• Title/Summary/Keyword: 췌장

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Pleural Effusion and Pancreatico-Pleural Fistula Associated with Asymptomatic Pancreatic Disease (췌장염 증상없이 췌장-흉막루를 통해 발생한 흉막저류)

  • Park, Sang-Myun;Lee, Sang-Hwa;Lee, Jin-Goo;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.226-230
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    • 1995
  • Effusions arising from acute pancreatitis are usually small, left sided and self limiting. The incidence of pleural effusions in acute pancreatitis is reported between 3% and 17%. In chronic pancreatitis, as a consequence of fistula and pancreatitic pseudocyst formation or by spontaneous rupture of a pancreatic psudocyst directly into thoracic cavity, extremely large effusions may be seen. When the underlying pacreatic disease is asymptomatic, the diagnosis is made by measuring the amylase content of the pleural fluid. We experience a case of left sided pleural effusions caused by pancreatico-pleural fistula associated with pancreatic pseudocyst. The diagnosis was made by measuring of pleural fluid amylase level(80000U/L). Abdominal CT scan revealed pancreatic pseudocyct and pancreatitis with extension to left pleural space through esophageal hiatus and extension to left subdiaphragmatic space. Left pleural effusions were decreased after fasting, total parenteral nutrition and percutaneous pleural fluid catheter drainage. We reported a case of pleural effusions and pacreatico-pleural fistula asssociated with asymptomatic pancreatic disease with review of literatures.

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Management of Small Pancreatic Neuroendocrine Neoplasm (크기가 작은 췌장 신경내분비종양의 관리)

  • Paik, Woo Hyun;Lee, Kyong Joo;Jang, Sung Ill;Cho, Jae Hee
    • Journal of Digestive Cancer Reports
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    • v.9 no.1
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    • pp.19-24
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    • 2021
  • The incidence of small and asymptomatic pancreatic neuroendocrine neoplasms (PNENs) has been increased due to the widespread use of high-resolution imaging techniques and endoscopic procedures in screening programmes. Most of PNENs are indolent neoplasms with slow-growing. However, sometimes, PNENs show local invasion or metastasis with poor prognosis. The management of small, nonfunctioning PNENs remain under debate. The National Comprehensive Cancer Network guidelines recommend observation in selected cases of small PNENs less than 2 cm. Pancreatic surgeons are divided into two factions: "the hawks," who indicate the high risk of malignancy even in small PNENs and, therefore, the need for an aggressive surgical treatment, and the "the doves," who accepts the risk of malignancy in some ≤ 2 cm PNENs, advocate that the risk of overtreating many benign ≤ 2 cm PNENs would be much higher. As the pancreatic surgery remains a high-risk operation with a 28-30% morbidity and 1% mortality, the decision for small PNENs is challenging.

Pictorial Review of Rare Pancreatic Tumors and Tumor-Like Lesions (췌장에서 생기는 희귀 종양 및 종양 유사 병변들의 영상 소견)

  • Seung Jae Lee;Sang Soo Shin;Suk Hee Heo;Yong Yeon Jeong
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1134-1150
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    • 2020
  • Various types of tumors and tumor-like lesions may affect the pancreas. Among them, pancreatic ductal adenocarcinoma is the most common and is generally referred to as "pancreatic cancer." Recently, the detection rates of rare pancreatic tumors and tumor-like lesions have increased owing to technological advancements and increased frequency of imaging tests. Considering that rare pancreatic tumors and tumor-like lesions differ from pancreatic ductal adenocarcinoma in terms of the treatment plan and prognosis, the differential diagnosis of these diseases is clinically relevant. Various imaging tests play an important role in the differential diagnoses of rare tumors, such as acinar cell carcinoma and schwannoma, tumor-like lesions, such as autoimmune pancreatitis and inflammatory pseudotumor, and pancreatic ductal adenocarcinoma, but accurately distinguishing these diseases solely based on imaging findings is difficult. The aim of this pictorial review was to present the imaging findings of rare pancreatic tumors and tumor-like lesions and discuss important points for the differential diagnosis.

