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2.
Arch. Soc. Esp. Oftalmol ; 95(6): 289-292, jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-199195

RESUMO

Presentamos el caso de un preescolar varón de 3 años con un coristoma óseo epibulbar. El paciente presentaba una masa subconjuntival de consistencia dura de 8×10 mm en el cuadrante superotemporal del ojo derecho con vascularización y presencia de cilios largos de aproximadamente 8 a 10 mm que tocaban la superficie corneal. El estudio histopatológico evidenció la presencia de trabéculas de hueso compacto maduro rodeado de tejido fibroso, canales de Havers con anillos concéntricos de hueso laminar sin médula ósea y con osteocitos normales, lo cual definió el diagnóstico de coristoma óseo epibulbar. El coristoma óseo es el tipo más raro de coristomas oculares y debe considerar en el diagnóstico diferencial de los tumores epibulbares pediátricos


We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8 × 10 mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10 mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumour


Assuntos
Humanos , Masculino , Pré-Escolar , Ossificação Heterotópica/patologia , Doenças da Esclera/patologia , Coristoma/patologia , Ossificação Heterotópica/cirurgia , Doenças da Esclera/cirurgia , Diagnóstico Diferencial , Neoplasias Oculares/diagnóstico , Coristoma/cirurgia
3.
PLoS One ; 15(5): e0232487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32401810

RESUMO

Endosalpingiosis, traditionally regarded as an incidental pathological finding, was recently reported to have an association with gynecologic malignancies. To determine the prevalence of endosalpingiosis, we evaluated all benign appearing adnexal lesions using the Sectioning and Extensively Examining-Fimbria (SEE-Fim) protocol, and queried the pathology database for the presence of endosalpingiosis, gynecologic malignancy, endometriosis, Walthard nests, and paratubal cysts. Using the SEE-Fim protocol, the prevalence of endosalpingiosis, endometriosis, Walthard nests, and paratubal cysts were 22%, 45%, 33%, and 42% respectively, substantially higher than previously reported. All lesions were observed to increase with age except endometriosis which increased until menopause then decreased dramatically. Among specimens including ovarian tissue, the prevalence of implantation of at least one lesion type was ubiquitous in patients age 51 and older (93%). The clinical significance of endosalpingiosis should be a continued area of research with larger trials assessing prevalence, factors affecting incidence, and association with malignancy. Our findings contribute to elucidating the origin of ectopic lesions and gynecologic disease risk.


Assuntos
Doenças das Tubas Uterinas/epidemiologia , Doenças dos Genitais Femininos/epidemiologia , Doenças dos Anexos/epidemiologia , Doenças dos Anexos/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Coristoma/epidemiologia , Coristoma/patologia , Endometriose/epidemiologia , Endometriose/patologia , Doenças das Tubas Uterinas/patologia , Tubas Uterinas/patologia , Feminino , Doenças dos Genitais Femininos/patologia , Neoplasias dos Genitais Femininos/epidemiologia , Neoplasias dos Genitais Femininos/patologia , Humanos , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Adulto Jovem
4.
Am J Surg Pathol ; 44(8): 1040-1049, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32282346

RESUMO

Prostatic-type differentiation in the lower female genital tract is encountered rarely and its causes and clinical associations are not well established. Within the vagina, reports to date have invariably described ectopic prostatic-type differentiation as restricted to the lamina propria. We recently encountered a patient receiving testosterone for gender dysphoria whose vaginectomy specimen showed a prostatic glandular proliferation within the surface epithelium. To elucidate its potential association with androgen exposure, we sought similar lesions, resected over a 26-year period, from patients with exogenous or endogenous androgen excess. Thirteen cases were identified, involving the vagina (n=12) and exocervix (n=1). The most common clinical context was gender dysphoria with long-term testosterone therapy; the lesion was present in 7 of 8 gender-dysphoric patients examined. Four other patients had congenital disorders of sexual development associated with endogenous androgen excess (congenital adrenal hyperplasia, 46,XY disorder of sexual development, and ovotesticular disorder of sexual development). Two had no known exposure to androgen excess. Immunohistochemically, glands stained for NKX3.1 (100% of cases), androgen receptor (100%), CK7 (92%), and prostate-specific antigen (69%). Follow-up (median duration, 11 mo) showed no masses or neoplasia. We propose the designation "androgen-associated prostatic metaplasia" for this form of prostate tissue with distinctive clinical, histologic and immunohistochemical features. It is novel and previously unrecognized within the vagina. It is strikingly prevalent among patients undergoing gender-affirming surgery, an increasingly common procedure. Recognition is important to distinguish it from other potentially neoplastic glandular lesions and facilitate accrual of more follow-up data to better understand its natural history.


