3.Medical Management of Intraductal Papillary Mucinous Neoplasm.
The Korean Journal of Gastroenterology 2008;52(4):214-219
Intraductal papillary mucinous neoplasm (IPMN) is frequently found recently and is a precancerous lesion. Main duct-type should be resected since it can easily progress to invasive IPMN, whereas branch duct-type (BD) usually remains silent without malignant transformation. BD-IPMN should be resected if it has mural nodule, thick wall or septum, or solid component which are the obvious risk factors for malignancy. If the cyst size of BD-IPMN is more than 3 cm in diameter without obvious risk factors, it can be followed-up regularly or can be treated either with surgical resection or endoscopic ultrasonography (EUS)-guided ethanol lavage. Small BD-IPMN less than 3 cm in size without risk factors can be followed up with sonography, CT scan or EUS annually.
Adenocarcinoma, Mucinous/diagnosis/pathology/*therapy
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Carcinoma, Pancreatic Ductal/diagnosis/pathology/*therapy
;
Carcinoma, Papillary/diagnosis/pathology/*therapy
;
Diagnosis, Differential
;
Ethanol/therapeutic use
;
Humans
;
Pancreatic Neoplasms/diagnosis/pathology/*therapy
;
Risk Factors
;
Tomography, X-Ray Computed
4.Gastric neuroendocrine carcinoma and gastric carcinoma with neuroendocrine cell differentiation: a clinical and prognostic analysis.
Hui-fang WANG ; Ai-Wen WU ; Peng YUAN ; Yi-qiang LIU ; Jia-fu JI
Chinese Journal of Gastrointestinal Surgery 2011;14(2):96-99
OBJECTIVETo investigate the clinicopathological features, treatment, and prognosis of gastric neuroendocrine carcinoma and gastric carcinoma with neuroendocrine cell differentiation.
METHODSA total of 19 patients were treated for gastric neuroendocrine cancer or gastric cancer with neuroendocrine differentiation in the Beijing Cancer Hospital from January 1997 to December 2008. Clinical data were retrospectively analyzed.
RESULTSFourteen patients had neuroendocrine carcinoma in the gastric cardia (n=9) or gastric body(n=5), and 5 patients had gastric cancer with neuroendocrine differentiation in the gastric cardia(n=2), the antrum(n=2), and the entire stomach(n=1). According to the International Classification of Disease for Oncology(2000), patients were divided into gastric carcinoid type I((n=2, 10.5%), type III( sporadic gastric carcinoid (n=9, 47.4%), small cell carcinoma of the stomach(n=3,15.8%), and gastric cancer with neuroendocrine cell differentiation(n=5, 26.3%). Clinical manifestations were mostly non-specific. Diagnosis was based on pathological and immunohistochemical examination. Eighteen patients underwent surgery including radical subtotal gastrectomy and total gastrectomy, of whom 3 underwent simultaneous resection of the liver metastasis. The remaining one patient with small cell carcinoma of the gastric body received chemotherapy alone because of unresectable liver metastasis. The survival rate was 73.7% at 1 year and 38.6% at 3 years.
CONCLUSIONSGastric neuroendocrine carcinoma usually develops in the cardia and body of the stomach. Gastric carcinoma with neuroendocrine cell differentiation can occur in any locations of the stomach. Immunohistochemistry is important to the diagnosis. Radical resection is the main treatment.
Aged ; Carcinoid Tumor ; diagnosis ; pathology ; therapy ; Carcinoma, Neuroendocrine ; diagnosis ; pathology ; therapy ; Carcinoma, Small Cell ; diagnosis ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; therapy
5.Cytology diagnosis and clinical management of fine-needle aspiration for thyroid nodules.
Jin-yu ZHENG ; Tao BAI ; Yi-fen ZHANG ; A-qing CHEN ; Qin HUANG
Chinese Journal of Pathology 2010;39(5):349-352
Biopsy, Fine-Needle
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Carcinoma
;
diagnosis
;
pathology
;
surgery
;
Carcinoma, Medullary
;
diagnosis
;
pathology
;
surgery
;
Carcinoma, Papillary
;
diagnosis
;
pathology
;
surgery
;
Carcinoma, Papillary, Follicular
;
diagnosis
;
pathology
;
surgery
;
Diagnosis, Differential
;
Goiter, Nodular
;
diagnosis
;
pathology
;
therapy
;
Hashimoto Disease
;
diagnosis
;
pathology
;
therapy
;
Humans
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Lymphoma
;
diagnosis
;
pathology
;
surgery
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Thyroid Nodule
;
pathology
;
surgery
;
Thyroidectomy
6.Unilateral sinonasal disease in 376 adult patients: a retrospective study.
