Subject(s)
Adenocarcinoma/pathology , Pancreatic Neoplasms/secondary , Rectal Neoplasms/pathology , Adenocarcinoma/surgery , Chemotherapy, Adjuvant , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Pancreatectomy , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Positron-Emission Tomography , Rectal Neoplasms/surgeryABSTRACT
The diffuse biliary or pancreatic papillomatosis is a rare pathology. Reported cases in the literature underscore the difficulties of preoperative diagnosis of these lesions, their extensive nature, their tendency to relapse, and their malignant potential. The case that we report differs by the isolated involvement of the biliary tract and by the increasing role of imaging (MRCP) for diagnosis and follow-up.
Subject(s)
Bile Duct Neoplasms/diagnostic imaging , Papilloma/diagnostic imaging , Aged , Humans , Magnetic Resonance Imaging , Male , Preoperative Care , Tomography, X-Ray ComputedSubject(s)
Celiac Disease/diagnosis , Transaminases/blood , Adolescent , Adult , Aged , Celiac Disease/enzymology , Diagnosis, Differential , Female , Humans , Male , Middle AgedABSTRACT
BACKGROUND: The occurrence of hepatocellular neoplasms is frequently reported in young females. The role of oral contraceptives in the development of these tumors is considered. METHODS: A 14-cm tumor was diagnosed in a 24-year-old female who had been taking the contraceptive pill for the last 3 years. Numerous blocks of this lesion were histologically and immunohistochemically analyzed. Some fragments of the lesion were snap-frozen in order to search for sex hormonal receptors and hepatitis B and C virus. RESULTS: On histological examination, the tumor was found to be a hepatocellular, multilobular adenoma with small foci of hepatocellular carcinoma. Neither hepatitis B virus nor hepatitis C virus was found in serum or in the tumor. Nuclear estrogen receptors and progesterone receptors were detected by immunohistochemical analysis in both the adenoma and the carcinoma, but only progesterone receptors were detected by a radio-ligand binding assay in the tumor. CONCLUSION: This finding suggests that the contraceptive pill may stimulate the growth of hepatocellular, multilobular adenomas through the binding of hormonal compounds to their specific receptors within tumoral cells.
Subject(s)
Adenoma, Liver Cell/chemically induced , Carcinoma, Hepatocellular/chemically induced , Contraceptives, Oral/adverse effects , Liver Neoplasms/chemically induced , Adenoma, Liver Cell/metabolism , Adenoma, Liver Cell/pathology , Adult , Biomarkers, Tumor , Carcinoma, Hepatocellular/metabolism , Carcinoma, Hepatocellular/pathology , Cell Division/drug effects , Female , Humans , Immunohistochemistry , Liver Neoplasms/metabolism , Liver Neoplasms/pathology , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolismSubject(s)
Esophagus/injuries , Foreign Bodies/therapy , Laser Therapy , Adult , Bone and Bones , Esophagus/pathology , Female , Humans , Ulcer/etiologySubject(s)
Adenomatous Polyps/epidemiology , Colonic Neoplasms/epidemiology , Rectal Neoplasms/epidemiology , Adenomatous Polyps/diagnosis , Adenomatous Polyps/pathology , Adenomatous Polyps/surgery , Aged , Colonic Neoplasms/diagnosis , Colonic Neoplasms/pathology , Colonic Neoplasms/surgery , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Prevalence , Rectal Neoplasms/diagnosis , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Risk FactorsABSTRACT
BACKGROUND: The survival of 52 patients with hepatocellular carcinoma (HCC) seen during the last 4 years was analyzed prospectively on the basis of disease stage and nuclear DNA content. METHODS: Ploidy was measured by flow cytometry (FCM). Cells for cytologic diagnosis and FCM were collected by ultrasound-guided fine needle aspiration. RESULTS: DNA aneuploidy, which was detected in 62% of the patients, did not correlate with clinicopathologic features, except in the sonographic aspect (P = 0.03). However, ploidy correlated significantly with survival; the survival times for patients with an aneuploid DNA index were significantly shorter than for those with a diploid index (P = 0.02). In a Cox multivariate analysis, DNA content was prognostically significant, as were the grade of cirrhosis severity and the echographic aspect. CONCLUSIONS: In addition to the clinicopathologic features observed, FCM DNA analysis of ultrasound-guided fine needle aspirates from HCC is a simple and valid method for estimating a prognosis of these patients.
