scholarly journals Gallbladder Ciliated Foregut Cyst Suspected of Malignancy Preoperatively

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Chikanori Tsutsumi ◽  
Toshiya Abe ◽  
Hirotaka Kuga ◽  
So Nakamura ◽  
Kazuyoshi Nishihara ◽  
...  

Background. Gallbladder ciliated foregut cysts (CFCs) of the lower diaphragm are extremely rare. Furthermore, they are rarely suspected of malignancy preoperatively. Case Presentation. A 50-year-old woman was referred to our hospital for further examination and treatment of a gallbladder tumor that was detected using abdominal ultrasonography (US). After a close inspection, she was diagnosed with a gallbladder tumor that was possibly malignant. Accordingly, open whole layer cholecystectomy was performed because intraoperative US revealed a tumor located on the intraperitoneal side of the gallbladder, and a rapid intraoperative pathological diagnosis identified no malignancy. A postoperative pathological examination revealed a cystic lesion with thin walls covered with ciliated epithelium, which laid on a connective tissue with smooth muscle fibers. Based on the above results, the final pathological diagnosis was CFC of the gallbladder without malignancy. Conclusions. Cases of gallbladder CFC can be considered as cysts requiring treatment owing to CFCs’ potential for malignant transformation and high-frequency symptoms.

2014 ◽  
Vol 21 (1) ◽  
pp. 91-92
Author(s):  
Justina Vaičiulėnaitė ◽  
Kęstutis Trainavičius

Primary diaphragmatic cyst – is a very rare diagnosis with complicated determination due to its specific anatomical location and close relation to other organs[1, 3]. However, diaphragmatic cysts are commonly discovered accidentally while performing visual examination because of totally other reasons [4]. 7-year-old male patient presented with abdominal pain and abdominal ultrasonography was performed. There was accidentally found a hepatic cyst of 39 × 30 mm size in right lobe of the liver. Operation was planned because of the cystic lesion enlargement. During the operation diaphragmatic cyst was found. Pathological examination revealed that this lesion is a mesothelial cyst of peritoneum.


2020 ◽  
Author(s):  
Lei Wang ◽  
Maoling Yuan ◽  
Feng Zhang ◽  
Haitao Wang ◽  
Qicheng Lu ◽  
...  

Abstract Background: Low-grade fibromyxoid sarcoma (LGFMS) is a rare fibrous tumor in soft tissues. Case presentation: A 25-year-old patient was admitted to our hospital for "more than two years with a mass in the left inguinal region". During the operation, rapid pathological examination and frozen section microscopy supported that the mass may be a low-grade mesenchymal tumor. Therefore, the surrounding tissues were resected correspondingly, Pathological diagnosis: low-grade fibromyxoid sarcoma in the inguinal region.Conclusions: Combined with literature analysis, the diagnosis of LGFMS mainly depends on pathological diagnosis, and surgical resection is the most effective treatment.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morichika Osa ◽  
Akihiro Sato ◽  
Maki Sakagami ◽  
Masaki Machida ◽  
Takao Sato ◽  
...  

Abstract Background Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx. Case presentation A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings. Conclusions This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tatsuki Ishikawa ◽  
Katsunori Nakano ◽  
Masafumi Osaka ◽  
Kenichi Aratani ◽  
Kadotani Yayoi ◽  
...  

Abstract Background  Primary neuroendocrine tumors of the gallbladder (GB-NETs) are rare, accounting for 0.5% of all NETs and 2.1% of all gallbladder cancers. Among GB-NETs, mixed neuroendocrine–non-neuroendocrine neoplasms of the gallbladder (GB-MiNENs) are extremely rare. Case presentation We present the case of a 66-year-old woman who was referred to us for the management of a gallbladder tumor (incidentally found during abdominal ultrasonography indicated for gallbladder stones). The patient had no history of abdominal pain or fever, and the findings on a physical examination were unremarkable. Blood tests showed normal levels of tumor markers. Imaging studies revealed a mass of approximately 10 mm in diameter (with no invasion of the gallbladder bed) located at the fundus of the gallbladder. A gallbladder cancer was suspected. Therefore, an open whole-layer cholecystectomy with regional lymph nodes dissection was performed. The postoperative course was uneventful, and she was discharged on postoperative day 6. Pathological findings showed GB-MiNENs with invasion of the subserosal layer and no lymph node invasion (classified T2aN0M0 pStage IIA according to the Union for International Cancer Control, 8th edition staging system). Analysis of the neuroendocrine markers revealed positive chromogranin A and synaptophysin, and a Ki-67 index above 95%. Fourteen months after the operation, a local recurrence was detected, and she was referred to another hospital for chemotherapy. Conclusions  GB-MiNENs are extremely aggressive tumors despite their tumor size. Optimal therapy should be chosen for each patient.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Dazhou Li ◽  
Linfu Zheng ◽  
Hongli Zhan

Abstract Background Oesophageal submucosal tumours are usually benign. We report a rare case of esophageal squamous cell carcinoma presenting as a submucosal tumour. Case presentation A 58-year-old man undergoing screening oesophago-gastroduodenoscopy was found to have a smooth-surfaced 0.6-cm sized submucosal tumour in the oesophagus 30 cm from the incisor. Endoscopic ultrasonography showed the tumour to be located in the muscularis mucosa; the lesion was heterogeneously hypoechoic and had a clear boundary. With a provisional diagnosis of leiomyoma, the tumour was removed by endoscopic submucosal dissection. Pathological examination showed it to be a moderately differentiated infiltrating squamous cell carcinoma, with normal overlying squamous epithelium. Immunohistochemistry indicated that it was caused by malignant transformation in mucosal glandular duct epithelium. Positron emission tomography–computer tomography showed no tumour spread to any other site. The patient was treated by oesophageal resection. Conclusion The clinician should be aware that oesophageal submucosal tumours with smooth overlying mucosa may not always be benign; malignancy must be ruled out.


