Ultrasound Guided Fine Needle Aspiration Cytology of Gallbladder Lesions Suspected to be Carcinoma Gallbladder: Experience of a Tertiary Care Hospital

Gallbladder carcinoma is the most common biliary tract malignancy in the world. Radiologicalinvestigations are helpful in diagnosing the gallbladder diseases especially carcinoma in most of thecases, but confirmation of diagnosis requires cytopathological correlation. We have undertaken astudy on 29 patients, who underwent ultrasound guided FNAC for evaluation of gallbladder lesionssuspected to be carcinoma gallbladder. 82.75% of patients had malignancy or suspicion of malignancyand 10.34% patients had abscesses, while in 6.9 % patients FNAC was inconclusive. Adenocarcinoma(NOS) was the most common diagnosis and was found in 62.6 % of patients. Poorly differentiatedcarcinoma, cytology suspicious of malignancy and abscesses were present in 7 % of patients each.Papillary carcinoma and squamous cell carcinoma were only seen in 3.44 % patients each. None ofthe patients in our study developed any minor or major complications during the procedure. A precisecytological examination is required not only to diagnose or rule out gallbladder malignancy, but alsofor prognostication of these carcinomas.

The diagnosis value of DWI in duodenal papillary adenocarcinoma / 实用放射学杂志

Objective To investigate the MRI findings of duodenal papillary adenocarcinoma(DPA),and to evaluate the importance of diffusion-weighted imaging(DWI)in diagnosis of DPA.Methods A complete data of 52 patients with DPA were prospectively collected.All patients underwent surgery within 72 hours after conventional MRI,DWI and MRCP scans.Before surgery,four different MRI findings were used to calculate the sensitivity,specificity and the probability of correctness.Two experienced radiologists who were blind to the pathologic diagnosis handled the MRI findings.Thirty eight patients were pathologically diagnosed for DPA.Based on the pathological diagnosis,the detection rate of DPA by the MR sequence was recorded and the chi square test was used to do the statistical analysis. Results The accuracy rate in diagnosis of DPA with MRI was 78.8% in our study.The findings of DPA consist of thickening wall of duodenal,duodenal papilla node imaging,DWI showing high signal of duodenal papilla and"beak"sign of dilated bile duct.Corresponding sensitivities were 70.5%,66.7%,86.3% and 87.9%,and specificities were 75.0%,30.0%,50.0% and 63.1% respectively.The incidences of positive on T2WI and T1WI,MRCP,DWI scans were 60.5%,76.3% and 92.1% respectively.The detection rate of each sequence has significant difference(χ2=10.48,P<0.005).Conclusion The MRI manifestations of DPA consist of thickening wall of duodenal,duodenal papilla node imaging,DWI showing high signal of duodenal papilla and"beak"sign of dilated bile duct.The detection rate of DWI sepuence on DPA lesions is significantly higher than that of other sequences.

Clinicopathological Features of Low-Grade Thyroid-like Nasopharyngeal Papillary Adenocarcinoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Primary low-grade thyroid-like papillary adenocarcinomas are extremely rare neoplasms that generally originate in the nasopharynx. Here, we describe a novel case of a 15-year-old Chinese girl who was diagnosed with low-grade thyroid-like papillary adenocarcinoma, including a brief review of the literature to reveal the clinicopathological features of low-grade thyroid-like nasopharyngeal papillary adenocarcinoma. MATERIALS AND METHODS: Immunohistochemistry was used to evaluate the expression of pan-cytokeratin (CKpan), cytokeratin (CK) 7, thyroid transcription factor 1 (TTF-1), vimentin, epithelial membrane antigen (EMA), thyroglobulin, CD15, S100, P40, CK20, CDX-2, glial fibrillary acidic protein (GFAP), and Ki-67. Additionally, in situ hybridization investigation was utilized to identify the presence of small Epstein-Barr virus (EBV)–encoded RNA. RESULTS: Histopathological analysis revealed florid proliferation of papillary structures lined by columnar epithelial cells with fibrovascular cores. Immunohistochemically, the neoplastic cells were positive for CKpan, CK7, TTF-1, vimentin, and EMA, but negative for thyroglobulin, CD15, S100, P40, CK20, CDX-2, and GFAP. The Ki-67–labeling index reached 5% in the most concentrated spot. In situ hybridization for EBV was negative. CONCLUSION: Due to the distinct rarity of low-grade thyroid-like papillary adenocarcinomaswith a favorable clinical outcome, a nationwide effort to raise public awareness of this neoplasm is required.