Subject(s)
Carcinoma, Hepatocellular/mortality , DNA, Neoplasm/analysis , Liver Neoplasms/mortality , Aged , Aneuploidy , Biopsy, Needle , Carcinoma, Hepatocellular/genetics , Female , Flow Cytometry , Humans , Liver Neoplasms/genetics , Male , Multivariate Analysis , Prognosis , Survival Rate , UltrasonicsABSTRACT
Endoscopic ultrasonography was performed in 80 cirrhotic patients and 50 control subjects. The aim of the study was to describe and classify the vascular abnormalities of the gastric wall as observed on echoendoscopy in cirrhotic patients and to compare the data with endoscopy. The size of gastric varices was classified into 3 grades: grade 0 (none), grade 1 (small or non-confluent varices < 5 mm), grade 2 (large or confluent varices > or = 5 mm). The abnormalities of the gastric wall were classified into 3 grades: 0 (none), grade 1 (thickening and brilliance of the third hyperechogenic layer with or without fine internal anechogenic structures), grade 2 (visible vessels in the third layer which deform the entire wall, with penetrating varices). Endoscopy provides better visualization of esophageal varices than echoendoscopy but does not detect gastric varices and the first signs of portal hypertension as well. In conclusion echoendoscopy should be a routine examination for screening portal hypertension in cirrhotic patients and could be used in therapeutic follow-up.
Subject(s)
Endoscopy, Gastrointestinal/methods , Esophageal and Gastric Varices , Liver Cirrhosis/complications , Ultrasonography/methods , Digestive System/pathology , Esophageal and Gastric Varices/classification , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/diagnostic imaging , Female , Humans , Hypertension, Portal/complications , Hypertension, Portal/diagnosis , Hypertension, Portal/pathology , Liver Cirrhosis/pathology , Male , Middle AgedABSTRACT
From January to December 1991, the portal venous system was evaluated by Doppler ultrasonography in 72 patients with liver cirrhosis. The objectives of this study were to evaluate the prevalence of spontaneous reversal of blood flow in the portal vein and to assess the relationship between Doppler ultrasound investigation and clinical, biochemical, endoscopic (70 patients), and endosonographic (44 patients) features. Reversed flow was quite frequent (alternating: 17%, permanent: 22%) and its prevalence did not differ in relation to age, sex, serum gammaglobulin concentration and Child-Pugh class. In patients with reversed portal venous flow, the prevalence of hepatic encephalopathy was higher (39% vs 13.5%, P < 0.05), but the prevalence of esophageal or gastric varices was not related to that pattern. Endosonography detected gastric wall abnormalities in a higher proportion of patients with reversed portal flow than in patients without it (P < 0.05). This study suggests that reversal of flow in the portal vein could play a role in the development of the gastric wall abnormalities in liver cirrhosis, which are detected by endosonography but not by endoscopy.
Subject(s)
Blood Flow Velocity , Hypertension, Portal/physiopathology , Liver Cirrhosis, Alcoholic/complications , Liver Cirrhosis/complications , Portal Vein/physiopathology , Adult , Aged , Aged, 80 and over , Endoscopy, Digestive System , Esophageal and Gastric Varices/diagnostic imaging , Esophageal and Gastric Varices/etiology , Female , Humans , Hypertension, Portal/complications , Hypertension, Portal/diagnostic imaging , Male , Middle Aged , Portal Vein/diagnostic imaging , Radiography , UltrasonographySubject(s)
Catheterization/adverse effects , Esophageal and Gastric Varices/surgery , Foreign Bodies/complications , Pain/etiology , Stomach , Aged , Esophageal and Gastric Varices/etiology , Female , Gastrointestinal Hemorrhage/complications , Gastrointestinal Hemorrhage/etiology , Hematemesis/etiology , Humans , Liver Cirrhosis, Alcoholic/complications , Male , Middle AgedABSTRACT
Samples from 64 consecutive resected colorectal polyps were preserved in liquid nitrogen and analyzed by flow cytometry to assess the nuclear DNA content, which was compared to the histopathologic findings. The frequency of aneuploidy in these nonselected polyps was 17.2%. There was a significant correlation between the diameter of the polyp and the frequency of aneuploidy (P = .04), with all aneuploid polyps being greater than or equal to 10 mm. Similarly, aneuploidy was significantly more frequent for polyps that were both greater than or equal 20 mm and showed at least severe dysplasia (P = .02). On the other hand, there was no correlation between the ploidy and the gross histopathologic type (tubular, tubulovillous or villous), and the proliferation index did not correlate with any of the parameters studied.