• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2679-2681
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• 2016

Background: Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN) are relatively rare tumors, not equally distributed in gastro-intestinal system. In 2010, a revised version of the WHO classification of GEP-NENs was published. This study reports for the first time the distribution and characteristics of GEP-NEN in a Lebanese population. Materials and Methods: This descriptive retrospective study concerns all the digestive neuroendocrine tumors with their characteristics diagnosed in $H\hat{o}tel$ Dieu de France in Beirut, Lebanon from 2001 to 2012, all the pathology reports being reanalyzed according to the latest WHO 2010 classification. The characteristics and features of GEP-NEN analyzed in this study were age, gender, grade and site. Results: A total of 89 GEP-NENs were diagnosed, representing 28.2% of all neuroendocrine tumors. The mean age of GEP-NEN patients was 58.7 years and the M/F sex ratio was 1.2. The primary localization was as follows: 21.3%(19) pancreatic, 18% (16) gastric, 15.7% (14) duodenal, 11.2% (10) appendix, 10.1% (9) intestinal, 10.1% (9) colorectal (7.9% colonic and 2.2% rectal), 5.6% (4) hepatic, 2.2% (2) ampulla, 1.1% (1) esophageal and 7.9%(5) NOS digestive (metastatic with unknown primary). Of the 89 patients with GEP-NEN, 56.2% (50) were diagnosed as grade I, 11.2% (10) as grade II, 20.2% (18) as grade III and 12.4% (11) were considered as mixed adeno-neuroendocrine carcinomas (MANEC). Conclusions: This study, one of the rare examples based on the 2010 WHO classification of neuroendocrine tumors in the literature, indicates that in the Lebanese population, all duodenal and appendicular tumors are G1 and the majority of MANEC tumors are gastric and pancreatic tumors. Moreover, more duodenal tumors and fewer rectal tumors were encountered in our study compared to European reports.

• Korean Journal of Radiology
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• 제24권12호
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• pp.1232-1240
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• 2023

Objective: To investigate the imaging characteristics of large duct pancreatic ductal adenocarcinoma (LD-PDAC) on computed tomography (CT) and magnetic resonance imaging (MRI). Materials and Methods: Thirty-five patients with LD-PDAC (63.2 ± 9.7 years) were retrospectively evaluated. Tumor morphology on CT and MRI (predominantly solid mass vs. solid mass with prominent cysts vs. predominantly cystic mass) was evaluated. Additionally, the visibility, quantity, shape (oval vs. branching vs. irregular), and MRI signal intensity of neoplastic cysts within the LD-PDAC were investigated. The radiological diagnoses rendered for LD-PDAC in radiology reports were reviewed. Results: LD-PDAC was more commonly observed as a solid mass with prominent cysts (45.7% [16/35] on CT and 37.1% [13/35] on MRI) or a predominantly cystic mass (20.0% [7/35] on CT and 40.0% [14/35] on MRI) and less commonly as a predominantly solid mass on CT (34.3% [12/35]) and MRI (22.9% [8/35]). The tumor morphology on imaging was significantly associated with the size of the cancer gland on histopathological examination (P = 0.020 [CT] and 0.013 [MRI]). Neoplastic cysts were visible in 88.6% (31/35) and 91.4% (32/35) of the LD-PDAC cases on CT and MRI, respectively. The cysts appeared as branching (51.6% [16/35] on CT and 59.4% [19/35] on MRI) or oval shapes (45.2% [14/35] on CT and 31.2% [10/35] on MRI) with fluid-like MRI signal intensity. In the radiology reports, 10 LD-PDAC cases (28.6%) were misinterpreted as diseases other than typical PDAC, particularly intraductal papillary mucinous neoplasms. Conclusion: LD-PDAC frequently appears as a solid mass with prominent cysts or as a predominantly cystic mass on CT and MRI. Radiologists should be familiar with the imaging features of LD-PDAC to avoid misdiagnosis.

• 대한영상의학회지
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• 제82권5호
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• pp.1207-1217
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• 2021

목적 췌장 및 췌장 주위의 주요 혈관에 인접한 병변에 대하여 초음파 유도하 경피적 중심 바늘 생검(ultrasound-guided percutaneous core needle biopsy; 이하 USPCB)의 안전성과 효능을 평가하였다. 대상과 방법 10년 동안 췌장(n = 98), 간문맥 근처 췌장 주위(n = 34), 또는 췌장 갈고리돌기 부위와 십이지장 제3부분과 인접한 대동맥주위(n = 30) 병변에 대하여 USPCB를 시행받은 162명의 환자의 검사 결과를 수집하였다. 초음파 유도하18게이지 바늘을 가진 자동 생검 총을 사용하였고, USPCB 결과는 수술 결과 또는 추적 관찰 영상과 비교하였다. USPCB의 진단 정확도 및 주요 합병증 비율을 계산했으며, 성공적인 생검의 예측을 위한 요인이 무엇인지 단변량 및 다변량 분석을 사용하여 평가하였다. 결과 USPCB에서 조직 병리학 진단은 149명(92%) 환자에서 일치했다. 주요 합병증은 장간막 혈종 4건과 십이지장 벽내혈종 1건이 발생했다(3%). 성공적인 생검을 위한 요인으로는 위 또는 장관을 통과하는 경로보다는 경장간막 경로를 이용할수록, 초음파상 표적 및 생검 경로가 잘 보일수록 등이 포함되었다. 또한 결과적으로 생검에 성공한 경우 생검 횟수가 더 적었다. 결론 USPCB는 주요 혈관에 인접한 췌장 및 간문맥 근처 췌장 주위 병변 또는 췌장 갈고리돌기 부위나 십이지장 제3부분과 인접한 대동맥 주위 병변의 조직학적 진단을 위한 높은 정확도 및 낮은 합병증 비율을 나타냈다.

