An Algorithmic Approach to the Diagnosis of Pancreatic Neoplasms

2009 ◽  
Vol 133 (3) ◽  
pp. 454-464 ◽  
Author(s):  
David S. Klimstra ◽  
Martha B. Pitman ◽  
Ralph H. Hruban
Keyword(s):  
Differential Diagnosis ◽  
Pancreatic Neoplasms ◽  
Pancreatic Neoplasm ◽  
Diagnostic Information ◽  
Data Sources ◽  
Algorithmic Approach ◽  
Normal Gland ◽  
Pathologic Evaluation ◽  
Additional Diagnostic Information

Abstract Context.—The pancreas gives rise to an array of distinct neoplasms that can be solid, cystic, or intraductal and can recapitulate the various lines of differentiation present in the normal gland. Objective.—To develop an algorithmic approach to the diagnosis of pancreatic neoplasms that simplifies their pathologic evaluation. Data Sources.—We reviewed literature related to the classification of pancreatic neoplasms on the basis of their gross, histologic, and immunohistochemical features. Conclusions.—By using a series of dichotomous decisions, the differential diagnosis of a pancreatic neoplasm can be narrowed, and in cases of the more common neoplasms, accurate classification can be achieved. Uncommon neoplasms not accounted for by this approach are also discussed, and the additional diagnostic information needed for complete pathologic reporting is presented.

Utility of Immunohistochemistry in the Pancreatobiliary Tract

2015 ◽  
Vol 139 (1) ◽  
pp. 24-38 ◽  
Author(s):  
Fan Lin ◽  
Zongming Eric Chen ◽  
Hanlin L. Wang
Keyword(s):  
Pancreatic Neoplasms ◽  
Pancreatic Neoplasm ◽  
Diagnostic Algorithm ◽  
Diagnostic Error ◽  
Research Data ◽  
Ancillary Study ◽  
Practice Experience ◽  
Therapeutic Decisions ◽  
Prognostic Outcome

Context Immunohistochemistry has become a useful ancillary study in the identification and classification of pancreatic neoplasms. The diagnostic accuracy has been significantly improved because of the continuous discoveries of tumor-associated biomarkers and the development of effective immunohistochemical panels. Objectives To identify and classify pancreatic neoplasms by immunohistochemistry. Data Sources Literature review and authors' research data and personal practice experience were used. Conclusions To better guide therapeutic decisions and predict the prognostic outcome, it is crucial to make an accurate diagnosis of a pancreatic neoplasm. Application of appropriate immunohistochemical panels enables pathologists to differentiate pancreaticobiliary adenocarcinomas from reactive conditions and to identify rare types of pancreatic neoplasms. Knowing the utilities and pitfalls of each tumor-associated biomarker is essential to avoiding a potential diagnostic error because an absolutely cancer-specific biomarker does not exist. This article reviews frequently used tumor-associated biomarkers, provides lists of effective immunohistochemical panels, and recommends a diagnostic algorithm as a standard approach to pancreatic neoplasms.

The therapeutic impact of 18F-FDG whole body PET

2005 ◽  
Vol 44 (01) ◽  
pp. 8-14 ◽  
Author(s):  
B. Dietl ◽  
J. Marienhagen
Keyword(s):  
Fdg Pet ◽  
Diagnostic Information ◽  
Whole Body ◽  
Therapeutic Concept ◽  
Therapeutic Impact ◽  
Additional Diagnostic Information ◽  
Therapeutic Decisions ◽  
Target Volumes ◽  
18F Fdg ◽  
Pet Scans

