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Pancreas adenocarcinoma

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https://www.readbyqxmd.com/read/27931107/a-diffusely-enlarged-pancreas-the-un-usual-suspect
#1
Pedro Magalhães-Costa, Maria José Brito, Pedro Pinto-Marques
An 81-years-old female presented with obstructive jaundice and a non-specific clinical picture of nausea and appetite loss. Labs demonstrated a conjugated hyperbilirrubinemia (7.7 mg/dL), increased aspartate aminotransferase and alanine aminotransferase (10xULN and 8xULN, respectively), increased lactate dehydrogenase (10xULN) and serum lipase (3xULN). CA 19.9 was 342 U/mL (Ref value < 37 U/mL). There was no evidence of peripheral lymphadenopathy or hepatosplenomegaly. Imaging (Figure 1A and 1B) revealed a marked homogeneous enlargement of the pancreas (without any well-defined mass), dilation of the extra and intra-hepatic bile ducts and ascites...
December 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27926368/genetic-syndromes-with-pancreatic-manifestations
#2
REVIEW
Meredith E Pittman, Lodewijk A A Brosens, Laura D Wood
Although the pancreas is affected by only a small fraction of known inherited disorders, several of these syndromes predispose patients to pancreatic adenocarcinoma, a cancer that has a consistently dismal prognosis. Still other syndromes are associated with neuroendocrine tumors, benign cysts, or recurrent pancreatitis. Because of the variability of pancreatic manifestations and outcomes, it is important for clinicians to be familiar with several well-described genetic disorders to ensure that patients are followed appropriately...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27924070/modified-methods-for-isolation-of-pancreatic-stellate-cells-from-human-and-rodent-pancreas
#3
Liangtao Zhao, Baobao Cai, Zipeng Lu, Lei Tian, Song Guo, Pengfei Wu, Dong Qian, Qingcheng Xu, Kuirong Jiang, Yi Miao
Primary cultures of pancreatic stellate cells (PSCs) remain an important basis for in vitro study. However, effective methods for isolating abundant PSCs are currently lacking. We report on a novel approach to isolating PSCs from normal rat pancreases and human pancreatic ductal adenocarcinoma (PDAC) tissue. After anaesthesia and laparotomy of the rat, a blunt cannula was inserted into the pancreatic duct through the anti-mesentery side of the duodenum, and the pancreas was slowly infused with an enzyme solution until all lobules were fully dispersed...
November 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/27919186/economic-evaluation-for-the-us-of-nab-paclitaxel-plus-gemcitabine-versus-folfirinox-versus-gemcitabine-in-the-treatment-of-metastatic-pancreas-cancer
#4
Mahdi Gharaibeh, Ali McBride, J Lyle Bootman, Hitendra Patel, Ivo Abraham
BACKGROUND: Nab-paclitaxel plus gemcitabine (NAB-P+GEM) and FOLFIRINOX have shown superior efficacy over gemcitabine (GEM) in the treatment of metastatic pancreatic ductal adenocarcinoma (mPDA). Though the incremental clinical benefits are modest, both treatments represent significant advances in the treatment of a high-mortality cancer. In this independent economic evaluation for the US, we aimed to estimate the comparative cost-utility and cost-effectiveness of these three regimens from the payer perspective...
December 6, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27909644/primary-squamous-cell-carcinoma-of-the-pancreas-as-a-cause-of-biliary-obstruction
#5
Kyle Rowe, Jeet Mehta, Fredy Nehme, William Salyers
Primary squamous cell carcinoma of the pancreas (SCCP) is a rare neoplasm, given a lack of naturally occurring squamous cells within the pancreas, accounting for only 0.2% of all pancreatic cancers. The etiology is unknown. Symptomatology is non-specific and similar to other pancreatic neoplasms. No non-invasive testing can adequately rule in SCCP, and workup should proceed similarly to any pancreatic mass. Tissue sampling is required for diagnosis and guidance of further management, most commonly by endoscopic ultrasound with fine needle aspirate...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27908924/excess-weight-as-a-risk-factor-common-to-many-cancer-sites-words-of-caution-when-interpreting-meta-analytic-evidence
#6
Melina Arnold, Andrew G Renehan, Graham A Colditz
For over a decade, excess body weight, commonly categorized as overweight (body mass index, BMI: 25.0 to 29.9 kg/m2) and obesity (BMI: ≥ 30 kg/m2) has been an established incidence risk factor for several adult cancers (1). For 2012, the burden of disease attributed to elevated BMI was estimated as nearly half-million new cancers worldwide, making this the third highest ranked cancer risk factor globally after smoking and infections (ranked second in most western populations) and an important public health problem (2, 3)...
