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1.
Virchows Arch ; 475(3): 383-389, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31250201

RESUMO

Gastric hyperplastic polyps are common and generally regarded as benign lesions, whereas gastric adenocarcinomas infrequently occur from gastric hyperplastic polyps. Although gastric hyperplastic polyps have received a lot of attention because of their association with malignant transformation, it remains unclear whether gastric hyperplastic polyps are neoplastic lesions that have sporadic genetic changes similar to colorectal hyperplastic polyps. We performed genome-wide analyses of two gastric adenocarcinomas with hyperplastic polyp components. The interface between "adenocarcinoma" and "hyperplastic polyp" components was fairly sharp, and the adenocarcinoma components had copy number alterations and TP53 mutations, whereas the hyperplastic polyp components had only single nucleotide polymorphisms, which were also found in adenocarcinoma components. We did not detect any somatic changes in the hyperplastic polyp components, even in genome-wide analyses, which was in contrast to the adenocarcinoma components. However, due to the small number of cases examined herein, further genetic analyses of more cases are needed.


Assuntos
Pólipos Adenomatosos/patologia , Pólipos Intestinais/patologia , Neoplasias Gástricas/genética , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Transformação Celular Neoplásica/patologia , Hibridização Genômica Comparativa/métodos , Variações do Número de Cópias de DNA/genética , Feminino , Estudo de Associação Genômica Ampla/métodos , Humanos , Hiperplasia , Polimorfismo de Nucleotídeo Único/genética , Pólipos/patologia , Neoplasias Gástricas/patologia , Proteína Supressora de Tumor p53/genética
2.
Indian J Pathol Microbiol ; 62(2): 290-292, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971558

RESUMO

Brunner's gland hamartomas (BGHs) are uncommon lesions of duodenum which show hyperplasia of these glands along with smooth muscle bundles, adipose tissue and lymphoid aggregates. These are usually benign, solitary, pedunculated, polypoidal lesions. Dysplastic changes in BGH are extremely rare and even rarer is the multiplicity of this lesion. We hereby report an index case of BGH showing features of high-grade dysplasia, presenting as multiple duodenal polyps.


Assuntos
Glândulas Duodenais/patologia , Duodenopatias/diagnóstico , Hamartoma/diagnóstico , Pólipos/patologia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Mucosa Gástrica/patologia , Hamartoma/patologia , Humanos , Hiperplasia , Masculino , Pancreaticoduodenectomia , Tomografia Computadorizada por Raios X , Adulto Jovem
3.
J Int Med Res ; 47(4): 1787-1792, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30819008

RESUMO

Prostatic-type polyps are uncommon lesions in the urinary tract. They are sometimes found in the lower urinary tract, particularly on the posterior urethra, but are rarely found in the bladder. We report a case of 15-year-old boy who presented with dysuria. Routine ultrasonography showed a mass in the bladder arising near the internal orifice of urethra. Further inspection with cystoscopy followed by transurethral resection and pathology confirmed the lesion to be a prostatic-type polyp. An overview of other similar case studies showed that the pathogenesis of this condition is controversial, haematuria and dysuria are common clinical symptoms and endoscopic transurethral resection is the best treatment option. Since the polyp is benign, recurrence and progression of this disorder is unlikely to occur.


Assuntos
Pólipos/patologia , Próstata/patologia , Doenças Uretrais/patologia , Bexiga Urinária/patologia , Adolescente , Humanos , Masculino , Pólipos/diagnóstico por imagem , Prognóstico , Próstata/diagnóstico por imagem , Ultrassonografia , Doenças Uretrais/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem
5.
BMJ Case Rep ; 12(3)2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-30898960

RESUMO

We present a 22-year-old pregnant woman at 15 weeks of gestation, with abdominal pain and vomiting. We demonstrate that diagnosis and treatment of vomiting and abdominal pain in pregnancy can be difficult. Therefore, involvement of other medical specialists is important when common treatments fail. Cholesterolosis can cause symptoms similar to those caused by cholelithiasis. Controversial to gallstones, identification of cholesterolosis by ultrasound is hard. Cholecystectomy is the only effective treatment option for cholesterolosis and can be performed safely during pregnancy. Cholecystectomy in pregnancy should be considered if, despite atypical symptoms, gallbladder disease is suspected and other diagnoses are ruled out. This may reduce recurrent symptoms, hospital admissions, exposure to harmful drugs and obstetric complications.


