共查询到20条相似文献,搜索用时 15 毫秒
1.
Hideaki Kazumori Toshihiro Sizuku Toru Ueki Yasushi Uchida Shyun Yamamoto 《Journal of gastroenterology》1997,32(5):700-703
A case of lymphoepithelial cyst (LEC) of the pancreas is presented. A 48-year-old man complaining of general fatigue was found
to have a heterogeneous water-dense mass protruding from the surface of the pancreas on plain computed tomography (CT). Dynamic
CT disclosed septa within the mass. Magnetic resonance imaging (MRI) showed a hypoiintense mass on T1-weighted imaging, and
a hyperintense mass on T2-weighted imaging. MRI with gadolinium enhancement revealed septa within the mass. Endoscopic ultrasonography
showed septa and fine echogenic structures within the cystic echoic lesion. Endoscopic retrograde pancreatecraphy showed a
normal duct system. Distal pancreatectomy with splenectomy was performed, with a suspected diagnosis of cystic neoplasms of
the pancreas. Histopathologic examination disclosed LEC of the pancreas. Our case suggests that LEC should be considered in
the differential diagnosis of cystic neoplasms of the pancreas. 相似文献
2.
Kyoji Yamamoto M.D. Keiichi Fujimoto Takashi Matsushiro Keisuke Ota 《Journal of gastroenterology》1990,25(6):758-761
A case of lymphoepithelial cyst in the pancreas was reported. A 64-year-old man without any specific compalints was found
to have a cystic lesion in the anterior portion of the pancreas, as revealed by ultrasonography of the abdomen at an annual
medical examination in 1988. This was dissected easily from the pancreas. Histologically, it was diagnosed to be a benign
lymphoepithelial cyst in the pancreas. Cysts of this type are rare, and their histogenesis is also not well understood. 相似文献
3.
Calogero Iacono Nicola Cracco Giuseppe Zamboni Fabio Bernardello Marianna Zicari Filippo Marino Ettore Montresor Giovanni Serio 《Journal of gastrointestinal cancer》1996,19(1):71-76
Summary
Conclusion
Lymphoepithelial cyst of the pancreas (LC) is a very rare benign lesion and preoperative diagnosis is difficult. Conservative
surgery seems to be the appropriate therapy in symptomatic patients or when a precise preoperative diagnosis is not achieved.
The benign behavior of all reported cases suggests that the asymptomatic patients with a certain morphological preoperative
diagnosis might be clinically followed up. The histogenesis of LC remains to be elucidated.
Background LC of the pancreas is a cyst that is histologically characterized by a fibrous tissue, a lymphoid component and a lining squamous
epithelium.
Methods Clinical and pathological findings of two personal cases are reported with review of the literature.
Results A 56-yr-old man, complaining of epigastric pain, and a 47-yr-old man, with a history of alcohol abuse, were admitted to hospital.
In both cases the lesion was detected with abdominal ultrasound but a certain diagnosis was obtained only after histological
examination of the resected cysts. 相似文献
4.
We recently encountered a patient with a lymphoepithelial cyst of the pancreas with sebaceous differentiation. We sought
to compare the characteristics of this patient with those previously reported in order to foster a keener understanding of
this rare clinical entity. After reviewing the present patient's case in detail, we conducted a comprehensive review of the
English-language literature and analyzed the clinical characteristics of reported cases of lymphoepithelial cysts. Our patient
was an asymptomatic 60-year-old man who presented with an incidental finding of a cystic lesion in the tail of the pancreas
documented by computed tomography. The cyst was enucleated, and was found to contain keratinized material. It was lined by
squamous epithelium with small sebaceous glands, and surrounded by lymphoid tissue with germinal centers. Of 33 reported cases,
only 6 (18%) contained sebaceous glands. In all patients who underwent operation, the cysts were easily resected, and the
outcome was favorable. Lymphoepithelial cyst of the pancreas is rare, and may be difficult to differentiate from cystic neoplasms
preoperatively. Therefore resection is indicated. The diagnosis, however, can be confirmed by careful histologic review, and
the prognosis is excellent.
