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https://www.readbyqxmd.com/read/28421458/surgical-management-of-pancreatic-cysts-a-shifting-paradigm-toward-selective-resection
#1
REVIEW
Jon M Gerry, George A Poultsides
Due to the widespread use of high-quality cross-sectional imaging, pancreatic cystic neoplasms are being diagnosed with increasing frequency. Clinicians are therefore asked to counsel a growing number of patients with pancreatic cysts diagnosed incidentally at an early, asymptomatic stage. Over the last two decades, accumulating knowledge on the biologic behavior of these neoplasms along with improved diagnostics through imaging and endoscopic cyst fluid analysis have allowed for a selective therapeutic approach toward these neoplasms...
April 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28416122/patients-with-a-resected-pancreatic-mucinous-cystic-neoplasm-have-a-better-prognosis-than-patients-with-an-intraductal-papillary-mucinous-neoplasm-a-large-single-institution-series
#2
James F Griffin, Andrew J Page, Georges J Samaha, Adrienne Christopher, Feriyl Bhaijee, Maryam K Pezhouh, Niek A Peters, Ralph H Hruban, Jin He, Martin A Makary, Anne Marie Lennon, John L Cameron, Christopher L Wolfgang, Matthew J Weiss
BACKGROUND/OBJECTIVES: Mucinous cystic neoplasms (MCNs) are rare pancreas tumors distinguished from intraductal papillary mucinous neoplasms (IPMNs) by the presence of ovarian-type stroma. Historical outcomes for MCNs vary due to previously ambiguous diagnostic criteria resulting in confusion with IPMNs. This study seeks to characterize and clarify the clinical features and long-term outcomes of MCNs versus IPMNs in the largest single-institution series of pathology-confirmed MCNs to date...
April 11, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28413390/a-serous-cystic-neoplasm-of-the-pancreas-coexisting-with-high-grade-pancreatic-intraepithelial-neoplasia-mimicking-an-intraepithelial-papillary-mucinous-neoplasm-a-case-report
#3
Aya Kawanishi, Kenichi Hirabayashi, Hirotaka Kono, Yumi Takanashi, Atsuko Hadano, Yohei Kawashima, Masami Ogawa, Yoshiaki Kawaguchi, Misuzu Yamada, Toshio Nakagohri, Naoya Nakamura, Tetsuya Mine
Serous cystic neoplasms of the pancreas are rare exocrine pancreatic neoplasms, most of which are benign and do not communicate with the pancreatic duct. Pancreatic intraepithelial neoplasm (PanIN) is considered a precursor of ductal adenocarcinoma that is microscopically recognized in pancreatic ducts. A 67-year-old Japanese woman presented with a 10-mm multilocular cystic lesion at the pancreatic body. Magnetic resonance pancreatography showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28411376/nodular-oncocytic-hyperplasia-can-cytomorphology-allow-for-the-preoperative-diagnosis-of-a-nonneoplastic-salivary-disease
#4
Lisa M Rooper, Mine Onenerk, Momin T Siddiqui, William C Faquin, Justin A Bishop, Syed Z Ali
BACKGROUND: Nodular oncocytic hyperplasia (oncocytosis) of the salivary glands is a benign process that does not inherently require surgical excision. However, cytologic findings in fine-needle aspiration (FNA) of oncocytosis cases have not been well characterized previously, limiting preoperative identification. METHODS: All available cases of oncocytosis with corresponding FNA specimens were identified from the pathology archives of 3 academic institutions. Clinical, cytologic, and histologic findings were tabulated for all cases...
April 14, 2017: Cancer
https://www.readbyqxmd.com/read/28404017/dna-testing-of-pancreatic-cyst-fluid-is-it-ready-for-prime-time
#5
REVIEW
Aatur D Singhi, Marina N Nikiforova, Kevin McGrath
Pancreatic cysts are a clinical quandary in both diagnosis and management. Although many cysts, such as pseudocysts and serous cystadenomas, are benign and can be monitored clinically, mucinous cysts, such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, have the potential to progress to pancreatic cancer. Considering the poor prognosis of pancreatic cancer, the detection of a pancreatic cyst can be a source of anxiety for both the patient and physician. This diagnosis in turn can lead to expensive, invasive, and even harmful surveillance and treatment options...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396777/pancreatic-pseudocyst-or-mucinous-cystadenocarcinoma-of-pancreas-a-diagnostic-dilemma
#6
Utsav Joshi, Prakash Poudel, Ram Kumar Ghimire, Babin Basnet
Pancreatic cystic neoplasm is difficult to distinguish from pseudocyst as clinical and radiological evidences may not be sufficient to make an accurate diagnosis. This may result in misdiagnosis with inappropriate management. Hence, every effort should be made for their distinction to avoid internal drainage procedures for neoplasms instead of extirpation.
