Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 119 Japanese patients with pancreas head carcinoma were treated in the Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan, from January 1976 to December 1991. Three of the 119 patients had carcinoma in the uncinate process, with a 2.5% incidence of pancreas head carcinoma. Those three cases consisted of two men, one 55 and one 72 yr old, and one 62-yr-old woman. Two patients developed abdominal pain, whereas another was vomiting; no patients were icteric. Hypotonic duodenography showed an irregular mucosa of the inner area of the third portion of the duodenum in two and an obstruction of the duodenum in one. Drip infusion cholangiography and/or endoscopic retrograde cholangiopancreatography revealed no abnormality of the biliary tract or pancreatic ducts in any of the three. Ultrasonography showed a hypoechoic mass in the uncinate process in three, and computed tomography showed a low-density mass in the uncinate process in two with a displacement of the superior mesenteric vessels toward the anterior. Angiography showed encasement of the pancreatoduodenal arcade in three, the dorsal pancreatic artery in two, and the middle colic artery in two. No neovascularity or tumor staining was present. Two patients underwent a pancreatoduodenectomy, and the other had a bypass operation (gastrojejunostomy). The histopathologic diagnosis was well-differentiated adenocarcinoma, mucinous carcinoma, and adenosquamous carcinoma, respectively. Two patients died from local recurrence and/or distant metastasis 5 and 6 months after a radical resection, and the other died 3 months after clinical diagnosis. Peculiar clinicopathologic features of these patients with pancreas carcinoma arising in the uncinate process are reported herein, and the clinical problems of this disorder are briefly discussed.
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PMID:Carcinoma of the uncinate process of the pancreas with a peculiar clinical manifestation. 164 9

Although clear cell carcinomas have been described in numerous anatomic sites, their occurrence in the gallbladder and extrahepatic bile ducts (EHBD) is practically unknown. We report 10 such cases. Seven arose in the gallbladder and three in the EHBD; all patients with gallbladder tumors were females with cholelithiasis whose ages ranged from 56 to 68 years. Patients with EHBD tumors were younger (38 and 40 years of age) and had extrahepatic biliary obstruction and abdominal pain. Two patients with gallbladder carcinomas had elevated serum carcinoembryonic antigen (CEA) levels, and another without hepatic involvement had markedly elevated circulating levels of alpha-fetoprotein (AFP). Histologically, nine tumors were adenocarcinomas and one was a squamous cell carcinoma. Seven adenocarcinomas consisted of cords, sheets, nests, papillae, and trabeculae of clear cells with well-defined cytoplasmic borders. Two were composed predominantly of glands and papillary structures. The cells contained PAS-positive diastase-labile granules and were cytokeratin- and EMA-positive and immunoreactive for erythropoiesis-associated antigen. One gallbladder tumor contained areas of hepatoid differentiation, a feature described in gallbladder neoplasms only once before. These areas were AFP-positive and immunoreactive for CEA. By electron microscopy, they showed hepatoid differentiation with formation of bile canaliculi. In two gallbladder tumors, neoplastic cells contained subnuclear vacuoles reminiscent of early secretory endometrium. Foci of conventional adenocarcinoma or mucinous carcinoma were recognized in all nine tumors. The squamous cell carcinoma showed only foci of squamous differentiation with keratinization. The clear cells of this neoplasm had a trabecular and solid growth pattern. These clear cell neoplasms of the gallbladder and EHBD must be differentiated from metastatic renal cell carcinoma, based upon the presence of areas of conventional adenocarcinoma or foci of squamous differentiation since results of special stains and immunohistochemistry are similar in both neoplasms. One of the patients with EHBD carcinoma is alive and symptom-free 6 years following right hepatic lobectomy. Five patients with gallbladder tumors had direct extension into the liver and died with metastases. Two are living with metastases.
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PMID:Clear cell carcinomas of the gallbladder and extrahepatic bile ducts. 780 41