Low‑grade papillary adenocarcinoma of nasopharynx with expression of thyroid transcription factor‑1: Case report and review of literature.

Low‑grade papillary adenocarcinomas with expression of thyroid transcription factor‑1 (TTF‑1) are rare tumors of the nasopharynx, with only a few cases reported in the literature. These tumors have an excellent prognosis following complete surgical excision. We report a 13‑year‑old boy with this rare tumor in the nasopharynx. The patient underwent complete surgical excision of the tumor and was on follow‑up without evidence of recurrence.

Serous Surface Papillary Adenocarcinoma: a rare variant of serous carcinoma - report of two cases.

Serous tumors constitute about 25% of all ovarian tumors. Serous adenocarcinomas are the commonest form of the malignant epithelial ovarian tumors accounting for 26% of the cases. The commonest morphologic form is the cystadenocarcinoma. Serous surface papillary adenocarcinoma is a very rare morphologic entity which is often bilateral and highly aggressive. Reports showing an exact incidence are not available in literature. We present a case of serous surface papillary adenocarcinoma confined to ovary.

Biliary tract intraductal papillary mucinous neoplasm: A brief report and review of literature.

Biliary Tract Intraductal Papillary Mucinous Neoplasm (BT-IPMN) is a very rare entity, gradually emerging into attention as sporadic cases are being reported worldwide. In this brief report we discuss about such an entity from our part of the world, based on a case from our institution. A 47-year-old female was referred to our department with jaundice, intermittent fever with chills and rigor of 6 weeks duration. Initial evaluation revealed obstructive jaundice with distended gall bladder. Imaging with ultrasonogram (USG) and magnetic resonance imaging (MRI) showed hugely dilated intra and extrahepatic biliary radicles with multiple and diffuse soft tissue lesions fi lling the common bile duct (CBD) extending to the ductal system of left lobe of liver. A side viewing endoscopy demonstrated mucin extruding from a prominent ampulla of Vater. The patient was managed successfully by left hepatectomy with pancreaticoduodenectomy (HPD). Gross pathological examination of the specimen showed marked dilatation of intra and extra hepatic bile ducts with multiple polypoidal lesions and plenty of mucin fi lling the entire biliary ductal system. Histopathology revealed predominantly intraductal papillary mucinous adenocarcinoma at the hilum extending to left bile duct with diffuse dysplastic changes throughout the biliary tree. Thus the clinical, radiological and pathological features of this lesion clearly fi t into the diagnosis of BT-IPMN, which is slowly being established as a defi nite clinical entity with features much similar to its pancreatic counterpart.

Adenocarcinoma Arising from Heterotopic Pancreas in Association with a Splenic Cyst.

We report a rare case of adenocarcinoma arising from heterotopic pancreas in splenectomy specimen operated for a Splenic Cyst. This 40 year old female patient presented with vague upper abdominal pain and swelling. USG showed a large cyst within the spleen. The cyst along with the spleen is removed after laparotomy. The pancreas and other abdominal organs were unremarkable on ultrasonography and intraoperative examination. Gross examination showed a cyst with a smooth lining, entirely within the spleen. A small locule, communicating with the main cyst showed small papillary projections. On light microscopy, the cyst wall is lined by single layer of columnar cells. Section from papillary areas showed histological appearance of papillary adenocarcinoma. Remnant of normal pancreatic tissue was discovered at the wall of the cyst. We presume an origin from heterotopic pancreatic tissue in the spleen for this neoplasm and reporting the case for its rarity.