Assuntos
Doenças da Vesícula Biliar/complicações , Doenças da Vesícula Biliar/diagnóstico , Complicações na Gravidez/diagnóstico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Colecistectomia , Diagnóstico Diferencial , Feminino , Vesícula Biliar/patologia , Doenças da Vesícula Biliar/cirurgia , Humanos , Pólipos/complicações , Pólipos/patologia , Gravidez , Vômito/diagnóstico , Vômito/etiologia , Adulto Jovem
7.
BMC Gastroenterol ; 19(1): 42, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30885181

RESUMO

BACKGROUND: The aim of our study was to investigate the prevalence and natural long-term progression of gallbladder polyps in a random sample of the general population. METHODS: Four hundred and thirteen subjects (190 women, 223 men; aged 29-75 years) were studied first in 2002 and again eleven years later in 2013. All subjects were interviewed using a standardised questionnaire, anthropometric data were recorded, and an abdominal ultrasound scan was carried out. RESULTS: The prevalence of gallbladder polyps was 6.1% (115/1880) in the 2002 study and 12.1% (50/413) in the 2013 follow-up study. After eleven years, 36 subjects (8.7%, 36/413) had developed new polyps, thirteen subjects (48.1%, 13/27) no longer had gallbladder polyps, and 14 subjects (51.9%, 14/27) still had polyps. The number of polyps had increased in six of these subjects (43%, 6/14), decreased in a further six (43%, 6/14), and remained unchanged in two (14%, 2/14). The mean polyp size was 4.7 mm (± 2.2 mm, range 2-20 mm) in 2002 and 4.0 mm (± 1.9 mm, range 0.5-11 mm) at follow-up. A decrease in polyp size was noted in seven (50%) of the 14 subjects, an increase in size in five subjects (35.7%), and no change in two subjects (14.3%). The shape of the polyps had changed from pedunculated to sessile in two subjects (14.3%, 2/14) and from sessile to pedunculated in one subject (7.1%, 1/14). CONCLUSIONS: In long-term follow-up, the prevalence of gallbladder polyps increased, with new lesions developing in 8.7% of the population. Polyps persisted in 51.9% of the subjects who had them in the original study and disappeared in the other 48.1%.


Assuntos
Progressão da Doença , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/patologia , Pólipos/epidemiologia , Pólipos/patologia , Adulto , Idoso , Feminino , Seguimentos , Neoplasias da Vesícula Biliar/diagnóstico por imagem , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/diagnóstico por imagem , Prevalência , Ultrassonografia
8.
Int. arch. otorhinolaryngol. (Impr.) ; 23(1): 116-124, Jan.-Mar. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1002187

RESUMO

Abstract Introduction Vocal fold polyps are one of themost frequent benign laryngeal lesions, impacting the quality of life of those affected by them, primarily the vocal production. Despite being a well-established therapy in conjunction with surgery, speech therapy alone may also be effective in treating these lesions. As such, otolaryngologists and speech therapists need updated bibliographic knowledge on the issue. Objective To describe the literature findings on vocal fold polyps that discuss prevalence, etiology, histology, physiopathology, vocal characteristics or treatment. Data Synthesis The present study is a review article based on a bibliographic search using platforms, databases and search engines, with no restrictions on means of publication, methodological quality or language. All the articles on vocal fold polyps pertaining to the object of study published in the past 15 years were included. Among the characteristics investigated, the most discussed were prevalence of men, smoking as an etiological cofactor, the possibility of histological differentiation from vocal nodules, the relationship with cover minor structural alterations, and the indication and effectiveness of different treatment options. Conclusion Despite the discrepancies found in the present literature review on vocal fold polyps, there has been a notable scientific progress in the otolaryngologic techniques and in the effectiveness of speech therapy as initial treatment, with direct and indirect techniques, corroborating the need for scientific investigation of the issue.


