Lymphangiomas are rare congenital benign tumors arising from the lymphatic system, and are mostly encountered in the neck and axillary regions of pediatric patients (95%). Lymphangioma of the pancreas is extremely rare accounting for less than 1% of these tumors. We report here on a case of pancreatic cystic lymphangioma. A 54-year-old woman presented with intermittent postprandial abdominal discomfort and radiating back pain. Abdominal computed tomography scan revealed 8 x 6.5 cm hypodense cystic mass arising from the tail of the pancreas without septa or solid component. The initial impression was a pancreatic pseudocyst. The patient underwent distal pancreatectomy with splenectomy. The histopathologic and immunohistochemical study helped make the diagnosis of a pancreatic cystic lymphangioma. Herein, we report a case of pancreatic cystic lymphangioma mimicking pancreatic pseudocyst and review the relevant medical literature.
Accounting ; Back Pain ; Female ; Humans ; Lymphangioma ; Lymphangioma, Cystic ; Lymphatic System ; Middle Aged ; Neck ; Pancreas ; Pancreatectomy ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Splenectomy

No abstract available.
Humans ; Neoplasm Metastasis*

Most patients with duodenal carcinoids are asymptomatic or suffer from nonspecific symptoms. But the tumors in the periampullary region may be associated with symptoms of obstruction related to the size of the lesion. Two serial internal dranage procedures (cystogastrostomy and cystojejunostomy) were performed in a 46-year-old man because of recurred pancreatic pseudocyst at an interval of five months. Eight months after the first operation, an abdominal CT showed a remained pancreatic pseudocyst. And duodenoscopic findings showed a luminally protrusing mass, with preserved mucosa at the second portion of duodenum. Local resection of the mass was perfomed. Grossly, the mass had a 2 cm-sized, well circumscribed yellowish appearance. Microscopic findings showed well-defined intramucosal mass having almost glandular and nest of tumor cells showing uniform round nuclei, glandular and basophilic cytoplasm. And the nonspecific neuroendocrine markers chromogranin and NSE are positive. We report a case of Periampullary duodenal carcinoid tumor with complicated pancreatic pseudocyst.
Basophils ; Carcinoid Tumor* ; Cytoplasm ; Duodenum ; Humans ; Middle Aged ; Mucous Membrane ; Pancreatic Pseudocyst* ; Tomography, X-Ray Computed

The CT findings of the adrenal disease in a total of 52 patients were analysed. 39 patients of them wereverified at operation and composed of 22 patients of Cushing's syndrome, 11 patients of pheochromocytoma, 6patients of aldosteronism. The remainder was finally diagnosed on the basis of compelling clinical and biochemical evidence. Aldosteronoma is very small (all under 3cm), round or oval mass with homogeneous low density, but pheochromocytoma is relatively large mass (all beyond 3cm) with heterogeneous or isodense comparing to pancreaticdensity. Size and density of Cushing's adenoma has transitional character between aldosteronoma andpheochromocytoma. Overall diagnostic accuracy, sensitivity and specificity of CT in adrenal tumor/adrenal diseaseare 96.2%/87%. 96.4%/78.9% and 95.7%/97.7% respectively. The relative low sensitivity of adrenal disease(78.9%) isdue to inclusion of normal sized bilateral hyperplasia. Of 28 adrenal tumors, 27 were correctly diagnosed by CT,and there were one false positive and one false negative diagnosis. CT is a highly accurate non-invasive method inlocalization of adrenal tumors and differentiation of the tumors from hyperplasia.
Adenoma ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Hyperplasia ; Methods ; Pheochromocytoma ; Sensitivity and Specificity

PURPOSE: Intraductal papillary mucinous tumor (IPMT) of the pancreas pathologically shows papillary proliferation and its tumor cells display a spectrum of changes ranging from adenoma to infiltrating carcinoma. Because of this variability, there have been many difficulties for making an accurate diagnosis and administering proper treatment. The aim of this study was to determine the treatment strategy and differential diagnosis of benign and malignant IPMT. METHODS: Between January 2000 and June 2007, 24 patients with IPMT of the pancreas underwent surgery. The relationships among the clinopathologic features and tumor locations and subtypes were retrospectively investigated. In addition, the type of surgical procedures and findings, the microscopic finding, the immunohistochemical staining and the clinopathological features were analyzed. RESULTS: There were 17 men and 7 women with a mean age of 65 (range: 45~81). Pathologically, 11 cases were benign, 9 were borderline and 4 were malignant. The tumor was located in the head of the pancreas in 17 patients. 16 cases received Whipple's procedure and pylorus preserving pancreaticoduodenectomy, and the others were received different kinds of operations. Regarding the subtypes of IPMT, 2 cases were the main duct type, 19 were the branched type and 3 were the combined type. There were no statistically significant differences in the clinical manifestations, radiologic findings and immnohistochemical staining between the patients with benign and malignant IPMT. Except two patients who were not followed up, all the patients had no recurrence and they survived. CONCLUSION: It is very difficult to exactly differentiate malignant IPMT from benign IPMT with using the current preoperative evaluations and immunohistochemical staining of the resected specimens. The patients who were operated on and followed in our hospital had no recurrence and they all survived. Therefore, if IPMT is suspected, we think the patients should be operated on and we should continue studying other specific antibodies for immunohistochemical staining.
Adenoma ; Antibodies ; Diagnosis, Differential ; Female ; Head ; Humans ; Male ; Mucins ; Pancreas ; Pancreaticoduodenectomy ; Pylorus ; Recurrence ; Retrospective Studies

