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Cystic pancreas

Anita Balázs, Marcus A Mall
The solute carrier family 26, member 9 (SLC26A9) is an epithelial chloride channel that is expressed in several organs affected in patients with cystic fibrosis (CF) including the lungs, the pancreas, and the intestine. Emerging evidence suggests SLC26A9 as a modulator of wild-type and mutant CFTR function, and as a potential alternative target to circumvent the basic ion transport defect caused by deficient CFTR-mediated chloride transport in CF. In this review, we summarize in vitro studies that revealed multifaceted molecular and functional interactions between SLC26A9 and CFTR that may be implicated in normal transepithelial chloride secretion in health, as well as impaired chloride/fluid transport in CF...
2018: Frontiers in Pharmacology
Aliye Uc, Dana K Andersen, Drucy Borowitz, Marshall J Glesby, Julia Mayerle, Robert Sutton, Stephen J Pandol
A workshop was sponsored by the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, on July 25, 2018, in Pittsburgh, Penn. The workshop was designed to bring together a multidisciplinary group of experts to accelerate the development of therapeutics for clinical application in inflammatory diseases of the exocrine pancreas. Three separate working groups (acute pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis) were formed to address the needs, gaps, and opportunities...
November 2018: Pancreas
Rei Suzuki, Hiroki Irie, Tadayuki Takagi, Mitsuru Sugimoto, Naoki Konno, Yuki Sato, Ko Watanabe, Jun Nakamura, Shigeru Marubashi, Takuto Hikichi, Hiromasa Ohira
BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for mucinous cystic neoplasm of the pancreas carries a potential risk of inducing peritoneal tumor cell dissemination. We investigated the diagnostic yield and safety of EUS-FNA-based cytology of cells obtained from the pancreatic invasion site of intraductal papillary-mucinous neoplasm-derived adenocarcinoma (IPMC). METHODS: We included 22 surgically resected IPMCs and 84 pancreatic ductal adenocarcinomas (PDACs)...
October 12, 2018: BMC Cancer
Qingyu Chen, Jianguo Xia
RATIONALE: Hemolymphangioma of the pancreas is an extremely rare benign tumor; only 10 patients with this disease have been reported to date, the majority of whom were women. PATIENT CONCERNS: We describe a 28-year-old man who presented with abdominal pain and discomfort. Computed tomography and magnetic resonance imaging data showed a huge heterogeneous solid cystic mass at the retroperitoneal pancreatic head. The maximum cross-sectional lengths of the pancreatic lesion were approximately 12 × 8...
October 2018: Medicine (Baltimore)
A V Smirnov, M A Zakharova, S V Berelavichus, A B Varava, A G Krieger
A rare case of virsungorrhagia in a 65 y/o patient with a mucinous tumor of the tail of the pancreas is presented. Recurrent gastrointestinal bleeding was associated with an arrosis of the splenic artery adjacent to the tumor, which required a two-step treatment - endovascular occlusion of the splenic artery and distal resection of the pancreas.
2018: Khirurgiia
Fei Hu, Xiaohui Qiu, Shizhong Bu
Islet dysfunction is a hallmark of type 2 diabetes mellitus (T2DM). Compelling evidence suggests that accumulation of islet amyloid in the islets of Langerhans significantly contribute to β-cell dysfunction and diabetes. Emerging evidence implicates a role for cystic fibrosis transmembrane-conductance regulator in the regulation of insulin secretion from pancreatic islets. Impaired first-phase insulin responses and glucose homeostasis have also been reported in cystic fibrosis patients. The transforming growth factor-β protein superfamily is central regulators of pancreatic cell function, and has a key role in pancreas development and pancreatic disease, including diabetes and islet dysfunction...
October 6, 2018: Archives of Physiology and Biochemistry
Nao Shimada, Shiro Miwa, Takuma Arai, Noriyuki Kitagawa, Shingo Akita, Nobuyoshi Iinuma, Keiko Ishii
INTRODUCTION: Pancreatic mixed adenoneuroendocrine carcinoma (MANEC) is a rare tumor. We report herein a case of pancreatic MANEC with cystic features. PRESENTATION OF CASE: A 67-year-old woman presented with jaundice. A CT scan revealed an 18-mm mass at the pancreatic head that obstructed the common bile duct and another 35-mm cystic lesion containing a mural nodule in the pancreatic body, which was suspected to be an intraductal papillary mucinous carcinoma. A biopsy of the head mass led to the diagnosis of adenocarcinoma...
