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1.
Prensa méd. argent ; 107(5): 245-251, 20210000. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1359179

ABSTRACT

Antecedentes: Los quistes hidatídicos primarios pancreáticos son raros por no decir excepcional, siendo en las grandes series su incidencia apenas entre el 0,2 % al 0,3%. Lugar de Aplicación: Servicio de Cirugía General "Pablo Luis Mirizzi" del Hospital Nacional de Clínicas, Sanatorio Allende y Clínica Privada Caraffa de Córdoba. Diseño: Cooperativo, retrospectivo. Material y Método: Entre diciembre de 2000 y diciembre del 2019 han sido tratados quirúrgicamente 9 pacientes con hidatidosis primaria de páncreas, siendo 5 del sexo masculino y los cuatro restantes del sexo femenino, con una edad promedio de 39,4 años. En relación con la clínica, todos los pacientes tenían dolor abdominal, acompañado de vómitos, distensión abdominal y fiebre. En tres presentaban una masa abdominal palpable. A todos se les solicito laboratorio y pruebas de hidatidosis, destacándose en 6 de los 9 pacientes dieron positivo. Resultados: Se estudiaron a todos los pacientes con una ecografía abdominal, TC de abdomen y en un paciente una CPRMN más RMN de abdomen. Se realizaron previamente el tratamiento con abendazol antes del tratamiento quirúrgico en todos los casos. En relación con el tratamiento quirúrgico, se llevó a cabo el destechamiento y drenaje del quiste con la técnica de Mabit-Lagrot en 6 oportunidades y en 3 con la Técnica de Goinard. Conclusión: La localización de los quistes hidatídicos en el páncreas es rara. El diagnóstico se basa fundamentalmente en los estudios por imágenes, además si se correlacionan con la epidemiología y la serología hidatídica positiva. El tratamiento del quiste hidatídico de páncreas es quirúrgico.


Background: Pancreatic primary hydatic cysts are rare not to say exceptional, with their incidence in large series being only 0.2% to 0.3%. Setting: General Surgery Service "Pablo Luis Mirizzi" of the National Hospital of Clinics, Allende Sanatorium and Caraffa Clinic of Córdoba. Design: Retrospective and cooperative. Methods: Between December 2000 and December 2019, 9 patients with primary pancreatic hydatic have been treated surgically, with 5 of the male sex and the remaining four of the female sex, with an average age of 39.4 years. In relation to the clinic, all patients had abdominal pain, accompanied by vomiting, bloating and fever. In three they had a palpable abdominal mass. All were asked for laboratory and hydatic tests, highlighting in 6 of the 9 patients tested positive. Results: All patients with abdominal ultrasound, abdominal CT and a patient were studied for CPRMN plus MRI of the abdomen. Abendazole was previously treated prior to surgical treatment in all cases. In relation to surgical treatment, the traditional unroofing and drainage of the cyst was carried out with the Mabit-Lagrot technique in 6 opportunities and in 3 with the Goinard Technique. Conclusions: The location of hydatic cysts in the pancreas is rare. Diagnosis is based primarily on imaging studies, in addition if they correlate with epidemiology and positive hydatic serology. Treatment of the pancreas hydatic cyst is surgical


Subject(s)
Humans , Adult , Middle Aged , Aged , Pancreas/pathology , Pancreatic Cyst/surgery , Attitude , Punctures , Ultrasonography , Echinococcosis/therapy
2.
Rev. argent. cir ; 112(3): 337-342, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1279749

ABSTRACT

RESUMEN La hiperplasia de células neuroendocrinas pancreáticas es una patología donde se produce un aumen to en el número de células de los islotes de Langerhans y a veces puede simular un proceso tumoral. Caso clínico: presentamos el caso de un paciente con tumor sólido de cola de páncreas, sintomático, al que se le realizó esplenopancreatectomía corporocaudal laparoscópica. El resultado anatomopatoló gico posterior informó una hiperplasia neuroendocrina. Conclusión: la hiperplasia de células neuroen docrinas debería considerarse en el diagnóstico diferencial de tumores sólidos de páncreas. La alterna tiva quirúrgica laparoscópica es factible cuando no es posible establecer el diagnóstico prequirúrgico con estudios de imágenes o biopsia.


ABSTRACT Pancreatic endocrine cell hyperplasia is defined as an increase in the number of cells of Langerhans islets and can sometimes mimic a tumoral process. Case report: a male patient with a symptomatic solid tail of pancreas tumor underwent laparoscopic distal pancreatectomy and splenectomy. The pathological examination reported neuroendocrine cell hyperplasia. Conclusion: pancreatic endocrine cell hyperplasia should be considered in the differential diagnosis of solid pancreatic tumors. Laparoscopic surgery is feasible when the preoperative diagnosis with imaging tests of biopsy is not possible.