December 1, 2016: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/27900729/radical-resection-of-t1-pancreatic-adenocarcinoma-with-a-pseudocyst-of-the-tail-due-to-acute-obstructive-pancreatitis-report-of-a-case
#7
Yuki Fujiwara, Fumitake Suzuki, Masaru Kanehira, Yasuro Futagawa, Tomoyoshi Okamoto, Katsuhiko Yanaga
A 53-year-old male visited his primary physician for epigastric and back pain. Abdominal-enhanced computed tomography (CT) revealed a simple cyst of the pancreatic tail attached to the stomach. A distal main pancreatic duct (MPD) was clearly dilated, but no pancreatic tumor was identified around the stenosis of MPD by CT scan and magnetic resonance cholangiopancreatography (MRCP). Endoscopic retrograde pancreatography (ERP) revealed stenosis and distal dilation of the MPD located between the body and tail of the pancreas...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27897439/il-4-mrna-is-downregulated-in-the-liver-of-pancreatic-cancer-patients-suffering-from-cachexia
#8
Olga Prokopchuk, Jürgen M Steinacker, Ulrich Nitsche, Stephanie Otto, Jeannine Bachmann, Elaine C Schubert, Helmut Friess, Marc E Martignoni
BACKGROUND: Interleukin-4 (IL-4) together with interleukin-13 (IL-13) play an important role in inflammation and wound repair, and are known to be upregulated in human skeletal muscle after strenuous physical exercise. Additionally, these cytokines may act as autocrine growth factors in pancreatic cancer cells. We hypothesize that IL-4, IL-13, and their corresponding receptors are involved in mechanism of cancer cachexia. METHODS: Tissue samples from human skeletal muscle, white fat, liver, healthy pancreas, and pancreatic ductal adenocarcinoma were analyzed by quantitative real-time polymerase chain reaction for mRNA expression levels of IL-4, IL-13, IL-4 receptor α, and IL-13 receptor α1...
November 29, 2016: Nutrition and Cancer
https://www.readbyqxmd.com/read/27895409/two-cases-of-pancreatic-ductal-adenocarcinoma-with-intrapancreatic-metastasis
#9
Yusuke Fujita, Minoru Kitago, Yohei Masugi, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yoko Fujii-Nishimura, Michiie Sakamoto, Yuko Kitagawa
There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma (PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring intrapancreatic metastasis. In both cases, the main lesions were located in the pancreatic body, and no other lesion was detected preoperatively. The patients were diagnosed with pancreatic body cancers and distal pancreatectomy was performed. Pathological findings revealed microscopic cancer nests, which had connections to neither the main lesion nor the premalignant lesion in the pancreatic tail parenchyma...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27891175/multidetector-computer-tomography-in-the-pancreatic-adenocarcinoma-assessment-an-update
#10
REVIEW
Vincenza Granata, Roberta Fusco, Orlando Catalano, Sergio Venanzio Setola, Elisabetta de Lutio di Castelguidone, Mauro Piccirillo, Raffaele Palaia, Roberto Grassi, Francesco Granata, Francesco Izzo, Antonella Petrillo
Ductal adenocarcinoma of the pancreas is one of the most aggressive forms of cancer, with only a minority of cases being resectable at the moment of their diagnosis. The accurate detection and characterization of pancreatic carcinoma is very important for patient management. Multidetector-row computed tomography (MDCT) has become the cross-sectional modality of choice in the diagnosis, staging, treatment planning, and follow-up of patients with pancreatic tumors. However, approximately 11% of ductal adenocarcinomas still remain undetected at MDCT because of the lack of attenuation gradient between the lesion and the adjacent pancreatic parenchyma...
