ABSTRACT
A retrospective review of 200 consecutive female patients who had undergone mammographically controlled needle localizations was performed to assess the effectiveness of the technique and to analyze the number and characteristics of malignancies found in this group. Fine-needle localization was recommended if one of the following criteria was present: (1) evidence of a mass, (2) microcalcifications, (3) architectural distortion. Of the 200 localizations, 192 specimen radiographs were analyzed: 186 contained the lesion, 6 (3 percent) missed the lesion. Forty-eight cancers were detected (24 percent). The reasons for biopsy were microcalcification, 61 percent; presence of a mass, 25 percent; abnormal architecture, 14 percent. Histologically the cancers included 38 invasive plus 10 in-situ tumors. The predominant histologic cell type was ductal in origin with only four having lobular characteristics. In the definitive treatment of these patients, pathologic findings of the lymph nodes showed 2 of the 38 were positive for metastases. In summary, the technique of preoperative needle localization in this series indicates a 93 percent success rate. An analysis of the surgical intervention indicates that conservative breast surgery is the treatment of choice. Another result is the detection of high-risk malignant lesions such as duct and lobular hyperplasia that require close follow-up.
Subject(s)
Biopsy, Needle , Breast Neoplasms/pathology , Adenofibroma/pathology , Adult , Axilla , Breast/pathology , Breast Diseases/pathology , Breast Neoplasms/surgery , Calcinosis/pathology , Carcinoma/pathology , Carcinoma in Situ/pathology , Carcinoma, Intraductal, Noninfiltrating/pathology , Female , Fibrocystic Breast Disease/pathology , Humans , Hyperplasia , Lymph Node Excision , Middle Aged , Retrospective Studies , Risk Factors , Time FactorsABSTRACT
The embryologic defect that results when the ventral and dorsal anlages of the pancreas do not fuse has been referred to as pancreas divisum. The patients who present with recurrent pancreatitis or pancreatitis-like pain in association with pancreas divisum should be investigated to determine the presence of minor papilla stenosis. In the present study of 11 patients, 9 became asymptomatic with surgical decompression of the dorsal pancreatic duct. Two surgical failures were related to wrong diagnosis and restenosis of the sphincteroplasty. A delay in the clearance of dye from the dorsal pancreatic duct after endoscopic retrograde cholangiopancreatography was utilized to determine minor papilla stenosis. In the future, secretin ultrasound tests should prove of value in assessing minor papilla stenosis. Once the diagnosis is made, sphincteroplasty of the minor papilla is the most logical procedure because of the good results obtained. In the present study, pancreaticojejunostomy provided good duct decompression as well.
Subject(s)
Pancreas/abnormalities , Pancreatitis/surgery , Abdomen , Adult , Amylases/blood , Clinical Enzyme Tests , Female , Humans , Male , Middle Aged , Pain/etiology , Pancreas/surgery , Pancreaticojejunostomy , Pancreatitis/diagnosis , Pancreatitis/etiology , Postoperative Complications , RecurrenceABSTRACT
The gastrointestinal tract may be involved in up to 25% of cases of von Recklinghausen's disease. The authors report such a case in which an 18-year-old girl presented with gastrointestinal symptoms secondary to a tumour in the sigmoid mesentery. There was no family history so it was presumed to be a case of spontaneous mutation. The authors discuss the protein manifestations of neurofibromatosis emphasizing the gastrointestinal presentations and the need for careful surgical management.
Subject(s)
Mesentery/pathology , Neurofibromatosis 1/diagnosis , Peritoneal Neoplasms/etiology , Sigmoid Neoplasms/etiology , Adolescent , Female , Humans , Neurofibromatosis 1/pathology , Peritoneal Neoplasms/pathology , Sigmoid Neoplasms/pathologyABSTRACT
The problems, results and treatment suggestions in regard to ruptured abdominal aortic aneurysms are discussed.