Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed the results of 187 consecutive ultrasound-guided fine-needle biopsies of the pancreas in 171 patients to assess the diagnostic accuracy of the method. The final diagnosis obtained at operation, autopsy or follow-up were: adenocarcinoma (n = 83), metastatic cancer (n = 11), cystadenocarcinoma (n = 2), lymphoma (n = 2), malignant gastrinoma (n = 1), pseudocyst (n = 25), cyst (n = 13), chronic pancreatitis (n = 9), normal pancreas (n = 10), abscess (n = 7), benign islet-cell tumour (n = 5), cystadenoma (n = 3). Sufficient cytologic material was obtained in 95.3% of biopsies and the overall accuracy in distinguishing benign from malignant disease was 85.4%. False negative results were obtained in 12 patients (13.1%). Inconclusive results (CIII) were found in aspirates from one cyst and two islet cell tumours. There were no false-positive results. The only complication was a post-biopsy haematoma around the head of pancreas, which resolved spontaneously. Ultrasound-guided pancreatic fine-needle biopsy is a safe method and allows of a high degree of diagnostic accuracy. It has a high specificity. Its sensitivity in the detection of malignancy improves if biopsies are repeated in doubtful cases. It further permits tumours to be graded and allows complications of pancreatitis to be diagnosed.
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PMID:Diagnostic accuracy of ultrasound-guided fine-needle pancreatic biopsy. 173 79

After an acute episode of pancreatitis, a 63-year-old man was found to have a pancreatic glucagonoma. The tumor was resected without evidence of metastases. Three years later he had symptoms of uncontrolled diabetes, no skin lesions, and diarrhea and was found to have a pancreatic pseudocyst and multiple hepatic metastases. Glucagon concentrations were raised but were suppressible by glucose and somatostatin and responded to arginine stimulation. He was treated for 6 months with octreotide (Sandostatin), which reduced his symptoms; the pseudocyst resolved, but liver metastases continued to grow. Although spontaneous resolution of the pseudocyst is possible, this case appears to illustrate differences in sensitivity of endocrine and exocrine tissues to suppression by Sandostatin.
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PMID:Somatostatin analogue in treatment of coexisting glucagonoma and pancreatic pseudocyst: dissociation of responses. 216 87

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

IBD CT is the single best modality for diagnosis and staging of patients with suspected pancreatic carcinoma. While carefully performed real-time US is an excellent technique for determining the level and etiology of bile duct obstruction, it is of more limited value for diagnosis of tumors in the body and tail of the gland, and is less accurate than IBD CT for assessment of tumor resectability. Thus, most patients require IBD CT for accurate, nonoperative staging. ERCP and angiography continue to be useful adjunctive procedures for evaluation of patients with suspected pancreatic carcinoma, particularly for evaluation of equivocal CT or US findings. An isolated pancreatic mass, that is, a mass with no ancillary CT or US findings of carcinoma (local extension, distant metastases), is a non-specific finding and requires further evaluation with either ERCP or angiography, and perhaps most importantly, with FNAB. Other neoplasms may mimic pancreatic ductal carcinoma, particularly islet cell carcinoma and lymphoma. Pancreatitis also can result in a focal pancreatic mass, simulating a neoplasm. These diseases usually respond to therapy and thus it is essential to confirm the radiologic diagnosis of pancreatic carcinoma with biopsy, particularly if surgery is not planned or if chemoradiation therapy is anticipated.
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PMID:Radiologic diagnosis and staging of pancreatic ductal adenocarcinoma. 253 84

CT has become an important tool in the diagnosis and management of diseases that affect the stomach and duodenum. By depicting the bowel lumen, wall, and extramural structures, CT can provide unique information that complements standard air contrast radiography and endoscopy. Proper scanning methods and knowledge of normal anatomy are necessary for optimal results. We utilize the gas contrast technique for organ-specific examination in patients with known or suspected gastroduodenal disease. Gastric adenocarcinoma is an important indication for CT evaluation. Unfortunately, early hopes that CT could accurately stage gastric cancer have not been realized. CT is not as accurate as laparotomy in staging early gastric cancer, primarily owing to its inability to detect small peritoneal implants, diagnose metastases in normal-sized lymph perigastric nodes, and predict pancreatic invasion. Nevertheless, CT retains an important role in depicting gross metastatic disease and guiding percutaneous biopsy, particularly in patients who are deemed poor surgical candidates or have undergone prior gastric resection. A variety of conditions other than primary gastric adenocarcinoma produce recognizable abnormalities on CT. Gastric lipoma, leiomyosarcoma, and varices have a distinctive appearance. Others, including gastritis and uncomplicated peptic ulcer, produce nonspecific gastric wall thickening. Endoscopic correlation and biopsy are required for specific diagnosis in these cases. The duodenum, by virtue of its location in the anterior pararenal compartment of the retroperitoneum, may be involved by numerous benign and malignant conditions. In blunt trauma, complicated pancreatitis, and peptic ulcer disease, as well as primary and metastatic malignancy, CT can provide data that may alter patient management.
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PMID:CT of the stomach and duodenum. 265 48