Received: March 8, 1999 / Accepted: October 22, 1999 相似文献
5.
《Hepatobiliary & pancreatic diseases international : HBPD INT》2014,13(5):539-544
Pancreatic lymphoepithelial cysts (LECs) are rare, benign lesions that are typically unexpected post-operative pathological findings. We aimed to review clinical, radiological and pathological features of LECs that may allow their pre-operative diagnosis. Histopathology databases of two large pancreatic units were searched to identify LECs and notes reviewed to determine patient demographic details, mode of presentation, investigations, treatment and outcome. Five male and one female patients were identified. Their median age was 60 years. Lesions were identified on computed tomography performed for abdominal pain in two patients, and were incidentally observed in four patients. Five LECs were located in the tail and one in the body of the pancreas, with a median cyst size of 5 cm. Obtaining cyst fluid was difficult and a largely acellular aspirate was yielded. The pre-operative diagnosis was mucinous cystic neoplasm in all patients. This series of patients were treated distal pancreatectomy and splenectomy. A retrospective review of radiological examinations suggested that LECs have a relatively low signal on T2 imaging and a high signal intensity on T1 weighted images. LECs appear more common in elderly males, and are typically incidental, large, unilocular cysts. Close attention to signal intensity on MRI may allow pre-operative diagnosis of these lesions. 相似文献
6.
Tetsuya Yamaguchi Hiroshi Takahashi Ryuzaburo Kagawa Ryoji Takeda Shingo Sakata Michihiro Yamamoto Daisuke Nishizaki 《Journal of hepato-biliary-pancreatic sciences》2008,15(6):652-654
An extremely rare case of a lymphoepithelial cyst associated with persistent elevation of serum carbohydrate antigen (CA) 19-9 levels is described. A 72-year-old man was incidentally found to have a cystic tumor in the uncus of the pancreas and to have a high serum CA 19-9 level. At 2-year follow up, the tumor size had gradually increased and the high CA 19-9 level persisted. Because the malignant potential of the tumor could not be ruled out, a laparotomy was performed. The tumor was excised from the pancreas. On pathological examination, the tumor was proven to be a lymphoepithelial cyst. After the operation, the patient’s serum CA 19-9 level decreased to the normal range. Lymphoepithelial cysts of the pancreas are a rare, benign entity. They are true pancreatic cysts, characterized by a mature, keratinizing, squamous lining surrounded by lymphoid tissue. Because the treatment options and the prognosis of these entities are quite different from those of other cystic neoplasms of the pancreas, preoperative differential diagnosis is the main issue. Thus, although they are rare, lymphoepithelial cysts should be considered in the differential diagnosis of cystic tumors of the pancreas. 相似文献
7.
Summary Compared to pseudocyst formation after prior pancreatitis, true cysts of the pancreas are rare. Pancreatic cysts with irregular
wall components or a mucinous content raise the suspicion for the presence of a cystic neoplasm, and surgical resection is
recommended. A case of a patient with a history of prostate cancer is described in whom a cyst of the pancreatic tail was
discovered incidentally. Based on the radiographic features, which did not support the presence of a serous cystadenoma, a
spleen-preserving distal pancreatectomy was performed. Histologic features were characteristic for a lymphoepithelial cyst
(LEC) of the pancreas, lined with thinned squamous epithelium surrounded by benign lymphoid tissue. Since LECs of the parotid
gland, which are associated with acquired human immunodeficiency, are frequently related to Epstein-Barr virus (EBV) infection,
EBVin situ hybridization was performed and did not reveal evidence for EBV. Twenty-eight instances of pancreatic LECs have been reported,
primarily affecting adult males, without evidence of increased numbers of EBV-positive cells. The pathogenesis, differential
diagnosis, and clinical implications of lymphoepithelial pancreatic cysts are discussed. 相似文献
8.
