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Query: UMLS:C0001418 (adenocarcinoma)
 68,496 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

When pancreatography shows a stenosis of the main pancreatic duct in patients with normal or inconclusive ultrasound and computed tomography, the exact nature of such stenosis is sometimes difficult to precise before surgical exploration. In such cases, the authors systematically performed a percutaneous fine-needle aspiration cytologic study of the stenosis under pancreatographic guidance. Fifteen patients were referred because of suspected pancreatic malignancy. The tumor markers, carcinoembryonic antigen (CEA) and CA 19-9 were normal in 11 patients and elevated in one patient, whereas only CA 19-9 was elevated in three others. In 14 cases, both the ultrasound and computed tomography did not show any obvious pancreatic mass. The pancreatography was done through endoscopic retrograde cholangiopancreatography (ERCP) (12 patients) or percutaneously in case of failure at ERCP3 and showed a main pancreatic duct stenosis that underwent aspiration by percutaneous fine needle precisely positioned using biplane fluoroscopy. The aspirated material was then smeared on glass slides, air-dried, and stained by Giemsa. In nine of the 15 patients, cytologic study revealed adenocarcinoma. This was confirmed by surgery in five and by progressive deterioration followed by death in four. In six patients, cytologic study gave a nonmalignant result. Chronic pancreatitis was found in five of them, confirmed at surgery in three and based on uneventful follow-up of at least 12 months in two others. In one case, a pancreatic adenocarcinoma not detected by cytologic study was found at surgery. Thus, the sensitivity and specificity of this diagnostic approach were 90% and 100%, respectively. No serious complication was noticed. The authors conclude that when ultrasound and computed tomography are inconclusive, percutaneous fine-needle aspiration cytologic study of main pancreatic duct stenosis under pancreatographic guidance is a safe, simple, and helpful procedure in the investigation of patients with suspected pancreatic malignancy.
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PMID:Percutaneous fine-needle aspiration cytologic study of main pancreatic duct stenosis under pancreatographic guidance. 201 42

We report a case of malakoplakia arising in the pancreas of a 45-year-old woman. Clinical and histological features are described. Malakoplakia was present with chronic pancreatitis and adenocarcinoma. The aetiology of malakoplakia at this site may be due to a stromal response to carcinoma or an abnormal localised histiocytic response to infection or inflammation. This case and previous reported cases suggest that the aetiology and pathogenesis of pancreatic malakoplakia is not the same for all patients.
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PMID:Malakoplakia of the pancreas. 211 98

Two murine monoclonal antibodies (MoAbs) Pak-1 and Pak-2 were established by immunizing Balb/c mice with human pancreatic adenocarcinoma xenografts, previously established in mice. Pak-1 showed a strong positive immunostaining to well- and moderately-differentiated tubular duct cell carcinoma of the pancreas but neither to poorly-differentiated nor to other non-tubular pancreatic carcinomas. Pak-2 showed a wide spectrum of immunostaining to ductal and islet cell carcinomas of the pancreas, revealing less reactivity to well-differentiated tubular duct cell carcinomas than Pak-1. The broad specificity of Pak-2 was similarly observed with extrapancreatic tumor tissues. Neither normal pancreatic tissues nor those with chronic pancreatitis were stained with Pak-1 and Pak-2, whereas the islet cells of normal pancreas were stained by both of them. Western blot analysis revealed that Pak-1 recognized two distinct glycoprotein molecules of ductal adenocarcinoma, 100K dalton molecular weight (MW) and pH6-7 isoelectric points (IP) on two dimensional electrophoresis, and that Pak-2 recognized three glycoprotein molecules, 35K dalton MW and pH7-10 IP. The treatment with periodic acid, neraminidase, trypsin and pronase revealed that antigenic epitopes of Pak-1 and Pak-2 may be composed of complex polysaccharide structure rather than terminal sialic acid residues.
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PMID:Human pancreatic adenocarcinoma-associated antigens defined by novel murine monoclonal antibodies Pak-1 and Pak-2. 216 75