We describe a rare case of a neuroendocrine carcinoma of the ovary in a 22-year-old woman who presented with abdominal pain and a pelvic mass. Exploratory laparotomy revealed a right ovarian tumor weighing 2100 g. A right salpingo-oophorectomy and an appendectomy were performed. There was no evidence intraoperatively or postoperatively of metastatic disease. Microscopic examination of the ovary revealed solid nests of tumor cells with a neuroendocrine appearance, high mitotic rate, necrosis, and vascular invasion; the tumor was associated with a predominantly borderline mucinous neoplasm with a small focus of mucinous carcinoma. Neuroendocrine differentiation was confirmed by Grimelius stains, immunohistochemical assays (chromogranin), and electron microscopy. The appendix was histologically unremarkable. The patient received a course of chemotherapy; 3 months after completing chemotherapy, she developed multiple liver metastases and died of disease a week later. To our knowledge, this case report is the second one involving a primary neuroendocrine carcinoma of the ovary occurring in association with a mucinous neoplasm. Mixed mucinous and neuroendocrine carcinoma of the ovary may represent a rare neoplasm with extremely aggressive behavior.
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PMID:Ovarian neuroendocrine carcinoma associated with a mucinous neoplasm. 794 90

The records of the General Surgery Department of the Cerrahpasa Medical Faculty of 10 years duration (1981-1991) were studied retrospectively to determine prognostic factors in colorectal cancer patients younger than 40-year old. Fifty patients between the ages of 10-39 were identified. The family history was positive in 7 of the 50 patients. We found Hematochezia (60%), abdominal pain (64%), alterations in bowel movements (60%) among the presenting symptoms. The pathologic examination revealed no patients in Dukes Stage A, 14 patients in stage B (28%), 36 patients in stage C and D (72%). Distant metastases were present in 10%. Mucinous adenocarcinoma was found in 40% of the patients in whom an histological differentiation could be made. The 5-year survival rate was 25.7% and the 5-year disease free survival rate was 17.1% in the patients who were followed up. The mean survival was 30 months. Poor prognostic factors were Dukes Stages C and D, sex, age, mucinous/nonmucinous histology, tumour differentiation and grade. Patients presenting with one or more of the symptoms above should be carefully examined for colorectal cancer regardless of age because of the importance of delay and presentation with progressive disease on survival. Colorectal cancer is the second leading cause of cancer in the U. S. A. Although colorectal cancer is a disease of older group of patients, the incidence of colorectal cancer in younger patients is being increasingly reported.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Colorectal cancer in patients younger than forty years of age. 814 Aug 35

The clinico pathological characteristics of colorectal carcinoma in 127 Black South African patients were studied. The main presenting symptoms were altered bowel habits in 70% of the patients, weight loss in 64.3% and abdominal pain in 47.1%. Anaemia was present in 75.7%. There was a 31% incidence of mucinous carcinoma with a particular predilection for the younger age groups. Mucinous tumors were found more commonly in Duke stage C and D than in earlier stages. Tumors arising from a pre-existing adenoma constituted to 5.5% of the lot of patients with cancer colon.
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PMID:Clinicopathological trends in colorectal carcinoma in a Black South African population. 885 59

A 51-year-old man was admitted to our hospital for investigation of fever, lower abdominal pain, and pain on micturition. Barium enema and endoscopic findings revealed an extracanal large cavity of the rectosigmoid colon, which suggested an abscess caused by penetration. Histological examination of the endoscopic biopsy specimen demonstrated no malignancy. A preoperative diagnosis of malignant lymphoma was strongly suspected from the imaging findings; however, intraoperative inspection revealed a large tumor invading the urinary bladder. An intraoperative incisional biopsy was performed and histological examination demonstrated mucinous carcinoma. The patient subsequently underwent pelvic exenteration about 1 week later followed by adjuvant chemotherapy and radiotherapy.
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PMID:The unusual presentation of mucinous carcinoma in the colon making preoperative diagnosis difficult: report of a case. 891 83

Intraductal papillary-mucinous carcinoma of the pancreas has been reported with increasing frequency. We report a case with intraductal papillary-mucinous carcinoma of the pancreas and discuss surgical treatment and current imaging modalities. A case with intraductal papillary-mucinous carcinoma was analyzed by radiological findings and clinical course. A 47-year-old man developed abdominal pain and nausea. Computed tomography showed a diffusely dilated main pancreatic duct. Duodenoscopy showed a patulous orifice of the pancreas with massive mucus secretion, but the pancreatic juice was not positive for malignant cells. Endoscopic retrograde cholangiopancreatography revealed a markedly dilated pancreatic duct extending from the body to the tail of the pancreas. Distal pancreatectomy was performed with splenectomy and lymph nodes dissection. Histopathological diagnosis was intraductal papillary-mucinous carcinoma. Endoscopic retrograde cholangiopancreatography is useful for diagnosing intraductal papillary mucin-producing tumors. To avoid unnecessary total pancreatectomy and preserve pancreatic function, intraoperative frozen section examination is widely available for the surgical treatment of intraductal papillary mucin-producing tumors.
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PMID:A case of intraductal papillary-mucinous carcinoma of the pancreas with the onset of acute pancreatitis. 1206 2