Assuntos
Diferenciação Celular , Coristoma/patologia , Células Epiteliais/patologia , Próstata , Doenças do Colo do Útero/patologia , Doenças Vaginais/patologia , Adolescente , Adulto , Androgênios/administração & dosagem , Androgênios/efeitos adversos , Diferenciação Celular/efeitos dos fármacos , Criança , Coristoma/induzido quimicamente , Células Epiteliais/efeitos dos fármacos , Feminino , Disforia de Gênero/tratamento farmacológico , Terapia de Reposição Hormonal/efeitos adversos , Humanos , Masculino , Metaplasia , Fatores de Risco , Testosterona/administração & dosagem , Testosterona/efeitos adversos , Transexualidade/tratamento farmacológico , Doenças do Colo do Útero/induzido quimicamente , Doenças Vaginais/induzido quimicamente , Adulto Jovem
6.
World Neurosurg ; 138: 115-119, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32147560

RESUMO

BACKGROUND: Nonlethal neural tube defects are developmental malformations with complex pathogenesis usually manifested at birth or in childhood. CASE DESCRIPTION: We report the case of a 61-year-old woman without significant previous clinical history presenting for neck pain and stiffness. An extensive workup detected multiple lytic lesions within the occipital bone and cervical vertebrae, suspicious for multiple myeloma or metastatic disease. Surgical resection of the occipital bone lesions revealed ectopic cerebellar tissue, some containing folia with mature cortical lamination, and no evidence of malignancy. CONCLUSIONS: To our knowledge, this study describes the oldest individual presenting with ectopic cerebellar tissue and the only instance in which oncologic workup for malignancy was carried out prior to resection. It also proposes surgical resection as a diagnostic and curative approach for this complex basicranium and neural developmental defect, and discusses retinoic acid toxicity as a possible cause of its occurrence.


Assuntos
Cerebelo/patologia , Coristoma/patologia , Osso Occipital/patologia , Neoplasias Cranianas/patologia , Neoplasias Cerebelares/patologia , Neoplasias Cerebelares/cirurgia , Cerebelo/cirurgia , Coristoma/diagnóstico , Coristoma/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/etiologia , Procedimentos Neurocirúrgicos/métodos , Osso Occipital/cirurgia , Neoplasias Cranianas/diagnóstico , Neoplasias Cranianas/cirurgia
7.
BMC Womens Health ; 20(1): 3, 2020 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-31906916

RESUMO

BACKGROUND: Endometriosis is a chronic, painful, and inflammatory disease characterized by extra-uterine growth of endometrial tissues. Increased angiogenesis and resistance to apoptosis have been suggested to be involved in pathogenesis and development of endometriosis. The objective of this study was to examine apoptosis potential and angiogenesis contribution of eutopic (EuESCs) and ectopic (EESCs) endometrial stromal cells in patients with endometriosis compared to endometrial stromal cells from non-endometriotic controls (CESCs). METHODS: Stromal cells were isolated by enzymatic digestion of ectopic (n = 11) and eutopic (n = 17) endometrial tissues from laparoscopically-confirmed endometriotic patients. Endometrial stromal cells of 15 non-endometriotic patients served as control. Following cell characterization by immunofluorescent staining and flow cytometry using a panel of antibodies, the total RNA was isolated from the cultured cells, and analyzed for the expression of genes involved in apoptosis (Bcl-2, Bcl-xL, Bax, and caspase-3) and angiogenesis [vascular endothelial growth factor-A (VEGF-A) and hepatocyte growth factor (HGF)] by Real-time PCR. RESULTS: Significantly higher gene expression levels of Bcl-2 and Bcl-xL were found in EESCs compared with EuESCs and CESCs (p < 0.01). The gene expression of Bax in EESCs, EuESCs, and CESCs was not statistically significant. Furthermore, EuESCs exhibited a significantly lower caspase-3 gene expression compared with CESCs (p < 0.01) or EESCs (p < 0.05). Regarding angiogenesis, VEGF-A gene expression in EESCs (p < 0.001) and EuESCs (p < 0.05) were significantly higher compared with those of CESCs. EESCs exhibited a significantly higher HGF gene expression compared with EuESCs (p < 0.05). CONCLUSIONS: These findings suggest reduced propensity to apoptosis and increased angiogenesis potential of EESCs, which may be involved in pathogenesis of endometriosis.