April 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28390868/small-nucleolar-noncoding-rna-snora23-upregulated-in-human-pancreatic-ductal-adenocarcinoma-regulates-expression-of-syne2-to-promote-growth-and-metastasis-of-xenograft-tumors-in-mice
#7
Lin Cui, Kenji Nakano, Sumalee Obchoei, Kiyoko Setoguchi, Masaki Matsumoto, Tsuyoshi Yamamoto, Satoshi Obika, Kazuaki Shimada, Nobuyoshi Hiraoka
BACKGROUND & AIMS: Small nucleolar noncoding RNAs (snoRNAs) regulate function of ribosomes, and specific snoRNAs are dysregulated in some cancer cells. We investigated dysregulation of snoRNAs in pancreatic ductal adenocarcinoma (PDAC) cells. METHODS: We investigated snoRNA expression in PDAC cell lines by cDNA microarray and quantitative reverse transcription (qRT)-PCR. In PDAC (n=133), intraductal papillary mucinous neoplasm (IPMN, n=16), mucinous cystic neoplasm-associated PDAC (n=1), and non-tumor pancreas (n=8) and liver (n=3) tissues from subjects who underwent surgical resection, levels of snoRNA were measured by qRT-PCR and compared with clinicopathological parameters and survival times determined by Kaplan Meier analysis...
April 5, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28383565/diversity-of-precursor-lesions-for-pancreatic-cancer-the-genetics-and-biology-of-intraductal-papillary-mucinous-neoplasm
#8
Krushna C Patra, Nabeel Bardeesy, Yusuke Mizukami
Pancreatic ductal adenocarcinoma (PDA), one of the most lethal cancers worldwide, is associated with two main types of morphologically distinct precursors-pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). Although the progression of PanIN into invasive cancer has been well characterized, there remains an urgent need to understand the biology of IPMNs, which are larger radiographically detectable cystic tumors. IPMNs comprise a number of subtypes with heterogeneous histopathologic and clinical features...
April 6, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28374746/intracellular-hmgb1-as-a-novel-tumor-suppressor-of-pancreatic-cancer
#9
Rui Kang, Yangchun Xie, Qiuhong Zhang, Wen Hou, Qingping Jiang, Shan Zhu, Jinbao Liu, Dexing Zeng, Haichao Wang, David L Bartlett, Timothy R Billiar, Herbert J Zeh, Michael T Lotze, Daolin Tang
Pancreatic ductal adenocarcinoma (PDAC) driven by oncogenic K-Ras remains among the most lethal human cancers despite recent advances in modern medicine. The pathogenesis of PDAC is partly attributable to intrinsic chromosome instability and extrinsic inflammation activation. However, the molecular link between these two events in pancreatic tumorigenesis has not yet been fully established. Here, we show that intracellular high mobility group box 1 (HMGB1) remarkably suppresses oncogenic K-Ras-driven pancreatic tumorigenesis by inhibiting chromosome instability-mediated pro-inflammatory nucleosome release...
April 4, 2017: Cell Research
https://www.readbyqxmd.com/read/28371566/cytologic-features-and-clinical-implications-of-undifferentiated-carcinoma-with-osteoclastic-giant-cells-of-the-pancreas-an-analysis-of-15-cases
#10
Michelle D Reid, Takashi Muraki, Kim HooKim, Bahar Memis, Rondell P Graham, Daniela Allende, Jiaqi Shi, David F Schaeffer, Remmi Singh, Olca Basturk, Volkan Adsay
BACKGROUND: The cytologic features of undifferentiated pancreatic carcinoma with osteoclastic giant cells (UOC) are rarely described. METHODS: Cytologic and clinicopathologic characteristics in 15 UOC fine-needle aspiration (FNA) specimens were analyzed. RESULTS: FNA specimens were obtained from 6 men and 8 women with a mean age of 65 years who had UOCs (head, n = 7; body, n = 3; and tail, n = 4) with a mean radiologic size 7.3 cm, and some had a cystic component (n = 9)...
