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)

Intraductal papillary-mucinous neoplasms (IPMNs) of the pancreas are rare lesions. We undertook this study to analyze these tumors by focusing on the diagnostic criteria and correlating the histologic features with clinical prognosis. Twenty-two cases of IPMN were retrieved from the Endocrine Tumor Registry of the Armed Forces Institute of Pathology. Blocks or unstained slides were available for histochemical and immunohistochemical studies (including proliferative markers and cell cycle regulators) and K-ras oncogene mutations in 15 cases. Patient follow-up was obtained in all of the cases. IPMN occurs in both genders with a slight male predominance, with a mean age at presentation of 64.4 years (range, 48-85 yr). The patients presented with abdominal pain. The neoplasms were radiologically and grossly cystic, usually (18 cases of 22) located in the head of the pancreas. Histologically, the tumors consisted of intraductal papillary proliferations protruding into and expanding the pancreatic ducts. Invasion into the surrounding pancreatic parenchyma was detected in 15 cases. Chronic pancreatitis was present in all of the cases. p27 immunoreactivity always exceeded the immunoreactivity of cyclin E. K-ras oncogene mutations were detected in two cases. Patients were treated with a complete surgical resection (n = 7) or a Whipple procedure (n = 13). Only 2 of 22 patients died of disease (3 died immediately postoperatively and 3 died of unrelated causes), whereas the remaining 14 patients were alive at last follow-up, without evidence of disease, an average of 58.2 months after initial presentation. IPMNs are rare, distinctive neoplasms, with complex intraductal papillae, that can be easily separated from in situ ductal adenocarcinoma and mucinous cystic neoplasms. The high ratio of p27 protein to cyclin E supports the excellent prognosis of these neoplasms, despite the presence of invasion and K-ras oncogene mutation.
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PMID:A clinicopathologic and immunohistochemical study of 22 intraductal papillary mucinous neoplasms of the pancreas, with a review of the literature. 1034 91

Adrenal cortical carcinoma is a rare endocrine neoplasm which can be either functioning or non-functioning. Usually, patients refer to the doctor because of abdominal pain or symptoms associated with the mass effect. We present an unusual case of a patient with adrenal cortical carcinoma who was immediately operated due to massive retroperitoneal haemorrhage following the spontaneous rupture of the tumour. Adrenal cortical carcinoma should enter in differential diagnosis of retroperitoneal haemorrhage. Surgeons should be familiar with this clinical entity and attempt complete resection if possible.
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PMID:Haemorrhagic shock from the spontaneous rupture of an adrenal cortical carcinoma. A case report. 1515 87

Primary pancreatic lymphomas are extremely rare. Clinically, primary pancreatic lymphomas usually present with symptoms of carcinoma of the pancreatic head. Patients with primary pancreatic lymphomas are between 35 and 75 years of age and with a strong male predominance. Common clinical manifestations include abdominal pain, jaundice, acute pancreatitis, small bowel obstruction, and diarrhea. An accurate cytopathologic diagnosis by fine-needle aspiration (FNA) is imperative because the primary treatment is non-surgical. Cytomorphologic features include hypercellularity with discohesive cells with round nuclei, often prominent nucleoli, mitoses, and karyorrhexis. Flow cytometry analysis demonstrates a monoclonal pattern of immunoglobulin light chain expression. FNA coupled with flow cytometry analysis appears to be highly accurate in the diagnosis of primary pancreatic lymphomas. Fluorescence in-situ hybridisation technique has been established its role in the diagnosis of lymphoid malignancies, including primary pancreatic lymphomas. LDH and beta-2 microglobulin are important diagnostic and prognostic tumor markers. The differential diagnoses of primary pancreatic lymphomas include secondary lymphoma, pancreatic endocrine neoplasm, and florid chronic pancreatitis. The role of surgery is limited to the rare occasions when initial FNA and flow cytometry analysis are non-diagnostic. Treatment usually consists of a combination of chemotherapy and radiation therapy, or stem cell transplantation. Primary pancreatic lymphomas has a much better prognosis than adenocarcinoma of the pancreas.
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PMID:Primary pancreatic lymphomas. 1668 7

We present a case of intrapancreatic accessory splenic infarction in a 28-year-old woman. It was discovered during a workup for an acute right epigastric pain. Computed tomography imaging of abdomen demonstrated a hemorrhagic high attenuation with enhancing solid portion in the tail of pancreas. The clinical and radiological differential diagnosis included pancreatic mucinous cystic neoplasm, pancreatic endocrine neoplasm, solid pseudopapillary tumor, ductal adenocarcinoma, and metastasis. A distal pancreatectomy was completed. The microscopic examination revealed heterotopic splenic tissue with infarction and her abdominal pain disappeared. In this case report, we first describe a symptomatic accessory splenic infarction which presented as a hemorrhagic mass in the tail of pancreas mimicking pancreatic neoplasm.
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PMID:[Accessory splenic infarction presenting as a hemorrhagic tumor in the pancreas]. 1907 92

Solid-pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm reported to have a favourable prognosis because of its slow-growing behaviour. Ignored and misdiagnosed in the past, SPN has recently been increasingly studied. Its clear cell variant creates challenges in distinction from other clear cell tumours in the pancreas. We report a 31-year-old Cambodian woman who presented with abdominal pain and a palpable epigastric mass. Exploratory laparotomy revealed a 5.2 cm well-demarcated tumour in the head of the pancreas, which was treated with Whipple procedure. Microscopically, the tumour showed an extensive solid growth pattern consisting of cells with abundant clear cytoplasm, and papillary areas containing cells with eosinophilic cytoplasm, indicating a clear-cell solid-papillary neoplasm. Perineural and duodenal wall invasion was present. The tumour cells were immunonegative for chromogranin-A and synaptophysin but positive for CD56, cyclin D1, CD10, vimentin, and progesterone receptor. They showed strong nuclear and cytoplasmic expression and reduced membranous expression of beta-catenin protein. In the pseudopapillary area, they showed nuclear E-cadherin localization and absence of membranous staining. The patient was well without local recurrence or metastasis at one year follow-up. Difficulties are recognized in differentiating clear-cell SPN from "sugar" tumours, metastatic renal cell carcinoma, clear-cell variant of pancreatic endocrine neoplasm and ductal adenocarcinoma. When facing such difficulties, nuclear and cytoplamic beta-catenin, nuclear E-cadherin expressions and absence of membranous E-cadherin staining are useful in differentiating clear-cell SPN from other clear cell tumours in the pancreas. Although a rare neoplasm, it is important to recognize this entity for appropriate management.
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PMID:Clear-cell variant of solid-pseudopapillary neoplasm of the pancreas: a case report and review of the literature. 2051 58