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Query: UMLS:C0030305 (pancreatitis)
 16,014 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We had a patient with cancer of the pancreas that was diagnosed by endoscopic retrograde pancreatography where conventional diagnostic methods (including arteriography) were negative. Pancreatic resection was possible and examination of the surgical specimen showed microscopic adenocarcinoma coexistent with an intraductal stone and pancreatitis.
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PMID:Pancreatitis with coexistent pancreatic duct stone and carcinoma. Early diagnosis by endoscopic retrograde pancreatography. 87 35

Chronic pancreatitis and carcinoma of the pancreas are being diagnosed with increasing frequency throughout the world. When both occur together, the question of their causal relationship arises. Secondary chronic pancreatitis following carcinoma of the pancreas is relatively frequent and can be proven histologically in at least 10% of pancreatic cancers. How often primary chronic pancreatitis develops into carcinoma is controversial. So far, there are only a few prospective clinical studies of chronic pancreatitis which cover this problem. We have followed 146 cases of chronic pancreatitis for an average of 8.7 years. Two thirds of our patients show pancreatic calcifications. Our series includes a family with congenital pancreatic insufficiency. So far only one adenocarcinoma of the head of the pancreas has been diagnosed in a 58-year-old male. Another 57-year-old male patient died from a solid metastatic carcinoma, probably of pancreatic origin. Therefore, the incidence of pancreatic cancer in our series is 0.7 and 1.4% respectively. However, 8 more patients suffering from extrapancreatic malignancies have turned up during the follow-up period: 2 cancers of the tongue, 2 colonic carcinomas, 2 bladder papillomas, and 1 bronchial and 1 gastric carcinoma. Our studies indicate that carcinoma of the pancreas probably does not occur more frequently in chronic non-hereditary pancreatitis than in the average population. A review of the literature suggests that there may be a higher incidence of carcinoma in families with hereditary chronic pancreatitis. The frequency of extrapancreatic cancer in our patients is remarkable. As pancreatic carcinoma is rare in chronic pancreatitis there is no reason for early aggressive surgery, e.g. pancreatectomy, in these patients.
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PMID:[Pancreatic carcinoma in chronic pancreatitis]. 114 57

Of 20 patients treated for pancreatic abscess during the years 1984-1991, two patients were found to have adenocarcinoma of the pancreas associated with their pancreatic abscesses. In one patient an adenocarcinoma of the proximal pancreas caused ductal obstruction, which may have been the primary cause of an abscess distal to the tumor. In the second patient, metastatic adenocarcinoma of the pancreas and a concurrent pancreatic abscess were found when the patient's abdomen was explored for complications related to gallstone pancreatitis. In both patients, the tumor was unresectable at presentation. A detailed review of these cases is presented as well as a review of the related literature.
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PMID:Adenocarcinoma of the pancreas coexisting with pancreatic abscess. 128 24

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

We report the morphonuclear characteristics of normal (13 cases), benign (ie, chronic) pancreatitis (six cases), and neoplastic (ie, ductal) adenocarcinoma (22 cases) tissues of the pancreas. This description is based on computerized cell image analysis, which permits the determination of parameters related to the morphometric (nuclear area), densitometric (nuclear DNA content), and chromatin texture features of Feulgen-stained nuclei from paraffin-embedded archival material. We observed that nuclear area discriminates between normal and benign (ie, chronic pancreatitis) as opposed to neoplastic cell nuclei. Morphonuclear parameters describing chromatin pattern characteristics made it possible to discriminate between grade I pancreatic carcinoma and normal and benign cell nuclei on the one hand, and grades I and III carcinoma on the other hand. The nuclear DNA content increased in a continuous manner from normal and benign through low-grade to high-grade neoplastic tissues of the pancreas. Combining the morphometric, densitometric, and textural parameters into one equation, we were able to calculate a score (ie, the malignancy level index) that showed a close relationship to conventional histopathologic grading. Thus, the computer-aided diagnosis of cytologic specimens from pancreatic lesions offers information of the same significance as that obtained by conventional histopathologic grading.
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PMID:Computerized morphonuclear characteristics and DNA content of adenocarcinoma of the pancreas, chronic pancreatitis, and normal tissues: relationship with histopathologic grading. 142 50