• Journal of Gastric Cancer
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• 제13권3호
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• pp.185-187
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• 2013

Neurofibromas are benign tumors that originate from the peripheral nerves, including neurites and fibroblasts. Generally, a solitary neurofibroma is located in the skin and rarely in other places. A 72-year-old female suffered from epigastric discomfort for 2 months. Endoscopic findings showed an early gastric cancer type IIc at the antrum. Abdominal computed tomography revealed early gastric cancer with a 1.6 cm-sized metastatic node posterior to the duodenum. Laparoscopic assisted distal gastrectomy and retro-pancreatic dissection were performed uneventfully. Histological examination revealed gastric adenocarcinoma, invading the mucosa without nodal metastasis, and a neurofibroma. Herein, we present a case of a gastric cancer patient with a solitary retroperitoneal neurofibroma which mimicked a distant metastatic node.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권4호
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• pp.280-285
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• 2015

Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.151-157
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• 2023

Backgrounds/Aims: Cholangiocarcinoma (CCA) can be classified as intrahepatic CCA or extrahepatic CCA (eCCA). We intended to analyze and reports the survival outcomes for eCCA. Methods: Surveillance, epidemiology, and end results (SEER) registry, site recode C24.0, was used to select cases of eCCA from 2000 to 2018. Patients with incomplete data or ages <18 years were excluded. Results: Male (52.69%) and White race (77.99%) predominated. Compared with 2000-2006, survival increased in 2013 (adjusted hazard ratio [HRadj]: 0.68, 95% confidence interval [CI] 0.58-0.70; p < 0.01). Surgery with chemoradiotherapy (HRadj: 0.69, 95% CI 0.60-0.7; p < 0.01) and surgery with chemotherapy (HRadj: 0.72, 95% CI 0.62-0.83; p < 0.01) improved survival over surgery alone. Compared with surgery without lymph node (LN) removal, surgery of four or more regional LN reduced the risk of death by 58% (HRadj: 0.42, 95% CI 0.36-0.51; p < 0.01). Compared with patients without surgery, patients who underwent bile duct excision (HRadj: 0.82, 95% CI 0.72-0.94; p < 0.01), simple or extended lobectomy (HRadj: 0.85, 95% CI 0.75-0.95; p = 0.009), and hepatectomy (HRadj: 0.80, 95% CI 0.72-0.88; p < 0.01) significantly improved survival. Patients with distal CCA had a 17% higher survival than perihilar CCA (HRadj: 0.83, 95% CI 0.74-0.92; p < 0.01) and LN dissection was equally beneficial for both subgroups (p < 0.01). Conclusions: Surgery with chemoradiotherapy has a proven increase in the 5-year survival of the eCCA. LN resection, bile duct excision, lobectomy, and hepatectomy have better outcomes.

• 대한영상의학회지
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• 제81권5호
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• pp.1216-1221
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• 2020

국소진행성 췌장암 환자에서 이차적 근치절제 가능성을 얻기 위해 수술 전 동시항암화학방사선요법이 점차 많이 이용되고 있다. 대부분의 환자들에게 담도의 감압이 필요함에도 불구하고, 담도 스텐트와 동시항암화학방사선요법을 함께 시행하는 안전성에 대한 연구는 많지 않다. 저자들은 동시항암화학방사선요법 후 담도 스텐트에 의해 발생한 지연성 간동맥 출혈의 드문 증례를 보고하는 바이다. 추적 관찰 CT에서 담도 스텐트와 우간동맥과의 거리가 점점 가까워졌고, 결국 스텐트가 간동맥을 압박하여 간동맥에 심한 굴곡이 생겼다. 카테터 혈관조영술에서 우간동맥에 조영제의 혈관 외 유출이 발견되어 혈관 내 색전술을 이용하여 치료하였다. 본 증례 보고는 동시항암화학방사선요법 후 발생하는 해부학적 변형이 심각한 합병증의 원인이 될 수도 있음을 강조하고 있다. 간동맥이 담도 스텐트에 의해 압박되는 소견은 혈관손상의 경고 신호로서 주의가 필요하다.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.277-286
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• 2023

Backgrounds/Aims: To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population. Methods: One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021. Results: Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer. Conclusions: This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

• 대한세포병리학회지
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• 제3권2호
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• pp.60-66
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• 1992

Islet cell neoplasms (ICNs) of pancreas are uncommon, and the cytologic features of ICN are not well delineated. We report a case of islet cell tumor with lymph node metastasis, describing the cytologic, histologic, and immunohistochemical findings. A 40-year-old woman was admitted due to upper gastrointestinal bleeding of 2 days' duration. Computed tomography of the abdomen showed a diffusely infiltrating bulky mass in the body and tail of the pancreas. The fine needle aspirate showed moderate to high cellularity, monotonous cell population, single ceil predominance over small cell clusters, and eccentrically located nuclei. Although the definite diagnosis of ICN on the cytologic basis is difficult, the cytomorphologic features are sufficiently distinctive to suggest the diagnosis.

• 대한세포병리학회지
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• 제16권2호
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• pp.88-92
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• 2005

Mucious cystic neoplasm of pancreas is a cystic neoplasm composed of columnar, mucin-producing epithelium and is supported by ovarian-type stroma. The key to the cytologic evaluation of pancreatic cystic lesions is to recognize the cytologic components as being diagnostic of a mucin-producing cystic neoplasm, as all of these neoplasms need to be resected. We report the use of fine needle aspiration cytology in the diagnosis of an invasive mucinous cystic carcinoma confirmed by partial pancreatectomy. The cytologic specimen showed a abundant mucin background and sheets or papillae of neoplastic cells. There are mucin-containing columnar cells that show a variable degree of cytologic atypia.