A case of 16 yrs male patient with parosteal lipoma affecting the lower metaphyseal end of the left femur is presented. Clinical suspicion, plain radiographs, CT (Plain and 3 D) as well as MRI suggested a diagnosis of...A case of 16 yrs male patient with parosteal lipoma affecting the lower metaphyseal end of the left femur is presented. Clinical suspicion, plain radiographs, CT (Plain and 3 D) as well as MRI suggested a diagnosis of parosteal lipoma. Lipomas may be defined as benign lesions of mature adipose tissue without evidence of cellular atypia [1]. Lipomas are the most common soft tissue lesions and surprisingly are among the rarest bone neoplasias. The most frequent complaints are a tumoral convexity presenting as a visible or palpable mass or a mild-intensity, dull pain. The parosteal type is a rare tumor accounting for 0.3% of all lipomas [2] and is usually asymptomatic. It is seen commonly affecting adults aged over 40 [3]. The present article describes a rare case of parosteal lipoma located in the femur, with extensive hyperostosis visible on plain xray and confirmed by imaging studies (CT and MRI). Unlike the parosteal lipomas reported in adults over 40 yrs in this case it presented in a much younger age group.展开更多
AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.METHODS: Only EUS studies confirmed by surge...AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.METHODS: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model). RESULTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.展开更多
Aim To purify and characterize flammulin, a basic protein with anti-tumoractivities. Methods Ammonium sulfate, ethanol fractionation and column chromatography were used forseparation and purification. Electrophoretic ...Aim To purify and characterize flammulin, a basic protein with anti-tumoractivities. Methods Ammonium sulfate, ethanol fractionation and column chromatography were used forseparation and purification. Electrophoretic analysis, amino acid analysis, and MS of flammulin werecarried out. Results Flammulin was purified to electrophoretic homogeneity and crystallized. With amolecular mass of 19891.13 Da, pI 8.9, λ_(max) = 276 - 278 nm, λ_(min) = 250 nm, flammulin wascharacterized by its lack of methionine. Fingerprint mapping of flammulin was determined by MALDI-MSfollowing in-gel protease digestion; no close matches were identified. Conclusion Flammulin waspurified to electrophoretic homogeneity, and its characteristics are discussed for the first time.展开更多
BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions(NMLs)is low at approximately 21%-43%.Shear wave elastography(SWE)can distinguish benign from malignant lesions by evaluating...BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions(NMLs)is low at approximately 21%-43%.Shear wave elastography(SWE)can distinguish benign from malignant lesions by evaluating the internal and peripheral stiffness.SWE has good reproducibility and high diagnostic efficacy.However,there are very few independent studies on the diagnostic value of SWE in breast NMLs.AIM To determine the value of SWE in the differential diagnosis of breast NMLs.METHODS This study enrolled a total of 118 patients with breast NMLs who underwent SWE examinations in the Beijing Shijitan Hospital Affiliated to Capital Medical University and The Second Hospital of Shandong University from January 2019 to January 2020.The internal elastic parameters of the lesions were recorded,including maximum(Emax),mean(Emean)and minimum elastic values and the standard deviation.The following peripheral parameters were noted:Presence of a“stiff rim”sign;Emax,and Emean elasticity values within 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm from the edge of NMLs.The receiver operating characteristic curve of each parameter was drawn,and the areas under the curve were calculated.RESULTS Emax,Emean and elastic values,and the standard deviation of the internal elastic values in malignant NMLs were significantly higher than those in benign NMLs(P<0.05).The percentage with the“stiff rim”sign in malignant NMLs was significantly higher than that in the benign group(P<0.05),and Emax and Emean at the shell of 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm in the malignant group were all higher than those in the benign group(P<0.05).Of the surrounding elasticity values,Emax of the shell at 2.5 mm in malignant NMLs had maximum areas under the curve of 0.900,and the corresponding sensitivity and specificity were 94.57%and 85.86%,respectively.CONCLUSION The“stiff rim”sign and multiple quantitative elastic values within and around the lesion had good diagnostic performance in the differential diagnosis of breast NMLs.Emax in peripheral tissue ha展开更多
