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BMC Gastroenterology Jan 2016Pancreatic hamartoma is an extremely rare benign disease of the pancreas. Only 30 cases have been reported to date. (Review)
Review
BACKGROUND
Pancreatic hamartoma is an extremely rare benign disease of the pancreas. Only 30 cases have been reported to date.
CASE PRESENTATION
A 68-year-old man presented with an asymptomatic solid and multi-cystic lesion in the uncus of the pancreas, incidentally detected on abdominal enhanced computed tomography. The tumor was found to be a well-demarcated solid and multi-cystic lesion without any enhancement, measuring 4 cm in diameter. After 28 months of follow-up, the tumor enlarged. At 31 months after initial diagnosis, the patient underwent surgical resection because it was difficult to clinically determine whether the tumor was malignant or not. Macroscopically, the solid tumor consisted of yellow adipose tissue with a smooth thin capsule confined to the pancreatic uncus. The inner structure of the tumor consisted of multiple cysts with a white nodule between the cysts. Histologically, the solid part and the multi-cystic portion consisted of mature adipose tissue and colonization of dilated pancreatic ducts with mild fibrosis, respectively. Immunohistochemical findings revealed cytokeratin 7 and 19 positive staining in the epithelial cells of the ducts. Adipose tissue showed positive staining for S-100 protein and there were only a few MIB-1 positive cells. The tumor was then diagnosed as a pancreatic hamartoma.
CONCLUSION
Beside on the above findings, we suggest that the term "well-demarcated solid and cystic lesion with chronological morphological changes" could be a clinical keyword to describe pancreatic hamartomas.
Topics: Aged; Diagnosis, Differential; Hamartoma; Humans; Male; Pancreas; Pancreatic Diseases; Rare Diseases; Tomography, X-Ray Computed
PubMed: 26762320
DOI: 10.1186/s12876-016-0419-2 -
The Korean Journal of Gastroenterology... May 2009Pancreatic tuberculosis is a rare clinical entity, presenting as malignancy mimicking pancreatic mass. Therefore, it represents a diagnostic challenge. To date, ten... (Review)
Review
Pancreatic tuberculosis is a rare clinical entity, presenting as malignancy mimicking pancreatic mass. Therefore, it represents a diagnostic challenge. To date, ten cases have been reported in Korea. I report an additional case and review all Korean reports about pancreatic tuberculosis. A 57-year-old woman presented with abdominal pain. Abdominal computed tomography (CT) revealed a 2.2x1.2 cm cystic mass in pancreatic body. She was followed for nine months, at which time a cystic mass was enlarged to 3.3x2.2 cm in size on the CT. An exploratory laparotomy was performed for the accurate diagnosis and to rule out the possibility of malignant change. Pathological examination of the resected specimen revealed chronic granulomatous inflammation with caseous necrosis and multinucleated giant cells, which was compatible with tuberculosis. Among the 11 cases of pancreatic tuberculosis, five cases were combined with pulmonary tuberculosis. The pancreatic tuberculosis frequently presented with multicystic pancreatic mass (81%) and the most common anatomic locations were the head (73%), tail (18%), and body (9%). Three cases were diagnosed by using US or EUS guided fine needle aspiration biopsy (FNAB), and all cases were medically cured without exploratory laparotomy. In summary, pancreatic tuberculosis, despite its rarity, should be considered for differential diagnosis of pancreatic cystic mass in endemic countries. Clinical suspicion and accurate diagnostic approach including FNAB of pancreatic tuberculosis are needed to avoid performing unnecessary laparotomy.
Topics: Diagnosis, Differential; Female; Humans; Middle Aged; Pancreatic Diseases; Pancreatic Neoplasms; Tomography, X-Ray Computed; Tuberculosis
PubMed: 19458471
DOI: 10.4166/kjg.2009.53.5.324 -
Gut Feb 2012
Topics: Fibrosis; Humans; Liver Cirrhosis; Liver Regeneration; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Pancreatic Stellate Cells; Pancreatitis, Chronic; Regeneration; Signal Transduction
PubMed: 22115911
DOI: 10.1136/gutjnl-2011-301220 -
Journal of Gastroenterology and... Aug 2013The ability of tissue injury to result in inflammation is a well-recognized phenomenon and is central to a number of common liver and pancreatic diseases including... (Review)
Review
The ability of tissue injury to result in inflammation is a well-recognized phenomenon and is central to a number of common liver and pancreatic diseases including alcoholic steatohepatitis and pancreatitis, as well as drug-induced liver injury, non-alcoholic steatohepatitis, and pancreatitis from other causes. The requirements of extracellular damage-associated molecules and a cytosolic machinery labeled the inflammasome have been established in in vitro culture systems and in vivo disease models. This has provided a generic insight into the pathways involved, and the challenge now is to understand the specifics of these mechanisms in relation to the particular insults and organs involved. One reason for the excitement in this field is that a number of therapeutic candidates such a toll-like receptor antagonists and interleukin-1R antagonists are either approved or in clinical trials for other indications.
