Intrapancreatic accessory spleen (IPAS) is a benign anomaly of splenic embryology and a rare cause of pancreatic pseudotumour. Here, we report a case of a 70-year-old Malay lady whose IPAS was discovered incidentally during her surveillance computed tomography for her underlying left lower lung fibrosis. Radiologically, the lesion mimicked a neuroendocrine pancreatic tumour and was only diagnosed pathologically as IPAS after surgery. In conclusion, recognising IPAS as a differential for enhancing pancreatic mass allows us to exhaust all non-invasive diagnostic means to diagnose this benign lesion. It will allow the patient to avoid unnecessary surgery and its accompanying complications.
Spleen ; Splenectomy ; Pancrelipase

We report a rescently experienced case with atypical radiologic manifestation of solid and papillary epithelial neoplasm of the pancreas in a 37 years old female patient. The tumor had heavy calcification on its capsule wall and septa. Instead of the usual encapsulated lesion with partly solid and partly cystic-hemorrhagic components, the lesion consisted of numerous fine cavitations containing air without fluid component except focal abscess fluid.
Abscess ; Female ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancrelipase*

We report a cases of solid and papillary neoplasm of the pancreas, which is a rare pancreatic tumor. we described clinical characteristics, sonographic, computed tomographic and pathologic finding. The tumors had a smooth, enhanced capsule and variable architecture. The tumor was distributed tail of pancreas without local invasion. the origin of the tumor is probably from a multipotential stem cell of the pancreas. Neoplasm usually behave like a very low grade malignancy, so that complete removal is the treatment of choice for the tumor arising anywhere in the pancrease. This unusual tumor should be considered in the differential diagnosis of a young female with pancreatic mass.
Diagnosis, Differential ; Female ; Humans ; Pancreas* ; Pancrelipase ; Stem Cells ; Ultrasonography

Although variation is the rule with pancreatic duct morphology, certain variants occur as a result of altered embroological development. These ductal configurations, most striking deviations from the normal configuration, may be classfied according to alterations of embryological development. These congenital variants of pancreatic duct may be important for several reasons. First, the pseudomass effect of ductal anomalies can be mistaken for carcinoma by the inexperienced radiologists. Second, whether or not the anomaly is important, it is present in many patients with recurrent pacreatitis. Original descriptions were based on small sampling of postmortem studies and surgical specimen, but more recently the advent of endoscopic retrograde cholangiopancreatography(ERCP) has confirmed of the work of early anastomists and increased awareness of these variants. To evalute of frequency, characteristics of associated disease and clinical significance of pancreatic anomalies, we have reviewed of 5330 case of ERCP filmes which were undertaken between July, 1973 and August, 1993. Having reviewed of ERCP filmes, we found out 9 case of pancreatic duct variants. Among them, 7 cases were classified as ductal duplication anomalies, 4 cases of number variation, most, bifuricaiton and 3 cases of form variation, which were composed of loop, spiral and terminal N. Three cases of fusion anomalies were also noted, which were 2 cases of panceratic divisum and 1 case of incomplete pancreatic divisum. The associated diseases were 6 cases of bile duct and galbladder stones and 3 cases of pancreatic cancer. We could not find out the case of congenital anomalies as cause of obstructive pain and pseudomass effect.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Humans ; Pancreatic Ducts* ; Pancreatic Neoplasms ; Pancrelipase ; Strikes, Employee

Small cell cancer commonly occurs in the lungs, but it is rarely found in other organs. Small cell cancer that occurs in the pancreas is rare and its progress very rapid, and most patoents' tumor has already spread by metastasis when it is discovered. Although this cancer has a poor prognosis, we report here on treating case with combined curative resection and chemotherapy and showed a good prognosis.
Carcinoma, Small Cell* ; Drug Therapy ; Lung ; Neoplasm Metastasis ; Pancreas* ; Pancrelipase* ; Prognosis

