RESUMO
BACKGROUND: Only a limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature. We report a case of two solid malignant tumors of the pancreas diagnosed preoperatively. CASE PRESENTATION: We describe a 65-year-old Sri Lankan woman who presented with progressive obstructive jaundice. Initial contrast-enhanced computed tomography imaging detected a malignant tumor at the tail of her pancreas. A second tumor of the pancreatic head was detected with integrated imaging using multidetector computed tomography and multimodal magnetic resonance imaging. She underwent total pancreaticoduodenectomy and splenectomy. Gross examination of the specimen confirmed the presence of two separate tumors. Histology of the ampullary tumor showed pancreatic-type adenocarcinoma and the tumor in the tail of her pancreas showed a colloid-type adenocarcinoma. CONCLUSION: The possibility of multiple primary malignant solid tumors of different types with malignant potential has to be considered even without background pathology when managing multiple tumors in the pancreas.
Assuntos
Icterícia Obstrutiva/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Pâncreas/patologia , Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia , Esplenectomia , Idoso , Feminino , Humanos , Icterícia Obstrutiva/etiologia , Icterícia Obstrutiva/patologia , Imagem Multimodal , Neoplasias Primárias Múltiplas/patologia , Neoplasias Pancreáticas/classificação , Neoplasias Pancreáticas/diagnóstico por imagem , Resultado do TratamentoAssuntos
Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Tumor de Células Granulares/diagnóstico , Tumor de Células Granulares/patologia , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Antígenos CD/metabolismo , Esôfago de Barrett/diagnóstico , Esôfago de Barrett/patologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Neoplasias Esofágicas/cirurgia , Esofagoscopia , Secções Congeladas , Gastrectomia , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/patologia , Tumor de Células Granulares/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Proteínas S100/metabolismo , Vimentina/metabolismoAssuntos
Neoplasias Esofágicas/patologia , Esôfago/patologia , Tumor de Células Granulares/patologia , Biópsia por Agulha Fina , Neoplasias Esofágicas/diagnóstico por imagem , Esôfago/ultraestrutura , Tumor de Células Granulares/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
INTRODUCTION: The workload of histopathologists is traditionally assessed by the total number of specimens handled annually (TSA). Development in medical science has resulted in an increased demand by clinicians for more information in histopathology reports. Inclusion of this information requires more work. Annual information output (AIO) is the total number of specimens handled annually multiplied by the average number of items of information per histopathology report (AIR). An item of information is any pathological feature of prognostic or therapeutic relevance. OBJECTIVE: This study aims to determine whether there has been an increase in annual information output (AIO) during a 17-year period. METHOD: This is a retrospective study in a University Department of Pathology. 200 histopathology reports per year at 4 yearly intervals from 1982 to 1998 were examined. TSA, AIR and AIO were calculated. RESULTS: TSA increased from 2912 in 1982 to 3919 in 1998 (34.6% increase). AIR increased from 1.11 to 3.12 (181.1% increase). AIO increased from 3232.3 to 12227.3 (278.3% increase). CONCLUSION: The increase in AIO was greater than the increase in TSA. Thus the use of TSA alone will not reflect the increase in workload accurately. We recommend the use of AIO rather than TSA to quantify workload and staffing requirements of histopathologists.