Xin Yan CUI ; Li Qin WANG ; Min YIN ; Xi CHEN ; Mei Ping LU ; Han ZHOU ; Wei Da DONG ; Zhi Bin CHEN ; Lei CHENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2018;32(6):439-446
OBJECTIVES:
To investigate the clinical and pathological features of patients with unilateral sinonasal disease (USD).
METHODS:
A retrospective analysis was completed on 376 adult patients with USD from January 2015 to December 2016. Their presenting symptoms, nasal endoscope, CT scanning, and pathology were analyzed respectively.
RESULTS:
Among the 267 (71.01%) patients with inflammatory disease, there were 4 pathological types. And there were 8 pathological types in 60 (15.96%) patients with benign tumor. Of the 49 patients with malignant tumor, there were 15 pathological types which included squamous carcinoma, malignant melanoma, and lymphoma, as well as myoepithelial carcinoma and Mesodermal mesoderm. The onset age of inflammation group was younger than that of benign (<0.05) or malignant tumor groups (<0.05). The misdiagnosis rate was 8.33% in benign tumor (5/60), and 10.20% in malignant tumor (5/49). Nasal polyps was the most common misdiagnosis in the groups of benign and malignant tumor.
CONCLUSIONS
The pathology of adult patients with USD is complicated, and no specific clinical feature was found for distinguishing between benign and malignant lesions. The tumor took a quite proportion in adult patients with USD. Therefore, careful consideration should be taken before diagnosing patients with USD in order to reduce misdiagnosis rate.
Adult
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Carcinoma, Squamous Cell
;
diagnosis
;
pathology
;
therapy
;
Humans
;
Melanoma
;
diagnosis
;
pathology
;
therapy
;
Nasal Cavity
;
Nasal Polyps
;
Nose Neoplasms
;
diagnosis
;
pathology
;
therapy
;
Retrospective Studies
7.Clinicopathologic study of 9 patients with neuroendocrine carcinoma of the larynx.
Dan LÜ ; Hui YANG ; Sha ZHAO ; Liu YANG ; Shi-xi LIU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2012;47(12):1017-1020
OBJECTIVETo evaluate the clinic manifestation, therapy and prognosis of neuroendocrine carcinoma of the larynx.
METHODSNine cases with neuroendocrine carcinoma of the larynx treated between May 2005 and June 2011 were analyzed retrospectively.
RESULTSThere were six males and three females, with a median age of 58 years (ranging from 35 to 65 years). Five cases were treated by only operation, and four cases by combined treatment (surgery followed by radiotherapy and chemotherapy). Two patients with typical carcinoid tumor had not any recurrence with following up of 28 and 30 months, respectively. Of three patients with atypical carcinoid tumor, one patient recurred in 36 months after the first operation and followed by re-operation, with no recurrence by further 30 month follow-up, and the other two patients did not recur 15 and 20 month follow-up, respectively. Of three patients with small cell neuroendocrine carcinoma, two died after 11 and 14 months, respectively, and another patient was followed up for 18 months, with no recurrence. One patient with paraganglioma showed no recurrence with a follow up of 32 months.
CONCLUSIONSNeuroendocrine carcinoma in larynx included typical carcinoid tumor, atypical carcinoid tumor, small cell neuroendocrine carcinoma and paraganglioma. Accurate diagnosis relies on histopathologic and immunohistochemical examination. There is no standard treatment plan and based-surgery combined treatment should be adopted to laryngeal neuroendocrine carcinoma. The prognosis is dependent on tumor types.
Adult ; Aged ; Carcinoma, Neuroendocrine ; diagnosis ; pathology ; therapy ; Female ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies
8.Clinical analysis of primary squamous cell carcinoma of the breast.
Chinese Journal of Surgery 2003;41(3):183-185
OBJECTIVETo study the clinicopathological features of primary squamous cell carcinoma (SCC) of breast and the diagnosis and treatment of the disease.
METHODSThe clinical, operative and pathological data from 7 cases of SCC of breast were retrospectively analysed.
RESULTSFive patients complained of painless mass and two of them were accompanied with local pain. All patients were diagnosed as having SCC by fine-needle aspiration before operation. Two patients underwent modified radical mastectomy, and the others received radical mastectomy. Pathological examination showed primary squamous cell carcinoma of the breast with metastasis to axlliary lymph nodes in one patient. Follow-up of four patients revealed that two patients are living well and two patients died. Three patients lost to follow up.
