1/118. Sclerosing mesenteritis seen clinically as pancreatic pseudotumor: two cases and a review.Sclerosing mesenteritis is an uncommon nonneoplastic inflammatory process in the mesentery that is seen as a pseudotumor, usually involving the small bowel mesentery, the mesenteric fat, and less commonly, the mesentery of the large bowel. We report two cases of sclerosing mesenteritis and review the literature on this rare disease. Both patients had pain, profound weight loss, and a mass on computed tomography (CT) scan of the abdomen. The provisional diagnosis was pancreatic neoplasm on the basis of clinical presentation and imaging studies. The diagnosis of sclerosing mesenteritis was established by histologic findings in biopsy material obtained at laparotomy in both cases. Interval histologic studies in one patient who had a high CA 19-9 level, progressive biliary ductal and partial duodenal compression, revealed a transitional histologic pattern from predominant inflammation and fat necrosis to predominant fibrosis. This may explain the varied descriptive terms used in the literature to describe this entity.- - - - - - - - - - ranking = 1keywords = fat (Clic here for more details about this article) |
2/118. panniculitis caused by acinous pancreatic carcinoma.subcutaneous fat necrosis is a form of panniculitis associated with pancreatitis or pancreatic carcinoma. The massive release in the bloodstream of lipolytic enzymes such as lipase, amylase and trypsin causes these lesions. As pancreatic disease is often asymptomatic, extensive investigations are mandatory in the presence of panniculitic lesions to search for an underlying disease.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
3/118. Squamous cell carcinoma and lipomatous pseudohypertrophy of the pancreas.A 68-year-old woman who had been treated for non-insulin-dependent diabetes mellitus for the past 20 years was admitted to hospital because of abdominal pain and weight loss. Radiological investigation revealed a tumour in the body of the pancreas and numerous intraductal calcifications in both the tail and the head of the pancreas. Left-sided pancreatectomy was performed to remove the tumour. The resection specimen showed fatty enlargement of the parenchyma and numerous intraductal calcifications in the tissue adjacent to the tumour, which was 7 cm in diameter and was found to be a primary squamous cell carcinoma with a spindle cell component. There was also lipomatous pseudohypertrophy.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
4/118. Excessive nodular hyperplasia of brunner glands associated with gastric hypersecretion and lipomatous atrophy of the pancreas.The case of a 34-year-old woman complaining of diarrhoea and abdominal pain is presented. Contrast radiography and endoscopy showed multiple polypoid tumours in the second part of the duodenum. Moreover, a severe fatty infiltration of the pancreas was shown by magnetic resonance and computed tomography scans. Due to pain, pancreatoduodenectomy (Whipple operation) was performed, and subsequent histopathologic examinations showed excessive Brunner gland hyperplasia of the duodenum and severe lipomatous atrophy of the pancreas. The occurrence of these two rare conditions in one patient has not been described previously, and it is conceivable that the lipomatous atrophy and exocrine insufficiency of the pancreas may have caused a compensatory stimulation of the submucosal structures of the duodenum.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
5/118. Islet cell tumor of the pancreas associated with tumor thrombus in the portal vein.We report the MR findings of a 70-year-old man with an islet cell tumor that diffusely involved the body of the pancreas associated with enhancing portal vein tumor thrombus and cavernous transformation. The diffusely infiltrative tumor mass was best shown on early post gadolinium spoiled gradient echo. The tumor thrombus enhanced intensely on early post gadolinium images and was also well shown on true FISP (Fast Imaging with Steady State Precession) images. The extent of liver metastases was best shown on fat suppressed T2-weighted images. The most unusual finding was tumor thrombus involving the SMV and portal vein.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