BACKGROUND Aggressive fibromatosis(AF),also known as desmoid tumor or desmoid-type fibromatosis,is a rare soft tissue neoplasm that can occur in almost any part of the body.Although it is a benign disease,AF is aggres...BACKGROUND Aggressive fibromatosis(AF),also known as desmoid tumor or desmoid-type fibromatosis,is a rare soft tissue neoplasm that can occur in almost any part of the body.Although it is a benign disease,AF is aggressive and infiltrative and has a high recurrence rate after surgery.Common sites for intra-abdominal AF are the small bowel mesentery,retroperitoneum,and pelvis.AF in the colon is extremely rare.CASE SUMMARY Here,we report the first case of sigmoid colon AF,which was accidentally discovered in a 27-year-old woman during laparoscopic myomectomy.Computed tomography confirmed a slightly enhanced mass in the sigmoid colon.Subsequent colonoscopy did not reveal a mass in the colonic lumen,but a suspected external compress was found in the sigmoid colon.Surgical disease involving a gastrointestinal stromal tumor was suspected.The patient underwent laparoscopic exploration,and sigmoidectomy with a negative margin was performed to excise the mass.Postoperative immunohistochemistry revealed that the mass was an AF.The patient recovered well and was recurrence-free at the 30-month follow-up without adjuvant therapy.CONCLUSION AF should be considered in the differential diagnosis of subepithelial colon masses.Radical resection alone can achieve good outcomes.展开更多
An 80-year-old woman presenting with chest pain was found to have a large,lobulated soft tissue mass in the liver and nearby tissues on abdominal computed tomography(CT).The tumor had invaded the common hepatic artery...An 80-year-old woman presenting with chest pain was found to have a large,lobulated soft tissue mass in the liver and nearby tissues on abdominal computed tomography(CT).The tumor had invaded the common hepatic artery and main portal vein.Jaundice developed 4 wk later,at which point,a pancreas and biliary CT scan revealed a large mass in the right lobe of the liver and a hilar duct obstruction,which was found to be a small cell carcinoma.Despite its rarity,liver and bile duct small cell carcinoma should be considered in the differential diagnosis of atypical chest pain without jaundice.展开更多
Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. T...Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.展开更多
文摘A case of 16 yrs male patient with parosteal lipoma affecting the lower metaphyseal end of the left femur is presented. Clinical suspicion, plain radiographs, CT (Plain and 3 D) as well as MRI suggested a diagnosis of parosteal lipoma. Lipomas may be defined as benign lesions of mature adipose tissue without evidence of cellular atypia [1]. Lipomas are the most common soft tissue lesions and surprisingly are among the rarest bone neoplasias. The most frequent complaints are a tumoral convexity presenting as a visible or palpable mass or a mild-intensity, dull pain. The parosteal type is a rare tumor accounting for 0.3% of all lipomas [2] and is usually asymptomatic. It is seen commonly affecting adults aged over 40 [3]. The present article describes a rare case of parosteal lipoma located in the femur, with extensive hyperostosis visible on plain xray and confirmed by imaging studies (CT and MRI). Unlike the parosteal lipomas reported in adults over 40 yrs in this case it presented in a much younger age group.
文摘AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.METHODS: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model). RESULTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.
文摘Aim To purify and characterize flammulin, a basic protein with anti-tumoractivities. Methods Ammonium sulfate, ethanol fractionation and column chromatography were used forseparation and purification. Electrophoretic analysis, amino acid analysis, and MS of flammulin werecarried out. Results Flammulin was purified to electrophoretic homogeneity and crystallized. With amolecular mass of 19891.13 Da, pI 8.9, λ_(max) = 276 - 278 nm, λ_(min) = 250 nm, flammulin wascharacterized by its lack of methionine. Fingerprint mapping of flammulin was determined by MALDI-MSfollowing in-gel protease digestion; no close matches were identified. Conclusion Flammulin waspurified to electrophoretic homogeneity, and its characteristics are discussed for the first time.
