperplasia of the liver.

    Characteristic alterations of marker enzymes and tumor-associated antigens have been detected in the preneoplastic lesions of experimental hepatocarcinogenesis. An identical pattern of enzyme activity (increased gammaglutamyl transferase, loss of glucose-6-phosphatase, and canalicular adenosine triphosphatase) was demonstrated in a case of nodular "regenerative" hyperplasia of liver. The lack of marker antigens (alphafetoprotein, carcinoembryonic antigen, alpha 1-antitrypsin) in the hyperplastic nodules in this patient may be related to the discontinuation of oral contraceptive steroids four years earlier. The phenotypic changes of enzyme activity suggest that nodular "regenerative" hyperplasia of the liver in man is preneoplastic.
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ranking = 42.249862767978
keywords = preneoplastic
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