Solid and papillary epithelial neoplasm arising in heterotopic pancreatic tissue of the mesocolon.

AIM: Solid and papillary epithelial neoplasm (SPEN) is an uncommon pancreatic tumour. Very rarely it has also been described outside the pancreas, usually arising from heterotopic pancreatic tissue. This report summarises all the published extrapancreatic SPENs and documents the sixth such case arising from heterotopic pancreatic tissue of the transverse mesocolon in a 15 year old girl. METHODS/RESULTS: Histological and immunohistochemical examination revealed typical papillary and solid areas composed of columnar, cuboidal, and round cells, which were focally positive for vimentin, cytokeratin, neurone specific enolase, carcinoembryonic antigen, alpha1-antitrypsin, alpha1-antichymotrypsin, and negative for neuroendocrine markers (neurofilament, PGP 9.5, chromogranin A, synaptophysin, and S100), p53, and oestrogen and progesterone receptors. Electron microscopy showed scant zymogen but no neurosecretory granules. In agreement with the flow cytometric result s of diploidy, comparative genomic hybridisation (CGH) did not reveal loss or gain of genetic material, and the in situ hybridisation analysis of the RB1 and p53 genes revealed no abnormality in the 13q and 17p arms. CONCLUSIONS: Immunohistochemical and electron microscopic data support exocrine differentiation. The CGH and the flow cytometric results suggest a subtle, yet unknown genetic change, rather than a large genetic alteration. RB1 and p53 in situ hybridisation ruled out the role of deletion at these sites in the pathogenesis of SPEN. Interestingly, review of the published and the present heterotopic pancreatic SPENs identified the mesocolon as the most common anatomical site (four of six), despite the very rare occurrence of ectopic pancreatic tissue at this site.

[Quality control--results of the first survey of pediatric surgery in Hungary]. / Minöségellenörzés--az elsö hazai gyermeksebészeti tanulmány tapasztalatai.

161 patients underwent appendectomy at the Surgical Unit of the Department Paediatrics, Medical School of Pécs, Hungary between 1. January, 1988 and 31. December, 1995. Biochemical results--sedimentation rate, CRP (C-reactive protein) and leucocytosis were compared to the operative findings as far as their predictive diagnostic value was concerned. The patients were grouped according to inflamed (n = 141) or non-inflamed appendix (n = 20). Based on the outcome of statistical analysis the author concluded, that there was no significant difference between the informations given by the above-mentioned biochemical results, regarding the strengthening of the preoperative diagnosis, also the combination of the data of the biochemistry tests did not help in deciding to operate on patients with suspected appendicitis. The changing policy and conditions of the health insurance in Hungary are forcing the medical doctors to analyse more frequently the effectiveness of their activity.

[Hiatal hernia in childhood]. / Hiatus herina gyermekkorban.

Authors studied the occurrence and clinical outcome of hiatal hernia in 18 patients during a 7-year period. The age of the children from 10 years to 15 years, with a mean age of 12.8 years. Their patients had recurrent abdominal pain, 4 of them had chest pain. 13 patients had macroscopic oesophagitis. Under medically treatment 16 patients has been well. Two cases required surgery. Aetiology of hiatal hernia in children is unknown.