9.
A giant retention cyst of the pancreas (cystic dilatation of dorsal pancreatic duct) associated with pancreas divisum 总被引:1,自引:0,他引:1
Morise Z Yamafuji K Tsuji T Asami A Takeshima K Hayashi N Baba H Yoshida F Abe Y Tokura Y 《Journal of gastroenterology》2002,37(12):1079-1082
We describe a rare case of pancreas divisum associated with a giant retention cyst (cystic dilatation of the dorsal pancreatic
duct), presumably formed following obstruction of the minor papilla. The patient was treated by pancreatico(cysto)jejunostomy.
A 50-year-old man was admitted with complaints of increasing upper abdominal distension and body weight loss. There was no
previous history of pancreatitis, gallstones, drinking, or abdominal injury. An elastic-hard tumor-like resistance was palpable
in the upper abdomen. Computed tomography and ultrasound (US) examinations revealed a giant cystic lesion expanding from the
pancreas head to the tail. Endoscopic retrograde cholangiopancreatography findings showed a looping pancreatic duct which
drained only the head and uncinate process of the pancreas to the main papilla. A US-guided puncture to the cystic lesion
revealed that the lesion continued to the main pancreatic duct in the tail of pancreas. The lesion was connected to a small
cystic lesion, which was located inside the minor papilla, and ended there. The amylase level in liquid aspirated from the
cyst was 37 869 IU/l, and the result of cytological examination of the liquid showed class II. A pancreatico(cysto)jejunostomy
was performed, with the diagnosis being pancreas divisum associated with a retention cyst following obstruction of the minor
papilla. The histological findings of a specimen from the cyst wall revealed that the wall was a pancreatic duct covered with
mildly inflammatory duct epithelium; there was no evidence of neoplasm. The patient is currently well, and a CT examination
2 years after the operation showed disappearance of the cyst and normal appearance of the whole pancreas.
Received: April 24, 2001 / Accepted: September 14, 2001 相似文献
10.
Isao Hamamoto Ken Ishimura Setsuo Okada Shoji Kobayashi Yoshio Kushida Takashi Maeba Hajima Maeta 《Journal of hepato-biliary-pancreatic sciences》1996,3(2):186-191
A lymphoepithelial cyst is reported. A 68-year-old man consulted a surgeon, presenting with a sense of abdominal fullness. Ultrasonography and computed tomography revealed a large tumor, 10 cm in diameter, behind the head of the pancreas. Celiac arteriography at our hospital showed feeding arteries from the dorsal pancreatic artery and the pancreatic arcades. CA19-9 was elevated to 178 U/ml. Laparotomy was performed. The tumor was well demarcated from the surrounding tissue by a fibrous capsule and there was no continuity to the pancreatic parenchyma. Simple tumorectomy and distal gastrectomy for peptic gastric ulcer disease were performed. The cut surface revealed a multicystic lesion containing atheromatous substances. Histopathologically, the internal surface of the cyst was lined with stratified squamous epithelium containing mucin-producing cells; many germinal centers were observed in the cyst wall. 相似文献
11.
12.
Calogero Iacono Giuseppe Zamboni Roberto Di Marcello Marianna Zicari Michela Maran Ettore Montresor Nicola Nicoli Giovanni Serio 《Journal of gastrointestinal cancer》1993,14(3):269-273
Summary We report a case of dermoid cyst of the head of the pancreas area in a 26-yr-old woman radically treated with pancreatoduodenectomy
and alive with no recurrence at 6-yr follow-up. The diagnostic and surgical procedures are described, and the literature is
reviewed. 相似文献
13.