Subject(s)
Humans , Male , Aged , Pancreas/pathology , Pancreatectomy/methods , Pancreatic Neoplasms/diagnosis , Pancreas/anatomy & histology , Tomography, X-Ray Computed , Ultrasonography , Laparoscopy , Neuroendocrine Cells , Abdomen/diagnostic imaging , Hyperplasia/diagnosis
3.
ABCD arq. bras. cir. dig ; 33(4): e1554, 2020. tab, graf
Article in English | LILACS | ID: biblio-1152626

ABSTRACT

ABSTRACT Background: It is important to obtain representative histological samples of solid biliopancreatic lesions without a clear indication for resection. The role of new needles in such task is yet to be determined. Aim: To compare performance assessment between 20G double fine needle biopsy (FNB) and conventional 22G fine needle aspiration (FNA) needles for endoscopic ultrasound (EUS)-guided biopsy. Methods: This prospective study examined 20 patients who underwent the random puncture of solid pancreatic lesions with both needles and the analysis of tissue samples by a single pathologist. Results: The ProCore 20G FNB needle provided more adequate tissue samples (16 vs. 9, p=0.039) with better cellularity quantitative scores (11 vs. 5, p=0.002) and larger diameter of the histological sample (1.51±1.3 mm vs. 0.94±0.55 mm, p=0.032) than the 22G needle. The technical success, puncture difficulty, and sample bleeding were similar between groups. The sensitivity, specificity, and diagnostic accuracy were 88.9%, 100%, and 90% and 77.8%, 100%, and 78.9% for the 20G and 22G needles, respectively. Conclusions: The samples obtained with the ProCore 20G FNB showed better histological parameters; although there was no difference in the diagnostic performance between the two needles, these findings may improve pathologist performance.


RESUMO Racional: As lesões sólidas pancreáticas não ressecáveis cirurgicamente demandam boa amostragem tecidual para definição histológica e condução oncológica . O papel das novas agulhas de ecopunção no aprimoramento diagnóstico ainda necessita elucidação. Objetivo: Comparar as biópsias guiadas por ecoendoscoopia com a nova agulha 20G de bisel frontal duplo (FNB) com a agulha de aspiração fina 22G convencional. Métodos: Este estudo prospectivo avaliou 20 pacientes submetidos à punção de lesões pancreáticas sólidas com ambas agulhas e envolveu análise de amostras teciduais por um único patologista. Resultados: A agulha FNB 20G forneceu amostras de tecido mais adequadas (16 vs. 9, p=0,039) com melhores escores quantitativos de celularidade (11 vs. 5, p=0,002) e maior diâmetro máximo da amostra histológica (1,51±1,3 mm vs. 0,94±0,55 mm, p=0,032) que a agulha 22G. O sucesso técnico, dificuldade de punção e sangramento da amostra foram semelhantes entre os grupos. A sensibilidade, especificidade e acurácia diagnóstica foram 88,9%, 100% e 90% e 77,8%, 100% e 78,9% para as agulhas 20G e 22G, respectivamente. Conclusão: As amostras obtidas com a FNB 20G apresentaram melhores parâmetros histológicos, embora não tenha havido diferença no desempenho diagnóstico entre as duas agulhas.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Pancreas/diagnostic imaging , Pancreatic Neoplasms/pathology , Endoscopic Ultrasound-Guided Fine Needle Aspiration/standards , Needles/classification , Pancreas/pathology , Pancreatic Neoplasms/diagnostic imaging , Prospective Studies , Sensitivity and Specificity , Endoscopic Ultrasound-Guided Fine Needle Aspiration/instrumentation , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Needles/adverse effects
4.
Autops. Case Rep ; 10(3): e2020171, 2020. graf
Article in English | LILACS | ID: biblio-1131828

ABSTRACT

The pancreatic neuroendocrine tumors (PanNETs) most commonly present as solid neoplasms; however, very rarely, they may present primarily as cystic neoplasms. Most of the cystic PanNETs are non-secreting tumors, and the radiological features are not well defined. Hence pre-operative diagnosis is usually challenging and the tumors are misdiagnosed as mucinous cystic neoplasms, intraductal papillary mucinous neoplasms, serous cystic neoplasms, solid pseudopapillary neoplasms, and non-neoplastic cysts. However, the management depends on the accurate diagnosis of these cystic lesions, which poses a dilemma. Herein, we report the case of a cystic PanNET in the tail of the pancreas, which was clinically and radiologically misdiagnosed as a mucinous cystic neoplasm. This case is reported to highlight this issue to the medical community regarding the diagnostic difficulty in such rare non-functioning pancreatic neuroendocrine tumors.


Subject(s)
Humans , Male , Middle Aged , Pancreatic Cyst/diagnosis , Neuroendocrine Tumors/diagnosis , Pancreatic Intraductal Neoplasms/diagnosis , Pancreas/pathology , Neoplasms, Cystic, Mucinous, and Serous/diagnosis , Rare Diseases , Diagnostic Errors
5.
Acta méd. costarric ; 61(1): 13-21, ene.-mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-983714

ABSTRACT

Resumen La pancreatitis aguda es un trastorno intracelular del calcio en las células pancreáticas, el cual constituye la vía final común de múltiples estímulos etiopatogénicos y puede desencadenar cambios necroinflamatorios locales, efectos multisistémicos y compromiso en órganos distantes. Todo esto lleva a los pacientes a múltiples complicaciones por disfunción orgánica e infección. El diagnóstico adecuado y oportuno, el abordaje según severidad y la optimización de la terapia nutricional, así como una adecuada analgésica, reanimación hídroelectrolítica, detección de disfunción orgánica y de complicaciones locales e infecciosas, determinan el desenlace clínico de dicha patología. Se realizó una revisión narrativa incluyendo estudios clínicos, guías de manejo, protocolos y revisiones pertinentes, y se aporta un enfoque desde el punto de vista de medicina crítica para el abordaje inicial de esta patología.