April 3, 2017: Cancer
https://www.readbyqxmd.com/read/28352653/defective-postsecretory-maturation-of-muc5b-mucin-in-cystic-fibrosis-airways
#11
Lubna H Abdullah, Jessica R Evans, T Tiffany Wang, Amina A Ford, Alexander M Makhov, Kristine Nguyen, Raymond D Coakley, Jack D Griffith, C William Davis, Stephen T Ballard, Mehmet Kesimer
In cystic fibrosis (CF), airway mucus becomes thick and viscous, and its clearance from the airways is impaired. The gel-forming mucins undergo an ordered "unpacking/maturation" process after granular release that requires an optimum postsecretory environment, including hydration and pH. We hypothesized that this unpacking process is compromised in the CF lung due to abnormal transepithelial fluid transport that reduces airway surface hydration and alters ionic composition. Using human tracheobronchial epithelial cells derived from non-CF and CF donors and mucus samples from human subjects and domestic pigs, we investigated the process of postsecretory mucin unfolding/maturation, how these processes are defective in CF airways, and the probable mechanism underlying defective unfolding...
March 23, 2017: JCI Insight
https://www.readbyqxmd.com/read/28343174/mirna-analysis-in-pancreatic-cancer-the-dartmouth-experience
#12
REVIEW
Francine B de Abreu, Xiaoying Liu, Gregory J Tsongalis
Pancreatic cancer is considered one of the most lethal cancers being the fourth leading cause of cancer deaths in adults in the United States because of the lack of early signs and symptoms and the lack of early detection. Pancreatic ductal adenocarcinoma (PDAC) is the most common histological type among pancreatic cancers, representing 80%-90% of all solid tumors of the pancreas. The majority of PDAC develops from three precursor lesions: pancreatic intraepithelial neoplasia, intraductual papillary mucinous neoplasm and mucinous cystic neoplasm...
May 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28321347/association-of-chronic-pancreatitis-and-malignant-main-duct-ipmn-a-rare-but-difficult-clinical-problem
#13
Zoltán Berger, Hernán De La Fuente, Manuel Meneses, Fernanda Matamala, Makarena Sepúlveda, Claudia Rojas
We report the case of a 70-year-old woman who consulted for recurrent short episodes of mild-to-moderate abdominal pain. Dilated main pancreatic duct was seen on CAT scan and magnetic resonance, with multiple calcifications and intraductal stones, typical in CP. However, for a more pronounced cystic dilatation in the pancreatic head, we could not exclude the coexistence of a main duct IPMN. ERCP was performed, with pancreatic sphincterotomy and extraction of pancreatic stones, but, at the same time, mucin extrusion was seen from the dilated duct through the papilla...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28316229/mucinous-carcinoma-with-extensive-signet-ring-cell-differentiation-a-case-report
#14
Hye Min Kim, Eun Kyung Kim, Ja Seung Koo
Breast cancers that present with mucin include mucinous carcinoma and carcinoma with signet ring cell differentiation. The former shows extracellular mucin and the latter shows abundant intracellular mucin. Here, we report a case of breast cancer showing both extracellular mucin and extensive signet ring cell differentiation due to abundant intracellular mucin. Unlike mucinous carcinoma, this case had the features of high-grade nuclear pleomorphism, high mitotic index, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor-2 positivity, and ductal type with positivity for E-cadherin...
March 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/28315508/tumor-markers-in-pancreatic-cystic-fluids-for-diagnosis-of-malignant-cysts
#15
Alexandre Levy, Theodora Popovici, Phuong-Nhi Bories
BACKGROUND AND AIM: Early diagnosis of premalignant or malignant pancreatic cysts is essential to improve prognosis. Sampling of pancreatic cyst fluid by fine-needle aspiration during endoscopic ultrasonography (EUS) enables cytopathological examination combined with biochemical analysis. This study aimed to provide an aid based on biological markers for the preoperative management of patients with pancreatic cysts. METHODS: Pancreatic fluids obtained by EUS-guided fine-needle aspiration from 115 patients with cystic lesions were assayed for amylase, lipase, carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4...