Assuntos
Humanos , Masculino , Feminino , Pólipos , Prega Vocal , Doenças da Laringe , Pólipos/diagnóstico , Pólipos/etiologia , Pólipos/fisiopatologia , Pólipos/patologia , Pólipos/terapia , Pólipos/epidemiologia , Tabagismo/complicações , Prega Vocal/patologia , Diagnóstico Diferencial
9.
Int J Colorectal Dis ; 34(4): 711-718, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30701384

RESUMO

PURPOSE: Data on the management of appendix orifice lesions are limited. We present our experience on the management of appendix orifice lesions focusing on the range of size, histology, treatment, and outcomes for polyps at the appendix orifice. METHODS: Retrospective descriptive study at a tertiary referral center. PATIENTS: Those having appendix orifice lesion removed and sent for histology between 2000 and 2017. INTERVENTIONS(S): Polypectomy, surgery. MAIN OUTCOME MEASURES: Polyp size, shape, histology, treatment. RESULTS: In total, 691 patients matched our inclusion criteria. Screening was the most common indication for colonoscopy (49.1%). Mean size was 10.1 mm. The most common excision method was cold biopsy forceps (36.3%), followed by hot snare (9.3%), cold snare (8.5%), jumbo cold forceps (6.7%), hot biopsy (6.8%), and endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) (4%). Recurrence was seen in 19/184 (10.3%) patients. Index polyps ≥ 10 mm had a significantly higher risk of recurrence compared to those ≤ 5 mm (odds ratio 3.2 95% CI 1.1-9.2, p = 0.027). None of the patients had complications. Surgery was performed in 45/691 (6.5%). Polyps > 5 mm (41/45) were more likely to require surgery than polyps ≤ 5 mm (4/45 6.67%), p < 0.001. LIMITATIONS: Retrospective study. CONCLUSION: Appendix orifice polyps can usually be managed by conventional endoscopic polypectomy methods without the need for ESD.


Assuntos
Apêndice/patologia , Pólipos/patologia , Apendicectomia/efeitos adversos , Apêndice/cirurgia , Colonoscopia , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Pólipos/cirurgia , Complicações Pós-Operatórias/etiologia , Recidiva
10.
In Vivo ; 33(2): 365-374, 2019 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30804114

RESUMO

Background/ Aim: A high polar xanthophyll of Fucoxanthin (Fx) is abundantly contained in edible brown algae, and it has chemopreventive effects in mouse cancer models, however, the underlying mechanisms of these effects are not well understood. Thus, we aimed to investigate the effects of Fx on the tumor microenvironment in cancer model mice. MATERIALS AND METHODS: We investigated the effect of Fx (30 mg/kg body weight) in a variety of cell types within the tumor microenvironment of α mouse preclinical colorectal cancer model and analyzed the mouse saliva in search of predictors for cancer chemopreventive effects. RESULTS: Fx administration significantly decreased the number of colorectal polyps and tended to decrease colonic lesions compared to untreated control mice. In addition, Fx administration showed significantly lower numbers of colorectal cancer stem cells-like CD44high/EpCAMhigh cells, cancer-associated fibroblasts-like αSMAhigh cells, tumor-associated macrophages-like and dendritic cells-like CD206high cells by 0.6-, 0.5- and 0.6-fold, respectively, compared to untreated control mice. Moreover, the treatment also showed significantly lower levels of salivary glycine by 0.5-fold. CONCLUSION: Our results suggest that salivary glycine may be a predictor representing the chemopreventive effect of Fx in mice.


Assuntos
Neoplasias Colorretais/tratamento farmacológico , Glicina/genética , Pólipos/tratamento farmacológico , Xantofilas/administração & dosagem , Animais , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Glicina/química , Humanos , Camundongos , Pólipos/genética , Pólipos/patologia , Saliva/química , Microambiente Tumoral/efeitos dos fármacos , Microambiente Tumoral/genética
11.
Int J Gynaecol Obstet ; 145(2): 212-218, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30763458