Hepatic arterial infusion chemotherapy using totally implantable reservoir was performed for the treatment of liver metastases of colo-rectal cancers, and the therapeutic effects, side effects and complications were evaluated. Reservoir catheters were implanted into hepatic artery via gastroduodenal artery during operation. Mitomycin C (MMC), adriamycin (ADM), and 5-fluorouracil (5-FU) were used as chemotherapeutic agents. Eleven cases of H1 (metastases in one lobe only), 7 cases of H2 (a few scattered metastases in both lobes) and 12 cases of H3 (multiple metastases in both lobes) were treated intermittently with one-shot administration of MMC or ADM (A-group). Ten cases (H1: 1, H2: 2, H3: 7) were treated with intermittent one-shot administration of MMC or ADM following two-week continuous infusion of 5-FU through infusion pump after operation (B-group). In 5 of 10 cases of B-group, serum CEA level fell below the preoperative level, and the tumor size regressed in 3 of those 5 cases which were evaluated on the basis of CT scan. But no remarkable change in CEA level or tumor size on CT scan was seen in A-group. No particular side effect such as leucopenia, liver dysfunction or gastroduodenal symptom was noted except one case developing multiple gastric ulcers and pancreatitis in B-group. Five cases (25%) showed obstruction of catheter and 3 cases (14%) evidence leakage of chemotherapeutic agents in A-group. Three cases (30%) in agents in A-group. Three cases (30%) in B-group displayed obstruction of gastroduodenal artery beyond the tip of catheter. Median survival time of both groups (A, B) was 6 months and 12 months, respectively. The treatment seemed effective for the improvement of serum CEA level and tumor size, and there was a tendency toward prolongation of survival time in B-group.
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PMID:[Hepatic arterial infusion chemotherapy using totally implantable reservoir in liver metastases in colorectal cancer]. 278 94

The introduction of new pictorial methods in the last decade and the increase of information for the surgeon have brought about changes not only in several therapeutic concepts but also in the indications for surgery and in surgical strategies. The influence of CT and MRT on surgery can be summarized in 3 points: 1. Substitution of previous forms of surgical therapy by interventional radiology. Examples are curative CT-guided percutaneous puncture and drainage of abscesses of the liver and other organs. 2. Improved diagnostics and follow-up of acute morphologic processes with non-correlating clinical signs, as acute necrotizing pancreatitis allows a better definition of the therapeutic concept. 3. Advances in tumour surgery by early detection of malignant processes and improved follow up after surgery for the early detection of recurrences and metastases.
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PMID:[CT and MRT--their influence on surgery]. 279 7

A patient with hepatic metastases from a carcinoid tumor was treated by hepatic artery embolization and developed pancreatitis. A subsequent computed tomography scan (CT) demonstrated evidence of pancreatic embolization. The CT findings are reviewed as well as the probable mechanism of the development of pancreatitis.
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PMID:Inadvertent pancreatic embolization as a complication of hepatic carcinoid treatment--computed tomography appearance. 281 85

Although tumour metastases to the pancreas and peripancreatic lymph nodes are found commonly at necropsy in cases of small cell carcinoma of lung, tumour-induced acute pancreatitis is described rarely. A case of metastasis-associated necrotising pancreatitis with the unusual presentation of epigastric pain followed by diabetes is described here. Patients (particularly cigarette smokers) with none of the conventional risk factors for acute pancreatitis merit chest radiography and if indicated prompt cytotoxic treatment.
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PMID:Necrotising pancreatitis and diabetes associated with disseminated small cell carcinoma of lung. 285 1

From a total of 153 patients with carcinoma of the periampullary region and of the head of the pancreas, 127 underwent surgical treatment. There were 79 men and 48 women with a mean age of 65 years (a range of 39 to 90 years). Of these, 26 had resectional operations. Fifteen were carried out at the initial laparotomy and 11 at a second look operation (SLO). Of the 112 patients who had a palliative bypass at the initial laparotomy, 30, who were less than 65 years of age and were fit and remained so when assessed at six and 12 weeks postoperatively, were re-evaluated for SLO. Of these, 12 had evidence of metastases and, therefore, were not considered for SLO. Eleven had a successful resection, and in seven, attempted resection had to be abandoned because of local invasion. The five year survival rate was 50 per cent for carcinoma of the periampullary region and 9 per cent for carcinoma of the head of the pancreas after primary resection. The comparable rates after SLO were 33.3 and 12.5 per cent, respectively. Based on our experience, SLO should be considered in young, fit patients as associated pancreatitis can make some tumors seem locally invasive and, hence, appear unresectable at the initial laparotomy.
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PMID:Second look operation in managing carcinoma of the pancreas and periampullary region. 291 52


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