Assuntos
Apoptose/genética , Endometriose , Fator de Crescimento de Hepatócito/genética , Neovascularização Patológica , Proteínas Proto-Oncogênicas c-bcl-2/genética , Células Estromais , Proteína bcl-X/genética , Adulto , Coristoma/metabolismo , Coristoma/patologia , Endometriose/genética , Endometriose/metabolismo , Endometriose/patologia , Endometriose/cirurgia , Feminino , Perfilação da Expressão Gênica , Humanos , Irã (Geográfico) , Laparoscopia/métodos , Neovascularização Patológica/metabolismo , Neovascularização Patológica/patologia , Células Estromais/metabolismo , Células Estromais/patologia , Fator A de Crescimento do Endotélio Vascular/genética
8.
Acta Neurochir (Wien) ; 162(5): 1137-1146, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31897730

RESUMO

INTRODUCTION: Desmoid-type fibromatosis (DTF) frequently arises in patients with neuromuscular choristoma (NMC). We hypothesize that NMC-associated DTF occurs in soft tissues innervated by the NMC-affected nerve, and arises from CTNNB1-mutated (myo) fibroblasts within or directly adjacent to the NMC. MATERIALS AND METHODS: A retrospective review of patients treated at our institution was performed for patients with biopsy-confirmed diagnosis of NMC-DTF. Clinical presentation, physical examination, electrodiagnostic findings and radiological features (MR and FDG PET/CT images for each NMC-DTF) and pathologic re-review of available materials were analyzed. A literature review was also performed. RESULTS: Eight patients from our institution met the inclusion criteria. All patients presented with neuropathic symptoms and soft tissue or bone changes in the nerve territory innervated by the NMC. All MR images (N=8 cases) showed the characteristic features of NMC, and also showed direct contact between unifocal (N=5) or multifocal (N=3) DTF(s) and the NMC-affected nerve NMC. FDG PET/CT (N=2 cases) showed diffuse, increased FDG uptake along the entire affected nerve segment, contiguous with the FDG-avid DTF. In all cases, the DTFs arose in the soft tissues of the NMC-affected nerve's territory. No patient developed DTF at any other anatomic site. CONCLUSIONS: These data demonstrate that NMC-DTF arises solely within the NMC-affected nerve territory, and has direct contact with the NMC itself. Based on all these findings and the multifocality of NMC in several cases, we recommend imaging and surveillance of the entire NMC-affected nerve (from spine to distal extremity) to identify clinically-occult DTF in patients with NMC.


Assuntos
Coristoma/patologia , Fibromatose Agressiva/patologia , Nervos Periféricos/diagnóstico por imagem , Adulto , Coristoma/complicações , Coristoma/diagnóstico por imagem , Feminino , Fibromatose Agressiva/diagnóstico por imagem , Fibromatose Agressiva/etiologia , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
9.
Medicina (Kaunas) ; 56(1)2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31952297

RESUMO

Introduction: Extended pelvic resection might be the option of choice in patients presenting locally advanced cervical cancer. However, the possibility of a co-existence of an ectopic, pelvic kidney that is invaded by such a tumor is extremely rare. Case Presentation: A 54-year-old female patient, diagnosed with locally advanced cervical cancer in the presence of a pelvic kidney, was submitted to surgery with curative intent. A large, abscessed cervical tumor invading the urinary bladder and the rectum was found, so a total exenteration was planned. Intraoperatively, tumor invasion of the left kidney, which was found in an ectopic, pelvic position was also encountered; therefore, total pelvic exenteration in association with a left nephrectomy was successfully performed. Conclusions: The presence of an ectopic, pelvic disposition of the kidney makes it susceptible to be invaded by locally advanced pelvic tumors; in such cases, a nephrectomy might also be needed.