September 23, 2018: International Journal of Surgery Case Reports
Tomohiko Taniai, Koichiro Haruki, Hiroaki Shiba, Shinji Onda, Taro Sakamoto, Katsuhiko Yanaga
Simultaneous resection of synchronous hepatocellular carcinoma (HCC) and pancreatic ductal adenocarcinoma (PDAC) is extremely rare. Case 1 is a 64-year-old woman, who had undergone anterior resection for rectal cancer 3 years earlier was pointed out to have a cystic tumor in the pancreatic tail and a solitary tumor in the liver. CT revealed a hypovascular tumor in the pancreatic tail and a liver tumor with early enhancement. With a diagnosis of simultaneous HCC and PDAC, she underwent laparotomy, in which intraoperative frozen section examination of the liver was compatible with HCC...
May 2018: Case Reports in Gastroenterology
Sara Iacopi, Carlo Lombardo, Francesca Menonna, Salvatore Mazzeo, Davide Caramella, Gabriella Amorese, Fabio Vistoli, Ugo Boggi
BACKGROUND/OBJECTIVES: Management of patients with pregnancy-associated cyst pancreatic cystic tumors (PA-PCT) is complicated by lack of large series. METHODS: A systematic literature review was conducted to extrapolate data on management of PA-PCT, and make a questionnaire on pending issues to be administered to the members of the Pancreas Club Inc. RESULTS: The literature review demonstrated a total of 35 PA-PCT in 34 women, described exclusively in the form of case reports, and permitted the identification of eleven key questions to be addressed in the survey...
September 26, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Chikara Shirata, Yoshikuni Kawaguchi, Kosuke Kobayashi, Yuta Kobayashi, Junichi Arita, Nobuhisa Akamatsu, Junichi Kaneko, Yoshihiro Sakamoto, Norihiro Kokudo, Kiyoshi Hasegawa
We evaluated the usefulness of fluorescence imaging using indocyanine green to identify pancreas tumors in 23 patients undergoing pancreas resection. This technique was useful in visualizing pancreas lesions during surgery, specifically, neuroendocrine tumors as fluorescence and cystic neoplasms as a fluorescence defect.
September 27, 2018: Journal of Surgical Oncology
Manuele Furnari, Alessandra De Alessandri, Federico Cresta, Maria Haupt, Marta Bassi, Angela Calvi, Riccardo Haupt, Giorgia Bodini, Iftikhar Ahmed, Francesca Bagnasco, Edoardo Giovanni Giannini, Rosaria Casciaro
BACKGROUND: Scientific literature shows a high prevalence of Small Intestinal Bacterial Overgrowth (SIBO) in patients with Cystic Fibrosis (CF). The role of SIBO in nutritional status and gastrointestinal symptoms in CF is not known. Our aim was to study epidemiology and clinical impact of SIBO while assessing the efficacy of rifaximin in eradicating SIBO in CF patients. METHODS: Symptoms questionnaire and Glucose Breath Test (GBT) were given to 79 CF patients (median age 19...
September 19, 2018: Journal of Gastroenterology
Kevin M Elias, Petros Tsantoulis, Jean-Christophe Tille, Allison Vitonis, Leona A Doyle, Jason L Hornick, Gurkan Kaya, Laurent Barnes, Daniel W Cramer, Giacomo Puppa, Sarah Stuckelberger, Jagmohan Hooda, Pierre-Yves Dietrich, Michael Goggins, Candace L Kerr, Michael Birrer, Michelle S Hirsch, Ronny Drapkin, Sana Intidhar Labidi-Galy
Mucinous ovarian tumors (MOTs) morphologically and epidemiologically resemble mucinous cystic neoplasms (MCNs) of the pancreas, sharing a similar stroma and both occurring disproportionately among young females. Additionally, MOTs and MCNs share similar clinical characteristics and immunohistochemical phenotypes. Exome sequencing has revealed frequent recurrent mutations in KRAS and RNF43 in both MOTs and MCNs. The cell of origin for these tumors remains unclear, but MOTs sometimes arise in the context of mature cystic teratomas and other primordial germ cell (PGC) tumors...
September 19, 2018: Journal of Pathology
Dr Frederic Bedard Dallaire, Dr Etienne Dallaire, Dr Martine Perigny
A 39-year-old female patient was referred to our tertiary oncologic center for additional investigations relating to a suspect pancreatic tail lesion. An abdominal computed tomography scan and magnetic resonance imaging scan showed a solid lesion demonstrating progressive enhancement. Complete resection was obtained and the final diagnosis was that of a desmoid tumor of the pancreas, an exceptionally rare tumor demonstrating overlap with other solid and cystic lesions of the pancreas [1]. Therefore, it is important to recognize the essential role of pathology, particularly immunohistochemistry, in identifying this tumor...