Usefulness of Scan Position Change on Dual Time Point PET-CT in Pancreas Cancer (췌장암 Dual Time Point PET/CT 검사에서 Scan Position Change의 유용성 평가)

  • Chang, Boseok;Kim, Jae Ho
    • Journal of the Korean Society of Radiology
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    • v.10 no.5
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    • pp.299-305
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    • 2016
  • Despite of the development of medical equipments and technology. Pancreatic cancer has maked high false positive rate and low survival rate compared to other cancers. Therefore, early catch of pancreatic cancer is the only way to enhance the viability. It is important to find the exact location of the pancreas cancer in early stage. The method of optimum scan for early detection of pancreatic cancer on PET/CT exam is proposed. Examined the anatomical region that potentially can be missing from the supine position of ordinary pet/ct exam. The characteristics and usefulness of angle variation ($0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$) of patients scan position is analyzed. The proposed scan method (named JJ-projection) is bringing advantage of anatomical discrimination by separating stomach, liver, gallbladder duodenum and pancreas. ROC curve analysis is shows to advantage of the JJ-Projection method. The sensitivity has increased 4.6% than the supine delay scan method, the results sensitivity has increased from 91% to 95.2%. The specificity has increased from 75.1% to 84%. Compared with the results observed in cancer by biological biopsy, The accuracy has increased from 86.8% to 94.1%.

The Study on Risk Factor of Metabolic Diseases in Pancreatic Steatosis (췌장지방증에서 대사성질환의 위험 요인에 관한 연구)

  • Cho, Jin-Young;Ye, Soo-Young;Kim, Dong-Hyun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.81-88
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    • 2016
  • The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDL-cholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

Study of SUVm Cut-off Value for the Distinction of Pancreatic Cancer In PET/CT Exam (PET/CT 검사에서 췌장암 판별을 위한 SUVm 경계값 연구)

  • Chang, Boseok;Kim, Jae Ho;Liu, Guoxu;Jang, Eun Sung
    • The Journal of the Korea Contents Association
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    • v.17 no.10
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    • pp.567-575
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    • 2017
  • In this study, when diagnosis pancreatic cancer by dual time point PET/CT, we propose SUVm 2.52 as the threshold value for performing the dual time point PET/CT exam. The hypothesis of normal distribution was adopted through data conversion of 60 pancreatic diseases. The proposed SUVm2.52 boundary value showed a significance level that could be applied to both 120 and 180 minutes of delay time scan for pancreatic cancer determination (p<0.05). C-value variation shows that delay time 2 hour test is more useful than delay time 3 hour test. When the SUVm 2.52 is set to the boundary value and the double-time point PET/CT exam is performed, the probability of distinguishing cancer from inflammation in the delayed image is 95%. When the delayed test is performed with the proposed boundary value SUVm 2.52, Compared with general PET / CT scans, it is thought that it may be helpful to distinguish pancreatic cancer.

Endoscopic Therapy for Pancreatic Benign Neoplasms (췌장 양성 종양의 내시경적 치료)

  • Hwang, Jun Seong;Ko, Sung Woo
    • Journal of Digestive Cancer Reports
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    • v.9 no.1
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    • pp.25-32
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    • 2021
  • Since Endoscopic ultrasound (EUS) was introduced in the 1980s, EUS has evolved from a diagnostic tool to a therapeutic modality for patients with pancreatic neoplasms. Traditionally, treatment policy of pancreatic benign neoplasms (PBN) has been a dichotomous approach to observation or surgery. However, EUS guided treatment provides an alternative option with minimally invasiveness for patients with PBN. This review aimed to provide the role of EUS guided treatment for PBN.

Pancreatic Collision Tumor of Desmoid-Type Fibromatosis and Mucinous Cystic Neoplasm: A Case Report (데스모이드 섬유종증과 점액성 낭성 종양으로 이루어진 췌장의 충돌 종양: 증례 보고)

  • Min Jung Ryu;Jae Woon Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1297-1303
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    • 2021
  • Pancreatic collision tumors are rare neoplasm, and cases consisting of ductal adenocarcinoma with a neuroendocrine tumor, intraductal papillary mucinous neoplasm with a neuroendocrine tumor, and solid pseudopapillary neoplasm with a neuroendocrine tumor have been reported. We report a case of a rapidly growing pancreatic collision tumor consisting of desmoid-type fibromatosis and mucinous cystic neoplasm in a 30-year-old pregnant female. To the best of our knowledge, this is the first reported case of a pancreatic collision tumor consisting of desmoid-type fibromatosis and mucinous cystic neoplasm.