Topics: Animals; Chemical and Drug Induced Liver Injury; Cytosol; Drug Discovery; Fatty Liver; Fatty Liver, Alcoholic; Humans; Inflammasomes; Inflammation; Liver Diseases; Molecular Targeted Therapy; Non-alcoholic Fatty Liver Disease; Pancreatic Diseases; Pancreatitis; Receptors, Interleukin-1; Toll-Like Receptors
PubMed: 23855298
DOI: 10.1111/jgh.12018 -
Gastroenterology Jun 2013The endocrine and exocrine cells in the adult pancreas are not static, but can change their differentiation state in response to injury or stress. This concept of cells... (Review)
Review
The endocrine and exocrine cells in the adult pancreas are not static, but can change their differentiation state in response to injury or stress. This concept of cells in flux means that there may be ways to generate certain types of cells (such as insulin-producing β-cells) and prevent formation of others (such as transformed neoplastic cells). We review different aspects of cell identity in the pancreas, discussing how cells achieve their identity during embryonic development and maturation, and how this identity remains plastic, even in the adult pancreas.
Topics: Adult Stem Cells; Animals; Cell Differentiation; Cell Lineage; Cell Proliferation; Embryonic Stem Cells; Gene Expression Regulation, Developmental; Humans; Pancreas; Pancreatic Diseases; Pancreatic Neoplasms; Regeneration; Signal Transduction; Stem Cells
PubMed: 23622126
DOI: 10.1053/j.gastro.2013.01.074 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Jan 2022Pancreatic panniculitis (PP) is a necrotizing inflammation of subcutaneous fat that is a rare complication of pancreatic disease appearing in 2% to 3% of all patients....
Pancreatic panniculitis (PP) is a necrotizing inflammation of subcutaneous fat that is a rare complication of pancreatic disease appearing in 2% to 3% of all patients. It is more common in the elderly and often affects the extremities. It presents as skin inflammation with pain and erythema nodules. We report a case of acute pancreatitis associated with PP in an old female. She was admitted for vomiting and abdominal pain for 3 days and presented with a 2-week history of erythematous subcutaneous nodules on her legs. Laboratory and ultrasonic findings revealed acute pancreatitis. High frequency ultrasound showed hypoechoic foci in subcutaneous soft tissue layer and adipose layer. Histopathological examination confirmed the diagnosis of PP. Nodules disappeared with the resolution of acute pancreatic inflammation. PP may be the first manifestation of pancreatic disease. Imaging features of this pathology are seldom described and ultrasonic diagnosis experience is worth to be accumulated.
Topics: Acute Disease; Aged; Female; Humans; Inflammation; Pancreatic Diseases; Pancreatitis; Panniculitis; Ultrasonography
PubMed: 35545374
DOI: 10.11817/j.issn.1672-7347.2022.210523 -
JOP : Journal of the Pancreas Jul 2010Melioidosis is endemic to tropical regions and, despite the common occurrence of intra-abdominal abscesses, pancreatic involvement in melioidosis has not previously been...
CONTEXT
Melioidosis is endemic to tropical regions and, despite the common occurrence of intra-abdominal abscesses, pancreatic involvement in melioidosis has not previously been reported.
OBJECTIVE
We report our experience with pancreatic melioidosis.
PATIENTS
All 65 patients treated for melioidosis who had computed tomography (CT) scans were identified from prospective databases and were retrospectively reviewed.
MAIN OUTCOME MEASURES
A detailed review of cases with pancreas involvement was carried out.
RESULTS
There were four cases (three males and one female; median age 29.5 years, range: 25-48 years) with pancreatic melioidosis, giving a prevalence of 6.2%. All had predisposing conditions (two had poorly controlled diabetes mellitus and two had thalassemia) for melioidosis. Fever (100%), anorexia (100%), weight loss (100%), rigor (75%) and abdominal pain (75%) were the most common symptoms at presentation and the median duration of symptoms before presentation was six weeks (range: 2-8 weeks). All pancreatic abscesses were detected on CT scan. Multiple foci involvement was common (3 to 6 sites): blood (4 patients), liver (3 patients), psoas muscle (2 patients), spleen (2 patients), infected ascites (2 patients) and lung (1 patient). Pancreatic involvement ranged from multi-focal micro-abscesses to focal large abscesses and involved all parts of the pancreas (body 100%, head 75% and tail 50%). Associated pancreatic findings included splenic vein thrombosis, peripancreatic inflammation and peripancreatic fat streaking. All the pancreatic abscesses were resolved with antibiotics without requiring pancreatic abscess drainage (including one patient who died from disseminated melioidosis).
CONCLUSION
Pancreatic involvement typically occurs as part of multi-organ involvement and commonly manifests as multifoci micro-abscesses. Associated pancreatic abnormalities were also common. All responded to treatment without requiring drainage.