B Bastens M Golaire J Cappelli V Lamy J Dryjski R Moisse 《Gastroentérologie clinique et biologique》1992,16(10):808-810
A 66-year-old woman presented with abdominal pain and weight loss. Ultrasonography and computed tomography demonstrated a cystic lesion of the pancreas. After surgical resection, the patient's symptoms disappeared. Microscopic examination of the cyst lining showed mature, keratinizing squamous epithelium, surrounded by lymphoid tissue. Only three cases of this type of lesion, called "lymphoepithelial cyst", have been described previously. Histogenesis of this particular type of cyst is not well know, but can be histologically differentiated from other pancreatic cysts. 相似文献
14.
Tajiri T Tate G Inagaki T Kunimura T Inoue K Mitsuya T Yoshiba M Morohoshi T 《Journal of gastroenterology》2004,39(2):181-187
A 56-year-old woman who had undergone excision of the gallbladder because of a choledochal cyst had a tumorous lesion of the pancreas identified by upper abdominal ultrasonography, but an operation was not carried out, because there was no apparent increase in the cystic mass and no elevation of serum tumor markers. In October 2001, she was admitted to our hospital to check for malignancy because of elevated levels of the tumor marker Dupan-2. Abdominal enhanced computed tomography and upper abdominal ultrasonography revealed a large multilocular cystic mass in the body to tail of the pancreas. Endoscopic retrograde cholangiopancreatography showed elongation of the common duct that communicates with the common bile duct and the main pancreatic duct, indicating an anomalous arrangement of the biliary and pancreatic duct system. No apparent communications between the cystic mass and the main pancreatic duct were observed. In January 2002, the patient underwent a spleen-preserving distal pancreatectomy, and histopathological and immunohistochemical examinations led to the diagnosis of pancreatic mucinous cystadenoma with ovarian-like stroma. The mucinous cystadenoma was detected 17 years after the operation for the choledochal cyst. To the best of our knowledge, no documented case reports of mucinous cystadenoma of the pancreas associated with a choledocal cyst have been reported to date. We present here the first case report of pancreatic mucinous cystadenoma occurring in the body to tail of the pancreas, associated with a choledocal cyst. 相似文献
15.
Takahashi O Kondo S Hirano S Ambo Y Tanaka E Morikawa T Okushiba S Kato H 《Journal of gastrointestinal cancer》2001,30(3):165-170
Background: Solitary true cyst of the pancreas is rare in adults, and the differential diagnosis of cystic lesions of the pancreas is
challenging.
Aim of the Study: To describe a solitary true cyst of the pancreas in an adult and discuss the differential diagnosis.
Methods: A 50 yr old woman presented with a mass lesion in the right upper quadrant of the abdomen. Abdominal computed tomography
showed a cystic lesion, with a maximum diameter of 12 cm, between the inferior surface of the liver and the ascending colon.
The cyst was homogenous and had smooth edges. On magnetic resonance imaging, a unilocular cyst was seen that was low intensity
on T1-weighted images and very high intensity on T2-weighted images. No connection between the cyst and the pancreatic ductal
system was demonstrated on endoscopic retrograde cholangiopancreatography. Laparotmy was performed with a presumptive diagnosis
of cystic tumor of the pancreas.
Results: On pathologic examination, the cyst was serous and was lined with a single layer of normal cuboidal epithelium that was periodic
acid Schiff stain negative. Meticulous examination failed to identify honeycomb-like microcysts characteristic of serous cystadenoma.
The final diagnosis was a solitary true cyst of the pancreas.
Conclusion: The differential diagnosis of solitary true cyst from other cystic lesion of the pancreas usually is based on histology.
Particular care must be taken to distinguish this lesion from macrocystic serous cystadenoma. 相似文献
16.
Lymphoepithelial cyst in the pancreas: a case report 总被引:1,自引:0,他引:1
A case of lymphoepithelial cyst in the pancreas was reported. A 64-year-old man without any specific complaints was found to have a cystic lesion in the anterior portion of the pancreas, as revealed by ultrasonography of the abdomen at an annual medical examination in 1988. This was dissected easily from the pancreas. Histologically, it was diagnosed to be a benign lymphoepithelial cyst in the pancreas. Cysts of this type are rare, and their histogenesis is also not well understood. 相似文献
17.
