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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Villous neoplasms of the main pancreatic duct are uncommon. Two cases of neoplasm of the main cephalic pancreatic duct in 61- and 42-year-old patients presenting with long standing (10 and 12 years) history of abdominal pain are reported. In both cases, duodenal fistula was present and mucus was observed by endoscopy at the fistula and major papilla levels. Endoscopic retrograde pancreatography showed a stricture of the main pancreatic duct in the pancreatic head. In one case, with incomplete stricture, pancreatic ducts disclosed typical features of chronic obstructive pancreatitis and contained mucus casts. Histologic examination of total and proximal duodenopancreatectomy showed a villous neoplastic pattern with focal malignant changes within the main pancreatic duct. The adjacent pancreatic tissue showed signs of stromal invasion without lymph node or nervous infiltration. Glandular parenchyma was atrophic in the pancreatic body and tail, with extensive fibrosis, and the pancreatic duct depicted signs of nonpapillary hyperplasia. Histochemical study disclosed a predominant sialomucin secretion by villous adenoma and sulfomucin secretion by epithelial cells lining the accessory or main caudal pancreatic ducts. These results lead us to suggest a possible relationship between villous adenoma of ducts and pancreatic adenocarcinoma.
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PMID:[Villous tumors of the Wirsung's duct and pancreatic intraductal adenocarcinoma: interrelation or accidental association?]. 136 60

Mucinous cystic neoplasms (MCNs) of the pancreas are uncommon tumors. The classification and biologic potential of these neoplasms remain the subject of controversy. Attempts to classify these tumors in a similar manner to ovarian MCNs remains controversial, as even histologically benign-appearing pancreatic MCNs metastasize and are lethal. One hundred thirty cases of MCNs were identified in the files of the Endocrine Pathology Tumor Registry of the Armed Forces Institute of Pathology from the years 1979 to 1993. The pathologic features, including hematoxylin and eosin staining, histochemistry, immunohistochemistry (IHC), cell cycle analysis, and K-ras oncogene determination were reviewed. These findings were correlated with the clinical follow-up obtained in all cases. There were 130 women, aged 20-95 years (mean age at the outset, 44.6 years). The patients had vague abdominal pain, fullness, or abdominal masses. More than 95% of the tumors were in the pancreatic tail or body and were predominantly multilocular. The tumors ranged in size from 1.5 to 36 cm in greatest dimension, with the average tumor measuring >10 cm. A spectrum of histomorphologic changes were present within the same case and from case to case. A single layer of bland-appearing, sialomucin-producing columnar epithelium lining the cyst wall would abruptly change to a complex papillary architecture, with and without cytologic atypia, and with and without stromal invasion. Ovarian-type stroma was a characteristic and requisite feature. Focal sclerotic hyalinization of the stroma was noted. This ovarian-type stroma reacted with vimentin, smooth muscle actin, progesterone, or estrogen receptors by IHC analysis. There was no specific or unique epithelial IHC. K-ras mutations by sequence analysis were wild type in all 52 cases tested. Ninety percent of patients were alive or had died without evidence of disease (average follow-up 9.5 years), irrespective of histologic appearance; 3.8% were alive with recurrent disease (average 10 years after diagnosis); and 6.2% died of disseminated disease (average 2.5 years from diagnosis). Irrespective of the histologic appearance of the epithelial component, with or without stromal invasion, pancreatic MCNs should all be considered as mucinous cystadenocarcinomas of low-grade malignant potential. Pancreatic MCNs cannot be reliably or reproducibly separated into benign, borderline, or malignant categories.
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PMID:Mucinous cystic neoplasm (mucinous cystadenocarcinoma of low-grade malignant potential) of the pancreas: a clinicopathologic study of 130 cases. 988 99