October 2018: Radiology Case Reports
Jae Hyuck Jun, Sung Koo Lee, So Yeon Kim, Dong Hui Cho, Tae Jun Song, Do Hyun Park, Sang Soo Lee, Dong-Wan Seo, Myung-Hwan Kim
BACKGROUND/OBJECTIVES: The pancreatoduodenal groove (anatomical groove) is a potential space bordered by the head of the pancreas, duodenum, and common bile duct. Discerning between groove carcinoma (GC) and groove pancreatitis (GP) is often difficult, but clinically important. We retrospectively analyzed and compared the findings of computed tomography (CT), laboratory tests, and endoscopic ultrasound-fine needle aspiration (EUS-FNA) for GC and GP. METHODS: GC (n = 36) and GP (n = 44) patients at Asan Medical Center from January 1, 2000, to May 31, 2017 were retrospectively reviewed...
October 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Eyas Mohamed, Richard Jackson, Christopher M Halloran, Paula Ghaneh
The evidence on the ability of radiological tests to predict a specific diagnosis and also their aptitude in identifying pathological markers indicative of malignancy in cystic lesions of the pancreas remains inconclusive. We conducted a systematic review on MEDLINE for the use of computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT (PET/CT) in the diagnosis and characterization of these cysts. The accuracy of CT scan for reaching a specific diagnosis was 39% to 61.4%, whereas its accuracy for differentiating benign from malignant lesions was 61...
October 2018: Pancreas
A Haddad, A Sebai, R Rhaiem, A Ghedira, A Makni
Mucinous cystadenomas are the most frequent cystic benign tumors of the pancreas. They are characterized by a malignant potential. Acute pancreatitis is their most common complication. This manuscript reports a unique complication of mucinous cystadenomas of the pancreas: retroperitoneal rupture associated to acute pancreatitis. After resuscitation, the patient underwent surgery. A cystic mass of the pancreas tail with retroperitoneal rupture was found. Splenopancreatectomy was performed. Outcomes were straightforward...
September 6, 2018: Journal of Visceral Surgery
Jan G D'Haese, Jens Werner
The management of cystic pancreatic neoplasms has increasingly gained clinical attention due to their frequent incidental detection by cross-sectional imaging and their potential for progression to pancreatic cancer. Surgical resection is warranted for all mucinous cystic neoplasms, solid pseudopapillary neoplasms, and main-duct intraductal papillary mucinous neoplasms since these lesions harbor a major risk for malignant transformation. For branch-duct IPMN (BD-IPMN), the risk for malignancy is considerably lower so that some lesions may be safely followed while others require surgical resection...
July 2018: Visceral Medicine
Jingjing Hu, Raji D Khalifa, Andres A Roma, Oluwole Fadare
The problems associated with the pathologic distinction of primary ovarian mucinous tumors from their metastatic counterparts are well-recognized. Herein, we systematically evaluate a variety of gross parameters to determine the combination of features that most optimally separate primary from secondary mucinous ovarian tumors, and to address the tumor types that are most frequently associated with exceptions. 129 consecutive mucinous tumors involving the ovary formed the study set, including 61 primary mucinous tumors (16 carcinomas, 45 borderline tumors), and 68 metastatic carcinomas (21 colon; 28 appendix; 5 breast; 3 lung; 3 pancreas; 3 cervix; 1 bladder; 4 stomach)...
August 8, 2018: Annals of Diagnostic Pathology
Luca Morelli, Gregorio Di Franco, Simone Guadagni, Matteo Palmeri, Niccoló Furbetta, Niccola Funel, Desirée Gianardi, Andrea De Palma, Luca Pollina, Andrea Moglia, Andrea Pietrabissa, Giulio Di Candio, Franco Mosca, Alfred Cuschieri
Background: Cystic pancreatic lesions (CPLs) are being identified increasingly, and some benefit from surgical treatment. With the increasing use of robotic-assisted surgery (RAS) for neoplasms of the pancreas, the aim of the present comparative study is to establish whether the RAS offered any advantages over conventional open surgery (OS) in the management of CPLs. Patients and Methods: Twenty-seven out of 37 robot-assisted left-sided pancreatectomy (LSP) performed between January 2010 and April 2017 were carried out for CPLs...
September 3, 2018: Journal of Minimal Access Surgery
Bojan Kovacevic, John Gásdal Karstensen, Roald Flesland Havre, Khanh Do-Cong Pham, Marc Giovannini, Emanuele Dabizzi, Paolo Arcidiacono, Erwin Santo, Enrique Vazquez Sequeiros, Pia Klausen, Charlotte Vestrup Rift, Jane Preuss Hasselby, Anders Toxværd, Evangelos Kalaitzakis, Carsten Palnæs Hansen, Peter Vilmann
Background and Objectives: Cystic lesions of the pancreas represent a diagnostic dilemma. Recently, a through-the-needle microbiopsy forceps has become available, enabling procurement of EUS-guided histological specimens from the pancreatic cyst wall. The aim of this study was to evaluate the use of this novel instrument in a multicenter clinical setting. Patients and Methods: Patients referred for EUS evaluation of pancreatic cysts and attempted EUS-guided microbiopsy was included retrospectively from six international tertiary centers...
August 27, 2018: Endoscopic Ultrasound
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