CONCLUSIONThe diagnosis of primary squamous cell carcinoma of the breast is dependent on pathological results. Radical mastectomy including modified radical mastectomy is most effective in the treatment of mammary SCC. Postoperative chemotherapy and radiation are necessary auxiliary therapy.
Adult ; Aged ; Breast Neoplasms ; diagnosis ; pathology ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; therapy ; Female ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies
9.Research Advances of Pan-negative Type of Non-small Cell Lung Cancer.
Li SUN ; Zhicheng XIONG ; Chengbo HAN
Chinese Journal of Lung Cancer 2018;21(2):129-138
In recent years, series of driver genes, such as EGFR, KRAS/NRAS, BRAF, PIK3CA, ALK and ROS1 and so on, have been found in non-small cell lung cancer (NSCLC) one after another with the development of molecular detecting technology. Targeted drugs bring benefits for these NSCLC patients with driver gene variations. However, some NSCLC did not have any known driver gene variations; we called it pan-negative lung cancer. In this paper, we summarize the concept, clinical pathological characteristics, the epidemiological characteristics, treatment and prognosis of pan-negative NSCLC.
Carcinoma, Non-Small-Cell Lung
;
diagnosis
;
drug therapy
;
genetics
;
pathology
;
Humans
;
Lung Neoplasms
;
diagnosis
;
drug therapy
;
genetics
;
pathology
;
Mutation
;
Prognosis
10.Cervical lymph node metastasis in medullary thyroid carcinoma.
Dangui YAN ; Bin ZHANG ; Email: DOCBINZHANG@HOTMAIL.COM. ; Zhengjiang LI ; Yuehuang WU ; Shaoyan LIU ; Wensheng LIU ; Zhengang XU ; Pingzhang TANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2015;50(4):290-294
OBJECTIVETo study the patterns of cervical lymph node metastasis of medullary thyroid carcinoma.
METHODSNinety-one patients with medullary thyroid carcinoma first treated between January 1999 and October 2014 were analyzed retrospectively. Of 91 patients, 39 cases presented with clinical negative node (cN0) and 52 cases with clinical positive node (cN+). Central compartment dissection was performed in all cases. Lateral neck dissection was performed in 52 cN+ cases (71 sides). All neck dissection specimens were obtained and analyzed for lymph node (LN) involvement with respect to neck levels. The distribution of LN with metastasis was studied in cN+ patients and the following factors were used to study the predictive value of central compartment LN metastasis: sex, age, family history, tumor size, bilateral tumor, multifocality of the tumor, extracapsular spread, and remote metastasis. Univariate analysis with the χ(2) test was used to analyze the statistical correlation between central compartment LN metastasis and other clinical factors. Multiple logistic regression analysis was used to identify the factors related to central compartment metastasis.
RESULTSNeck and bilateral neck metastasis rates were 73.6%, 19.8% respectively. Metastasis rates in central compartment and superior mediastinal region were 68.1% and 27.5% respectively. The central compartment metastasis rate was 33.3% in cN0 patients and 94.2% in cN+ patients. The superior mediastinal metastasis rate was 2.6% in cN0 patients and 46.2% in cN+ patients. Extracapsular spread was an independent predictive factor for central compartment metastasis (χ(2)=15.592, P=0.000, OR=12.876). The incidences of LN metastases at level II, III, IV, V were 62.9%,84.5%,83.1%,50.0% in cN+ patient, respectively. Multi-sites were involved. The possibility of lateral neck metastasis was higher when preoperative value of calcitonin was higher than 300 ng/L (66.7% vs 28.6%, χ(2)=5.771, P=0.016).
CONCLUSIONSCervical lymph node metastasis of medullary thyroid carcinoma is higher. Central compartment dissection is necessary in cN0 patients with extracapsular spread. Neck dissection from level II to level VII was necessary in cN+ patients. Preoperative value of calcitonin maybe can predict the lateral neck metastasis incidence.
Carcinoma ; Carcinoma, Neuroendocrine ; diagnosis ; pathology ; therapy ; Head and Neck Neoplasms ; diagnosis ; pathology ; therapy ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Mediastinal Neoplasms ; Neck ; Neck Dissection ; Retrospective Studies ; Thyroid Neoplasms ; diagnosis ; pathology ; therapy