Four cases of mucinous ductal ectasia of the pancreas are presented, along with a review of the literature. Mucinous ductal ectasia is a clinicopathologic entity characterized by dilation and filling of the main pancreatic duct or its side branches with thick, viscid mucus, leading to recurrent acute pancreatitis or symptoms that mimic chronic pancreatitis. Three of the patients were male (M:F=3:1) and the patients were 54~74 years old. The symptoms of two patients were abdominal pain and they had a frequent admission history due to pancreatitis. One patient had jaundice, and one patient presented no symptoms. In all of the patients, the tumor was located in the read of the pancrease and the size of tumor was about 3 cm. A total pancreatectomy was performed, and three pancreatico-duodenectomy were performed. The pathologic report revealed that two cases were malignant and two cases were borderline malignant. The tumor marker did not correlate with the presence of malignancy. Because mucinous ductal ectasia is recognized as a premalignant disease, the treatment of choice is pancreatic resection.
Abdominal Pain ; Dilatation, Pathologic* ; Humans ; Jaundice ; Male ; Mucins* ; Mucus ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pancreatitis ; Pancreatitis, Chronic ; Pancrelipase

Tuberculosis of the pancreas is a rare disorder. The clinical presentation of pancreatic tuberculosis include nonspecific symptoms such as fever, fatigue and weight loss. The radiological features mimic pancreatic malignancy or pancreatitis. So, the diagnosis of pancreatic tuberculosis is very difficult. A 62-year-old man was referred for pancreatic mass. Findings on preoperative imaging modalities were consistent with pancreatic carcinoma, and fine needle aspiration test indicated microcystic adenoma or carcinoma. Pylorus-preserving pancreaticoduodenectomy was done. Final diagnosis was pancreatic tuberculosis combined with microcystic adenoma. We conclude in that patients who have a mass in the pancreas, pancreatic tuberculosis should be considered, particularly in the developing country and immunosuppressed individuals.
Adenoma* ; Biopsy, Fine-Needle ; Developing Countries ; Diagnosis ; Fatigue ; Fever ; Humans ; Middle Aged ; Pancreas ; Pancreaticoduodenectomy ; Pancreatitis ; Pancrelipase ; Tuberculosis* ; Weight Loss

BACKGROUND: Although several pathophysiological sequences, such as protease activation, free radical generation, and inflammatory mediator release, have been described in acute pancreatitis, the precise mechanism by which acute pancreatitis is initiated is unkown. Cellular calcium, a key function and also a crucial pathological intracellular messenger in cell injury, appears to be involved in the initiation and development of acute pancreatitis. The aim of this study is to evaluate the role of cellular calcium and therapeutic effect of administering the Ca++ channel blocker nicadipine as an antioxidant. METHOD:Nicardipine, known to be a calcium channel blocker and a most potent antioxidant, was wed as a pretreatment 1 hour before induction of pancreatitis by intraductal infusion of 3% sodium taurocholate or as a post-treatment 1 hour after induction of aucte pancreatitis by retrograde infusion of sodium taurocholate. The net weight of the pancrease, the amounts of s-amylse, GSH and MDA in the pancreatic tissue, and the histologic damage were examined 12 hours after the induction of pancreatitis. RESULTS: Nicardipine administration ameliorated pancreatic edema and reduced the amount of s-amylase compare to untreated necrotizing pancreatitis group. Also, pre- or post-treatment with nicardipine had beneficial protective effect with respect to free radical-induced injury; in particular, pre-treatment with nicardipine was much better. With respect to the histologic findings, pancreatic necrosis, hemorrhage, and neutrophil infiltration were prominent in the necrotizing group, however, in the group treated with nicardipine, the necrosis and hemorrhage were ameliorated remarkably. CONCLUSION:The free oxygen radicals and the intracellular calcium influx were major elements in the pathogenesis of acute pancreatitis, and nicardipine ameliorated pancreatic necrosis and hemorrage and exerted an antioxidant effect. The administration of nicardipine should be considered in the early stage of pancreatitis or in case of risk of pancreatitis.
Antioxidants ; Calcium Channels* ; Calcium* ; Edema ; Hemorrhage ; Necrosis ; Neutrophil Infiltration ; Nicardipine* ; Pancreas ; Pancreatitis* ; Pancrelipase ; Reactive Oxygen Species ; Taurocholic Acid

BACKGROUNDHuman embryonic stem cells have prospective uses in regenerative medicine and drug screening. Every human embryonic stem cell line has its own genetic background, which determines its specific ability for differentiation as well as susceptibility to drugs. It is necessary to compile many human embryonic stem cell lines with various backgrounds for future clinical use, especially in China due to its large population. This study contributes to isolating new Chinese human embryonic stem cell lines with clarified directly differentiation ability.

