Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty patients with pancreatic diseases (11 cancer, 1 islet cell tumor, 12 mucin-producing tumor, 1 teratoma, and 15 chronic pancreatitis) were studied in vivo with ERP and were also scanned with an intraductal ultrasound (IDUS) probe at a frequency of 30 MHz inserted into the main pancreatic duct. The usefulness of in vivo IDUS was evaluated by comparison of images with the ERP findings. IDUS was of diagnostic value in 18 of the 40 patients; it distinguished between 4 malignant and 6 benign causes of localized stenosis revealed by ERP, provided parenchymal information in 2 cases with only displacement revealed by ERP (1 islet cell tumor and 1 teratoma), and determined the extent of tumor in 6 cases with main-duct-type mucin-producing tumor. Ten of 11 cancer, 4 of 12 mucin-producing tumor, 1 islet cell tumor, and 11 of 15 chronic pancreatitis (previously scanned in vivo), and 2 islet cell tumor (not scanned in vivo), were resected and scanned in vitro. Fifteen normal pancreases from autopsy subjects were also scanned in vitro. The IDUS images were then compared with corresponding histopathological sections from the 15 normal pancreases and 28 post-operative pancreatic specimens. Differential diagnosis of the pancreatic diseases by echo patterns was possible in all cases except those with intraductal papillary adenocarcinoma and adenoma.
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PMID:Differential diagnosis of pancreatic diseases with an intraductal ultrasound system. 801 24

We report a 74-yr-old woman who was referred to our hospital because of abdominal fullness. ERP showed a questionable irregularity of the main pancreatic duct at the body. Examination of pure pancreatic juice was positive for K-ras point mutation at codon 12 and negative for cytology. Because neither US nor CT showed apparent lesions in the pancreas, we decided to follow up the patient with serial ERP and pure pancreatic juice studies at 3-month intervals. No changes had been seen up to 18 months later, when cytology was conclusive for malignancy with an apparent stenosis of the main pancreatic duct at the body. Distal pancreatectomy with splenectomy was performed. A round mass, 12 mm in diameter, was found in the body, which proved to be an adenocarcinoma at histological examination. No extrapancreatic extension and metastases were noted. Although positive K-ras point mutation has been reported in some cases of adenoma or mucinous cell hyperplasia of the pancreas and chronic pancreatitis, our case, along with previous reports, indicated the importance of testing K-ras point mutation in pure pancreatic juices for the diagnosis of pancreatic cancer at an early stage.
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PMID:A case of small pancreatic cancer diagnosed by serial follow-up studies promptly by a positive K-ras point mutation in pure pancreatic juice. 970 68

We describe the specific findings for the diagnosis of cystic pancreatic tumors, serous cystic tumor (SCT), mucinous cystic tumor (MCT), and intraductal papillary-mucinous tumor (IPMT). The typical SCT is easy to diagnose as it is ball shaped and a honeycomb composition is seen on enhanced computed tomography (CT). SCT with large cysts on the periphery, or large cysts which themselves are the major part of the lesion, which we have often seen recently, causes diagnostic problems. The points for diagnosing such a lesion as SCT are 1) ERP does not show communication with the pancreatic duct, and 2) endoscopic ultrasound(EUS) reveals creeping small cysts inside the lesion. While MCT is ball shaped, covered with a relatively thick capsule, and has cysts that are convex into the cavity, IPMT has protruding cavities although it is also ball shaped. Since IPMT basically arises in the large pancreatic ductal system, the diagnosis is easy with by ERP. However, the problem is that histologically IPMT contains invasive cancer and/or hyperplasia, in addition to adenoma and/or adenocarcinoma. For the qualitative diagnosis of IPMT, it is important to measure the height of the tumor protrusions, for which EUS is excellent. Nonetheless, discrimination between adenoma and adenocarcinoma is not easy. Presently, IPMT lesions are differentiated as "adenoma or adenocarcinoma" and "hyperplasia."; Surgery is suggested for the former, and follow-up observation is appropriate for the latter.
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PMID:[Intraductal papillary mucinous tumor: imaging diagnosis]. 1285 91

A 74-year-old man was admitted to a nearby clinic complaining of high fever. Abdominal CT showed a 10 mm diameter cystic mass in the head of pancreas and dilation of the pancreatic duct. Endoscopy revealed a fistula filled with mucin in the posterior wall of the duodenum. The patient was referred to our institution for a surgical resection. Endoscopic ultrasonography revealed dilation of the pancreatic duct and also mural nodules in the pancreatic duct, ERP demonstrated a fistula from the pancreatic duct to the duodenum. Biopsied specimen from the papillary nodule in the pancreatic duct showed adenoma. We performed pancreaticoduodenectomy for main-duct IPMN penetrating to the duodenum. Pathological findings showed a non-invasive type of IPMC. Furthermore, a cancer invasion to the duodenum was not detected. These findings suggest that the increased pressure within the pancreatic duct caused a fistula to the duodenum.
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PMID:[A resected case of non-invasive type of intraductal papillary mucinous carcinoma penetrating to the duodenum]. 2122 78