RESUMO

OBJECTIVE: To assess three-dimensional (3D) ultrasound combined with power Doppler (PD) for the differential diagnosis of endometrial lesions among infertile women. METHODS: A prospective study carried out at a reproductive medicine center in Luoyang, China, between January and December 2015. The inclusion criteria were asymptomatic infertility with normal endometrium or specific endometrial lesions. Participants were subdivided by whether they had normal endometrium (group 1, n=357), or endometrial lesions including polyps, hyperplasia, intrauterine adhesions, or endometritis (group 2, n=99). 3D PD and hysteroscopy were performed in the follicular phase. Endometrial thickness, volume, vascularization index (VI), flow index (FI), and vascularization flow index (VFI), and subendometrial VI, FI, and VFI were calculated. Endometrial lesions were confirmed by pathologic analysis. RESULTS: The overall prevalence of endometrial lesions was 99/456 (21.3%). Endometrial thickness and volume were significantly larger in group 2 than in group 1 (9.96 ± 3.24 vs 8.15 ± 2.50 mm and 3.70 ± 2.54 vs 2.42 ± 1.64 cm3 , respectively; both P<0.001). Endometrial thickness and volume were larger among women with endometrial polyps and hyperplasia; endometrial VI, FI, and VFI were lower among women with intrauterine adhesions. CONCLUSION: Three-dimensional PD has value for the differential diagnosis of endometrial lesions among infertile women. CLINICAL TRIAL REGISTRATION: The trial is registered in the Chinese Clinical Trial Registry as ChiCTR1800015799.


Assuntos
Endometriose/diagnóstico por imagem , Endométrio/diagnóstico por imagem , Imagem Tridimensional/métodos , Ultrassonografia Doppler/métodos , Adulto , Estudos de Casos e Controles , China , Endometriose/complicações , Endometriose/patologia , Endométrio/patologia , Feminino , Humanos , Histeroscopia , Infertilidade Feminina/complicações , Infertilidade Feminina/diagnóstico por imagem , Pólipos/diagnóstico por imagem , Pólipos/patologia , Gravidez , Estudos Prospectivos
13.
Medicine (Baltimore) ; 98(5): e14305, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30702604

RESUMO

It was aimed to report 5 cases of pharyngeal hairy polyps, and to summarize the characteristics combined with literature review.Five cases with pathological diagnosis of pharyngeal hair polyps were diagnosed and treated in our department from June, 2006 to October, 2016, and retrospective analysis of their clinical data was performed. Among the 5 cases, there were 1 male and 4 female, with the age of 2 days to 26 months old. After birth, these patients were accompanied by stridor, difficulty breathing, snoring, feeding difficulties, and slow weight gain.Gray mass in the stem original from the pharynx was found in all 5 cases, with the surface hair-covering. The polyp resections were performed under general anesthesia, with the complete removal of polyp along the pars basilaris during surgery smoothly. The operation during was 5 to 20 minute, with an average of 12 minute, and there was little hemorrhage during operation. Symptoms disappeared completely after the surgery, and follow-up was performed for 1 year without recurrence shown.Pharyngeal hairy polyp is a rare non-malignant clinical disease, mainly caused by symptoms in respiratory tract obstruction. Complete removal of polyps along the pars basilaris is an effective treatment, with no recurrence case reported after surgery.


Assuntos
Doenças Faríngeas/patologia , Doenças Faríngeas/cirurgia , Pólipos/patologia , Pólipos/cirurgia , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Imagem por Ressonância Magnética , Masculino , Doenças Faríngeas/diagnóstico por imagem , Pólipos/diagnóstico por imagem , Estudos Retrospectivos
14.
Fertil Steril ; 111(4): 772-779, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30683588