Topics: Adult; Anti-Bacterial Agents; Female; Humans; Male; Melioidosis; Middle Aged; Pancreatic Diseases; Retrospective Studies
PubMed: 20601811
DOI: No ID Found -
World Journal of Gastroenterology Aug 2010Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has received considerable interest in recent years. Although minimal access surgery... (Review)
Review
Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has received considerable interest in recent years. Although minimal access surgery has increasingly replaced traditional open abdominal surgical approaches for a wide spectrum of indications, in pancreatic diseases its widespread use is limited to few indications because of the challenging and demanding nature of major pancreatic operations. Nonetheless, there have been attempts in animal models as well as in the clinical setting to perform diagnostic and resectional NOTES for pancreatic diseases. Here, we review and comment upon the available data regarding currently analyzed and performed pancreatic NOTES procedures. Potential indications for NOTES include peritoneoscopy, cyst drainage, and necrosectomy, palliative procedures such as gastroenterostomy, as well as resections such as distal pancreatectomy or enucleation. These procedures have already been shown to be technically feasible in several studies in animal models and a few clinical trials. In conclusion, NOTES is a rapidly developing concept/technique that could potentially become an integral part of the armamentarium dealing with surgical approaches to pancreatic diseases.
Topics: Animals; Humans; Natural Orifice Endoscopic Surgery; Pancreatic Diseases; Patient Selection; Treatment Outcome
PubMed: 20712045
DOI: 10.3748/wjg.v16.i31.3859 -
World Journal of Gastroenterology Nov 2013To evaluate the usefulness of real-time virtual sonography (RVS) in biliary and pancreatic diseases.
AIM
To evaluate the usefulness of real-time virtual sonography (RVS) in biliary and pancreatic diseases.
METHODS
This study included 15 patients with biliary and pancreatic diseases. RVS can be used to observe an ultrasound image in real time by merging the ultrasound image with a multiplanar reconstruction computed tomography (CT) image, using pre-scanned CT volume data. The ultrasound used was EUB-8500 with a convex probe EUP-C514. The RVS images were evaluated based on 3 levels, namely, excellent, good and poor, by the displacement in position.
RESULTS
By combining the objectivity of CT with free scanning using RVS, it was possible to easily interpret the relationship between lesions and the surrounding organs as well as the position of vascular structures. The resulting evaluation levels of the RVS images were 12 excellent (pancreatic cancer, bile duct cancer, cholecystolithiasis and cholangiocellular carcinoma) and 3 good (pancreatic cancer and gallbladder cancer). Compared with conventional B-mode ultrasonography and CT, RVS images achieved a rate of 80% superior visualization and 20% better visualization.
CONCLUSION
RVS has potential usefulness in objective visualization and diagnosis in the field of biliary and pancreatic diseases.
Topics: Aged; Aged, 80 and over; Biliary Tract Diseases; Female; Humans; Male; Middle Aged; Multimodal Imaging; Pancreatic Diseases; Predictive Value of Tests; Radiographic Image Interpretation, Computer-Assisted; Tomography, X-Ray Computed; Ultrasonography
PubMed: 24259973
DOI: 10.3748/wjg.v19.i42.7419 -
Cerebellum (London, England) Dec 2023Hom ozygous variants in the peptidyl-tRNA hydrolase 2 gene (PTRH2) cause infantile-onset multisystem neurologic, endocrine, and pancreatic disease. The objective is to...
Hom ozygous variants in the peptidyl-tRNA hydrolase 2 gene (PTRH2) cause infantile-onset multisystem neurologic, endocrine, and pancreatic disease. The objective is to delineate the mechanisms underlying the core cerebellar phenotype in this disease. For this, we generated constitutive (Ptrh2LoxPxhCMVCre, Ptrh2 mice) and Purkinje cell (PC) specific (Ptrh2LoxPxPcp2Cre, Ptrh2mice) Ptrh2 mutant mouse models and investigated the effect of the loss of Ptrh2 on cerebellar development. We show that Ptrh2 knockout mice had severe postnatal runting and lethality by postnatal day 14. Ptrh2 PC specific knockout mice survived until adult age; however, they showed progressive cerebellar atrophy and functional cerebellar deficits with abnormal gait and ataxia. PCs of Ptrh2 mice had reduced cell size and density, stunted dendrites, and lower levels of ribosomal protein S6, a readout of the mammalian target of rapamycin pathway. By adulthood, there was a marked loss of PCs. Thus, we identify a cell autonomous requirement for PTRH2 in PC maturation and survival. Loss of PTRH2 in PCs leads to downregulation of the mTOR pathway and PC atrophy. This suggests a molecular mechanism underlying the ataxia and cerebellar atrophy seen in patients with PTRH2 mutations leading to infantile-onset multisystem neurologic, endocrine, and pancreatic disease.
Topics: Humans; Mice; Animals; Adult; Cerebellar Ataxia; Ataxia; Purkinje Cells; Mice, Knockout; Pancreatic Diseases; Cell Differentiation; Atrophy; Mammals
PubMed: 36219306
DOI: 10.1007/s12311-022-01488-z