2016: Infectious Agents and Cancer
https://www.readbyqxmd.com/read/27885876/predictors-and-survival-for-pathologic-tumor-response-grade-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-induction-chemotherapy-and-neoadjuvant-stereotactic-body-radiotherapy
#11
Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
November 25, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27879189/gemcitabine-induced-hemolytic-uremic-syndrome-treated-with-eculizumab-or-plasmapheresis-two-case-reports%C3%A2
#12
María Esperanza López Rubio, Raquel Rodado Martínez, María Luisa Illescas, Encarnación Mateo Bosch, Mercedes Martínez Díaz, Lourdes de la Vara Inesta, Basilio Cabezuelo, María Elisa Morales Albuja, Eladio Lucas Guillén, Luisa Jimeno García
BACKGROUND: Drug-induced hemolytic-uremic syndrome (HUS) has shown good response to eculizumab (ECU). We present 2 cases of patients with gemcitabine-induced HUS (GEM-HUS), one of whom was treated with ECU and the other with conventional treatment. Patient 1: A 74-year-old male with resected adenocarcinoma of the pancreas started adjuvant treatment with GEM, but after 5 months GEM was discontinued due to acute kidney injury and severe hypertension. Laboratory analyses identified microangiopathic hemolytic anemia (MHA) and thrombocytopenia...
November 23, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27876341/imaging-of-neuroendocrine-tumors-of-the-pancreas
#13
C Dromain, D Déandréis, J-Y Scoazec, D Goere, M Ducreux, E Baudin, L Tselikas
Pancreatic neuroendocrine tumors (PNETs) are rare and represent a heterogeneous disease. PNET can be functioning or non-functioning with different clinical presentations and different prognosis based on WHO and pTNM classifications. The role of imaging includes the localization of small functioning tumor, differentiation of these tumors from adenocarcinoma, identification of signs of malignancy and evaluation of extent. PNETs have a broad spectrum of appearance. On CT and MRI, most of functioning PNETs are well defined small tumors with intense and homogeneous enhancement on arterial and portal phases...
December 2016: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/27872140/primary-cilia-are-increased-in-number-and-demonstrate-structural-abnormalities-in-human-cancer
#14
Binnaz Yasar, Kim Linton, Christian Slater, Richard Byers
AIMS: Primary cilia play an important role in the regulation of cell signalling pathways and are thought to have a role in cancer but have seldom been studied in human cancer samples. METHODS: Primary cilia were visualised by dual immunofluorescence for anti-CROCC (ciliary rootlet coiled-coil) and anti-tubulin in a range of human cancers (including carcinomas of stomach, pancreas, prostate, lung and colon, lobular and ductal breast cancers and follicular lymphoma) and in matched normal tissue (stomach, pancreas, lung, large and small intestines, breast and reactive lymph nodes) samples using a tissue microarray; their frequency, association with proliferation, was measured by Ki-67 staining and their structure was analysed...
November 21, 2016: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/27865459/molecular-pathogenesis-of-pancreatic-cancer
#15
T J Grant, K Hua, A Singh
Pancreatic cancers arise predominantly from ductal epithelial cells of the exocrine pancreas and are of the ductal adenocarcinoma histological subtype (PDAC). PDAC is an aggressive disease associated with a poor clinical prognosis, weakly effective therapeutic options, and a lack of early detection methods. Furthermore, the genetic and phenotypic heterogeneity of PDAC complicates efforts to identify universally efficacious therapies. PDACs commonly harbor activating mutations in the KRAS oncogene, which is a potent driver of tumor initiation and maintenance...
2016: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/27865273/genetics-of-pancreatic-cancer-and-its-implications-on-therapy
#16
REVIEW
Talar Tatarian, Jordan M Winter
Over the past decade, emerging technologies have provided new insights into the genomic landscape of pancreatic ductal adenocarcinoma (PDA). In addition to the commonly recognized genetic drivers of pancreatic carcinogenesis (KRAS, CDKN2A, TP53, SMAD4), new genes and pathways have been implicated. However, these efforts have not identified any new high-frequency actionable mutations, limiting the success of mutation-targeted therapy in PDA. This article provides a report on the current landscape of pancreas cancer genetics and targeted therapeutics...