RESUMO

OBJECTIVE: To evaluate the role of hysteroscopy in the diagnosis of chronic endometritis (CE). DESIGN: Retrospective cohort study. SETTING: University teaching hospital. PATIENT(S): A consecutive series of 1,189 cases of diagnostic hysteroscopy. INTERVENTION(S): Endometrial biopsy specimens were obtained after hysteroscopy for routine histology and immunohistochemistry for plasma cells using a CD138 epitope. MAIN OUTCOME MEASURE(S): Observer variability, sensitivity, specificity, and accuracy of the hysteroscopic features in the diagnosis of CE. RESULT(S): Immunohistochemistry of biopsy specimens showed presence of CD138 cells in 322 of 1,189 cases (27.1%). Among cases that tested positive for CD138 cells, the prevalence of hysteroscopic features was as follows: endometrial hyperemia, 169 of 322 (52.5%); endometrial interstitial edema, 27 of 322 (8.4%); and micro-polyps, 11 of 322 (3.4%). The κ value of intraobserver and interobserver agreement on the presence or absence of the hysteroscopic feature of CE was 0.86 and 0.73, respectively. The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of the presence of one or more hysteroscopy features were 59.3%, 69.7%, 42.1%, 82.8%, and 66.9%, respectively. CONCLUSION(S): The finding of endometrial hyperemia, micro-polyps or endometrial interstitial edema during hysteroscopy should alert to the diagnosis of CE, but the overall accuracy of hysteroscopic examination with regard to the diagnosis of CE is only 67%, so it should not be used to replace histologic examination as the diagnostic tool of choice. In women in whom a diagnosis of CE is considered likely, endometrial biopsy should be obtained to examine plasma cells by immunohistochemistry, which should remain the preferred method for diagnosis.


Assuntos
Endometrite/diagnóstico , Endométrio/diagnóstico por imagem , Endométrio/patologia , Histeroscopia , Adulto , Doença Crônica , Endometrite/metabolismo , Endometrite/patologia , Endométrio/metabolismo , Feminino , Técnicas Histológicas , Humanos , Histeroscopia/métodos , Imuno-Histoquímica , Pessoa de Meia-Idade , Variações Dependentes do Observador , Pólipos/diagnóstico , Pólipos/patologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
15.
Br J Radiol ; 92(1095): 20180430, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30604637

RESUMO

OBJECTIVE:: This study aimed to assess the efficacy of MRI for differentiating between uterine submucosal polypoid adenomyomas (PAs) and endometrial polyps (EPs). METHODS:: MRI was used to examine 40 histopathologically confirmed benign polypoid endometrial tumors (8submucosal PAs and 32 EPs). Atypical PAs were excluded from this study. Quantitative measurements (maximum tumor diameter, maximum cyst diameter, number of cysts, and apparent diffusion coefficient values) and qualitative imaging findings (predominance of cystic or solid components as well as presence of cysts, hemorrhage, myometrial invasion, fluid-fluid level, and fibrous core) were correlated with the two pathologies. RESULTS:: The predominance of cystic components (37% vs 6%; p < 0.05) was more frequently observed in PAs than in EPs. The frequency of cysts (88% vs 25%; p < 0.01), hemorrhage (50% vs 9%; p < 0.05), and myometrial invasion (25% vs 0%; p < 0.05) were significantly higher in PAs than in EPs. No significant differences were observed in terms of the maximum tumor diameter, maximum cyst diameter, number of cysts, apparent diffusion coefficient values, and presence of fluid-fluid level and fibrous core between PAs and EPs. CONCLUSION:: The differences of MR findings with emphasis on cystic components and hemorrhage may be useful for differentiating between PAs and EPs. ADVANCES IN KNOWLEDGE:: The predominance of cystic or solid components and the presence of cysts, hemorrhage, and myometrial invasion were useful MR findings for differentiating between PAs and EPs.


Assuntos
Adenomioma/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Pólipos/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico por imagem , Adenomioma/patologia , Adulto , Idoso , Diagnóstico Diferencial , Endométrio/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Pólipos/patologia , Estudos Retrospectivos , Neoplasias Uterinas/patologia
16.
J Gynecol Obstet Hum Reprod ; 48(3): 207-211, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30660657

RESUMO

Cervical polyps are benign neoplasms of the cervix and frequently asymptomatic; however, they may cause intermenstrual, postcoital, and postmenopausal bleeding. The excision of cervical polyps and necessity of endometrial sampling is remain controversial. The objective of our study was to determine the association between cervical polyps and smear and endometrial pathologies. 221 patients were included in the study and all patients data reviewed retrospectively. All patients were divided into two groups; 1. Premenopausal, 2. Postmenopausal. The groups were compared in terms of demographic information, histopathological results and polyp number and size. Also endometrial sampling results were divided; 1. premalignant-malignant group 2. benign group. There was a statistically significant difference between polyp size and premalignant and malignant endometrial pathologies in the postmenopausal patient group (p = 0.048 and p = 0.002). The cut-off value for polyp length was determined to be 19 mm and that for polyp volume was determined to be 2150 mm3. The use of Pap smear screening before polypectomy can give information about malignancy potential of asymptomatic cervical polyps. However, if polyps sizes are length of >19 mm and volume of >2300 mm3, especially in postmenopausal females endometrial sampling should be recommended.