Assuntos
Coristoma/cirurgia , Doenças Urogenitais Femininas/cirurgia , Rim , Nefrectomia/métodos , Exenteração Pélvica/métodos , Neoplasias do Colo do Útero/cirurgia , Coristoma/complicações , Coristoma/patologia , Feminino , Doenças Urogenitais Femininas/complicações , Doenças Urogenitais Femininas/patologia , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica , Pelve/patologia , Pelve/cirurgia , Neoplasias do Colo do Útero/complicações , Neoplasias do Colo do Útero/patologia
10.
World Neurosurg ; 137: 158-163, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31996339

RESUMO

BACKGROUND: Cerebellar ectopy is a rare finding, with few cases previously reported. Intraventricular localized cerebellar ectopy was described in only 1 case within the fourth ventricle. CASE DESCRIPTION: A 9-year-old girl suffered for 2 years from bilateral frontoparietal headaches, sometimes accompanied by vomiting and photophobia. Magnetic resonance imaging demonstrated an oval-shaped lesion within the left lateral ventricle, characterized by well-defined margins without a clear cleavage plane from the adjacent choroid plexus. The mass presented an intermediate signal on T1- and T2-weighted sequences, similar to gray matter, and reduced ADC values on ADC maps compared with white matter, with no enhancement after gadolinium-based contrast injection. After resection, macroscopic examination revealed an organoid structure with leptomeningeal lining and a clear-cut cortex and white matter components. Histology demonstrated normal cerebellum with a double-layered cortex and normal underlying white matter. The cerebellar ectopy was focally covered by bundles of capillary vascular structures covered by a monostratified ependymal cell lining, consistent with choroid plexus. CONCLUSIONS: We describe, for the first time to our knowledge, the case of a child with ectopic cerebellar tissue harboring the supratentorial ventricular system. Plausible etiologic mechanism consists in the herniation of the cerebellar germinal tissue into the ventricular system through the ependyma, allowing cell migration to the supratentorial compartment, followed by maturation into the normal cerebellum.


Assuntos
Cerebelo , Coristoma/diagnóstico por imagem , Ventrículos Laterais/diagnóstico por imagem , Criança , Coristoma/complicações , Coristoma/patologia , Coristoma/cirurgia , Feminino , Cefaleia/etiologia , Humanos , Ventrículos Laterais/patologia , Ventrículos Laterais/cirurgia , Imagem por Ressonância Magnética , Procedimentos Neurocirúrgicos
11.
Int J Surg Pathol ; 28(1): 60-62, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31566037

RESUMO

Endosalpingiosis is the presence of ectopic Müllerian-type epithelium resembling Fallopian tube epithelium. It usually appears as small glandular inclusions in various peritoneal sites or lymph nodes. Rarely, it is papillary in configuration, and lack of familiarity with this entity could lead to overinterpretation as a malignancy. We recently encountered a case of papillary endosalpingiosis found incidentally at laparotomy for ectopic pregnancy. Awareness of this entity is important, as it may be a diagnostic challenge.


Assuntos
Coristoma/diagnóstico , Tubas Uterinas , Doenças Peritoneais/diagnóstico , Coristoma/patologia , Diagnóstico Diferencial , Epitélio , Feminino , Humanos , Achados Incidentais , Doenças Peritoneais/patologia , Neoplasias Peritoneais/diagnóstico , Gravidez , Gravidez Tubária/diagnóstico , Adulto Jovem
12.
J Pathol ; 250(2): 148-158, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31576556

RESUMO

Endosalpingiosis, a microscopic lesion composed of ectopic Fallopian tube epithelium, frequently involves the peritoneum and lymph nodes in patients with ovarian serous borderline tumour or low-grade serous carcinoma, but its pathogenic significance remains unclear. Using laser-capture microdissection and droplet digital PCR, we investigated whether endosalpingiosis harbours the driver mutations in BRAF and KRAS that characterise ovarian low-grade serous neoplasms. Somatic mutations were detected in 14 (33%) of 43 endosalpingiotic lesions analysed. Of 21 women with endosalpingiosis associated with a synchronous or metachronous ovarian low-grade serous tumour, mutations were identified in endosalpingiotic lesions from 11 (52%) women, with most cases (10/11, 91%) demonstrating identical mutations in both tumour and endosalpingiosis. In contrast, of 13 cases of endosalpingiosis not associated with an ovarian tumour, only one harboured a KRAS mutation. The proliferative activity as assessed by Ki-67 immunohistochemistry was lower in endosalpingiosis than in low-grade serous tumours, and endosalpingiosis with either a BRAF or KRAS mutation had a significantly lower Ki-67 index than those without. Ectopic expression of KRASG12V in Fallopian tube epithelial cells led to ERK phosphorylation, p21 induction, growth arrest and cellular senescence. In conclusion, we demonstrate that endosalpingiosis represents an interesting example of cancer driver mutations in deceptively normal-appearing cells, which may be prone to neoplastic transformation upon bypass of endogenous oncosuppressive mechanisms. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