Summary Aims: An explorative analysis of the diagnostic as well as therapeutic impact of 18F-FDG whole body PET on patients with various tumours in the setting of an university hospital radiation therapy was performed. Patients and methods: 222 FDG PET investigations (148 initial stagings, 74 restagings) in 176 patients with diverse tumour entities (37 lung carcinoma, 15 gastrointestinal tumours, 38 head and neck cancer, 30 lymphoma, 37 breast cancer, 19 sarcoma and 16 other carcinomas) were done. All PET scans were evaluated in an interdisciplinary approach and consecutively confirmed by other imaging modalities or biopsy. Unconfirmed PET findings were ignored. Proportions of verified PET findings, additional diagnostic information (diagnostic impact) and changes of the therapeutic concept intended and documented before PET with special emphasis on radiooncological decisions (therapeutic impact) were analysed. Results: 195/222 (88%) FDG-PET findings were verified, 104/222 (47%) FDG-PET scans yielded additional diagnostic information (38 distant, 30 additional metastasis, 11 local recurrencies, 10 primary tumours and 15 residual tumours after chemoptherapy). The results of 75/222 (34%) scans induced changes in cancer therapy and those of 58/222 (26%) scans induced modifications of radiotherapeutic treatment plan (esp. target volumes). Conclusion: 18F-FDG whole body PET is a valuable diagnostic tool for therapy planning in radiooncology with a high impact on therapeutic decisions in initial staging as well as in restaging. Especially in a curative setting it should be used for definition of target volumes.

Classification of papillary thyroid carcinoma histological images based on deep learning

2021 ◽  
pp. 1-11
Author(s):  
Yaning Liu ◽  
Lin Han ◽  
Hexiang Wang ◽  
Bo Yin
Keyword(s):  
Neural Network ◽  
Differential Diagnosis ◽  
Deep Learning ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Image Features ◽  
Papillary Thyroid ◽  
Histological Image ◽  
Histological Images

Papillary thyroid carcinoma (PTC) is a common carcinoma in thyroid. As many benign thyroid nodules have the papillary structure which could easily be confused with PTC in morphology. Thus, pathologists have to take a lot of time on differential diagnosis of PTC besides personal diagnostic experience and there is no doubt that it is subjective and difficult to obtain consistency among observers. To address this issue, we applied deep learning to the differential diagnosis of PTC and proposed a histological image classification method for PTC based on the Inception Residual convolutional neural network (IRCNN) and support vector machine (SVM). First, in order to expand the dataset and solve the problem of histological image color inconsistency, a pre-processing module was constructed that included color transfer and mirror transform. Then, to alleviate overfitting of the deep learning model, we optimized the convolution neural network by combining Inception Network and Residual Network to extract image features. Finally, the SVM was trained via image features extracted by IRCNN to perform the classification task. Experimental results show effectiveness of the proposed method in the classification of PTC histological images.

Cystic pancreatic neoplasms: a differential diagnosis on CT and MR imaging

2019 ◽  
Vol 6 (4) ◽  
Author(s):  
Silvia Pellegrino ◽  
Dario Giambelluca ◽  
Roberto Cannella ◽  
Cecilia Gozzo ◽  
Giovanni Caruana ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Mr Imaging ◽  
Pancreatic Neoplasms ◽  
Cystic Pancreatic Neoplasms

Placental Mesenchymal Dysplasia

2007 ◽  
Vol 131 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Zahida Parveen ◽  
Jane Elaine Tongson-Ignacio ◽  
Cory R. Fraser ◽  
Jeffery L. Killeen ◽  
Karen S. Thompson
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Data Sources ◽  
Molar Pregnancy ◽  
Close Attention ◽  
Normal Fetus ◽  
Fetal Complications ◽  
Microscopic Features ◽  
Placental Mesenchymal Dysplasia

