Subject(s)
Lipomatosis , Thyroid Diseases , Humans , Neck , Lipomatosis/diagnostic imaging , Lipomatosis/surgeryABSTRACT
Presentamos el caso de un varón de 76 años con antecedente de colecistitis aguda intervenido mediante colecistectomía laparoscópica. Intraoperatoriamente, se evidenció una colecistitis crónica con conducto cístico engrosado. La anatomía patológica informó de displasia de alto grado que afectaba al borde distal del cístico. Ante los hallazgos, se practicó colangiopancreatografía retrógrada endoscópica (CPRE) con SpyGlass(R) con la cual se observó, adyacente a la unión del cístico-colédoco, lesión excrecente sugestiva de malignidad. Se decidió nueva intervención quirúrgica y se realizó una resección de vía biliar extrahepática con linfadenectomía del hilio hepático y hepaticoyeyunostomía. El informe anatomopatológico definitivo informó de neoplasia mucinosa papilar intraductal pancreatobiliar con displasia de alto grado con márgenes libres
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Subject(s)
Humans , Male , Aged , Bile Duct Neoplasms/surgery , Carcinoma, Ductal/surgery , Neoplasms, Cystic, Mucinous, and Serous/surgery , Cholangiopancreatography, Endoscopic Retrograde/instrumentation , Endoscopy, Digestive System/instrumentation , Predictive Value of Tests , Bile Duct Neoplasms/pathology , Pancreatic Diseases/pathology , Common Bile Duct/pathologyABSTRACT
We present the case of a 76-year-old male with a history of acute cholecystitis who underwent a scheduled laparoscopic cholecystectomy. Chronic cholecystitis with a thickened cystic duct was observed intraoperatively. The anatomic pathology report found high-grade dysplasia that affected the distal edge of the cystic duct. In view of these findings, an endoscopic retrograde cholangiopancreatography (ERCP) was performed with SpyGlass® and an excrescent lesion suggestive of malignancy adjacent to the cystic-common bile duct junction was observed. A resection of the extrahepatic bile duct was performed with lymphadenectomy of the hepatic hilum and hepaticojejunostomy in a subsequent procedure. The definitive pathology report confirmed pancreaticobiliary intraductal papillary mucinous neoplasia with high-grade dysplasia and free margins.
Subject(s)
Bile Duct Neoplasms , Bile Ducts, Extrahepatic , Pancreatic Neoplasms , Aged , Bile Duct Neoplasms/surgery , Cholangiopancreatography, Endoscopic Retrograde , Hepatectomy , Humans , Male , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/surgeryABSTRACT
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Subject(s)
Humans , Female , Aged , Hepatic Insufficiency/complications , Amyloidosis/pathology , Multiple Myeloma/pathology , Hepatic Insufficiency/diagnosis , Hepatic Insufficiency/pathology , Multiple Myeloma/diagnosis , Biopsy , Liver/pathologyABSTRACT
Liver failure (LF) is a severe entity, which represents a diagnostic challenge for clinicians. Knowing the etiology of liver aggression is key for its management. We present a rare case of cholestatic LF secondary to primary AL (kappa-light chain) amyloidosis as a presentation associated to multiple myeloma.