Despite being relatively common in the rectum, foamy histiocytes have received scant attention as to the antecedent lesion that causes them to form or their histologic characterization on the types of muco-substances they accumulate. One-hundred consecutive tissue sections of the rectum from an equal number of patients were reviewed for the presence of foamy histiocytes, evaluated for their associated histologic features, and examined histochemically for five types of mucin. Immunohistochemical and electron microscopic studies were performed. Forty (40%) of the rectal biopsy tissues contained foamy histiocytes. Patients presented with diarrhea, hematochezia, intestinal habit change, constipation, hemorrhoids, and abdominal pain. Endoscopically, 19 patients were thought to have rectal nodules or polyps. Histologically, 25 of the patients had regenerative changes in the adjacent mucosa and 14 had hyperplastic changes. In 36 patients (90%), the foamy histiocytes were located superficially in the lamina propria. Associated changes indicated that they are found in areas that are subject to an injury that is in a healing phase. These changes included mild fibrosis and chronic inflammation of lamina propria with mild architectural distortion. Thirty-five (88%) cases showed staining for D-PAS, Alcian blue stain pH 2.5, and the cocktail Alcian blue stain/PAS. Mucicarmine was positive in 25 (63%) cases. The Alcian blue stain pH 1.0 was positive in 19 (59%) of 32 cases. Ultrastructural studies showed electron-dense globules. Two cases were histologically identical to the other 38 but they did not stain for any mucin. Ultrastructural features disclosed clear vacuoles and thus represent a xanthelasma of the rectum. The foamy cells in all cases were confirmed to be histiocytes by immunohistochemistry and electron microscopy. Although muciphages and xanthelasma of the rectum may mimic polyps endoscopically, they are not related to any specific symptom or clinical finding, despite the fact that they probably represent remnants of a previous injury. Muciphages contain neutral, weakly acidic or strongly acidic mucin. The main type of acidic mucin is sialomucin with a smaller component of sulfated mucin.
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PMID:Histochemical and immunohistochemical characterization of foamy histiocytes (muciphages and xanthelasma) of the rectum. 1089 24

Cholangiocarcinoma (CC) is a malignant neoplasm deriving from intra- and extrahepatic bile ducts. It affects both sexes, and is most prevalent at the age 50 to 70. Chronic nonspecific ulcerative colitis, primary sclerosing cholangitis, hepatolithiasis, congenital hepatic fibrosis, and Caroli's disease may lead to the increased incidence of CC. Recently, hepatic cirrhosis in the course of virus-associated chronic hepatitis has been suggested to be involved in the pathogenesis CC. Histologically, 90-95% of CC are well differentiated adenocarcinomas. Usually the tumor grows slowly and metastazes late locally and even less frequently extrahepaticly. CC often causes symptoms by blocking the bile ducts, abdominal pain, weight loss, signs of portal hypertension, rare ascites and thrombophlebitis. Serum chemistry was compatible with obstructive jaundice. The increased expression of CEA, Ca19-9, as well as loss or reduction of sialomucin/sulfomucin concentration in the biliary lining epithelium may be indicative of malignant changes. CC as usually non-vascularized nonencapsulated tumor with a large amount of fibrosis. It is isochogenic in classical USG, CT or MRI. MRCP-magnetic resonance cholangiopancreatography and virtual endoscopy are more helpful methods on the diagnostics of CC. Recently, FDG positron emission tomography has been suggested to be a sensitive technique in identifying small bile duct cancers. Surgical excision of the lesion confirmed localized CC. The adjuvant radio- and chemotherapy and transplantation are not satisfactory. Palliative therapy includes surgical biliary-intestinal bypass procedures as well as operative and nonoperative techniques for biliary intestinal drainage. Recently, the local treatment of CC by photodynamic therapy as a palliative strategy is very promising. Ordinary CC is reported as a neoplasm with a poor prognosis. Post resection 5-year survival is affirmed in about 25% of CC, whereas after palliative treatment only 1 year.
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PMID:[Cholangiocarcinoma--bile ducts cancer]. 1290 Dec 70

A case of incidentally identified ectopic gastric mucosa in the gallbladder of a 26-year-old man with a three year history of recurrent abdominal pain is presented. The aberrant gastric tissue consisted of gastric pyloric glands and fundic glands. Focal intestinal metaplasia characterized by goblet cells containing sialomucin was seen in the surrounding gallbladder mucosa but no metaplastic change was seen in the heterotopic tissue.
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PMID:Gastric heterotopia in the gallbladder: a case report. 1637 1