Abstract Acute pancreatitis is an intracellular calcium disorder in pancreatic cells, which constitutes the final common pathway of multiple etiopathogenic stimuli and can trigger local necroinflammatory changes, multisystemic effects and compromise distant organs. All of this leads to multiple complications due to organ dysfunction and infection in patients. The adequate and opportune diagnosis, the approach according to severity and the optimization of the nutritional therapy; as well as an adequate analgesic, hydroelectrolytic resuscitation, the detection of organic dysfunction and of local and infectious complications, determine the clinical outcome of this pathology. A narrative review was carried out including clinical studies, management guidelines, protocols and reviews. An initial approach for this pathology, from the critical medicine point of view, is provided.


Subject(s)
Humans , Pancreas/pathology , Pancreatitis/complications , Peritonitis/pathology , Pancreatitis, Acute Necrotizing , Necrosis
6.
Clinics ; 73: e49, 2018. tab, graf
Article in English | LILACS | ID: biblio-952783

ABSTRACT

OBJECTIVES: The number of pancreatic transplants has decreased in recent years. Pancreatic grafts have been underutilized compared to other solid grafts. One cause of discard is the macroscopic appearance of the pancreas, especially the presence of fatty infiltration. The current research is aimed at understanding any graft-related association between fatty tissue infiltration of the pancreas and liver steatosis. METHODS: From August 2013 to August 2014, a prospective cross-sectional clinical study using data from 54 multiple deceased donor organs was performed. RESULTS: Micro- and macroscopic liver steatosis were significantly correlated with the donor body mass index ([BMI]; p=0.029 and p=0.006, respectively). Positive gamma associations between pancreatic and liver macroscopic and microscopic findings (0.98; confidence interval [CI]: 0.95-1 and 0.52; CI 0.04-1, respectively) were observed. Furthermore, comparisons of liver microscopy findings showed significant differences between severe versus absent (p<0.001), severe versus mild (p<0.001), and severe versus moderate classifications (p<0.001). The area under the receiver operating curve was 0.94 for the diagnosis of steatosis by BMI evaluation using a cut-off BMI of 27.5 kg/m2, which yielded 100% sensitivity, 87% specificity, and 100% negative predictive value. CONCLUSIONS: We observed a positive association of macroscopic and microscopic histopathological findings in steatotic livers with adipose infiltration of pancreatic grafts.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Pancreas/pathology , Adipose Tissue/pathology , Fatty Liver/pathology , Liver/pathology , Tissue Donors/statistics & numerical data , Biopsy , Body Mass Index , Adipose Tissue/transplantation , Cross-Sectional Studies , Prospective Studies , Sensitivity and Specificity , Pancreas Transplantation , Area Under Curve , Parenchymal Tissue/pathology , Liver/ultrastructure
7.
Clinics ; 73: e261, 2018. tab, graf
Article in English | LILACS | ID: biblio-890756

ABSTRACT

Our aim in this study was to compare the efficiency of 25G versus 22G needles in diagnosing solid pancreatic lesions by EUS-FNA. We performed a systematic review and meta-analysis. Studies were identified in five databases using an extensive search strategy. Only randomized trials comparing 22G and 25G needles were included. The results were analyzed by fixed and random effects. A total of 504 studies were found in the search, among which 4 randomized studies were selected for inclusion in the analysis. A total of 462 patients were evaluated (233: 25G needle/229: 22G needle). The diagnostic sensitivity was 93% for the 25G needle and 91% for the 22G needle. The specificity of the 25G needle was 87%, and that of the 22G needle was 83%. The positive likelihood ratio was 4.57 for the 25G needle and 4.26 for the 22G needle. The area under the sROC curve for the 25G needle was 0.9705, and it was 0.9795 for the 22G needle, with no statistically significant difference between them (p=0.497). Based on randomized studies, this meta-analysis did not demonstrate a significant difference between the 22G and 25G needles used during EUS-FNA in the diagnosis of solid pancreatic lesions.


Subject(s)
Humans , Pancreas/pathology , Pancreatic Neoplasms/pathology , Endoscopic Ultrasound-Guided Fine Needle Aspiration/instrumentation , Needles/standards , Pancreatic Neoplasms/diagnostic imaging , Likelihood Functions , Randomized Controlled Trials as Topic , Sensitivity and Specificity , Efficiency , Endoscopic Ultrasound-Guided Fine Needle Aspiration/standards , Data Accuracy
8.
Braz. J. Pharm. Sci. (Online) ; 54(3): e17669, 2018. graf, ilus
Article in English | LILACS | ID: biblio-974396

ABSTRACT

Olanzapine and risperidone are widely prescribed atypical antipsychotics used in the treatment of schizophrenia and various other psychiatric disorders. Both of these drugs have been extensively reported to cause Type 2 diabetes mellitus and pancreatitis, however, the mechanism of olanzapine and risperidone-induced toxicity has not been so far unveiled. We, therefore, compared the streptozocin-induced pancreatic damage with that of pancreas isolated from olanzapine and risperidone treated rats. It was noticed that fibrotic growth, necrosis and derangement of the pancreatic islet cells caused by streptozocin were more pronounced than olanzapine and risperidone.