18.
19.
Kobayashi T Shimura T Araki K Ogawa A Mochida Y Suzuki H Suehiro T Kuwano H 《Hepato-gastroenterology》2008,55(84):1107-1109
The aim of this report is to describe the clinical and pathological features of a lympoepithelial cyst of the pancreas and to recommend fine-needle aspiration biopsy for the differential diagnosis of this lesion. A 55-year-old man was incidentally diagnosed as having a pancreatic tumor by abdominal ultrasonography. A hypoechoic cystic lesion was detected on the surface of the pancreatic body. A computed tomography revealed a cystic lesion surrounded by a smooth, flat wall. Magnetic resonance imaging revealed that the lesion was a low-intensity mass on the T1-image and a slightly high-intensity mass on the T2-image. The lesion was diagnosed as a benign cystic tumor, and enucleation of the tumor was scheduled. The fine needle aspiration biopsy was performed after laparotomy, and cytology of the contents was negative for malignant cells. The postoperative pathological diagnosis was a lymphoepithelial cyst of the pancreas. This cyst is an unusual but benign mass that requires minimal surgery. 相似文献
20.
Chuanyan Mao Ayman El Attar Don R. Domenico Kitai Kim John M. Howard 《Journal of gastrointestinal cancer》1998,23(2):153-164
Summary
Conclusion. The diagnosis of a pancreatic carcinoid should be based on the measurement of serotonin in serum or its demonstration
in the tumor and/or by the measurement of its derivative (5-HIAA) in urine. Carcinoid of the pancreas is a rare but definite
entity; usually having metastasized by the time of diagnosis. The term “serotonin-producing tumor of the pancreas” has been
suggested as an alternative designation for “pancreatic carcinoid.”
Background. The literature on carcinoid tumors of the pancreas is confusing because much of it preceded the development of the more specific
immunological, chemical and staining techniques currently available.
Methods. 43 case reports were collected from the world’s literature, based on a demonstrable pancreatic neuroendocrine tumor plus
a positive finding of at least one of the following without another dominant hormone being demonstrated: elevation of 5-Hydroxytryptamine
(5-HT) (serotonin) in the serum or detected in tumor tissue, and/or elevation of 5-Hydroxyindole acetic acid (5-HIAA) in the
urine. In addition to these two hormone-specific assays, information was collected on the silver-staining properties of the
tumor; properties which have traditionally been associated with carcinoid tumors. Positive silver staining in tumor cells
(argyrophilic and/or argentaffin reaction) is strongly indicative of the carcinoid tumor but the findings are less specific
than the hormone assays and immunohistologic stains.
Results. In this review of 43 cases, including two current ones, the pancreatic carcinoid tumor has the following important features:
Its growth characteristics may be related more to its cell of origin than to its extent of hormone secretion. Not all of the
tumors result in recognizable hyperserotoninemia. 相似文献
1. | It is a rare tumor that is usually diagnosed late when the tumor is large and has metastasized. Thirty-eight (88.4%) have been malignant. They are, therefore, associated with a high incidence of the “carcinoid syndrome.” |
2. | To date, prognosis in therapy is poor, based on delayed diagnosis, a resultant low incidence of resectability, and an uncertain duration of survival after resection. |
3. | Pancreatic carcinoid tumors remain difficult to differentiate from other endocrine tumors. The measurement of urinary 5-HIAA excretion or the demonstration of elevated serotonin level in the tumor or in serum is essential to its distinction. Silver staining of the tumor, although of historic importance, has been superceded by the hormone-specific studies. |
4. | To distinguish it from other endocrine tumors of the pancreas, the terms “pancreatic serotoninoma” or “serotonin-producing tumor of the pancreas” have been suggested as possible alternatives. |