• Title/Summary/Keyword: Pancreatic lesion

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A Case of Primary Pancreatic Lymphoma Presenting with Obstructive Jaundice

  • Ga Young Kim;Min Keun, Kim;Dong Wook Lee;Ho Gak Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.101-104
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    • 2015
  • A 55-year-old man was admitted to the hospital for jaundice. Computed tomography (CT) scans showed a diffuse mass in the pancreas and peripancreatic area, with infiltration to of the whole pancreas, and overall reduced enhancement compared to normal pancreas. Esophagogastroduodenoscopy revealed elevated mucosal lesion covered hyperemic mucosa at duodenal bulb and ulcerative lesion at body of stomach. Endoscopic ultrasonography revealed an irregular mass with unclear boundaries was observed within the pancreas. Abrupt narrowing of mid to distal common bile duct was seen and the stricture was caused by compression of pancreatic mass. Plastic stent was inserted and clinical improvement was achieved including resolution of jaundice. The patient is currently being treated with combination of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone. We report a case of primary pancreatic lymphoma presenting with obstructive jaundice.

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Study on clinico-pathological and ultrasonographic changes for experimental induced-acute pancreatitis in dogs (개에서 실험적으로 유발시킨 급성 췌장염에 있어서 혈액화학치와 췌장의 초음파학적 변화)

  • Yun, Young-min;Park, Su-jin;Yoon, Jung-hee;Youn, Hwa-young;Choi, Hee-in
    • Korean Journal of Veterinary Research
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    • v.38 no.2
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    • pp.423-435
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    • 1998
  • In acute pancreatitis group, all the dogs are showed increase of amylase and lipase after the 1st day of surgery, and amylase and lipase activity were significantly more increased than those of control group. The methemalbumin was increased significantly after the 2nd day of surgery in the acute pancreatitis group. In pancreatitis group, ultrasonographic findings included thickened duodenal wall and poorly circumscribed hyperechoic lesion of pancreatic mass after the 2nd day of surgery. And the lesion was exacerbated until the 4th day and reduced after the 6th day of surgery. To identify the lesion of pancreas, it is considered that transverse view is more useful Than sagittal view. Gross findings showed increase of pancreatic parenchymal consistency, surface nodule, and extensive pancreatic necrosis. Necrosis of peripancreatic fat tissue was also a prominent feature. The microscopic appearance of the pancreas was characterized by pancreatic acinar cell necrosis, hemorrhage, infiltration of the inflammatory cell and fat necrosis and saponification were also observed.

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Gastroduodenal intussusception of a gastrointestinal stromal tumor: a rare cause of acute pancreatitis

  • Pornpayom Numpraphrut;Sorachat Niltwat;Thammawat Parakonthun;Nonthalee Pausawasdi
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.447-451
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    • 2022
  • Patients with symptomatic gastrointestinal stromal tumor (GIST) typically present with gastrointestinal bleeding and abdominal pain. This report presents an unusual case of fundic GIST complicated by gastroduodenal intussusception, manifesting as acute pancreatitis. The patient presented with epigastric pain and pancreatic enzyme elevation; thus, he was diagnosed with acute pancreatitis. Computed tomography showed evidence of pancreatitis and a 4×4.7 cm well-defined hyperdense lesion in the 2nd part of the duodenum, compressing the pancreatic head and pancreatic duct. Esophagogastroduodenoscopy revealed invagination of the gastric folds into the duodenum, causing pyloric canal blockage consistent with gastroduodenal intussusception. Spontaneous reduction of the lesion during endoscopy revealed a 4 cm pedunculated subepithelial mass with central ulceration originating from the gastric fundus. Endoscopic ultrasound demonstrated a heterogeneous hypoechoic lesion originating from the 4th layer of the gastric wall. Laparoscopic-endoscopic intragastric wedge resection of the fundic lesion was subsequently performed, and surgical histology confirmed GIST.

Role of contrast-enhanced harmonic endoscopic ultrasonography (EUS) and EUS elastography in pancreatic lesions

  • Yasunobu Yamashita;Masayuki Kitano
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.164-174
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    • 2024
  • Pancreatic cancers have a poor prognosis, and their incident rates have risen. Endoscopic ultrasonography (EUS) is an efficient and reliable diagnostic modality for pancreatic lesions, providing high spatial resolution. However, while EUS helps to detect minor pancreatic lesions, nearly all solid pancreatic lesions are hypoechoic, which creates difficulty in making differential diagnoses of pancreatic lesions. When diagnosing pancreatic lesions, the performance of image-enhanced EUS techniques is essential, such as EUS elastography or contrast-enhanced harmonic EUS (CH-EUS). CH-EUS diagnosis is based on assessing the vascularity of lesions, whereas tissue elasticity is measured via EUS elastography. Elastography is either strain or shear-wave, depending on the different mechanical properties being evaluated. The usefulness of enhanced EUS techniques is demonstrated in this review for the differential diagnosis of pancreatic lesions, including solid and cystic lesions, and pancreatic cancer staging.

Diagnosis and resolution of pancreatic pseudocysts with percutaneous ultrasound-guided aspiration in two dogs (개 췌장 위낭종에서 초음파 유도 흡인 생검을 통한 진단 및 치료 2례)

  • Choi, Jihye;Kim, Hyunwook;Seo, Jeemin;Lee, Minjung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.47 no.3
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    • pp.341-347
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    • 2007
  • Pancreatic pseudocyst is one of the most common pancreatic mass lesions developed following acute or chronic pancreatitis. Two dogs were presented with nonspecific clinical signs such as abdominal pain, vomiting and depression and diagnosed as pancreatic pseudocysts through percutaneous ultrasound-guided aspiration. Pancreatic pseudocyst may contain pancreatic juice, so leads the deteriorate state of patient through pertinent inflammation and autodigestion of pancreas. In this study, the clinical signs and pancreatic lesion were improved after aspiration. Percutaneous ultrasound-guided aspiration can provide the diagnostic information through cytology and lipase and amylase concentration, and be selected as the first choice for treatment.

