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PubMed1978

[Ultrasound in tumor diagnostics. Possibilities and problems with regard to internal medicine as an example (author's transl)].

Ultrasound B-scan (real time and gray scale technique) has proved to be a noninvasive, low expensive and suitable method in internal tumor diagnostics. The most important fields are the diagnosis of pancreatic tumors, of malignant lymphomas, of tumors of the kidneys and the adrenal gland. Furthermore there is possible the diagnosis of tumors of the liver, the bile ducts, the spleen and the thyroid gland. The differentiation between solid and cystic tumors has shown to be a domain of ultrasonography. The limitations of the method are caused by the relatively bad (lateral) resolution of ultrasonography. Therefore tumors smaller than 1.5 cm cannot be diagnosed regularly. There is, moreover, no ultrasonic pattern typical of malignancy.

Adrenal Gland Neoplasms↗
PubMed1995

Mutations of p16Ink4/CDKN2 and p15Ink4B/MTS2 genes in biliary tract cancers.

p16Ink4 and p15Ink4B are cyclin-dependent kinase 4 inhibitors and link to the regulation of cell cycle in mammalian cells. The genes encoding these inhibitors are located at 9p21, which is a frequent site of allelic loss in various types of tumors. Twenty-five primary biliary tract cancers were examined for somatic mutations in p16Ink4/CDKN2, p15Ink4B/MTS2, p53, and K-ras genes and allelic loss of 9p21 by microsatellite analysis. Four biliary tract cancer cell lines were analyzed for homozygous deletions and point mutations. We found frequent homozygous deletions in p16Ink4/CDKN2 and p15Ink4B/MTS2 genes in the biliary tract cancer cell lines. Each cancer cell line had alteration of either p16Ink4/CDKN2, p15Ink4B/MTS2, or p53 genes. In primary tumors, 16 of 25 (64%) biliary tract cancers had point mutations in the p16Ink4/CDKN2 gene. These include 14 missense and 2 silent mutations. The frequency of mutations in gall bladder cancer and hilar bile duct cancer were 80% (8 of 10) and 63% (5 of 8), respectively. Each of codons 1, 80, and 111 was changed in two cases of these cancers. One of three intrahepatic bile duct cancers, one of two common bile duct cancers, and one of two ampullary cancers had mutations in the p16Ink4/CDKN2 gene. In contrast, no mutation in the p15Ink4B/MTS2 gene, one base change in the K-ras gene, and one loss of heterozygosity at the IFN alpha locus in 25 cancers and one base change in the p53 gene in 19 cancers were observed. These results suggest that p16Ink4/CDKN2, rather than p15Ink4B/MTS2 or p53 genes, and its inactivation may be important in biliary tract carcinogenesis.

Base Sequence↗
PubMed1994

Secondary involvement of femur in carcinoma of gall bladder.

A case with bony metastasis to right femur from a primary carcinoma of gall bladder is described. This is probably one of the most rare presentation of the disease without producing any signs or symptoms suggestive of a primary pathology in gall bladder.

Adenocarcinoma↗
PubMed1993

[Immunoscintigraphy of human pancreatic cancer an experimental study].

A monoclonal antibody against human pancreatic carcinoma APCA-1, was developed. By immunohistochemical staining, it had pretty good reactivity to carcinoma of the pancreas, bile duct and gall bladder. Their positive rates were 94.1%, 80% and 75%, respectively. It cross reacted weakly with normal epithelial cells of the pancreas, gall bladder and bile duct in relatively low frequency. Immunoscintigraphy was performed in nude mice with xenograft of human pancreatic cancer using 131I-labeled APCA. Good radio-imaging of the tumor xenograft was achieved. The ratio of radioactivity of each gram of tumor tissue to total radioactivity reached 5.1%, 6.9% and 6.2% at 72,120 and 168 hr respectively.

Adenocarcinoma↗
PubMed1993

[Endosonography in tumors of the pancreas and bile ducts].

