共查询到20条相似文献，搜索用时 15 毫秒
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目的：为内镜下副胰管插管、十二指肠小乳头切开等提供解剖学基础。方法：在30例成人尸体上对十二指肠小乳头的形态、位置、开口以及与大乳头之间的关系进行解剖观察。结果：十二指肠小乳头的出现率为70%。可见明显开口的占55%。小乳头形态有半球形、圆锥形、半颗粒形、扁平形和不规则形。小乳头距离幽门、十二指肠第一环、大乳头的距离分别为(58．69±15．74)mm,(23．21±8．82)mm和(22．75±6．81)mm;大、小乳头开口连线与十二指肠纵襞纵轴线的夹角为(20．80±9．40)°。结论：十二指肠小乳头的出现率与副胰管的发育程度相关,本文结果为内镜下行十二指肠小乳头插管和小乳头切开术提供了参考。 相似文献
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Kajiwara M Fujii S Takahashi S Konishi M Nakagohri T Gotohda N Kinoshita T 《Virchows Archiv : an international journal of pathology》2007,451(6):1075-1081
It is extremely rare to encounter tumors arising exclusively in the minor duodenal papilla. We report a 60-year-old male patient
with a polypoid type of adenocarcinoma of the minor papilla. Preoperative examinations, including computed tomography (CT)
and magnetic resonance cholangiopancreatography (MRCP), suggested pancreas divisum and showed a series of stones in the dorsal
pancreatic duct. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy (SSpPD). On histology, an adenocarcinoma
was located in the minor papilla, which was limited to the mucosa, without invasion of the duodenum, sphincter muscles of
the minor papilla, or the underlying pancreas. The carcinoma cells, together with dysplastic and hyperplastic epithelium of
the pancreatic duct, extended peripherally within the pancreatic duct. No cystic dilatation of the pancreatic duct was observed.
The ventral pancreatic duct was short and narrow; there was evidence of chronic pancreatitis in the dorsal pancreas, whereas
the ventral pancreas was almost normal, suggesting the existence of pancreas divisum. Although it is well known that adenocarcinoma
of the duodenal papilla is sometimes accompanied by intraepithelial spread in the pancreatic duct, an adenocarcinoma arising
in the minor papilla in this case with pancreas divisum was more extended than our thoughts. 相似文献
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Background Clinical expression of pancreas divisum is often explained as a consequence of relative or true stenosis of the minor papilla with dorsal duct obstruction. This anatomo-functional study of the minor papilla in pancreas divisum has included its topographical, functional and structural features.Materials and methods The study was carried out on 37 human autopsy specimens of duodenopancreas, which underwent pancreatography, manometrically controlled perfusion and light microscopy.Results One pancreas divisum was detected in the study group. In this case, the distances between the minor and the major papilla was 24.0 mm, and between the minor papilla and the superior duodenal flexure 27.4 mm. The minor papilla was patent when perfused under pressure of 10 mmHg, and its light microscopy revealed regular global histological organization with only light fibrosis and no cellular atypia.Conclusions The structure and position of the minor papilla in pancreas divisum did not significantly differ from the ones in fused pancreases. 相似文献
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Mai KT Belanger EC Al-Maghrabi HM Robertson S Wang D Margnean C 《Pathology, research and practice》2008,204(4):251-258
The central zone (CZ) of the prostate is embryologically, anatomically, and histologically distinct. High-grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma (PAC) are encountered in the CZ, but have not been well studied. Non-CZ PAC that spread into the CZ can mimic CZ PAC. We reviewed 300 consecutive radical prostatectomies performed for PAC to identify cases showing PAC and HGPIN in the CZ. There were nine PAC (3%) localized predominantly in the CZ, presenting as a single tumor nodule (8/9) and associated with 4.5+/-1.1 foci HGPIN in the CZ and with only 1.7+/-0.5 foci in the PZ. Of the 291 non-CZ PAC, 24 cases showed satellite tumor nodules in the CZ, and 92 cases demonstrated secondary contiguous spread to the CZ. As compared to the non-CZ PAC, CZ PAC tended to have lower tumor volume, but had higher Gleason scores (8.10+/-0.6 vs. 6.30+/-0.7, p<0.05), as well as a higher incidence of a ductal carcinoma component (6/9), higher rates of capsular penetration, positive resection margins (4/9), and seminal vesicle spread (2/9). The CZ HGPIN associated with CZ PAC demonstrated cells with prominent nucleoli and formed either slender papillary structures or cribriform/solid patterns. The correlating positive biopsy cores were from the mid portion or from base of prostate and contained foci of HGPIN in 4/7 cases. The CZ PAC is characteristically accompanied by more foci of HGPIN in the CZ than in non-CZ and is associated with high grade and high stage. Preoperative diagnosis of CZ PAC can be suspected due to the histopathological features in the biopsy and is important to improve the free surgical resection rate. 相似文献
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目的： 探讨原发性十二指肠球部腺癌的临床特点及诊治方法。方法：对中国人民解放军第163医院消化内科2012年诊断的1例十二指肠球部腺癌的临床资料进行回顾性分析。结果：胃镜检查见十二指肠球部大弯侧一乳头样肿物,表面凹凸不平,质脆触之易出血;病理检查报告为十二指肠球部低分化腺癌,侵犯至外膜,腺管内癌栓形成,两断缘未见癌细胞,胃大弯侧淋巴结有转移（2/2）,胃小弯侧淋巴结有转移（3/7）;其余检查结果均为阴性。结论：内镜活组织病理检查或术中活组织病理检查是确诊原发性十二指肠球部腺癌的依据;早期诊断及手术是彻底治疗本病,提高患者生存率,改善预后的关键。 相似文献
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H. -R. Zenklusen J. Landmann A. Feess M. Dürig M. Kasper M. Oberholzer 《Virchows Archiv : an international journal of pathology》1989,414(6):529-533
Summary Primary duodenal carcinoma and duodenal adenoma are rare tumours. Duodenal carcinoma makes up about 0.3% of all malignant tumours of the gastrointestinal tract (Alwmark et al. 1980; Spira et al. 1977). The present paper describes a duodenal carcinoma arising in a mixed tubulo-villous non-Vaterian adenoma in a 68 year old male. Immunocytochemical analysis revealed evidence of neuroendocrine differentiation in both adenoma and carcinoma. In a review of the literature a correlation between the size of adenoma and the probability of concomitant carcinoma is demonstrated. Duodenal adenoma measuring more than 4 cm in diameter should be considered potentially malignant. 相似文献
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