6/118. A case of pancreatic cancer achieving symptomatic improvement with systemic chemotherapy.We present a case of pancreatic cancer demonstrating symptomatic improvement with systemic chemotherapy using 5-fluorouracil and cisplatin (FP therapy). A 43 year-old man had pancreatic cancer with para-aortic lymph node metastases. He received FP therapy and achieved a partial response. After the initiation of chemotherapy, his symptoms such as severe pain and fatigue improved remarkably. serum interleukin-6 levels correlated with these symptoms; the level was high before chemotherapy, but the levels were decreased during the courses of FP therapy. It is important to achieve symptomatic improvement in patients with pancreatic cancer, and serum interleukin-6 levels may be useful to evaluate a symptomatic response to chemotherapy.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
7/118. Laparoscopic management of neuroendocrine tumours of the pancreas.Neuroendocrine tumours of the pancreas are rare but can be fatal due to excessive secretion of regulatory peptides. The localization of these small tumours can be difficult while open surgical treatment is associated with a relatively high morbidity. Two cases are presented where endocrine tumours of the pancreas were successfully removed by laparoscopy. In the surgical treatment of endocrine pancreatic tumours, the use of laparoscopic techniques can provide a valuable means for localizing the tumour while improving the patient's comfort and decreasing operative morbidity.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
8/118. Haemobilia from pancreatic cystadenoma.Hamobilia from a pancreatic source is a rare cause of gastrointestinal haemorrhage. Most of the reported cases have arisen from haemorrhage into a pancreatic pseudocyst, which is frequently fatal. This report describes a patient with gastrointestinal haemorrhage arising from a pancreatic cystadenoma.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
9/118. Large goiter and multiple rib tumors.We report an interesting case of a 47-yr-old who had a large goiter and multiple rib tumors. The patient was initially suspected of having thyroid cancer, which had metastasized on the ribs, based on imaging studies. However, laboratory tests revealed a high level of ionized calcium and parathyroid hormone (PTH). The large goiter was diagnosed as having parathyroid tumors owing to the high level of PTH in the tissue fluid. The biopsy specimen from a rib tumor was diagnosed as containing brown tumors associated with primary hyperparathyroidism (PHP). The patient also had prolactinoma and pancreatic gastrinoma. Her daughter had both prolactinoma and PHP, and her brother and her father had PHP. Thus, the patient was diagnosed as having multiple endocrine neoplasia type 1.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
10/118. Pleomorphic carcinoma of the pancreas with massive lymphocytic stromal infiltration and long-term survival after resection.BACKGROUND: Pleomorphic carcinoma of the pancreas is a rare tumor with an extremely poor prognosis. The mean survival time is reported to be approx 3 mo. CLINICAL AND HISTOLOGICAL FINDINGS: A 56-yr-old Japanese man presenting with general fatigue, loss of weight, and high fever was found to have a large hypervascular mass in the body of the pancreas with regional lymph node metastases. Laboratory investigation revealed leukocytosis, elevated erythrocyte sedimentation rate (ESR), and high serum c-reactive protein (CRP). In addition to distal pancreatectomy, splenectomy and lymph node dissection were performed. histology showed the presence of pleomorphic large cells with bizarre mono- or multinuclei, growing in sarcomatoid pattern without mutual cohesiveness. Another noticeable finding was massive lymphocytic infiltration of the stroma of the neoplasm. Immunohistochemically, the infiltrating lymphocytes consisted of cytotoxic type of T cells. In addition, in situ hybridization for Epstein-Barr virus-encoded rna (EBAR-1) was not seen in the tumor cells or in lymphocytes. After surgery the patient did not undergo chemotherapy or radiotherapy. He has been well without recurrence for 8 yr. CONCLUSION: We report a case of pleomorphic carcinoma, possibly lymphoepithelioma-like carcinoma, of the pancreas with massive lymphocytic stromal infiltration and long-term survival after resection. Cytokine responses and cellular immunoreactivity may have contributed to a long-term survival, which is unusual in the common type of pleomorphic carcinoma of the pancreas.- - - - - - - - - - ranking = 0.5keywords = fat (Clic here for more details about this article) |
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