Clinical histories, endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) material, and immunohistochemical stains performed on cell block samples of 6 solid-pseudopapillary tumors of the pancreas (SPTPs) were reviewed in the cases of 5 females (13-58 years) and 1 man (57 years); all had abdominal pain. Preliminary cytologic diagnoses at endoscopy included 1 SPTP 2 low-grade neoplasms, and 3 pancreatic endocrine tumors. Variable numbers of branching fragments with central capillaries and myxoid stroma were seen in the smears of 5 of 6 cases but were more apparent in the cell block material of all cases. The cells had bland nuclear features and rare grooves. Extensive necrosis was noted in 1 case and rare mitotic figures in 1. SPTPs showed strong cellular immunoreactivity for vimentin and focal weak keratin reactivity. Neuron-specific enolase, alpha1-antitrypsin, and alpha1-antichymotrypsin stains performed in 2 cases were strongly positive. Subsequent surgical resection confirmed all diagnoses. EUS-guided FNA diagnosis of SPTP is accurate. The characteristic branching papillae with myxoid stroma are best seen in cell block slides. Clinical setting, cytomorphologic features, and immunostains of the cell block help distinguish SPTP from pancreatic endocrine tumors, acinar cell carcinoma, and papillary mucinous carcinoma.
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PMID:Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid-pseudopapillary tumor of the pancreas: a rare neoplasm of elusive origin but characteristic cytomorphologic features. 1515 Dec 5

We describe the clinical, imaging and cytopathological features of solid pseudopapillary tumor of the pancreas (SPTP) diagnosed by endoscopic ultrasound-guided (EUS-guided) fine-needle aspiration (FNA). A 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic abdominal pain for 2 mo and a short history of hypertension in the endocrinology clinic. Clinical laboratory examinations revealed polycystic ovary syndrome, splenomegaly and low serum amylase and carcinoembryonic antigen (CEA) levels. Computed tomography (CT) analysis revealed a mass of the pancreatic tail with solid and cystic consistency. EUS confirmed the mass, both in body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct (major diameter 3.7 mm). The patient underwent EUS-FNA. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform malignant cells, forming microadenoid structures, branching, papillary clusters with delicate fibrovascular cores and nuclear overlapping. Naked capillaries were also seen. The nuclei of malignant cells were round or oval, eccentric with fine granular chromatin, small nucleoli and nuclear grooves in some of them. The malignant cells were periodic acid Schiff (PAS)-Alcian blue (+) and immunocytochemically they were vimentin (+), CA 19.9 (+), synaptophysin (+), chromogranin (-), neuro-specific enolase (-), a1-antitrypsin and a1-antichymotrypsin focal positive. Cytologic findings were strongly suggestive of SPTP. Biopsy confirmed the above cytologic diagnosis. EUS-guided FNA diagnosis of SPTP is accurate. EUS findings, cytomorphologic features and immunostains of cell block help distinguish SPTP from pancreatic endocrine tumors, acinar cell carcinoma and papillary mucinous carcinoma.
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PMID:Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: a case report and literature review. 1787 86

We present a case of primary ureteral carcinoma composed of both transitional cell carcinoma and mucinous carcinoma. A 79-year-old woman visited her home doctor with the chief complaint of right lower abdominal pain. Abdominal computed tomographic scan (CT) disclosed a tumor measuring about 5 cm in diameter at the right lower quadrant of the abdomen. Percutaneous nephrostomy was performed for hydronephrosis and pyonephrosis. The urinary cytology revealed class V, transitional cell carcinoma. Re-abdominal CT showed further enlargement of tumor diameter, but the primary site of the tumor was not identified. Her general condition worsened, and she died 42 days after her initial complaint. Pathologic examinations upon autopsy revealed both mucinous carcinoma and transitional cell carcinoma in the right ureter. Pathogenesis and management of this rare condition are discussed.
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PMID:[Primary ureteral carcinoma composed of both transitional cell carcinoma and mucinous carcinoma: a case report]. 1820 27


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