Subject(s)
Pancreas/pathology , Benchmarking/statistics & numerical data , Antipsychotic Agents/analysis , Risperidone/pharmacokinetics
9.
Braz. j. med. biol. res ; 51(6): e7238, 2018. tab, graf
Article in English | LILACS | ID: biblio-889106

ABSTRACT

Ulomoides dermestoides is a beetle traditionally consumed to treat diabetes. In this study, we performed a composition analysis of U. dermestoides to obtain the principal fractions, which were used to assess the effect on glycemia, liver and pancreatic architecture, and PPARγ and GLUT4 expression. Normal mice and alloxan-induced diabetic mice were administered fractions of chitin, protein or fat, and the acute hypoglycemic effect was evaluated. A subacute study involving daily administration of these fractions to diabetic mice was also performed over 30 days, after which the liver and pancreas were processed by conventional histological techniques and stained with hematoxylin and eosin to evaluate morphological changes. The most active fraction, the fat fraction, was analyzed by gas chromatography-mass spectrometry (GC-MS), and PPARγ and GLUT4 mRNA expressions were determined in 3T3-L1 adipocytes. The protein and fat fractions exhibited hypoglycemic effects in the acute as well as in the 30-day study. Only the fat fraction led to elevated insulin levels and reduced glycemia, as well as lower intake of water and food. In the liver, we observed recovery of close hepatic cords in the central lobule vein following treatment with the fat fraction, while in the pancreas there was an increased density and percentage of islets and number of cells per islet, suggesting cellular regeneration. The GC-MS analysis of fat revealed three fatty acids as the major components. Finally, increased expression of PPARγ and GLUT4 was observed in 3T3-L1 adipocytes, indicating an antidiabetic effect.


Subject(s)
Animals , Male , Pancreas/drug effects , Tissue Extracts/therapeutic use , Coleoptera/chemistry , Fat Body/chemistry , Hypoglycemic Agents/therapeutic use , Liver/drug effects , Pancreas/metabolism , Pancreas/pathology , Tissue Extracts/isolation & purification , RNA, Messenger/drug effects , RNA, Messenger/metabolism , Gene Expression Regulation , PPAR gamma/drug effects , PPAR gamma/metabolism , Diabetes Mellitus, Experimental/metabolism , Diabetes Mellitus, Experimental/pathology , Diabetes Mellitus, Experimental/drug therapy , Glucose Transporter Type 4/drug effects , Glucose Transporter Type 4/metabolism , Hypoglycemic Agents/isolation & purification , Liver/metabolism , Liver/pathology , Gas Chromatography-Mass Spectrometry
10.
Arq. ciênc. vet. zool. UNIPAR ; 20(2): 109-115, jan-mar. 2017.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-879684

ABSTRACT

O pâncreas é conhecido como uma glândula mista, uma vez que atua tanto na secreção de enzimas digestivas através de sua porção exócrina, quanto na secreção de insulina e glucagon pela porção endócrina. Envolvendo a porção exócrina, nos cães a principal alteração evidenciada é a pancreatite, enquanto que no pâncreas endócrino a principal moléstia é o Diabetes mellitus. Não obstante, o pâncreas pode ser acometido por diversas patologias, dentre elas neoplasias, processos isquêmicos, traumas ou ainda por doenças idiopáticas. Dessa forma, o diagnóstico das disfunções deste órgão torna-se um desafio na Medicina Veterinária, tornando relevante a realização de maiores estudos acerca deste tema. Tendo em vista que abordagens sobre as patologias pancreáticas em cães são escassas, propõe-se assim a realização de uma revisão de literatura mensurando as principais enfermidades pancreáticas diagnosticadas em cães.(AU)


The pancreas is known as a mixed gland, since it acts both in the secretion of digestive enzymes through its exocrine portion, and in the secretion of insulin and glucagon through its endocrine portion. Pancreatitis is main disease developed in the pancreas exocrine portion in dogs, while Diabetes mellitus is the main disease in the endocrine portion. Nevertheless, the pancreas may be affected by several pathologies, among them neoplasms, ischemic processes, injuries or idiopathic diseases. The diagnosis of disorders in this organ becomes a challenge in veterinary medicine, thus the relevance of holding further studies on this subject. Considering the scarcity of approaches on pancreatic diseases in dogs, this study proposes to hold a literature review, addressing the major pancreatic diseases diagnosed in dogs.(AU)


El páncreas es conocido como una glándula mixta, una vez que actúa en la secreción de enzimas digestivas a través de su porción exocrina, así como en la secreción de insulina y glucagón por la porción endocrina. Involucrando la porción exocrina, en perros, la principal alteración observada es la pancreatitis, mientras que en el páncreas endócrino la molestia más común es el Diabetes mellitus. Sin embargo, el páncreas puede ser afectado por diversas patologías, tales como neoplasias, procesos isquémicos, traumas o por trastornos idiopáticos. De este modo, el diagnóstico de las disfunciones de este órgano se convierte en un reto para la Medicina Veterinaria, haciendo relevante la realización de nuevos estudios sobre este tema. Teniendo en cuenta que los enfoques sobre enfermedades pancreáticas en perros son escasos, se propone la realización de una revisión de literatura abordando las principales enfermedades pancreáticas diagnosticadas en perros.(AU)


Subject(s)
Humans , Dogs , Pancreas/pathology , Review
11.
Autops. Case Rep ; 7(4): 26-29, Oct.-Dec. 2017. ilus
Article in English | LILACS | ID: biblio-905402