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27861201/tissue-classification-using-optical-spectroscopy-accurately-differentiates-cancer-and-chronic-pancreatitis
#17
Robert H Wilson, Malavika Chandra, James M Scheiman, Seung Yup Lee, Oliver E Lee, Barbara J McKenna, Diane M Simeone, Jeremy M G Taylor, Mary-Ann Mycek
OBJECTIVES: Current pancreatic cancer diagnostics cannot reliably detect early disease or distinguish it from chronic pancreatitis. We test the hypothesis that optical spectroscopy can accurately differentiate cancer from chronic pancreatitis and normal pancreas. We developed and tested clinically compatible multimodal optical spectroscopy technology to measure reflectance and endogenous fluorescence from human pancreatic tissues. METHODS: Freshly excised pancreatic tissue specimens (39 normal, 34 chronic pancreatitis, 32 adenocarcinoma) from 18 patients were optically interrogated, with site-specific histopathology representing the criterion standard...
November 17, 2016: Pancreas
https://www.readbyqxmd.com/read/27860444/cytological-findings-and-bcl10-expression-in-pancreatic-acinar-cell-carcinoma-a-case-report
#18
Akinobu Ohno, Yuichiro Sato, Eriko Nakamura, Hiroshi Noguchi, Takako Tokumitsu, Masahide Hiyoshi, Atsushi Nanashima, Yujiro Asada
BCL10 was recently demonstrated to be a biomarker for pancreatic acinar cell carcinoma, but whether altered BCL10 expression can be detected in cell block specimens is unclear. Here, we report a pancreatic acinar cell carcinoma with cytological findings that showed BCL10 expression in a cell block. A 72-year-old man presented with a pancreatic tumor and underwent endoscopic ultrasound-fine needle aspiration (EUS-FNA) with additional passes performed for cell block preparation. The EUS-FNA cytology showed loose cohesive clusters with focal acinar- or gland-like-structures and prominent nucleoli...
November 17, 2016: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/27848241/a-mixed-adenoneuroendocrine-carcinoma-of-the-pancreas-a-case-report
#19
Kouki Imaoka, Saburo Fukuda, Hirofumi Tazawa, Yoshio Kuga, Tetsuya Mochizuki, Yuzo Hirata, Seiji Fujisaki, Mamoru Takahashi, Toshihiro Nishida, Hideto Sakimoto
A tumor consisting of an adenocarcinoma component and a neuroendocrine carcinoma component, with each component accounting for at least 30% of the tumor, is defined as a mixed adenoneuroendocrine carcinoma (MANEC). We report a case of MANEC of the pancreas. A 63-year-old man presented with hyperglycemia and was referred to our hospital for further examination. Abdominal contrast-enhanced computed tomography (CT) revealed a mass of 2 cm in size in the pancreas head with portal vein narrowing. Fluorin-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) CT revealed increased accumulation in the mass of the pancreas head...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27842669/acoustic-radiation-force-impulse-shear-wave-elastography-arfi-of-acute-and-chronic-pancreatitis-and-pancreatic-tumor
#20
Ruediger S Goertz, Johanna Schuderer, Deike Strobel, Lukas Pfeifer, Markus F Neurath, Dane Wildner
INTRODUCTION: Acoustic Radiation Force Impulse (ARFI) elastography evaluates tissue stiffness non-invasively and has rarely been applied to pancreas examinations so far. In a prospective and retrospective analysis, ARFI shear wave velocities of healthy parenchyma, pancreatic lipomatosis, acute and chronic pancreatitis, adenocarcinoma and neuroendocrine tumor (NET) of the pancreas were evaluated and compared. MATERIAL AND METHODS: In 95 patients ARFI elastography of the pancreatic head, and also of the tail for a specific group, was analysed retrospectively...
December 2016: European Journal of Radiology
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