Abstract Context.—Placental mesenchymal dysplasia is characterized by placentomegaly and may be mistaken for molar pregnancy both clinically and macroscopically because of the presence of “grapelike vesicles.” It may be associated with a completely normal fetus, a fetus with growth restriction, or a fetus with features of Beckwith-Wiedemann syndrome. Objective.—To review the etiology, molecular pathology, gross and microscopic features, clinical presentation, complications, and differential diagnosis of placental mesenchymal dysplasia. Data Sources.—The PubMed and the Medline databases were systematically searched for articles between 1970 and 2006. The following keywords were used: placental mesenchymal dysplasia, mesenchymal hyperplasia, molar pregnancy, pseudomolar pregnancy, Beckwith-Wiedemann syndrome, and placentomegaly. Relevant references from review articles were also searched. Conclusions.—Placental mesenchymal dysplasia should be considered in the differential diagnosis when the ultrasonographic findings show a cystic placenta. Close attention should be paid to fetal morphology for early recognition of fetal complications and to prevent unnecessary termination of pregnancy in cases associated with a normal fetus.

scholarly journals Thoracic Kidney: Extremely Rare State of Aberrant Kidney

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Mahdi Khoshchehreh ◽  
Omalbanin Paknejad ◽  
Mehrdad Bakhshayesh-Karam ◽  
Marzieh Pazoki
Keyword(s):  
Differential Diagnosis ◽  
Rare Case ◽  
Medical Literature ◽  
Management Options ◽  
Rare Form ◽  
Renal Ectopia ◽  
Diagnosis And Management

The thorax is the rarest place among all forms of renal ectopia. We report a rare case of an unacquired thoracic kidney. Only about 200 cases of the thoracic kidney have ever been reported in medical literature worldwide. In this paper we present the rarest form of nontraumatic nonhernia associated, truly ectopic thoracic kidney. The differential diagnosis and management options and classification of this rare form of aberrant kidney are discussed.

scholarly journals Diagnosis-prescription studies – important steps towards a national drug prescription statistics in Norway

2009 ◽  
Vol 11 (1) ◽  
Author(s):  
Jørund Straand
Keyword(s):  
General Practice ◽  
Drug Prescription ◽  
Diagnostic Information ◽  
Data Sources ◽  
Font Size ◽  
Use Of Data ◽  
National Drug ◽  
Prescribing Practice ◽  
Drug Statistics ◽  
A Current

<strong><span style="font-family: TimesNewRomanPS-BoldMT;"><font face="TimesNewRomanPS-BoldMT"><p align="left"> </p></font></span><p align="left"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;"><span style="font-size: x-small; font-family: TimesNewRomanPS-BoldMT;">ABSTRACT</span></span></p></strong><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><span style="font-size: x-small; font-family: TimesNewRomanPSMT;"><p align="left">In the first part of this article, drug utilization and prescribing practice is discussed as seen from a</p><p align="left">Norwegian general practice perspective. Which are the data sources available? What kind of studies</p><p align="left">have been performed? Prescription-diagnosis studies are reviewed, in particular the Møre & Romsdal</p><p align="left">Prescription Study (MRPS). Because the wholesales drug statistics do not include information about</p><p align="left">neither patients, prescribers or diagnoses, there is a current need for establishing a more comprehensive</p><p align="left">statistics giving wider and deeper insights into the prescribing and utilization of drugs in the Norwegian</p><p align="left">society. The proposed Norwegian prescription statistics is discussed in relation to previous experiences</p><p align="left">from prescription-diagnosis studies and current needs for research and statistics in the field. Some</p><p align="left">examples are given illustrating why the 11-digit person number probably should be included in the</p><p align="left">database. Lack of diagnostic information may to some extent be compensated for by introducing a more</p><p align="left">differentiated list of diagnoses for the drugs reimbursed. The use of data from this statistics for quality</p><p align="left">assurance in e.g. general practice is discussed. Finally, some suggestions are given for how the Norwegian</p><p>prescription statistics may be organised.</p></span></span>

scholarly journals An updated classification of the jumping plant-lice (Hemiptera: Psylloidea) integrating molecular and morphological evidence

2021 ◽  
Vol 736 ◽  
pp. 137-182
Author(s):  
Daniel Burckhardt ◽  
David Ouvrard ◽  
Diana M. Percy
Keyword(s):  
New Species ◽  
New Genus ◽  
Molecular Data ◽  
Data Sources ◽  
Morphological Evidence ◽  
Sampling Strategies ◽  
Molecular Studies ◽  
Family Level ◽  
A New Species