METHODSDonated embryos that exceeded clinical use in our in vitro fertilization-embryo transfer (IVF-ET) center were collected to establish human embryonic stem cells lines with informed consent. The classic growth factors of basic fibroblast growth factor (bFGF) and recombinant human leukaemia inhibitory factor (hLIF) for culturing embryonic stem cells were used to capture the stem cells from the plated embryos. Mechanical and enzymetic methods were used to propagate the newly established human embryonic stem cells line. The new cell line was checked for pluripotent characteristics with detecting the expression of stemness genes and observing spontaneous differentiation both in vitro and in vivo. Finally similar step-wise protocols from definitive endoderm to target specific cells were used to check the cell line's ability to directly differentiate into pancreatic and hepatic cells.

RESULTSWe generated a new Chinese human embryonic stem cells line, CH1. This cell line showed the same characteristics as other reported Chinese human embryonic stem cells lines: normal morphology, karyotype and pluripotency in vitro and in vivo. The CH1 cells could be directly differentiated towards pancreatic and hepatic cells with equal efficiency compared to the H1 cell line.

CONCLUSIONSThis newly established Chinese cell line, CH1, which is pluripotent and has high potential to differentiate into pancreatic and hepatic cells, will provide a useful tool for embryo development research, along with clinical treatments for diabetes and some hepatic diseases.

Cell Differentiation ; physiology ; Cell Line ; Embryonic Stem Cells ; cytology ; Hepatocytes ; cytology ; metabolism ; Humans ; Karyotyping ; Pancrelipase ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

BACKGROUND: Many tumor markers have been investigated for early diagnosis of the malignancy, yet they were turned out to be inappropriate for the purpose. This study was carried out to investigate the efficacy of tumor markers. METHODS: Employing radioimmunoassay, CEA, AFP, CA19-9, PSA, CA125 were done in 31,389 patients(20,878 males, 10,511 females) who visited our medical screening center from Jan. 1 1997 to Dec. 31 1997. RESULTS: Total mean value of CEA is 1.90+/-1.37 ng/mL(male: 2.17+/-1.37, female: 1.37+/-0.86). Male showed significantly higher level of CEA. Only 2 subjects had values over 25 ng/mL, and one was diagnosed to have stomach cancer but the other did not. Total mean value of AFP is 2.46+/-6.47 ng/mL (male: 2.32+/-3.55 ng/mL, female: 2.73+/-10.06 ng/mL). Female showed significantly higher level of measured AFP. One had AFP value over 400 ng/mL and was diagnosed of hepatoma. Total mean value of CA19-9 is 11.48+/-7.61 ng/mL,(male: 10.9+/-26.78 ng/mL, female: 12.61+/-8.97 ng/mL). Female showed significantly higher CA19-9. 65 subjects (male: 31, female: 34) showed measured CA19-9 level over 37 ng/mL. 5 subjects had values over 100 ng/mL and 1 subject was diagnosed of pancrease cancer. Total mean value of PSA is 0.79+/-1.88 ng/mL. 90 subjects showed measured PSA level over 4 ng/mL and mean value in this group was 10.92 ng/mL. 54 subjects were older than age 50. 4 out of 90 subjects were diagnosed of prostate cancer. Total mean value of CA125 is 13.08+/-10.93 ng/mL. 160 subjects showed measured CA125 level over 35 ng/mL. 19 subjects had value over 100 ng/mL and none of the malignancy was detected. CONCLUSION: Tumor markers are inappropriate measures for screening of malignancy.
alpha-Fetoproteins ; Carcinoembryonic Antigen ; Carcinoma, Hepatocellular ; Early Diagnosis ; Female ; Humans ; Male ; Mass Screening* ; Pancreas ; Pancrelipase ; Prostatic Neoplasms ; Radioimmunoassay ; Stomach Neoplasms ; Biomarkers, Tumor*