1.Extrahepatic Biliary Schwannomas: A Case Report.
Ji Heon JUNG ; Kwang Ro JOO ; Myung Jong CHAE ; Jae Young JANG ; Sang Gil LEE ; Seok Ho DONG ; Hyo Jong KIM ; Byung Ho KIM ; Young Woon CHANG ; Joung Il LEE ; Rin CHANG ; Youn Hwa KIM ; Sang Mock LEE
Journal of Korean Medical Science 2007;22(3):549-552
Benign schwannomas arise in neural crest-derived Schwann cells. They can occur almost anywhere in the body, but their most common locations are the central nervous system, extremities, neck, mediastinum, and retroperitoneum. Schwannomas occurring in the biliary tract are extremely rare and mostly present with obstructive jaundice. We recently experienced a case of extrahepatic biliary schwannomas in a 64-yr-old female patient who presented with intra- and extrahepatic bile duct and gallbladder stones during a screening program. To the best of our knowledge, extrahepatic biliary schwannomas associated with bile duct stones have not been reported previously in the literature.
Adult
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Bile Ducts/pathology
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Bile Ducts, Extrahepatic/*metabolism/*pathology
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Central Nervous System/pathology
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Cholangiography/methods
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Endoscopy
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Female
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Humans
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Male
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Middle Aged
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Neurilemmoma/*diagnosis/*pathology
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Tomography, X-Ray Computed
2.Small Cell Carcinoma of Extahepatic Bile Duct Presenting with Hemobilia.
Sung Bum CHO ; Sun Young PARK ; Young Eun JOO
The Korean Journal of Gastroenterology 2009;54(3):186-190
We report a case of small cell carcinoma of extrahepatic bile duct presenting with jaundice and hemobilia. A 59-year-old woman was admitted due to right upper quadrant pain and jaundice. An abdominal computed tomography revealed a 2 cm sized mass in the extrahepatic bile duct. Endoscopic retrograde cholangiopancreatography revealed bloody discharge coming out of the papillary orifice in endoscopic view and a dilated extrahepatic bile duct with multiple irregular filling defects in cholangiogram. A coronal T2-weighted image revealed a hyperintense mass at extrahepatic bile duct. Laparotomy was performed, and pathologic examination of resected specimen showed tumor cells having round to oval nuclei with coarsely granular chromatin and scanty cytoplasm, which were immunoreactive for synaptophysin and chromogranin A, compatible with the diagnosis of small cell carcinoma. The small cell carcinoma of bile duct, despite its rarity, should be considered in differential diagnosis of the causes for obstructive jaundice and hemobilia.
Bile Duct Neoplasms/*diagnosis/pathology/radiography
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Bile Ducts, Extrahepatic/*pathology/radiography
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Carcinoma, Small Cell/*diagnosis/pathology/radiography
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Cholangiopancreatography, Endoscopic Retrograde
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Chromogranin A/metabolism
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Female
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Hemobilia/complications/*diagnosis
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Humans
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Magnetic Resonance Imaging
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Middle Aged
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Synaptophysin/metabolism
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Tomography, X-Ray Computed
3.Expression of Survivin protein in extrahepatic cholangiocarcinoma and its relationship with the prognosis.
Xing-lei QIN ; Huan-zhou XUE ; Zuo-ren WANG ; Hong-shan LIU ; Huai-bin ZHOU ; Wei MA
Chinese Journal of Surgery 2009;47(24):1852-1856
OBJECTIVESTo investigate the expression of Survivin in patients with extrahepatic cholangiocarcinoma (EHCC) and its relationship with clinicopathological features of EHCC, and the correlation between the expression of Survivin and lymph node micrometastasis, tumor markers, and the prognosis of EHCC.
METHODSThe expression of Survivin protein in paraffin-embedded specimens of 59 patients with EHCC and their 20 para-carcinoma tissues were evaluated by S-P method of immunohistochemical staining. The correlation between the expression of Survivin and the lymph node micrometastasis, clinicopathological features of EHCC and the prognosis of EHCC were analyzed.
RESULTSThe positive expression rate of Survivin protein was 67.8% (40/59) in paraffin-embedded specimens of 59 patients with EHCC and was 20.0% (4/20) in para-carcinoma tissues, and difference between carcinoma tissues and para-carcinoma tissues was significant (P<0.01). Histological differentiation in EHCC had a negative correlation with the expression of Survivin protein, while the expression of Survivin protein in EHCC had a positive correlation with TNM of EHCC, lymphatic vessel infiltration, lymph node metastasis and perineural invasion (P<0.05). The serum CA19-9 levels in the positive group with expression of Survivin protein was (290,300+/-55 500) U/L and was obviously higher than that in the negative group [(113,300+/-31,400) U/L, P<0.05]. The mean survival time of the patients with negative expression of Survivin protein was higher than that of the patients with positive expression (43.5 vs. 21.1 months, P<0.01). Screened to significance univariate, the multivariate analysis through Cox proportional hazard model analysis showed that lymph node metastasis, residual tumor margins, and expression of Survivin protein were independent prognosis factors of the patients with EHCC (P<0.05, P<0.01, P<0.01).
CONCLUSIONSThe expression of Survivin protein in EHCC has a negative correlation with histological differentiation, while has a positive correlation with lymphatic vessel infiltration and serum CA19-9 concentrations. The expression of Survivin protein maybe an independent prognosis factor of the patients with EHCC.
Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; metabolism ; pathology ; Bile Ducts, Extrahepatic ; Cholangiocarcinoma ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis
4.Expression of G-protein gamma 7 in patients with extrahepatic cholangiocarcinoma.
Chinese Journal of Oncology 2006;28(10):771-772
Bile Duct Neoplasms
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genetics
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pathology
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Bile Ducts, Extrahepatic
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Cholangiocarcinoma
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genetics
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pathology
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Female
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GTP-Binding Protein gamma Subunits
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genetics
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Gene Expression Regulation, Neoplastic
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Humans
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Male
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Middle Aged
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Neoplasm Staging
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RNA, Messenger
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genetics
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metabolism
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Reverse Transcriptase Polymerase Chain Reaction