The sensitivity of EUS in demonstrating pancreatic tumors lies above 90% and tumors smaller than 2 cm in diameter can be visualized. Therefore EUS can be applied e.g. in the early diagnosis of symptomatic endocrine tumors. However, it is not suited as a screening method for pancreatic carcinoma in asymptomatic patients. The EUS findings do not permit a clear differentiation between malignant and inflammatory (pseudo) tumors. The specificity for the demonstration of malignant tumors is 74%. Its main importance is in the locoregional staging of tumors. EUS is superior to all other imaging tools in determining tumor extension and infiltration into the portal or splenic vein. The pT-stage is determined correctly preoperatively in 90% and lymph node metastases (N1) in about 73% (sensitivity 80-90%/specificity 50%) of the cases. Malignant tumors of Vater's papilla (ampullary tumors) and of extrahepatic bile ducts can be demonstrated endosonographically in nearly all cases. However, tumors of the proximal bile ducts, especially of the right hepatic duct are difficult and sometimes impossible to visualize. The value of EUS in bile duct cancer is in local tumor staging. The pT-stage is determined correctly in 80-90%, the sensitivity and specificity for N1-stage is 80-90% and 30% respectively. Comparative studies with other methods are lacking at the present time. The value of EUS in gall bladder tumors is not yet determined. Stones in the gall bladder may hinder the visualization of the gall bladder wall. In one study the pT-stage for gall bladder carcinoma was determined correctly preoperatively in 76.9% and the N1-stage in 80.7% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Ampulla of Vater↗
PubMed1977

[Malignant obstructive jaundice. Current status of surgical therapy].

424 patients with malignant jaundice were treated from 1964 to 1976. 152 carcinomas of the extrahepatic biliary tract and 272 carcinomas of the duodenopancreatic region were reported. Initial symptoms of cancer of this region are often vague, so that physicians must employ a high index of suspicion if earlier diagnosis is to be effected. Most of the carcinomas of pancreas and the biliary tract are unresectable because of the early dissemination. The dismal of the malignant tumors of the biliary tract is unchanged during the last 50 years but survival rates are better in carcinoma of the duodeno-pancreatic region.

Bile Duct Neoplasms↗
PubMed1996

[Contrast enhanced CT].

Although CT is one of major diagnostic imaging methods, the role of CT in the detection and diagnosis of early carcinomas depends on the organ and character of the tumors. Because difference in attenuation between lung parenchyma and carcinomas is large, contrast enhanced CT is not effective to diagnose early lung carcinoma. However, difference in attenuation between parenchyma and tumor is small and change of the contour of the organ is not seen in many cases of small carcinomas in the liver, pancreas and kidneys, therefore helical (spiral) CT with contrast enhancement has markedly improved the diagnostic capability of small carcinomas in these organs. In the biliary tract, bladder, uterus and prostate small carcinomas can not be detected even on enhanced helical CT.

Bile Duct Neoplasms↗
PubMed2003

Primary endocrinomas (carcinoids and variant neoplasms) of the gallbladder. A statistical evaluation of 138 reported cases.

This study was carried out to obtain extensive information on carcinoids (the carcinoid group) and related variant endocrinomas (the variant group) of the gallbladder, and to statistically analyze their characteristics from various clinicopathologic aspects. A total of 138 cases were collected from the international sources, 101 belonging to the carcinoid group and 37 to the variant group. The first group consisted of 81 cases of typical and 20 atypical carcinoids. Comparative evaluation was attempted mainly between the carcinoid and variant groups, and occasionally between the typical and atypical carcinoid series when statistical significance was suspected. The carcinoid group showed a statistically significant difference from the variant group by exhibiting a younger average age (61.7 years vs 69.7 years: P<0.01), a higher incidence of associated cholelithiasis (87.3% vs 56.0%: P<0.01), a higher incidence of small tumors 50 mm or less (85.2% vs 52.9%: P<0.01), a smaller average tumor-size (29.6 mm vs 58.7 mm: P<0.01), a lower rate of metastases (40.7% vs 70.6%: P<0.05), a higher immunoreactivity rate of chromogranin (100.0% vs 66.7%: P<0.01), a lower immunoreactivity rate of gastrin (23.8% vs 70.6%: P<0.01), and a higher five-year survival rate (60.4% vs 21.3%: P<0.0005). Significant differences in various clinicopathological aspects confirmed between the carcinoid group and the variant group suggested that endocrine carcinomas of these two groups perform a different clinical pattern, represented most clearly by postoperative outcomes. These groupings are decided on the basis of histologic patterns, namely, well to poorly differentiated endocrine carcinomas (typical to atypical carcinoids) and undifferentiated or anaplastic variants of other endocrine carcinomas. The basic criteria for such classification of these endocrine carcinomas based on international agreements are required.

Age Factors↗