Author(s):  
Biluo Shen ◽  
Zhe Zhang ◽  
Xiaojing Shi ◽  
Caiguang Cao ◽  
Zeyu Zhang ◽  
...  

Abstract Purpose Surgery is the predominant treatment modality of human glioma but suffers difficulty on clearly identifying tumor boundaries in clinic. Conventional practice involves neurosurgeon’s visual evaluation and intraoperative histological examination of dissected tissues using frozen section, which is time-consuming and complex. The aim of this study was to develop fluorescent imaging coupled with artificial intelligence technique to quickly and accurately determine glioma in real-time during surgery. Methods Glioma patients (N = 23) were enrolled and injected with indocyanine green for fluorescence image–guided surgery. Tissue samples (N = 1874) were harvested from surgery of these patients, and the second near-infrared window (NIR-II, 1000–1700 nm) fluorescence images were obtained. Deep convolutional neural networks (CNNs) combined with NIR-II fluorescence imaging (named as FL-CNN) were explored to automatically provide pathological diagnosis of glioma in situ in real-time during patient surgery. The pathological examination results were used as the gold standard. Results The developed FL-CNN achieved the area under the curve (AUC) of 0.945. Comparing to neurosurgeons’ judgment, with the same level of specificity >80%, FL-CNN achieved a much higher sensitivity (93.8% versus 82.0%, P < 0.001) with zero time overhead. Further experiments demonstrated that FL-CNN corrected >70% of the errors made by neurosurgeons. FL-CNN was also able to rapidly predict grade and Ki-67 level (AUC 0.810 and 0.625) of tumor specimens intraoperatively. Conclusion Our study demonstrates that deep CNNs are better at capturing important information from fluorescence images than surgeons’ evaluation during patient surgery. FL-CNN is highly promising to provide pathological diagnosis intraoperatively and assist neurosurgeons to obtain maximum resection safely. Trial registration ChiCTR ChiCTR2000029402. Registered 29 January 2020, retrospectively registered


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng-Zhi Zhao ◽  
Bin Wang ◽  
Chun-yan Zhong ◽  
Shen-tao Lu ◽  
Li Lei

Abstract Background Endometriosis of the uterine body can be manifested as diffuse solid lesions or cystic lesions. The former is common, while the latter is rare, especially for cystic adenomyosis larger than 5 cm. Case presentation A 30-year-old woman was admitted for severe and worsening dysmenorrhea. Ultrasound examination revealed a rare well-circumscribed cystic lesion about 5.5 × 4 × 5.0 cm. CA-125 level was slightly elevated. She accepted laparoscopic surgery and the adenomyotic tissues were excised. The histopathology of the specimen demonstrated the endometrial glands in the walls of cysts and an area of extensive hemorrhage can be seen in the inner wall of cyst. The patient made a good recovery after surgery and her symptoms complete resoluted. Conclusions This is a rare case of a cystic adenomyotic lesion that was treated by laparoscopic surgery.


2020 ◽  
Author(s):  
Zhitao Chen ◽  
Yaoxiang Lin ◽  
Mengxia Li ◽  
Ting Zhang ◽  
Lele Zhang ◽  
...  

Abstract BackgroundPancreatic inflammatory myofibroblastic tumor (IMT) is a relatively rare disease, which is often confused with pancreatic cancer or pancreatic neuroendocrine tumor. Its histological features are fibroblast and myofibroblast proliferation, accompanied by varying degrees of inflammatory cell infiltration. Case presentationHerein, we presented the management of IMT occurring at the neck of pancreas. A 66-year-old female patient was diagnosed as pancreatic neck mass after a series of tests. Then she underwent enucleation of pancreatic neck tumor followed by pathological diagnosis of IMT. Meanwhile, we reviewed the clinical features and pathological diagnosis and treatment of pancreatic IMT which were previously reported. To our knowledge, this is the unique case of enucleation of pancreatic IMT. ConclusionIn the management of pancreatic IMT, we concluded that enucleation may be a safe and efficient surgical method for the management of pancreatic IMT and may also provide a better prognosis. Further accumulation of cases is required to explore the surgical measure of pancreatic IMTs.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohammed Aldahmashi ◽  
Abdalmotaleb Elmadawy ◽  
Mahmoud Mahdy ◽  
Mohamed Alaa

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jingli Guo ◽  
Wenyi Tang ◽  
Wei Liu ◽  
Min Zhou ◽  
Qing Chang ◽  
...  

Abstract Background To report undescribed characteristics of patients with bilateral diffuse uveal melanocytic proliferation (BDUMP) on ultrasound biomicroscopy (UBM) and high-frequency B-scan ultrasonography. Case presentation Two of four participants presented with worsening bilateral vision after previously diagnosed primary pulmonary or ovarian carcinoma. The other two patients were diagnosed with lung carcinoma after presentation with BDUMP. All patients had ciliary body nevi-like lesion in combination with iris or ciliary body cysts, and uveal thickening on UBM. Focally elevated choroidal nevi-like lesion and exudative retinal detachment with choroidal thickening were detected with B-scan ultrasonography. Conclusions Our case series demonstrates the uveal characteristics of patients with BDUMP based on high-frequency B-scan ultrasonography and UBM. Ultrasonographic findings are crucial in the diagnosis of BDUMP because it is occult in nature.


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