Isolated pancreatic myeloid sarcoma: A potential mimicker of pancreatic adenocarcinoma

Myeloid sarcoma (MS) is an extramedullary proliferation of immature myeloid cells which may occur as a progression of myelodysplastic syndrome (MDS), myeloproliferative neoplasm (MPN), or myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) and as acute myeloid leukemia (AML) relapse. Rarely may it be de novo. Lymph nodes, skin, lungs, intestine are the commonly involved sites. However, an isolated pancreatic MS is seldom reported in the literature. Herein, we report one such case which was misdiagnosed as pancreatic adenocarcinoma on the clinico-radiological examination which misled us away from preoperative diagnostic sampling, and a Whipple pancreaticoduodenectomy was performed. Histopathological examination in conjunction with immunohistochemistry revealed the final diagnosis of isolated MS of the pancreas. We emphasize that although rare, a clinical suspicion along with preoperative histopathological examination may lead to early diagnosis, targeted management, and a better clinical outcome in such cases.

Application and progress of three dimensional imaging and printing for the clinical management of pancreatic malignancy / 中华肝胆外科杂志

Three dimensional (3D) imaging and 3D printing have been applied in pancreatic malignancy management.The 3D imaging can not only be applied in pre-procedural evaluation and planning,but also it can be used for residents and fellows for training and education,and families of patients advsing.A model of pancreatic and its surrounding structures can be gotten by the 3D printing technique based on 3D imaging,which can not only recognize the anatomical structure,but also can make the guidance for the procedure.3D imaging and 3D printing technique have an important role in the management of pancreatic malignancy.In this review,we summarized the application of 3D) imaging and 3D printing in malignant neoplasm of pancreas.

The Value of Diagnostic Laparoscopy for Assessment of Resectability in Hepatobiliary and Pancreatic Malignancy under the Local Anesthesia / 한국간담췌외과학회지

BACKGROUNDS: Despite the advance of radiologic imaging techniques, not a fewer number of patients with hepatobiliary and pancreatic malignancies are found to be unresectable just at the time of laparotomy. The aim of this study was to evaluate the accuracy of diagnostic laparoscopy for assessing resectability of hepatobiliary and pancreatic malignancies. METHODS: From May 1999 to March 2000, diagnostic laparoscopy was performed in 16 patients with suspected hepatobiliary and pancreatic malignancies after clinical examination, laboratory tests, and radiologic imaging techniques(ultrasonography, computed tomography, ERCP, and PTC). Local anesthesia with intravenous sedation was used. A 10-mm infraumbilical port was used for the telescope and another 5-mm port was used for the working instrument depending upon intra-abdominal findings. During the procedure, we tried to find any evidence of distant metastasis or advanced local invasion such as, peritoneal seeding, metastatic nodule at the liver, major vascular involvement or invasion of adjacent other intraabdominal organ. RESULTS: 4 of 16 patients were found to have unresectable malignancies because of peritoneal seeding, hepatic metastases or ascites by diagnostic laparoscopy. 3 patients had invasion to superior mesenteric vein and adjacent structures overlooked at diagnostic laparoscopy. Sensitivity, specificity, and overall accuracy for assessing resectability were 66.7%, 28.6% and 50.0% for radiologic imaging techniques and 100%, 57.1% and 81.3% for diagnostic laparoscopy. CONCLUSION: Diagnostic laparoscopy under local anesthesia proved to be an effective diagnostic tool for assessing resectability of hepatobiliary and pancreatic malignancies by means of assisting the radiologic imaging technique.