Brain metastasis as initial presentation of papillary adenocarcinoma of the lung: case report / Metástase cerebral como apresentação inicial de adenocarcinoma papilífero de pulmão: relato de caso

The authors describe the case of a 33-year-old patient with history of seizures alone without any previous symptom, being diagnosed with brain metastases from primary papillary adenocarcinoma of the lung. Emphasis is given to the diagnostic investigation for brain metastasis and prognostic evaluation of papillary adenocarcinoma of the lung, and a brief literature review on such diseases is performed.

Os autores descrevem um caso de paciente de 33 anos de idade com história de crises convulsivas isoladas sem qualquer antecedente, sendo diagnosticadas metástases cerebrais tendo como sítio primário um adenocarcinoma papilífero de pulmão. É enfatizada a investigação diagnóstica para metástase cerebral e avaliação prognóstica do adenocarcinoma papilífero de pulmão, além de realizar breve revisão sobre essas doenças.

Exclusive Endoscopic Resection of Nasopharyngeal Papillary Adenocarcinoma via Combined Transnasal and Transoral Approach

Low grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is an extremely rare variant of nasopharyngeal cancer, which exhibits distinct clinicopathological characteristics. Surgical resection has been regarded as the principal treatment. For this, transpalatal or transfacial approach has been classically used for exposure of the field. Up for now, there has been no report on applying endoscopic approach for this disease, which could be an effective alternative to minimize possible morbidities of palatotomy or maxillotomy. Endoscopic approach can be justified considering narrow extent and indolent behavior of LGNPPA. We report a patient with LGNPPA, which was successfully resected exclusively by endoscopic visualization. Our case exhibited narrow-based exophytic features with compatible immunopathologic profiles of LGNPPA. Exclusive endoscopic resection can be effective and less-morbid modality for this rare disease as in this case.

A Case of Papillary Intestinal Type Sinonasal Adenocarcinoma of the Nasal Cavity / 대한이비인후과학회지

Malignant tumors of the sinonasal tract are relatively rare and adenocarcinomas of various types account for 10% to 20% of primary malignancies of the nasal cavity and paranasal sinuses. According to the classification of World Health Organization, primary adenocarcinomas of the sinonasal tract can be initially classified as salivary and non-salivary types, and non-salivary types are further divided into intestinal and non-intestinal types. The authors experienced a case of papillary intestinal type sinonasal adenocarcinoma of the right nasal cavity in a 59-year-old woman, which was resected successfully via endoscopic approach. We present the clinical characteristics, pathology, treatment, and prognosis of the tumor with a review of the literature.

Endolymphatic sac tumour

We present a case of a papillary tumour at the cerebellopontine angle in a 41-year-old man. He presented with left-sided facial and ear pain associated with dizziness, nystagmus and hearing loss. CT scan of the temporal bone showed a destructive tumour at the left cerebellopontine angle. Surgical excision was performed and the diagnosis of the endolymphatic sac tumour was made. Endolymphatic tumour is a low grade adenocarcinoma that originates from the endolymphatic sac. The defi nitive diagnosis requires a combination of clinical features, radiological fi nding and pathological correlation.

A Case of Nasopharyngeal Papillary Adenocarcinoma: Nasal Endoscopic Approach / 대한이비인후과학회지

Low-grade nasopharyngeal papillary adenocarcinoma is an unusual nasopharyngeal tumor. This malignant tumor originates in the epithelium and exhibits adenocarcinomatous differentiation and indolent behavior. Macroscopically, these tumors are pedunculated polypoid masses that arise on the roof of the nasopharynx. Microscopically, they are characterized by papillary and glandular epithelial proliferation. We report a case of a 25-year-old woman who presented with a papillary adenocarcinoma on the roof of nasopharynx; in describing the case, we have focused on the histological features and endoscopic management of the tumor. The tumor was completely excised via nasal endoscopic approach. Immunohistochemical analysis of the tumor was performed based on a differential diagnosis of metastatic papillary thyroid carcinoma. The testing involved thyroid transcription factor-1, thyroglobulin, and epithelial membrane antigen analysis. The patient remained disease-free for over 6 months after the surgical excision performed via nasal endoscopic approach.