The c-erb B-2 oncogene encodes a 190 kD transmembrane growth factor receptor which is closely related to the EGF receptor and has been found to be amplified and overexpressed in a number of human adenocarcinomas, particularly of the breast. We have analysed, by immunocytochemistry using the 21N antibody, expression of c-erb B-2 in a retrospective series of pancreatic adenocarcinoma, chronic pancreatitis, and examples of histologically normal pancreas. In three cases (21 per cent) of chronic pancreatitis, there were focal areas of cytoplasmic immunoreactivity in regenerating epithelium. In 15 cases (17 per cent) of pancreatic adenocarcinoma, cytoplasmic immunoreactivity was seen, while in two cases (2 per cent) strong membrane staining of tumour cells was seen which could be blocked by peptide controls. c-erb B-2 immunoreactivity was also demonstrated using a second antibody, 20N, which recognizes another peptide sequence of the c-erb B-2 protein. There was no relationship between immunoreactivity and histological subtype or grade, but there was absolute concordance between staining in primary and metastatic deposits. Since the rat homologue (neu) of the c-erb B-2 oncogene may be activated by a specific point mutation in its transmembrane region, we have analysed 23 cases from this series for mutations by polymerase chain reaction amplification and sequence-specific oligonucleotide hybridization. We were unable to identify activity mutations in this series. These data suggest that there is abnormal expression of c-erb B-2 oncogene in nearly 20 per cent of cases although mutational activation of this gene is not seen in human pancreatic adenocarcinoma.
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PMID:The c-erb B-2 proto-oncogene in human pancreatic cancer. 220 1

We have performed 33 pylorus-preserving duodenopancreatectomies. Twenty patients presented with severe chronic pancreatitis and 13 with periampullary adenocarcinoma. We have no postoperative mortality and a 24% rate of morbidity. Complications include anastomotic leaks (2), surgical bleeding (1), anastomotic ulceration (1), and others (4). We have complete follow-up for all cases. In the tumor group, 8 (62%) patients are alive with a mean survival time of 20 months (range: 2-46). In the pancreatitis series, all patients are alive after a mean of 34 months (range: 4-66). We have observed 5 cases (15%) of anastomotic ulcerations responsible for stenosis (2) and acute perforation with peritonitis (2) occurring after a mean interval of 18 months. Four cases have been confirmed histologically after resection. The short- and long-term beneficial effects of the pylorus-preserving operation on patient well-being and nutritional status were confirmed and compared with the results achieved after a Whipple procedure performed in a series of 18 consecutive patients.
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PMID:Pylorus-preserving duodenopancreatectomy: long-term complications and comparison with the Whipple procedure. 223 66

A 61-year-old male was admitted to our hospital with a complaint of epigastric discomfort and back pain. Chronic pancreatitis was suspected after an abdominal US study. Therefore, an ERCP study was performed. Macroscopically, the papilla of Vater showed an irregular shaped swelling. An ERCP X-ray revealed no abnormal findings, but biopsied specimens from the papilla showed a well differentiated adenocarcinoma in the adenoma, so that a pancreatoduodenectomy was performed. The lesion was 15 x 9 x 6 mm in size, and a histological examination revealed that a minor portion of the tumor was a carcinoma while the major portion was an adenoma, and the invasion as being d0 panc0 n0.
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PMID:[An early cancer in adenoma of the papilla of Vater]. 225 Mar 71

The pancreatographic appearance and the clinical presentation of ten patients presenting with adenocarcinoma of the head of the pancreas coexisting with chronic pancreatitis were compared with those of 45 patients with chronic pancreatitis (CP), without malignancy, investigated at the same time period. All ten patients, had typical pancreatographic findings of CP, combined with an elongated narrowing of the duct of Wirsung. Marked localized irregularity of the adjacent main duct and of side branches were found in all ten patients. Such findings were not detected in the other 45 patients with CP only. Ultrasonography or computed tomography have detected a definite pancreatic mass in only five of these patients, and in six patients with CP without malignancy. It is concluded that endoscopic retrograde cholangiopancreatography is highly accurate in detecting pancreatic cancer coexisting with CP. It is primarily helpful in elderly patients having severe degrees of CP to rule out cancer.
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PMID:Role of endoscopic retrograde cholangiopancreatography in differentiating pancreatic cancer coexisting with chronic pancreatitis. 229 60