Assuntos
Coristoma/genética , Tubas Uterinas , Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Proliferação de Células/genética , Transformação Celular Neoplásica , Células Cultivadas , Coristoma/patologia , Cistadenocarcinoma Seroso/genética , Células Epiteliais/patologia , Feminino , Humanos , Microdissecção e Captura a Laser/métodos , Doenças Linfáticas/genética , Doenças Linfáticas/patologia , Neoplasias Ovarianas/genética , Doenças Peritoneais/genética , Doenças Peritoneais/patologia , Lesões Pré-Cancerosas/genética , Lesões Pré-Cancerosas/patologia
14.
Dig Dis Sci ; 65(2): 583-590, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31410755

RESUMO

BACKGROUND: In cases of subepithelial tumors (SETs) located in the cardiac area, a preoperative histologic diagnosis might be helpful in determining the requirement of surgery. AIM: To investigate the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in gastric SETs located in the cardia. METHODS: The data of 107 patients who underwent EUS-FNB, from 2012 to 2017, for tissue sampling of gastric SETs located in the cardia were collected. The clinicopathological data, EUS-related parameters, and surgical outcomes were retrospectively reviewed. RESULTS: The EUS-FNB results were diagnostic in 86.9% (93/107) and nondiagnostic in 13.1% (14/107) of the patients. Immunostaining of the FNB specimens led to the diagnosis of gastrointestinal stromal tumor (GIST) in 25 SETs (23.4%), leiomyoma in 62 SETs (57.9%), heterotopic pancreas in 3 SETs (2.8%), and schwannoma in 2 SETs (1.9%). In the multivariate analysis, patients with GISTs showed significantly more inhomogeneous echogenicity [odds ratio (OR), 8.867], more cystic foci (OR, 26.98), and older age (OR, 1.087). In 26 patients who underwent surgical resection, the agreement between EUS-FNB and surgical pathological findings was 100% with respect to the diagnosis of GISTs (n = 20) and leiomyoma (n = 7). Among these cases, the proportion of high-risk GISTs was 20.0% (4/20), and no leiomyosarcoma was detected. CONCLUSIONS: Although a majority of the subepithelial lesions in the cardia of the stomach are benign, 20% of the cases diagnosed with GIST have a high malignant potential. Preoperative EUS-FNB might be a useful tool for decision-making regarding the ultimate management and outcomes of these lesions.


Assuntos
Cárdia/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Tumores do Estroma Gastrointestinal/patologia , Leiomioma/patologia , Neoplasias Gástricas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cárdia/diagnóstico por imagem , Cárdia/cirurgia , Coristoma/diagnóstico , Coristoma/patologia , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/patologia , Pâncreas , Estudos Retrospectivos , Gastropatias/diagnóstico , Gastropatias/patologia , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Adulto Jovem
15.
Head Neck Pathol ; 14(1): 268-271, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30840224

RESUMO

Choristomas and hamartomas within the oral cavity are relatively uncommon lesions and may present with diverse clinical and histopathological appearances. In this report, we describe two infant patients with hamartoma with ectopic meningothelial elements involving tongue and maxillary alveolar ridge. To the best of our knowledge, these are the first two cases in which a meningothelial proliferation has been identified in the oral cavity. Hamartoma with ectopic meningothelial elements is a rare condition that has been classically described occurring in the scalp. These lesions are characterized by bland round to spindle-shape cells that interdigitate through collagen bundles and express progesterone receptor and epithelial membrane antigen by immunohistochemistry supporting a meningothelial origin.


Assuntos
Coristoma/patologia , Hamartoma/patologia , Meninges , Doenças da Boca/patologia , Humanos , Lactente , Masculino
16.
Am J Case Rep ; 20: 1966-1968, 2019 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-31885033

RESUMO

BACKGROUND Ectopic or heterotopic pancreas is relatively rare pathology described as pancreatic tissue lacking communication with the normal pancreas. Ectopic pancreatic tissue can be found along the gastrointestinal tract, with the most common location the stomach along the greater curvature. This congenital condition could be identified incidentally, or present with symptoms that range from pain and bleeding to obstruction and malignant transformation. CASE REPORT We report a case of a 30-year-old female, who underwent laparoscopic sleeve gastrectomy for morbid obesity of body mass index (BMI) of 46 kg/m², and who was found to have a 3 cm submucosal mass at the lesser curvature while dividing the stomach. The sleeved stomach tube's intraoperative gastroscopy showed a submucosal mass at the posterior stomach wall towards the lesser curvature, increasing the suspicion of gastrointestinal stromal tumor (GIST) tumor. The choice was to continue with a secure margin and conversion to roux-en-y gastric bypass with gastric tumor resection. It turned out that the final pathology was submucosal ectopic pancreas. Despite being a rare pathology, for any submucosal gastric mass, ectopic pancreas should be on the differential diagnosis list. During the sleeve surgery, the mass was found, and the approach was changed to intraoperatively subtotal gastrectomy and roux-en-y gastric bypass. CONCLUSIONS Before any bariatric operation, even in asymptomatic young patients, it is worth doing routine upper endoscopy to prevent surprising intraoperative pathology.