An ectopic pancreas, also known as a heterotopic or aberrant pancreas, is defined as pancreas tissue lying outside its normal location and lacking anatomic or vascular connections with the pancreas. Most occurrences of an ectopic pancreas are located in the stomach, duodenum, or jejunum. However, an ectopic pancreas can sometimes be found in unusual sites such as the Meckel's diverticulum, gallbladder, umbilicus, mediastinum and fallopian tubes. An ectopic pancreas rarely produces clinical symptoms, but occasionally can result in varying symptoms according to its location, size and involvement of the overlying mucosa. Herein, a case of 41-year-old male with an ectopic pancreas in the duodenum, presenting as a duodenal obstructing mass, is reported.
Adult ; Deception ; Duodenum ; Fallopian Tubes ; Female ; Gallbladder ; Humans ; Jejunum ; Male ; Meckel Diverticulum ; Mediastinum ; Mucous Membrane ; Pancreas* ; Stomach ; Umbilicus

A-57-year-old male patient suddenly developed cramping pain in the left lower abdomen with a slight abdominal distension. He had undergone a laparoscopic nephrectomy for transitional cell carcinoma 7 days earlier. An abdominal CT scan revealed a dilated small bowel loop and an internal hernia was suspected. Surgery revealed a herniation of the jejunal loop through defects in the retroperitoneum, which was successfully reduced. We report a case of an internal hernia following a laparoscopic nephrectomy. To the best of our knowledge, this is the only reported case of an internal hernia as a complication of laparoscopic nephrectomy.
Abdomen ; Carcinoma, Transitional Cell ; Hernia* ; Humans ; Laparoscopy ; Male ; Muscle Cramp ; Nephrectomy* ; Tomography, X-Ray Computed

Lymphangioma of the spleen is a rare benign neoplasm with clinical manifestations ranging from insignificant incidental findings to large, symptomatic cystic masses requiring surgical intervention. We report a case of splenic cavernous lymphangioma mimicking splenic hemangioma. A 59-year-old woman presented with left upper quadrant pain and epigastric discomfort. Computed tomography showed a 9.5x8 cm high attenuated mass with relatively homogenous enhancement in the spleen. The initial impression was a splenic hemangioma. The patient underwent splenectomy. Gross pathologic examination revealed a 9.5x6.8x9 cm-sized fairly well circumscribed soft mass. Histologically, the tumor was composed of dilated lymphatic vessels, which contained homogenous eosinophilic material. The Final diagnosis was cavernous lymphangioma of the spleen. Herein, we report a case of splenic cavernous lymphangioma mimicking splenic hemangioma and also review the existing literature.
Caves ; Eosinophils ; Female ; Hemangioma ; Humans ; Incidental Findings ; Lymphangioma ; Lymphatic Vessels ; Middle Aged ; Spleen ; Splenectomy

BACKGROUND: An increasing number of small prospective studies have been published, since the first report of laparoscopic liver resection by Gagner et al. in 1992. They have shown encouraging results for the feasibility and safety of the procedure. This paper provides a retrospective analysis of a single center's experience with elective laparoscopic liver resections. METHODS: We did a retrospective study on laparoscopic liver resections performed from July 2005 to April 2009, undertaken in 34 patients with preoperative diagnosis of a benign lesion (7 cases, 20.6%), hepatocellular carcinoma in absence of complicated cirrhosis (18 cases, 52.9%), or liver metastasis (9 cases, 26.4%). The mean tumor size was 2.63+/-1.57 cm (range 0.55-7.5) RESULTS: We carried out 15 wedge resections (44.1%), 3 right hemi-hepatectomies (8.8%), 4 left hemi-hepatectomies (11.8%), 5 liver segmentectomies (14.7%), 7 left lateral sectionectomies (20.6%). The average duration of an operation was 175.00+/-129.12 minutes. There were 6 patients (15%) in which a conversion to laparotomy was required none of the conversions occurred under emergency situations. Intraoperative transfusion was required for 5 patients (14.7%). Postoperative complications developed in 2 patients (5.8%) (1 intraabdominal abscess, 1 bile leakage). There were no deaths and no reoperations for complications. The mean postoperative hospital stay was 9.9 days. CONCLUSION: Our experience shows that laparoscopic liver resections, including major hepatectomies, are feasible and safe. Nonetheless, a prospective randomization study with a greater number of cases and longer follow-up is needed before laparoscopic liver resection can be regarded as the gold-standard approach for hepatic lesions.
Abscess ; Bile ; Carcinoma, Hepatocellular ; Emergencies ; Fibrosis ; Follow-Up Studies ; Hepatectomy ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Postoperative Complications ; Random Allocation ; Retrospective Studies

Pulmonary asbestosis is defined as bilateral diffuse interstitial fibrosis of the lungs caused by exposure to asbestos. Many occupations are at risk for asbestos exposure, particularly in the mining, milling, manufacturing, construction, shipbuilding, and automotive industries. Therefore, the prevalence of asbestosis should be fairly widespread. The diagnosis of asbestosis can be made on either clinical or pathological grounds. We recently encountered one case of asbestosis which was confirmed histologically. On HRCT, there was ground-glass opacity with irregular linear shadows, subpleural curvilinear lines and parenchymal bands. Neither plaque nor calcification were noted. The histologic findings observed on open-lung biopsy specimen were well in accord with those in HRCT. Many asbestos-coated bodies were present along with black dust.
Asbestosis/radiography* ; Asbestosis/pathology* ; Biopsy ; Case Report ; Human ; Male ; Middle Age ; Radiography, Thoracic ; Tomography, X-Ray Computed