ABSTRACT

Pancreatic hamartomas are extremely rare tumors in adults and even more so in children. They are lesions characterized by acinar, islet and ductal components found in varying proportions and in a disorganized pattern. We report a case of a premature female with trisomy 18 diagnosed by amniocentesis. The newborn was delivered by cesarean section at thirty-three weeks of gestation and expired within one hour of birth. Postmortem examination exhibited numerous features associated with Trisomy 18 including lanugo on the torso and arms, micrognathia, microstomia, left low-set ear with small flat pinna, closed ear canal, clenched fists with overlapping fingers, rocker-bottom feet, narrow pelvis, large right diaphragmatic hernia and left pulmonary hypoplasia. Microscopic examination of the pancreas revealed an area, 1.2 cm in greatest dimension, with branching ducts and cysts lined by cuboidal epithelium intermingled within primitive mesenchymal proliferation and exocrine glands. The cysts measured up to 0.2 cm and were surrounded by a collarette of proliferating spindle cells as highlighted by Masson's trichrome stain. A diagnosis of pancreatic hamartoma was rendered. A total of thirty-four cases of pancreatic hamartomas have been reported in the literature including twenty-seven in adults, five in children and two in newborns. Our case may be the third pancreatic hamartoma reported in association with Trisomy 18. We recommend that careful examination of the pancreas be performed in individuals with Trisomy 18 to further characterize this lesion as one of the possible abnormal findings associated with this syndrome.


Subject(s)
Humans , Female , Infant, Newborn , Hamartoma/pathology , Trisomy 18 Syndrome/pathology , Autopsy , Pancreas/pathology , Pancreatic Neoplasms/pathology , Rare Diseases , Trisomy 18 Syndrome/diagnosis
12.
Rev. chil. endocrinol. diabetes ; 10(4): 154-156, oct. 2017. ilus
Article in Spanish | LILACS | ID: biblio-999029

ABSTRACT

A 41-year-old woman, multiparous of 4, with personal or familiar history of diabetes, with a history of Nissen fundoplication due to pathological gastro-oesophageal reflux, is refer to an endocrinologjst during her post-operatiye follow up, 4 months after her surgery for a 14 kg weight loss in 10 months and symtomatic hypoglycemia to repetition. A positive prolonged fasting test for hypoglycemia was performed. In addition, abdominal computed axial tomography was performed, which resulted normal and endosonography, showing a lesion on the head of the pancreas. Octreoscan positive for pancreatic head focal lesion with positive somatostatin receptors compatible with insulinoma. Whipple surgery was performed where surgeon palpated pancreatic tumor, biopsy showed tissue compatible with diffuse nesidioblastosis. In the postoperative period, the patient decreased frequency and intensity of hypoglycemic episodes compared to their previous stage. Control prolonged fasting test and Octreoscan were within normal ranges. However, 4 months after surgery, the patient presented hypoglycemia of lower intensity and frequency than before surgery. Currently he remains in control with nutritionist and endocrinologist, mainly adjusting diet and with good control glycemias.


Subject(s)
Humans , Adult , Pancreas/pathology , Nesidioblastosis/diagnosis , Pancreatic Neoplasms/diagnosis , Nesidioblastosis/surgery , Nesidioblastosis/complications , Diagnosis, Differential , Hyperinsulinism/etiology , Hypoglycemia/etiology , Insulinoma/diagnosis
13.
Einstein (Säo Paulo) ; 15(3): 366-368, July-Sept. 2017. graf
Article in English | LILACS | ID: biblio-891408

ABSTRACT

ABSTRACT An asymptomatic 79-year-old woman, with incidental finding on abdominal ultrasound of a solid nodule in the tail of the pancreas. Magnetic resonance imaging showed a 12mm solid tumor. The suggested diagnosis was pancreatic neuroendocrine tumor. The pathological examination showed an intrapancreatic splenic tissue. This is a rare ectopic location of spleen tissue and it should be considered in the differential diagnosis of pancreatic solid tumors.


RESUMO Mulher de 79 anos, com achado incidental em ultrassonografia de abdome de lesão sólida em cauda de pâncreas. Em ressonância magnética, foi confirmada lesão de 12mm. Foi aventada a hipótese diagnóstica de tumor neuroendócrino não secretor, sendo realizada pancreatectomia distal laparoscópica. Em estudo anatomopatológico, diagnosticou-se tecido esplênico, configurando baço acessório intrapancreático. Este tipo de manifestação topográfica de baço é rara, mas deve fazer parte dos diagnósticos diferenciais em tumores sólidos do pâncreas.


Subject(s)
Humans , Female , Aged , Pancreatic Cyst/diagnosis , Spleen , Choristoma/diagnosis , Pancreas/pathology , Pancreatectomy , Pancreatic Diseases/surgery , Pancreatic Diseases/diagnosis , Choristoma/surgery , Incidental Findings , Diagnosis, Differential
14.
Int. j. morphol ; 35(3): 942-949, Sept. 2017.
Article in English | LILACS | ID: biblio-893078