Magnetic resonance imaging (MR) was performed in 14 healthy subjects and 16 patients with pancreatic disease. All the 16 patients were subjected to ultrasonography (USG), computed tomography (CT) and MR while endoscopic retrograde cholangiopancreatography (ERCP) was performed in 10 cases. In one patients with adenocarcinoma and two with gastrinoma, MR demonstrated abnormalities while USG and CT were normal. MR was, however, inferior to ERCP in demonstrating ductal abnormalities in chronic pancreatitis. Our initial experience suggests that MR is superior to other imaging modalities in the diagnosis and staging of pancreatic tumors; however, it is inferior to ERCP in the diagnosis of pancreatitis.
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PMID:Magnetic resonance imaging in pancreatic diseases: comparison with other imaging techniques. 142 31

A 61-year-old man experienced four bouts of pancreatitis in 1 year. Detailed history taking and a series of examinations, including sonography, computed tomography scan, and endoscopic retrograde cholangiopancreatography (ERCP), revealed pancreas divisum on the first admission. He was treated conservatively. However, repeated ERCP on the fourth admission, 1 year later, showed a small filling defect in the tail of the pancreatic duct. A distal pancreatectomy was carried out. Pathological studies revealed a small papillary adenocarcinoma (1.5 x 1.0 x 0.5 cm) confined to the pancreatic duct grossly with minimal parenchymal invasion microscopically. He has been free from cancer and pancreatitis for 13 months since the operation.
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PMID:Pancreas divisum with early pancreatic cancer--presenting as chronic obstructive pancreatitis. 155 75

Over a 7-year period, 91 patients with tropical pancreatitis underwent operation for intractable pain. Univariate and multivariate analyses were performed to identify factors correlating with mortality, major complications, poor pain relief and associated malignancy. Patients with benign disease (group 1, n = 72) had longer survival than those with superimposed malignancy (group 2, n = 19). Pain relief was better in group 1 (59 patients compared with none, P less than 0.01). Age above 40 years, short duration of symptoms, mass lesions on ultrasonography and main pancreatic duct obstruction on endoscopic retrograde pancreatography were associated with a high risk of cancer. After reoperation major complications (four of ten) or death (three of ten) occurred more commonly than after primary procedures (seven of 81, P = 0.019 and five of 81, P less than 0.05, respectively). Poor pain relief in group 1 patients was more common after incomplete clearance of main duct stones (four of 13 versus three of 53, P less than 0.01) and after short length ductotomy (three of eight versus four of 58, P less than 0.01). Tropical pancreatitis has a high association with pancreatic adenocarcinoma. Wide ductotomy, stone clearance and drainage gave good symptomatic results in patients with benign disease. Overall results were poor in patients with cancer.
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PMID:Surgery in tropical pancreatitis: analysis of risk factors. 161 49

A variety of neoplasms and nonneoplastic hepatic lesions have been noted in winter flounder, Pseudopleuronectes americanus, from Boston Harbor, Massachusetts. Inflammatory lesions include cholangiitis, pericholangiitis, pericholangial fibrosis, hepatitis, and pancreatitis. Necrotic lesions consist essentially of focal coagulative necrosis and a distinctive vacuolated cell lesion of the hepatic parenchyma. The most conspicuous and numerous proliferative lesion is macrophage aggregate hyperplasia and hypertrophy. Preneoplastic lesions include principally basophilic foci of cellular alteration and hepatocellular adenoma. Carcinomas consist of several morphologic varieties: hepatocarcinoma, cholangiocarcinoma, and anaplastic adenocarcinoma. The pathogenesis of the lesions observed is discussed with respect to anthropogenically introduced chemical contaminants and the resistant hepatocyte model of hepatocarcinogenesis. This study, and others of bottom-living food fish with enzootic neoplastic disease, warrants further evaluation, particularly with respect to possible bioaccumulation of chemical contaminants in edible tissues.
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PMID:Neoplasms and nonneoplastic liver lesions in winter flounder, Pseudopleuronectes americanus, from Boston Harbor, Massachusetts. 164 9

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


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