Assuntos
Pólipos/diagnóstico , Pólipos/patologia , Pós-Menopausa , Pré-Menopausa , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Pólipos/cirurgia , Estudos Retrospectivos , Neoplasias do Colo do Útero/cirurgia
17.
Medicine (Baltimore) ; 98(1): e14009, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30608447

RESUMO

RATIONALE: Lymphangiomatous polyps of the palatine tonsils are benign tumors that are rare in both adults and children. Most patients suffering from this disease present with nonspecific symptoms similar to those of chronic tonsillitis. PATIENT CONCERN: We report a case of a 21-year-old male miner who presented with a chronic history of a foreign body sensation in the oropharynx and an intermittently sore throat. DIAGNOSIS: The patient was preoperatively diagnosed with the palatine tonsils neoplasm. INTERVENTIONS: The neoplasm with palatine tonsils was completely resected under general anesthesia. The tissue was sent for histological examination, and the diagnosis was lymphangiomatous polyps of the palatine tonsils. OUTCOME: The surgical outcome was good, and no surgical site infection was recorded. After 12 months of follow-up, the miner was asymptomatic with no recurrence. LESSONS: Tonsillectomy is a curative method to address lymphangiomatous polyps (LAPs) of the tonsils which resulted in no recurrence during the clinical follow-up period. The etiology of this rare disorder and potential pathogenesis should be studied in the future, which would help prevent its occurrence.


Assuntos
Linfangioma/patologia , Tonsila Palatina/patologia , Pólipos/patologia , Humanos , Linfangioma/cirurgia , Masculino , Mineradores , Tonsila Palatina/cirurgia , Faringite/diagnóstico , Faringite/etiologia , Pólipos/cirurgia , Tonsilectomia/métodos , Resultado do Tratamento , Adulto Jovem
18.
Anticancer Res ; 39(1): 437-441, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30591492

RESUMO

BACKGROUND: Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) in distal common bile duct (CBD) is a rare entity. CASE REPORT: This case report describes a 45-year-old male with a history of a choledochal cyst status post partial excision and cholecystectomy who presented with a mass in the remaining distal/intrapancreatic common bile duct. It was initially mistaken for post-surgery hematoma; however, the rapid growth raised concern for malignancy, and prompted a pancreaticoduodenectomy (Whipple) procedure. Macroscopic examination revealed a 5.5 cm polypoid mass grossly confined in the lumen of the distal CBD. Histology was consistent with UC-OGC, with minimal invasion into the polyp stalk and adjacent CBD wall. Immunohistochemistry demonstrated co-expression of CK7 and p40, normal/wild-type p53, and retained SMAD4 expression in tumor cells. Next-generation sequencing detected mutations at p.Q61H (c.183A>C) of KRAS and p.E545K (c.1633G>A) of PIK3CA, keeping in line with similarity to conventional cholangiocarcinoma. The patient remained disease-free after two years of follow-up without chemotherapy. CONCLUSION: To our knowledge, this is the first case report of UC-OGC presented as a polypoid mass in the distal CBD. It highlights the complex dynamism and controversial pathogenesis of this unique entity, which should be made aware to avoid diagnostic pitfalls.