ABSTRACT

Prolonged alcohol consumption has consequences on the liver, producing necrotic precipitates and fibrosis, on the pancreas, causing the pancreatic acini to atrophy and destroying insulin-producing cells, and on the central nervous system (CNS), causing the gray and white matter in the frontal lobes of the brain and cerebellum to atrophy. Generally, alcohol is metabolized via oxidative pathways, where the enzymes alcohol dehydrogenase and aldehyde dehydrogenase participate during its metabolization in the liver and CNS, or via non-oxidative pathways during its metabolization in the pancreas. Ethanol metabolism can produce oxidative stress and tissue damage mediated by free radicals, causing morphological and functional alterations in the liver. In the pancreas, it can cause progressive and irreversible damage affecting the endocrine and exocrine functions, a result of the activation of the stellate cells, which are activated directly by alcohol, causing pancreatic fibrosis. In the CNS ethanol can bind directly to proteins, nucleic acids and phospholipids to develop its pathogenesis. The effects produced by alcohol can be counteracted by supplementation with antioxidants, which reduce the inflammation and areas of focal necrosis in the liver, inhibit the activation of pancreatic stellate cells, and reduce oxidative stress in the CNS. Additionally, in order to reduce the negative effects associated with alcohol consumption, recent studies have suggested the administration of antioxidants as a treatment strategy.


El consumo prolongado de alcohol tiene consecuencias en hígado, produciendo precipitados necróticos y fibrosis; en páncreas, provocando atrofia del acino pancreático y destrucción de las células productoras de insulina, y en Sistema Nervioso Central (SNC) generando atrofia de la sustancia gris y blanca en lóbulos frontales del cerebro y cerebelo. En general, el metabolismo del alcohol se consigue mediante las vías oxidativas, donde participan las enzimas alcohol-deshidrogenasa y aldehído deshidrogenasa durante su metabolización en hígado y SNC; o bien, mediante las vías no oxidativas durante su metabolización en páncreas. El metabolismo del etanol es capaz de producir estrés oxidativo y daño tisular mediado por radicales libres, causando alteraciones morfológicas y funcionales del hígado; en el páncreas, puede causar daño progresivo e irreversible afectando las funciones endocrinas y exocrinas de este órgano producto de la activación de las células estrelladas que son activadas directamente por el alcohol generando fibrosis pancreática; mientras que, en SNC se puede unir directamente a proteínas, ácidos nucleicos y fosfolípidos para desarrollar su patogenia. Los efectos producidos por el alcohol pueden contrarrestarse mediante la suplementación con antioxidantes, que reducen la inflamación y las zonas de necrosis focal en el hígado, inhiben la activación de células pancreáticas estrelladas, y reducen el estrés oxidativo en SNC. Asimismo, para reducir los efectos negativos asociados al consumo de alcohol, estudios recientes han propuesto la administración de antioxidantes como estrategia terapéutica.


Subject(s)
Humans , Central Nervous System/drug effects , Ethanol/toxicity , Alcoholic Intoxication/drug therapy , Antioxidants/therapeutic use , Pancreas/drug effects , Pancreas/pathology , Central Nervous System/pathology , Oxidative Stress , Ethanol/metabolism , Liver/drug effects , Liver/pathology
15.
Arq. bras. med. vet. zootec. (Online) ; 69(3): 600-602, jun. 2017. ilus
Article in English | LILACS, VETINDEX | ID: biblio-846898

ABSTRACT

Undifferentiated carcinoma of the pancreas is a malignant neoplasm that is uncommon among domestic species, especially cockatiels (Nymphicus hollandicus), one of the most popular birds kept as a pet throughout the world. The aim of this study was to describe the occurrence of an undifferentiated carcinoma in the pancreas of a cockatiel. A bird, an adult male that died naturally with swelling in the abdominal region, was referred to necropsy. Macroscopic examination showed poor body condition, the coelomic cavity filled with liquid and a white mass attached to the pancreas and other smaller masses attached to the duodenum. Tissue samples and organs were harvested and fixed in 10% buffered formalin, then routinely processed for histopathology and stained with hematoxylin and eosin. Microscopic analysis demonstrated an epithelial neoplasia with a predominantly solid pattern, lymphatic invasion and involvement of the intestinal serous membrane. These findings indicate the occurrence of an undifferentiated pancreatic carcinoma in a cockatiel that was diagnosed by histopathology.(AU)


O carcinoma indiferenciado de pâncreas é uma neoplasia maligna, incomum entre as espécies domésticas, especialmente em calopsitas (Nymphicus hollandicus), uma das aves mais populares como animal de companhia no mundo. O objetivo deste trabalho foi descrever a ocorrência de carcinoma indiferenciado de pâncreas em Nymphicus hollandicus. Uma ave, macho adulto, com morte natural e com aumento de volume em região abdominal, foi encaminhada para necropsia. Ao exame macroscópico foram observados mau estado corporal, cavidade celômica repleta de líquido e massa esbranquiçada aderida ao pâncreas e outra menor aderida ao duodeno. Amostras de tecidos e órgãos foram colhidas em formol 10% tamponado, processadas rotineiramente para histopatologia e coradas por hematoxilina e eosina. Na microscopia foi observada neoplasia epitelial com padrão predominantemente sólido, com invasão linfática e implantação na serosa intestinal. Com esses achados, comprovou-se a ocorrência de carcinoma indiferenciado de pâncreas em Nymphicus hollandicus, o qual pode ser diagnosticado por meio de histopatologia.(AU)


Subject(s)
Animals , Carcinoma/veterinary , Cockatoos , Pancreatic Neoplasms/veterinary , Pancreas/pathology
16.
Int. j. morphol ; 35(1): 16-20, Mar. 2017. ilus
Article in English | LILACS | ID: biblio-840925