Partial Pancreatectomy Using Ultrasonic Scalpel for Exocrine Pancreatic Ductal Papillary Carcinoma in a Cat

  • Park, Jiyoung;Lee, Young Won;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.294-298
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    • 2018
  • This report presents a rare case of feline exocrine pancreatic ductal carcinoma including treatment and prognosis. A 4.6-year-old castrated male American Shorthair cat, weighing 5 kg was presented with intermittent vomiting, diarrhea and loss of appetite. Through physical examination and radiography, a cranial abdominal mass was identified. Exploratory laparotomy was carried out. The largest mass was connected to the left lobe of the pancreas, and there were several small, nodular masses scattered along the abdominal lining. The pancreatic mass was removed using an ultrasonic scalpel, and the patient recovered favorably. Histopathologically, the resected lesion was diagnosed as an exocrine pancreatic ductal papillary carcinoma. The patient was maintained with conservative therapy and euthanized on post-operative day 262. Partial pancreatectomy using an ultrasonic scalpel was accomplished safely without evidence of pancreatic leakage.

A Case of Pancreatic Neuroendocrine Tumor Accompanied by a Cystic Change in Early Stage

  • Sang Soo Bae;Eun Jeong Kim;Dong Wook Lee;Ho Gak Kim;Jimin Han
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.50-54
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    • 2017
  • Pancreatic neuroendocrine tumors are rare pancreatic neoplasms comprising 1-2% of all pancreatic tumors and typically present high attenuating mass on arterial and venous phase images, due to their rich capillary network. A 70-year-old South Korean female visited our hospital presenting with jaundice and dark urine color. She had received an operation for treatment of small bowel perforation seven years ago. On physical examination, icteric sclera was observed but otherwise unremarkable. Laboratory tests were abnormal liver function test and suspected obstructive jaundice. Computed tomography revealed 4 cm sized cystic mass lesion with homogeneous low attenuation in the head of pancreas and distal common bile duct was compressed by the mass. During review of past medical records, we found that the mass was observed and measured about 1.7 cm seven years ago. To resolve obstructive jaundice, pylorus preserving pancreaticoduodenectomy was performed and diagnosed with well differentiated pancreatic neuroendocrine carcinoma with intermediate grade.

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Rare variant of type V choledochal cyst masquerading as a biliary cystadenoma

  • Murugappan Nachiappan;Srikanth Gadiyaram
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.289-292
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    • 2022
  • Cystic lesions of the liver are commonly encountered in routine clinical practice with a reported prevalence of 15%-18%. They may range from a benign simple developmental cyst to a malignancy. Therefore, an accurate diagnosis is essential for adequate management. Cystic tumors of the liver are classified based on the content (mucin containing or not), presence of ovarian stroma, and biliary communication. Biliary cystadenoma are a group of hepatobiliary neoplasia which by definition must be multilocular, lined by a columnar epithelium, and have a densely cellular ovarian stroma. We report a case of a cystic lesion in the hilar region of the liver, which had features of biliary cystadenoma on the preoperative imaging. However, on exploration was found to be a diverticular variant of type V choledochal cyst arising from both hepatic ducts. We have discussed the preoperative imaging features, intraoperative cholangiogram, and the management of this cystic lesion.

A Case of Pancreatic Pseudocysts with Oriental Medical Treatment (췌장 가성낭종 환자 치험 1례)

  • Hur, Won-Young;Ryu, Bong-Ha;Kim, Yoo-Seung;Hong, In-A;Kim, So-Yeon;Eom, Guk-Hyeon;Lee, Seon-Young;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.963-971
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    • 2007
  • A pancreatic pseudocyst is the most common cystic lesion in the pancreas. There are several treatment methods with variable results. Recently, conservative treatment has been preferred because it has fewer complications. In this case, a 37-year-old male patient had pancreatic pseudocysts with upper abdominal pain, left upper back pain, diarrhea, weight loss, and general weakness. We prescribed him Banchongsangamibang (蟠蔥散加味方). For about 1 year, he was treated with oriental medicine. All of his pancreatic pseudocysts disappeared on abdominal CT follow-up and the symptoms mostly subsided. There had been no recurrence of pancreatic pseudocysts on abdominal CT follow-up after 1 year.

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Case of Solitary Pancreatic Metastasis from Small Cell Lung Cancer

  • Park, Chul;Kim, Tae Hyeon;Yun, Ki Jung;Choi, Soon Ho;Lee, Sam Youn;Lee, Mi Kyung;Ryu, Dae Woong;Yang, Sei Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.6
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    • pp.980-982
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    • 2012
  • Metastasis to the pancreas from extra-pancreatic primary cancers are rare; they commonly present as a manifestation of widespread disease and rarely as an isolated mass of the pancreas. Examinations showed a pancreatic tumor infiltrating the pancreas tail portion and an endoscopic ultrasound guided percutaneous biopsy proved that the lesion was metastatic from the lung carcinoma. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastasis are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. This report that patient undergoing chemotherapy for a small cell lung cancer, who 1 year and 3 months later, accidentally diagnosed of solitary pancreas metastasis and confirmed histology by needle biopsy using endoscopic ultrasound.