The classification of the superfamily Psylloidea is revised to incorporate findings from recent molecular studies, and to integrate a reassessment of monophyla primarily based on molecular data with morphological evidence and previous classifications. We incorporate a reinterpretation of relevant morphology in the light of the molecular findings and discuss conflicts with respect to different data sources and sampling strategies. Seven families are recognised of which four (Calophyidae, Carsidaridae, Mastigimatidae and Triozidae) are strongly supported, and three (Aphalaridae, Liviidae and Psyllidae) weakly or moderately supported. Although the revised classification is mostly similar to those recognised by recent authors, there are some notable differences, such as Diaphorina and Katacephala which are transferred from Liviidae to Psyllidae. Five new subfamilies and one new genus are described, and one secondary homonym is replaced by a new species name. A new or revised status is proposed for one family, four subfamilies, four tribes, seven subtribes and five genera. One tribe and eight genera / subgenera are synonymised, and 32 new and six revised species combinations are proposed. All recognised genera of Psylloidea (extant and fossil) are assigned to family level taxa, except for one which is considered a nomen dubium.

scholarly journals Primary Urachal Hydatid Cyst in a Child: A Case Report

2019 ◽  
Author(s):  
Tugay TARTAR ◽  
Unal BAKAL ◽  
Mehmet SARAC ◽  
Ibrahim AKDENIZ ◽  
Ahmet KAZEZ
Keyword(s):  
Differential Diagnosis ◽  
Hydatid Cyst ◽  
Abdominal Wall ◽  
Pediatric Surgery ◽  
Anterior Abdominal Wall ◽  
Cystic Mass ◽  
Parasitic Disease ◽  
Pathologic Evaluation ◽  
School Of Medicine ◽  
Median Incision

The hydatid cyst (HC) is an endemic parasitic disease worldwide. Although the HC can locate in every part of a body, it rarely occurs over the abdominal wall. A 12-year-old female patient was brought to Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey in 2017. She had been suffering from abdominal pain for one week. A lump was determined underneath her skin in the suprapubic region. It was swollen, tense and movable. A cystic mass filling the midline was found in the radiological bladder superior. It was an anechoic cyst causing ondulation on the muscles of the anterior abdominal wall. The sizes of the mass were measured approximately as 9x7 cm (mesentery cyst?). The cystic mass was occurred in the urachal area of the anterior abdominal wall, not in the abdomen. After the cyst was emptied with applying mini median incision below the umbilicus, we saw the germinative membrane inside the cyst. Diagnosis of the HC was confirmed with the pathologic evaluation. For the differential diagnosis of a pure cystic mass, which can locate in every part of a body, diagnosis of the HC should be considered.

scholarly journals Current Status of Histogenetic and Morphogenetic Concepts of Salivary Gland Tumorigenesis

1993 ◽  
Vol 4 (5) ◽  
pp. 639-677 ◽  
Author(s):  
Irving Dardick ◽  
Aileen P. Burford-Mason
Keyword(s):  
Salivary Gland ◽  
Acinar Cells ◽  
Neoplastic Transformation ◽  
Cell Types ◽  
Salivary Gland Tumors ◽  
Current Status ◽  
Normal Gland ◽  
Routine Diagnosis ◽  
Diagnosis And Classification

Because of their complexity and relative infrequency, salivary gland tumors commonly result in diagnostic problems. Histogenetic and morphogenetic concepts of tumorigenesis in these glands are reviewed and their relevance to routine diagnosis and classification of salivary gland tumors evaluated. Evidence is presented from animal and human studies that under steady-state and pathophysiological conditions, all cell types present in the normal gland, including acinar cells, are capable of rapidly entering the cell cycle and are, therefore, possible targets for neoplastic transformation.

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