ABSTRACT

Several studies indicated that pancreatic ß-cell death occurs in both type 1 and type 2 diabetes. This experimental study was designed to determine the effect of gestational diabetes on the ß-cells in 16-week-old rat offspring. By this aim, adult Wistar rats aged 10-12 weeks were randomly allocated in control and diabetic groups. The diabetic group received 40 mg/kg/body weight of streptozotocin (STZ) on day zero of gestation. After delivery, diabetic offspring of GDM mothers and controls at the age of 16 weeks were sacrificed and pancreases harvested and fixed. The number of ß-cells and were counted by Gomori's method staining. Also, apoptosis in pancreas tissue of diabetic and control offspring was detected by TUNEL assay. Results showed a significant reduction in ß-cell number in offspring of GDM (p<0.05). TUNEL assay showed that the number of apoptotic cells increased in GDM compared to controls (P<0.05). This study revealed that gestational diabetes induces pancreatic beta-cells apoptosis in 16-week-old rat offspring.


Varios estudios indican que la muerte de las células ß del páncreas se produce tanto en la diabetes Tipo 1 como en la Tipo 2. Este estudio experimental fue diseñado para determinar el efecto de la diabetes gestacional en las células ß del páncreas en crías de ratas de 16 semanas. Para ello, ratas Wistar adultas de entre 10-12 semanas fueron asignadas al azar en dos grupos: control y diabetes. El grupo diabetes recibió 40 mg / kg / peso corporal de estreptozotocina (STZ) en el día cero de la gestación. Después del parto, a las 16 semanas, las crías de las madres diabéticas y controles de madres con diabetes gestacional (MDG), fueron sacrificadas para la extracción del páncreas, el cual posteriormente fue fijado. Se contó el número de células ß del páncreas mediante tinción con el método de Gomori. Además, se detectó apoptosis en el tejido del páncreas de la descendencia diabética y el grupo control mediante un ensayo TUNEL. Los resultados mostraron una reducción significativa en el número de células b en la descendencia de MDG (p <0,05). El ensayo TUNEL mostró que el número de células apoptóticas aumentó en MDG en comparación con los controles (P <0,05). Este estudio reveló que la diabetes gestacional induce apoptosis de células ß en el páncreas de crías de ratas de 16 semanas.


Subject(s)
Animals , Rats , Apoptosis , Diabetes, Gestational/pathology , Islets of Langerhans/pathology , Blood Glucose/analysis , In Situ Nick-End Labeling , Pancreas/pathology , Rats, Wistar
17.
Braz. j. med. biol. res ; 50(5): e5858, 2017. tab, graf
Article in English | LILACS | ID: biblio-839295

ABSTRACT

Modifications in life-style and/or pharmacotherapies contribute to weight loss and ameliorate the metabolic profile of diet-induced obese humans and rodents. Since these strategies fail to treat hypothalamic obesity, we have assessed the possible mechanisms by which duodenal-jejunal bypass (DJB) surgery regulates hepatic lipid metabolism and the morphophysiology of pancreatic islets, in hypothalamic obese (HyO) rats. During the first 5 days of life, male Wistar rats received subcutaneous injections of monosodium glutamate (4 g/kg body weight, HyO group), or saline (CTL). At 90 days of age, HyO rats were randomly subjected to DJB (HyO DJB group) or sham surgery (HyO Sham group). HyO Sham rats were morbidly obese, insulin resistant, hypertriglyceridemic and displayed higher serum concentrations of non-esterified fatty acids (NEFA) and hepatic triglyceride (TG). These effects were associated with higher expressions of the lipogenic genes and fatty acid synthase (FASN) protein content in the liver. Furthermore, hepatic genes involved in β-oxidation and TG export were down-regulated in HyO rats. In addition, these rats exhibited hyperinsulinemia, β-cell hypersecretion, a higher percentage of islets and β-cell area/pancreas section, and enhanced nuclear content of Ki67 protein in islet-cells. At 2 months after DJB surgery, serum concentrations of TG and NEFA, but not hepatic TG accumulation and gene and protein expressions, were normalized in HyO rats. Insulin release and Ki67 positive cells were also normalized in HyO DJB islets. In conclusion, DJB decreased islet-cell proliferation, normalized insulinemia, and ameliorated insulin sensitivity and plasma lipid profile, independently of changes in hepatic metabolism.


Subject(s)
Animals , Male , Duodenum/surgery , Fatty Liver/metabolism , Gastric Bypass/methods , Hypothalamic Diseases/metabolism , Islets of Langerhans/cytology , Islets of Langerhans/metabolism , Jejunum/surgery , Obesity/metabolism , Animals, Newborn , Blood Glucose/metabolism , Cell Proliferation , Cholesterol/blood , Fatty Acid Synthase, Type I/metabolism , Fatty Acids/blood , Fatty Liver/physiopathology , Hypothalamic Diseases/physiopathology , Hypothalamic Diseases/surgery , Insulin Resistance , Insulin/metabolism , Islets of Langerhans/physiopathology , Lipogenesis/genetics , Liver/metabolism , Liver/pathology , Obesity/physiopathology , Obesity/surgery , Pancreas/metabolism , Pancreas/pathology , Random Allocation , Rats, Wistar , Reproducibility of Results , Time Factors , Triglycerides/blood
18.
Braz. j. med. biol. res ; 49(9): e5388, 2016. tab, graf
Article in English | LILACS | ID: biblio-951696

