Pancreatic neoplasms

Biliary tract infections Necrotizing pancreatitis Neoplasms... 

Fuhrman GM, et al. Thin-section contrast-enhanced computed tomography accurately predicts the resectability of malignant pancreatic neoplasms. Am J Surg 1994 167(1) 104-111 discussion 111-113. 

Induction of Pancreatic Neoplasms by 2,2 -Dioxopropyl-N-propyl-nitrosamine", Cancer Letters, 1975, 3-6. 

Intake of dietary sources of n-3 fatty acids is associated with reduced incidence and severity of inflammatory disorders, cardiovascular diseases, and some cancers in humans (12, 98-103). Populations consuming fish that are rich in n-3 fatty acids are known to have a low incidence of atherosclerotic disorders (104). Dietary fish oil, which is high in EPA and DHA, also was shown to reduce myocardial ischemic damage (105) and ventricular fibrillation (106). The antitumorigenic effect of n-3 fatty acids was demonstrated in breast cancer (107), colon cancer (108-110), and pancreatic neoplasm (111). In addition to their beneficial influence on cardiovascular disorders and cancers, n-3 fatty acids are also known to decrease the severity and minimize symptoms of inflammatory diseases, including rheumatoid arthritis (15) and inflammatory bowel disease (16), and may be of benefit in correcting psychological disorders (17). 

Fournie, J.W. and W.K. Vogelbein. Exocrine pancreatic neoplasms in the mummichog (Fundulus heteroclitus) from a creosote-contaminated site. Toxicol. Pathol. 22 237-247, 1994. 

Pancreatoblastoma is a rare pancreatic tumor showing differentiation toward all three lineages in the pancreas (acinar, ductal, and endocrine) in variable amounts. It is the most common pancreatic neoplasm of childhood, although one third of reported cases were in adults. 

Yonezawa S, Nakamura A, Horinouchi M, Sato E. The expression of several types of mucin is related to the biological behavior of pancreatic neoplasms. J Hepatobiliary Pancreat Surg. 2002 9 328-341. 

Vlasoff DM, Baschinsky DY, Frankel WL. Cytokeratin 5/6 im-munostaining in hepatobiliary and pancreatic neoplasms. Appl Immunohistochem Mol Morphol. 2002 10 147-151. 

Shi C, Daniels JA, Hruban RH. Molecular characterization of pancreatic neoplasms. Adv Anat Pathol. 2008 15 185-195. 

Sessa F, Solcia E, Capella C, et al. Intraductal papillary-mucinous tumours represent a distinct group of pancreatic neoplasms an investigation of ttrmottr cell differentiation and K-ras, p53 and c-erbB-2 abnormalities in 26 patients. Virchows Arch. 1994 425 357-367. 

Albores-Saavedra J, Sheahan K, O Riain C, ShuklaD. Intraductal tubular adenoma, pyloric type, of the pancreas additional observations on a new type of pancreatic neoplasm. Am J Surg Pathol. 2004 28 233-238. 

Helpap B, Vogel J. Immunohistochemical smdies on cystic pancreatic neoplasms. Pathol Res Pract. 1988 184 39-45. 

Skacel M, Ormsby AH, Pettas RE, et ak Immunohistochemistry in the differential diagnosis of acinar and endocrine pancreatic neoplasms. Appl Immunohistochem Mol Morphol. 2000 8 203-209. 

Can we further characterize the pancreatic neoplasm as solid or cystic, and as being hypo-vascular or hyper-vascular ... 

Fig. 21.2. Sagittal oblique MIP image showing the celiac trunk and the vessels around a neuroendocrine pancreatic neoplasm the spatial relationship of the vessel is not maintained...

CT pancreatography is, in substance, the application of virtual endoscopy to the pancreatic gland, allowing the study the inner surface of the gland ducts and resulting useful in evaluating many ductal diseases and, overall, in case of cystic pancreatic neoplasms, especially intraductal papillary mucinous neoplasms (IPMN). 

One of the most important and difficult steps in pancreatic neoplasm staging is to evaluate the relationship between the neoplasm and the surrounding major peripancreatic vessels a number of studies have been conducted in order to establish a correct grading in neoplastic vessel infiltration (Lu et al. 1997 Mazzeo et al. 2007), being this one of the most important key points in determining patient resectablity (Allema et al. 1995). 

Even if cystic pancreatic neoplasms account for a very small percentage of the gland tumours, the possibility of some of them to change into malignant lesions determines the necessity to study and stage accurately them and especially mucinous neoplasms and intraductal papillary mucinous neoplasms (IPMN) in both its variants (main and branch duct type) (ITAY et al. 2001). 

The dilation of the MPD, the location and size of the neoplasms are in feet accurately assessed by performing a MDCT study, even in patients with obstruction of the main duct, in vdiom ERP can be difficult to perform because of the mucinous obstruction of the lumen of the duct. In evaluating cystic pancreatic neoplasms, CPR and MPR play a fundamental role, while MIP and VR are less used, mainly because of the less frequent vascular invasion. 

Regarding 3D imaging, the most frequently applied technique when analysing cystic pancreatic neoplasms is certainly MinIP, usually obtained using multi-projection volume reconstruction (MPVR) software by selecting an oblique slab that contained the entire lesion/anatomical structure to be evaluated MinIP permits to highlight hypodense tumours in order to increase the conspicuity of the lesion, the common bile duct and pancreatic dilated ducts (Nino-Murcia et al. 2003), thus furnishing a better visualisation of small lesions and finest ductal details (Fig. 21.8). 

Pancreatic adenocarcinoma typically appears as hy-podense mass at CT. The low attenuation is primarily due to fibrosis and desmoplasia within the tumor. Dual-phase imaging of the pancreas performed during the pancreatic phase (approximately 40 s) and por-tovenous phases of enhancement at CT optimizes detection pancreatic neoplasms (Prokesch et al. 2002a). The tumor usually appears more conspicuous during the pancreatic as opposed to the venous phase of enhancement because of the fibrosis and desmoplasia within the tumor. 

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