Carcinoma de la trompas de falopio presentación de caso / Fallopian tube carcinoma case presentation

Se reporta una paciente con diagnóstico histopatológico de Adenocarcinoma papilar infiltrante de la trompa de Falopio moderadamente diferenciado, que invade hasta la capa muscular, sin rebasar a ésta, con metástasis a un ganglio del epiplón y no invade endometrío. Operada en la clínica de Onco-Ginecología y Patología cervical del Departamento de Gineco-obstetricia Hospital Obrero No 2 de la Caja Nacional de Seguro, constituyendo el único caso conocido en nuestro Hospital. Se completa el tratamiento remitiendo al Servicio de Oncología.

Its report a patient with a diagnosis of papillary adenocarcinoma of the fallopian tubes moderately differentiated, than invades until the muscle layer, without exceeding this layer, metastasis to the ganglyon of epiplon and does not invades endometrial layer. Operated at the Onco-gynecology and cervix pathology clinic of the Department of Gynecology - obstetrics of the Hospital worker at the CNS, been the only one case Knowed in our hospital. The treatment its completed sent the patient to the oncology service.

A Case of Choledochocele Associated with Papillary Adenocarcinoma / 대한소화기내시경학회지

Choledochocele is a rare abnormality that's defined as cystic or diverticular dilatation of the common bile duct, and this protrudes into the duodenal lumen. It may cause abdominal pain, recurrent pancreatitis, obstructive jaundice etc. Although its anatomic form does not meet the criteria of pancreaticobiliary malunion, malignant changes of the choledochocele in relation to pancreaticobiliary reflux may occur. It still is regarded as having a lower malignant potential than any other type of choledochal cyst. Only one case has been currently been reported in Korea. We experienced a case of a 71 year-old woman with upper abdominal pain that was caused by a choledochocele with duodenal ampullary adenocarcinoma. She was successfully treated by surgical excison without severe complications. We report here on this case along with a review of the literature.

Papillary gastric adenocarcinoma / 대한내과학회지

No abstract available.

A Case of Low-grade Papillary Adenocarcinoma of the Nasopharynx / 대한이비인후과학회지

Low-grade nasopharyngeal papillary adenocarcinoma is a very rare nasopharyngeal, surface epithelium-derived malignant tumor characterized with adenocarcinomatous differentiation and an indolent biological behavior. We report a case of 36-year old female presenting a papillary adenocarcinoma of the nasopharynx. The tumor was of a 0.5 cm sized exophytic mass located on the nasopharyngeal mucosa near the posterior choanal septum. Because of the histologic similarities with thyroid papillary carcinoma, it was necessary to rule out metastasis from thyroid by immunohistochemical staining for thyroglobulin. Surgical excision was done via transpalatal approach; mass was removed with a clear resection margin.