ABSTRACT

Galunisertib (LY2157299), a selective ATP-mimetic inhibitor of TGF-β receptor I (TGF-βRI), is the only known TGF-β pathway inhibitor. In the present study, we investigated the effect of galunisertib on taurocholate (TAC)-induced acute pancreatitis (AP) in rats, and the role of TGF-β and NF-κB signaling pathways. AP was induced by infusion of TAC into the pancreatic duct of Sprague-Dawley male rats (n=30). The rats (220±50 g) were administered galunisertib intragastrically [75 mg·kg-1·day-1 for 2 days (0 and 24 h)]. Serum IL-1β, IL-6, TNF-α, amylase (AMY), lipase (LIP), and myeloperoxidase (MPO) levels were measured by ELISA. NF-κB activity was detected by electrophoretic mobility shift assay (EMSA); NF-κBp65 and TGF-β1 proteins, as well as TGF-βRI and p-Smad2/3 proteins, were detected by western blot assay. Cell apoptosis was detected by TUNEL assay. H&E staining was used to evaluate the histopathological alterations of the pancreas. Galunisertib treatment attenuated the severity of AP and decreased the pancreatic histological score. In addition, number of apoptotic cells were significantly increased in the galunisertib-treated group (16.38±2.26) than in the AP group (8.14±1.27) and sham-operated group (1.82±0.73; P<0.05 and P<0.01, respectively). Galunisertib decreased the expression levels of TGF-βRI and p-Smad2/3 and inhibited NF-κB activation and p65 translocation compared with the sham-operated group. Furthermore, serum IL-1β, IL-6, TNF-α, AMY and LIP levels and tissue MPO activity were significantly decreased in the galunisertib-treated group. Our data demonstrate that galunisertib attenuates the severity of TAC-induced experimental AP in rats by inducing apoptosis in the pancreas, inhibiting the activation of TGF-β signals and NF-κB as well as the secretion of pro-inflammatory cytokines.


Subject(s)
Animals , Male , Pancreatitis/drug therapy , Pyrazoles/therapeutic use , Quinolines/therapeutic use , Protein-Serine-Threonine Kinases/antagonists & inhibitors , Protein Kinase Inhibitors/therapeutic use , Pancreas/drug effects , Pancreas/pathology , Pancreatitis/pathology , Enzyme-Linked Immunosorbent Assay , Blotting, Western , Acute Disease , Interleukin-6/blood , Treatment Outcome , Apoptosis , Peroxidase/analysis , In Situ Nick-End Labeling , Electrophoretic Mobility Shift Assay , Interleukin-1beta/blood , Amylases/blood , Lipase/blood
19.
Arch. endocrinol. metab. (Online) ; 59(5): 466-469, Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-764117

ABSTRACT

Hyperinsulinemia, diagnosed by laboratory tests, should be diagnosed and treated as soon as possible to prevent fatal complications such as neurological damage. Patients who are resistant to medical therapy should be treated surgically. Minimally invasive surgery, a newly developed approach, is a good choice among surgical procedures to avoid unnecessary extensive pancreatectomy. Here, a 12-year-old boy is presented with diagnosis of hyperinsulinemic hypoglycemia who had recurrent attacks of hypoglycemia and seizures from infancy. Because of his unresponsiveness to medical therapy and his family’s preference, he underwent laparoscopic pancreatectomy to reduce morbidity and hospital stay. Two years postsurgical follow-up revealed a normo-glycemic state.


Subject(s)
Child , Humans , Male , Congenital Hyperinsulinism/surgery , Pancreas/pathology , Congenital Hyperinsulinism/pathology , Hyperplasia/pathology , Laparoscopy/methods , Overweight , Pancreatectomy/methods , Treatment Outcome
20.
Acta cir. bras ; 30(7): 503-508, 07/2015. tab, graf
Article in English | LILACS | ID: lil-754980

ABSTRACT

PURPOSE: To evaluate the diagnosis improvement of EUS-FNA when using ROSE performed by the endosonographer. METHODS: A retrospective study was conducted. A total of 48 pancreatic solid masses EUS-FNA were divided into two groups according to the availability of on-site cytology (ROSE) - the first 24 patients (group A-without ROSE) and the latter 24 cases (group B-with ROSE). Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, complications and inadequacy rate of EUS-FNA were determined and compared. RESULTS: Among the 48 EUS-FNA, the overall performance was: sensitivity 82%; specificity 100%; positive predictive value (PPV) 100%; negative predictive value (NPV) 70% and accuracy 87%. The sensitivity of the Group A was 71%, versus 94% in-group B (p=0.61). Moreover, the negative predictive value was 58% versus 87% (p=0.72). The accuracy rate increased from 79% to 96% (p=0.67) in the ROSE group. The number of punctures was similar between the groups. No major complications were reported. CONCLUSION: Rapid on-site cytopathological examination, even when performed by the endosonographer, may improve the diagnostic performance in the diagnosis of solid pancreatic lesions, regardless of the slight increase in the number of punctures. .


Subject(s)
Humans , Endoscopic Ultrasound-Guided Fine Needle Aspiration/standards , Endosonography/standards , Pancreas/pathology , Pancreatic Diseases/pathology , Adenocarcinoma/pathology , Adenocarcinoma , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Endosonography/methods , Prospective Studies , Pancreas , Pancreatic Diseases , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms , Quality Improvement , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity
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