Twenty-one years ago, Howard published a paper entitled "Forty-one Consecutive Whipple Resections Without an Operative Mortality." That paper stimulated the present analysis of the last 118 consecutive pancreatoduodenectomies (107 Whipple and 11 total resections) performed at the Surgical University Clinic Mannheim from November 1985 to the present day with no deaths. Ninety-one resections were performed for neoplasms and 27 were for complicated chronic pancreatitis. The preoperative evaluation, operative technique, and postoperative care of these cases is discussed in detail and compared to the experience of Howard. While there was general agreement on operative technique, there were differences concerning preoperative evaluation (modern imaging methods) and postoperative care (simplification). In this series 21 postoperative complications required seven relaparotomies. Long-term survival after resection for carcinoma was analyzed for 133 consecutive patients who were shown to have true ductal adenocarcinoma. In 76 patients, who had radical (R0-) resections, the actuarial 5-year-survival rate was 36%. In 44 patients, whose R0-resections for pancreatic cancer occurred more than 5 years ago, the actual survival rate was 25%.
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PMID:Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. 2874 83

The immunohistologic distribution of the feto-acinar pancreatic protein (FAP), detected by the monoclonal antibody (MoAb) J28 using an indirect immunoperoxidase technique, is described. Tests were carried out on normal adult pancreas (n = 10), chronic pancreatitis (n = 14), pancreatic adenocarcinoma (n = 17), intraabdominal metastases of pancreatic and nonpancreatic origin (n = 22), metastatic tumors invading the pancreas (n = 3), nonpancreatic fetal (n = 39) and adult (n = 65) normal organs (n = 104), and nonpancreatic malignancies (n = 145). All sections were formalin fixed and paraffin embedded. In the normal pancreas, only a few positive acinar cells were found around some islets of Langerhans. In pancreatitis there was an increased expression of FAP protein in the acinar tissue in relation to inflammatory changes. In cases of primary pancreatic adenocarcinoma and metastatic tumors in the pancreas, a strong expression of FAP protein in the peritumoral acinar area was found. The tumors themselves were FAP protein negative, as were the nonpancreatic tumors and normal organs. It can be concluded that FAP protein, detected by MoAb J28 in tissue sections, is specific for pancreatic exocrine tissue with reactive changes.
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PMID:An immunohistologic study of the feto-acinar pancreatic protein (FAP) in the normal pancreas, chronic pancreatitis, pancreatic adenocarcinoma, and intraabdominal metastases of adenocarcinomas. 240 40

A clinicopathologic study was conducted on six patients with intraductal papillary neoplasms of the pancreas. The patients were of both sexes and their ages ranged from 64 to 79 years. Three patients had a long history of symptoms mimicking chronic pancreatitis. The tumors involved the main pancreatic duct in the head-body region either diffusely or focally. Histologic examination showed papillary proliferations of well-differentiated, mucus-secreting cells that occasionally stained for carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9). The proliferations filled the main pancreatic duct, and extended into smaller ducts in some cases. In three patients, the lesions contained foci of pronounced to severe cellular atypia and carcinoma in situ. None of our series or any similar cases reported in the literature has shown invasion into peripancreatic tissue, metastasis, or tumor recurrence after pancreatectomy. Because of their favorable prognosis, intraductal papillary neoplasms should be considered low-grade malignancies that must not be confused with the common ductal adenocarcinoma.
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PMID:Intraductal papillary neoplasms of the pancreas. A clinicopathologic study of six patients. 254 3


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