Cytologic detection of small pancreaticoduodenal and biliary cancers in the early developmental stage.

Employing pancreozymin-secretin stimulation and percutaneous transhepatic cholangiographic aspiration, cytologic examination for pancreaticoduodenal and biliary tract cancers was carried out in 763 patients, with 47 of 61 cancers cytologically detected (79%). The cancers detected included seven minute or small cancers less than 1.0 cm in maximum diameter, all of which were successfully surgically extirpated. The results indicate that diagnostic cytology contributed to the detection of cancers in these anatomic sites at an early developmental stage.

Point, minute and small cancers of the stomach at the early developmental stage detected by improved chymotrypsin lavage method for diagnostic cytology.

The improved selective chymotrypsin lavage method under fluoroscopy for cytologic detection led to the discovery of 12 point or minute gastric cancer lesions of less than one cm maximum diameter among 420 patients. It is reported herein how tiny cancers of the stomach can be found by the method, and how valuable it is to employ morphologic criteria for correct identification of the individual atypical cells in these tiny gastric cancers.

[Effect of 5'-deoxy-5-fluorouridine (5'-DFUR) on the activity of pyrimidine nucleoside phosphorylase (pyNPase) in normal and tumor tissues of human stomach].

PyNPase (pyrimidine nucleoside phosphorylase) activity and IL-1 alpha were measured in normal and tumor tissues of the specimens resected from gastric cancer patients who had been divided into two groups; one given preoperative 5'-DFUR (oral administration at a mean dose of 10.0 g) and one not given 5'-DFUR (control). PyNPase activities in both groups were higher in tumor than in normal tissues (p = 0.0001), but, less in tumor tissue of the preoperative administration group than the controls (p = 0.0376). IL-1 alpha levels in both groups were higher in tumor than in normal tissues (p < 0.01). Multiple regression analysis of the results showed that IL-1 alpha strongly influenced on PyNPase activity in tumor tissues (higher IL-1 alpha levels resulted in higher PyNPase activities in tumor tissues) (p = 0.0334).

[Ultrasonic diagnosis of early gallbladder cancer].

In a series of 514 consecutive cholecystectomy specimens excised for biliary disease, 1.4% exhibited early carcinoma and 4.5% advanced. On the other hand benign tumors and pseudotumors were observed in 2.0% of cholesterol polyps, 0.8% adenomas, 1.0% inflammatory polyps and 10.8% adenomyomatosis. On the basis of these finding in this series, diagnostic usefulness and difficulties of ultrasound were discussed. Sonography can provide critical diagnostic information for preoperative identification of small polypoid lesion and irregular wall thickness.

Ovarian mucinous cystadenocarcinoma as a cause of Zollinger-Ellison syndrome: report of a case and review of the literature.

Gastrin producing ovarian tumor is a rare cause of the Zollinger-Ellison syndrome. We report the case of an ovarian carcinoma showing increased plasma gastrin concentration. A 60-yr-old woman presented with epigastric pain and diarrhea. Physical examination showed a large mass in the lower abdomen. Computed tomography revealed a large multilocular ovarian cyst. Upper gastrointestinal endoscopy examination showed multiple ulcerations of the stomach and duodenum. The plasma gastrin level was 1500 pg/ml. No tumors were found in the pancreas and duodenum, and salpingo-oophorectomy was performed. Histologic examination revealed a mucinous tumor of borderline malignant potential. Immunoperoxidase studies for gastrin showed many gastrin-producing cells within the epithelium of the tumor. There have been 11 cases (including our patient) of gastrin-producing ovarian tumor reported in the literature. We review here the relevant literature. Although ovarian gastrinoma is extremely rare, it should be considered as a possible cause of the Zollinger-Ellison syndrome in women.