A Clinical Analysis of Recurrence in Differentiated Thyroid Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Differentiated thyroid carcinoma (DTC) is a known malignant tumor arising from the follicular epithelium in thyroid gland. Although the prognosis for patients with DTC is generally good, appropriate surgical management can further reduce recurrence and cancer death rates significantly. The therapeutic methods performed are total thyroidectomy plus radioactive iodine (131I) therapy and life-long thyroid-stimulating hormone (TSH) suppression. Histopathologically, DTC contains papillary and follicular adenocarcinoma. In numerous studies, staging systems-AMES, AGES, MACIS, etc-have been created to evaluate prognostic outcome. By applying staging systems, we have treated 394 patients with DTC since 1998. The purpose of our study was to analyze characteristics of recurrent cases and evaluate remission rates of recurrent cases according to diagnostic methods. MATERIALS AND METHOD: From January 1998 to December 2001, we performed 630 thyroidectomies and 487 malignant tumors (421 papillary, 28 follicular, 20 medullary, 12 undifferentiated carcinoma and 6 other malignant tumors). We analyzed 394 DTC cases; excluding other malignancy, 65 cases were recurrent cancer (58 papillary and 7 follicular carcinoma). The medical records of 394 patients with DTC treated at our hospital were reviewed retrospectively. We analyzed impact of primary surgery on recurrence in 65 recurrent patients and compared the remission rates of those patients using physical examination with those using laboratory tests and imaging studies. RESULTS: 347 patients with DTC were treated initially in our hospital and 18 patients showed recurrence. Among them, lobectomy was performed as a primary surgery in 69 patients of whom one (1.4%) had recurrence. Forty-seven patients with DTC treated initially in other hospitals were referred to our hospital. Lobectomy was performed as a primary surgery in 23 patients (54.7%). Recurrence of 32 patients was detected by palpation. Of these patients, the remission rate was 25.0%, whereas patients diagnosed by laboratory tests and imaging systems showed 53.3% remission rate (p=0.056). CONCLUSION: The extent of primary thyroid resection appeared to have significant impact on the recurrence of DTC. In view of this, we should apply staging system strictly in treating DTC-total thyroidectomy and central neck dissection in high-risk groups. In following up patients, we should check the thyroglobulin level and use image tests like computed tomography and positron emission tomography to detect recurrence earlier.

A Case of Papillary Adenocarcinoma of Intrahepatic Duct: Malignant Transformation from Papillary Adenoma / 대한소화기내시경학회지

Biliary papilloma usually consists of single or multiple papillary adenomas in the biliary tract and has a potential for recurrence and malignant transformation. We described herein a case of papillary adenoma of intrahepatic duct that transformed into papillary adenocarcinoma. A 49-year-old male patient was admitted to our hospital because of right upper quadrant pain. A CT scan revealed marked dilatation of S7 segmental duct and cholangioscopy and biopsy revealed mucin-secreting papillary adenoma in the right intrahepatic duct. Three years later, a follow up of CT scan showed aggravated S7 ductal dilatation and inner ill-defined mass. Cholangioscopy revealed multiple papillary mucosal projections with large amount of mucin in the right intrahepatic duct and biopsy revealed well differentiated papillary adenocarcinoma. The patient underwent right lobectomy, the papillary adenocarcinoma was extended in the dilated right intrahepatic duct and also showed hepatic parenchymal invasion.

Primary Papillary Adenocarcinoma of the Ureteric Stump / 대한비뇨기과학회지

After nephrectomy for non-malignant disease, primary tumors of the ureteric stump are extremely rare and present a significant diagnostic problem, and only few cases have been reported in the literature. The very rare adenocarcinoma of the ureter is typically papillary and is associated with urinary tract infection and stones. In adenocarcinoma, because it is often difficult to determine whether the tumor is primary or secondary due to the generalized instability of the urothelium, and its histogenesis and biologic behavior remain uncertain partially due to the rarity of this neoplasm, a diagnostic differentiation pathologically from other tumors is required. We herein describe a case of 68 year old man who had a primary well-differentiated papillary mucigenic. adenocarcinoma of the ureteric stump after nephrectomy for renal stones.

A Case of Thyroid Hemiagenesis with Papillary Adenocarcinoma / 대한내분비학회지

Variation in the gross anatomy of the thyroid is relatively common. Although thyroid hemiagenesis is considered to be a rare congenital anomaly, its incidence is probably underestimated because the diagnosis is usually incidental.We present the case of a 26-year-old woman with right thyroid hemiagenesis associated with papillary adenocarcinoma. The diagnosis of hemiagenesis was established by isotope imaging, which showed hot nodule, thyroid ultrasonography and surgical exploration for proper management of a nodule in the left lobe of thyroid gland. As she was diagnosed to have papillary adenocarcinoma, total thyroidectomy was performed and at present she remains disease-free.