March 3, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28287942/fdg-pet-ct-pitfalls-in-gynecologic-and-genitourinary-oncologic-imaging
#16
Amish Lakhani, Sairah R Khan, Nishat Bharwani, Victoria Stewart, Andrea G Rockall, Sameer Khan, Tara D Barwick
The role of whole-body positron emission tomography (PET)/computed tomography (CT) with fluorodeoxyglucose ( FDG fluorodeoxyglucose ) is now established in the assessment of many gynecologic and genitourinary malignant tumors. FDG fluorodeoxyglucose PET/CT has been widely adopted for staging assessments in patients with suspected advanced disease, in cases of suspected disease recurrence, and for determining prognosis in a number of malignancies. A number of pitfalls are commonly encountered when reviewing FDG fluorodeoxyglucose PET/CT scans in gynecologic and genitourinary cases; these pitfalls can be classified into those that yield potential false-positive or false-negative results...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28286093/needle-based-confocal-laser-endomicroscopy-for-the-diagnosis-of-pancreatic-cystic-lesions-an-international-external-interobserver-and-intraobserver-study-with-videos
#17
Somashekar G Krishna, William R Brugge, John M Dewitt, Pradermchai Kongkam, Bertrand Napoleon, Carlos Robles-Medranda, Damien Tan, Samer El-Dika, Sean McCarthy, Jon Walker, Mary E Dillhoff, Andrei Manilchuk, Carl Schmidt, Benjamin Swanson, Zarine K Shah, Phil A Hart, Darwin L Conwell
BACKGROUND AND AIMS: EUS-guided nCLE characteristics of common types of PCLs have been identified; however surgical histopathology was available in a minority of subjects. We sought to assess the performance characteristics of EUS-nCLE for differentiating mucinous from non-mucinous PCLs in a larger series of subjects with a definitive diagnosis. METHODS: Six endosonographers (nCLE experience >30 cases each) blinded to all clinical data, reviewed nCLE images of PCLs from 29 subjects with surgical (n=23) or clinical (n=6) correlation...
March 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28281482/laparoscopic-spleen-preserving-distal-pancreatectomy-for-a-primary-hydatid-cyst-mimicking-a-mucinous-cystic-neoplasia
#18
Tugan Tezcaner, Yahya Ekici, Onur Huseyin Aydın, Gonca Barit, Gökhan Moray
Pancreatic hydatid cysts are fairly rare. The disease can be encountered concurrently with systemic involvement or as an isolated pancreatic involvement. We report the first case of spleen-preserving laparoscopic distal pancreatectomy for a pancreatic hydatid cyst. There was no complication or recurrence. A 55-year-old woman was admitted to our centre with epigastric and back pain. Upper abdominal magnetic resonance imaging revealed a solitary cystic lesion with septations at the pancreatic tail level measuring 24 mm × 18 mm, which was initially thought to be a pancreatic mucinous cystic neoplasia...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28281172/needle-based-confocal-laser-endomicroscopy-for-evaluation-of-cystic-neoplasms-of-the-pancreas
#19
Abdurrahman Kadayifci, Mustafa Atar, Omer Basar, David G Forcione, William R Brugge
BACKGROUND: The accurate diagnosis of cystic neoplasms of the pancreas (CNP) with current diagnostic methods is limited. Endoscopic ultrasound (EUS)-guided needle-based confocal laser endomicroscopy (nCLE) is a new technique which can obtain images from the cyst wall during EUS-fine needle aspiration (EUS-FNA). The aim of this study was to assess the safety, feasibility, and diagnostic value of nCLE for CNP. METHODS: Patients who underwent EUS-FNA to evaluate a CNP larger than 2 cm were enrolled...
May 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#20
Yusuke Takahashi, Naoyuki Yokoyama, Daisuke Sato, Tetsuya Otani, Koko Mitsuma, Hideki Hashidate
INTRODUCTION: Pancreatic cysts are often observed incidentally on abdominal computed tomography (CT). For cysts involving intracystic nodules, malignant neoplasms such as intraductal papillary-mucinous carcinoma (IPMC) should be suspected. In contrast, cholesterol granuloma (CG) rarely occurs in the pancreas, and CG-associated autoimmune pancreatitis (AIP) has not yet been reported. To our knowledge, this is the first reported case of AIP with CG mimicking IPMC. PRESENTATION OF CASE: A 56-year-old woman underwent abdominal CT for preoperative breast cancer screening...
March 1, 2017: International Journal of Surgery Case Reports
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