文摘BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions(NMLs)is low at approximately 21%-43%.Shear wave elastography(SWE)can distinguish benign from malignant lesions by evaluating the internal and peripheral stiffness.SWE has good reproducibility and high diagnostic efficacy.However,there are very few independent studies on the diagnostic value of SWE in breast NMLs.AIM To determine the value of SWE in the differential diagnosis of breast NMLs.METHODS This study enrolled a total of 118 patients with breast NMLs who underwent SWE examinations in the Beijing Shijitan Hospital Affiliated to Capital Medical University and The Second Hospital of Shandong University from January 2019 to January 2020.The internal elastic parameters of the lesions were recorded,including maximum(Emax),mean(Emean)and minimum elastic values and the standard deviation.The following peripheral parameters were noted:Presence of a“stiff rim”sign;Emax,and Emean elasticity values within 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm from the edge of NMLs.The receiver operating characteristic curve of each parameter was drawn,and the areas under the curve were calculated.RESULTS Emax,Emean and elastic values,and the standard deviation of the internal elastic values in malignant NMLs were significantly higher than those in benign NMLs(P<0.05).The percentage with the“stiff rim”sign in malignant NMLs was significantly higher than that in the benign group(P<0.05),and Emax and Emean at the shell of 1 mm,1.5 mm,2 mm,2.5 mm and 3 mm in the malignant group were all higher than those in the benign group(P<0.05).Of the surrounding elasticity values,Emax of the shell at 2.5 mm in malignant NMLs had maximum areas under the curve of 0.900,and the corresponding sensitivity and specificity were 94.57%and 85.86%,respectively.CONCLUSION The“stiff rim”sign and multiple quantitative elastic values within and around the lesion had good diagnostic performance in the differential diagnosis of breast NMLs.Emax in peripheral tissue ha
基金Supported by Hangzhou Health Science and Technology Program,No.A20210271.
文摘BACKGROUND Aggressive fibromatosis(AF),also known as desmoid tumor or desmoid-type fibromatosis,is a rare soft tissue neoplasm that can occur in almost any part of the body.Although it is a benign disease,AF is aggressive and infiltrative and has a high recurrence rate after surgery.Common sites for intra-abdominal AF are the small bowel mesentery,retroperitoneum,and pelvis.AF in the colon is extremely rare.CASE SUMMARY Here,we report the first case of sigmoid colon AF,which was accidentally discovered in a 27-year-old woman during laparoscopic myomectomy.Computed tomography confirmed a slightly enhanced mass in the sigmoid colon.Subsequent colonoscopy did not reveal a mass in the colonic lumen,but a suspected external compress was found in the sigmoid colon.Surgical disease involving a gastrointestinal stromal tumor was suspected.The patient underwent laparoscopic exploration,and sigmoidectomy with a negative margin was performed to excise the mass.Postoperative immunohistochemistry revealed that the mass was an AF.The patient recovered well and was recurrence-free at the 30-month follow-up without adjuvant therapy.CONCLUSION AF should be considered in the differential diagnosis of subepithelial colon masses.Radical resection alone can achieve good outcomes.
文摘An 80-year-old woman presenting with chest pain was found to have a large,lobulated soft tissue mass in the liver and nearby tissues on abdominal computed tomography(CT).The tumor had invaded the common hepatic artery and main portal vein.Jaundice developed 4 wk later,at which point,a pancreas and biliary CT scan revealed a large mass in the right lobe of the liver and a hilar duct obstruction,which was found to be a small cell carcinoma.Despite its rarity,liver and bile duct small cell carcinoma should be considered in the differential diagnosis of atypical chest pain without jaundice.
文摘Introduction: Majority of mesenchymal tumors of gastrointestinal tract are Gastrointestinal Stromal Tumor (GIST). It is, however, a rare tumor, accounting for less than 1% of primary gastrointestinal (GI) neoplasms. Though, these tumors are refractory to conventional chemotherapy or radiotherapy but show a good response to targeted adjuvant chemotherapy with tyrosine kinase inhibitors following surgical resection. Case Report: we report here a case of primary Extra-GIST tumor arising from mesentry of small bowel near duodeno-jejunal junction in a 69 years old male patient. The patient presented with a palpable mass in upper abdomen for past 15 days. On examination, a non-tender mobile lump of size around 17 × 10 cm, with bosselated surface and firm in consistency was palpable involving epigastric, left hypochondrium and umbilical region. Contrast enhanced computed tomography of abdomen revealed a heterogenous mesentric mass. On surgical intervention a mass was found involving mesentery near dudenojejunal junction without involvement of gastrointestinal tract. Complete surgical resection of the tumor was done and adjuvant chemotherapy with Imatinib mesylate was started as HPE revealing GIST with mitotic index of >10/50 HPF and 17 × 10 cm size placed the patient in high risk category. Patient was discharged on 12th of post-operative day with advice of regular follow-up. Conclusion: GIST occurrence is not restricted to bowel but can involve unusual sites also. The mainstay of treatment remains surgical resection with adequate margin. In cases where tumour has malignant potential (high mitotic figures on histopathology) adjuvent treatment with tyrosine kinase may prevent or delay relapse.