Assuntos
Coristoma/patologia , Achados Incidentais , Pâncreas , Gastropatias/patologia , Adulto , Coristoma/cirurgia , Feminino , Gastrectomia , Humanos , Gastropatias/cirurgia
18.
Rev. esp. patol ; 52(4): 256-259, oct.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-191947

RESUMO

El adenoma hipofisario ectópico es una entidad poco frecuente que se localiza más frecuentemente en el seno esfenoidal. Presentamos el caso de un paciente con adenoma hipofisario ectópico sin expresión funcional asociado a silla turca vacía, lo cual plantea un amplio diagnóstico diferencial. Es un tumor de naturaleza benigna a pesar de que se describe la presencia de necrosis en un porcentaje de casos. La resonancia es el método diagnóstico que permite estudiar los trastornos endocrinos relacionados con el eje hipotálamo-hipofisario y la biopsia endoscópica, su confirmación histológica. Es importante incluir marcadores hipofisarios en el panel de técnicas inmunohistoquímicas


Ectopic pituitary adenoma is a rare entity that is most commonly located in the sphenoid sinus. We report a case of a patient with ectopic pituitary adenoma with no functional expression associated with empty sella turcica, which gives rise to a broad differential diagnosis. Although it is a benign neoplasm, necrosis is encountered in a proportion of cases. Magnetic resonance imaging is the diagnostic method of choice for hypothalamic-pituitary-related endocrine diseases with endoscopic biopsy for histological confirmation. It is important to include pituitary markers in the immunohistochemical diagnostic panel


Assuntos
Humanos , Feminino , Adulto , Síndrome da Sela Vazia/complicações , Neoplasias Hipofisárias/patologia , Coristoma/patologia , Imuno-Histoquímica/métodos , Adenoma/patologia , Neoplasias da Base do Crânio/patologia , Biomarcadores Tumorais/análise , Diagnóstico Diferencial
20.
Medicine (Baltimore) ; 98(44): e17691, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689793

RESUMO

BACKGROUND: Ectopic pancreas in the ileum, including lesions within Meckel diverticulum, can cause severe manifestations and complications; yet, it was seldom reported in English literature. AIM: This study aimed to raise awareness and provide information for better clinical management of this rare yet serious condition. METHODS: A total of 1713 cases of small bowel resection were performed in our hospital between 2009 and 2018, among which 10 cases of ileac ectopic pancreas were identified. A comprehensive retrospective review of the 10 cases was taken. RESULTS: Five lesions were located in the ileum wall and 5 were within Meckel diverticulum. Two lesions within Meckel diverticulum were incidental; the remaining 8 lesions were all associated with abdominal pain, gastrointestinal bleeding, and anemia. Of the 5 patients with lesions in the ileum wall, computed tomography uniformly revealed ileoileal intussusceptions with masses as lead points. Capsule endoscopies were performed in 6 cases, of which 3 showed positive findings. Double-balloon enteroscopy was conducted in one case and revealed an ileal diverticulum. Therapeutically, the offending bowel segments were removed, and intussusceptions were restored except for one case in which diverticulectomy was applied. No relapse or sequela was observed in the follow-up. CONCLUSIONS: Ileac ectopic pancreas can be seen in the ileum wall or Meckel diverticulum. The majority of the lesions found in clinical practice present with abdominal pain, gastrointestinal bleeding, and anemia. Lesions in the ileum wall often cause ileoileal intussusception. Computed tomography, capsule endoscopy, and double-balloon enteroscopy are helpful preoperative examinations. Segmental small bowel resection is the treatment of choice.


Assuntos
Coristoma/patologia , Doenças do Íleo/patologia , Pâncreas , Adolescente , Adulto , Idoso , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , Enteroscopia de Duplo Balão , Feminino , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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