Assuntos
Carcinoma/cirurgia , Cisto do Colédoco/cirurgia , Ducto Colédoco/cirurgia , Pólipos/cirurgia , Carcinoma/fisiopatologia , Cisto do Colédoco/patologia , Cisto do Colédoco/fisiopatologia , Ducto Colédoco/fisiopatologia , Feminino , Regulação Neoplásica da Expressão Gênica , Células Gigantes/patologia , Humanos , Pessoa de Meia-Idade , Proteínas de Neoplasias/genética , Osteoclastos/patologia , Pancreaticoduodenectomia , Pólipos/patologia
19.
Int. j. morphol ; 36(4): 1485-1489, Dec. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-975726

RESUMO

La neoplasia papilar intracolecística (NPIC), es un tumor compuesto por células neoplásicas preinvasivas, que forman masas de hasta 1,0 cm, clínicamente detectables. El objetivo de este estudio fue reportar un caso de NPIC y revisar la evidencia existente. Se trata de un paciente sexo masculino, de 33 años de edad, asintomático, que en el curso de un examen de salud, se realiza una ecotomografía abdominal, en la que se verifica una lesión polipoide vesicular de 32 x 19 mm de diámetro. Se programa para colecistectomía electiva, la que se realizó por vía laparoscópica, cirugía que se pudo realizar sin inconvenientes. Una vez extirpado el espécimen, se fue a estudio histopatológico en el que tras un mapeo vesicular se concluye NPIC, colecistitis crónica inespecífica, colesterolosis y pólipos colesterínicos. El paciente ha evolucionado sin inconvenientes. Presentamos un caso de NPIC en un paciente joven, cuyo diagnóstico fue confirmado por anatomía patológica tras una colecistectomía electiva, descartándose la presencia de carcinoma invasivo y displasia de alto grado, por lo que el pronóstico es favorable.


Intracholecystic papillary neoplasm (ICPN) is a tumor composed of pre-invasive neoplastic cells, with up to 1.0 cm clinically detectable masses. The objective of this study was to report a case of NPIC and review the evidence in the literature. A 33-year-old asymptomatic male patient had an abdominal ultrasonography during a health examination, in which a vesicular polyp lesion of 32 x 19 mm in diameter was verified. Thepatient was subsequently scheduled for elective cholecystectomy, which was performed laparoscopically and the surgery was uneventful. Once removed, the specimen was studied histopathologically and after performing vesicular mapping, we determined an ICPN, chronic non-specific cholecystitis, cholesteroliasis and cholesteric polyps. The patient has evolved without reported problems. We present a case of ICPN in a young patient, whose diagnosis was confirmed by pathological anatomy after an elective cholecystectomy, ruling out the presence of invasive carcinoma and high-grade dysplasia, with a favorable prognosis.


Assuntos
Humanos , Masculino , Adulto , Adenocarcinoma Papilar/patologia , Neoplasias da Vesícula Biliar/patologia , Pólipos/patologia , Adenocarcinoma Papilar/cirurgia , Colecistectomia Laparoscópica , Neoplasias da Vesícula Biliar/cirurgia
20.
Rev Gastroenterol Peru ; 38(3): 297-300, 2018 Jul-Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-30540736

RESUMO

Primary gastric choriocarcinoma (PGC) is an extremely rare and highly invasive tumor with rapid hematogenous spread. We present the case of a 57-year-old female patient who started with hematemesis and progressive episodes of melena, weight loss and epigastralgia. It is derived from the National Institute of Neoplastic Diseases where gastroscopy and biopsy are performed. Histological analysis reported pattern suggestive of PGC; that was confirmed by immunohistochemical analysis for human chorionic gonadotrophin and fetal alpha protein. Subsequently, the patient underwent a radical D2 gastrectomy with splenic preservation and tail of the pancreas preservation. Unfortunately, her evolution was not favorable and died due to the progression of the disease.


Assuntos
Coriocarcinoma/patologia , Neoplasias Gástricas/patologia , Adenocarcinoma/diagnóstico , Biomarcadores Tumorais/análise , Coriocarcinoma/química , Coriocarcinoma/diagnóstico , Coriocarcinoma/cirurgia , Gonadotropina Coriônica/análise , Diagnóstico Diferencial , Evolução Fatal , Feminino , Gastrectomia/métodos , Gastroscopia , Hematemese/etiologia , Humanos , Melena/etiologia , Pessoa de Meia-Idade , Pólipos/diagnóstico , Pólipos/patologia , Neoplasias Gástricas/química , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Úlcera Gástrica/etiologia , Perda de Peso , alfa-Fetoproteínas/análise
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