Academic literature on the topic 'Stomach Neoplasms, radiography'

Abstract Introduction/Objective Mixed Acinar Neuroendocrine Carcinoma (MACNEC) is rare and usually occurrs in the head of the pancreas. This is an epithelial neoplasm of the pancreas exhibiting both acinar and neuroendocrine differentiation. Each component must represent at least 30% of the tumor. Extrapancreatic acinar cell carcinoma arising in the stomach are also rare and represent <1% of all gastric neoplasms. Here we report a case of MACNEC arising in the stomach of a 60 yo female and we review the literature. Methods The specimen was formalin-fixed and paraffin embedded. 4-microns sections of the tumor block were stained for hematoxylin and eosin and immunostained for CAM5.2, Chromogranin, synaptophysin, trypsin, chymotrypsin, BCL10, HepPar1 and AFP using a Ventana Discovery XT automated system (Ventana Medical Systems, Tucson, Ariz) as per manufacturer’s protocol with proprietary reagents. Results The patient presented with heartburn and weight loss. An upper endoscopy revealed an ulcer along the stomach greater curvature. Endoscopic ultrasound revelaed an hypoechoic round mass involving the submucosa. Imaging showed no lesions in the pancreas. A stomach wedge resection was performed: a 1.2 x 0.6 x 0.5 cm. submucosal tan-brown mass was found. Microscopically the tumor had alternated solid/acinar areas with cords/ribbons neuroendocrine-like areas. Both components were immunohistochemically positive for keratin (CAM 5.2), chromogranin (diffuse), and synaptophysin (patchy). The trypsin, chymotrypsin and BCL10 immunostains were patchy and stained 30 to 40% of the tumor. The immunostains for HepPar-1 and AFP were negative. These results support the diagnosis of MACNEC. Pancreatic heterotopia was not identified in the tissue examined. The margins of resection were free of tumor. The tumor was staged as T1NXMX. The patient has been under close surveillance for 3 years and she has no radiographic evidence of tumor recurrence or metastases. Conclusion We found only 6 prior cases of MACNEC originating in the stomach. They had similar histopathologic and immunohistochemical features. In the absence of a pancreatic lesions, in this patient the tumor may have originated from ectopic pancreatic tissue or from a pluripotent stem cell in the stomach.

Case summary An 11-year-old female spayed domestic shorthair cat was referred to the Foster Hospital for Small Animals, USA for suspected dysautonomia based on weight loss, vomiting and referral radiographs that showed severe dilation of the esophagus, stomach and entire gastrointestinal tract. After recheck radiographs revealed a decrease in gas compared with the referral images, persistently reduced gastrointestinal motility was deemed less likely; however, cardiomegaly and a soft tissue opacity overlying the esophagus were noted. Echocardiogram identified a pulmonary mass either impinging on or invading the local organs. At necropsy, gross pathology and histopathology showed an aggressive pulmonary carcinoma invading the heart, trachea and esophagus, resulting in a focal esophageal stricture. Gastrointestinal gas dilation was most likely secondary to aerophagia as a result of chronic partial esophageal obstruction. Relevance and novel information To our knowledge, this is the first reported feline case of invasion of the esophagus and heart by a pulmonary adenocarcinoma. Other than weight loss, the clinical signs for this invasive neoplasm were not evident until the cat was diagnosed with hyperthyroidism and prescribed oral medications. This reinforces the fact that pulmonary adenocarcinoma is difficult to detect clinically until secondary problems from the primary or metastatic neoplasm arise.

There have been no reports of ruptured solid pseudopapillary neoplasm (SPN) into adjacent organs. A 22-year-old female was referred to our hospital for treatment of a pancreatic head tumor. Computed tomography (CT) examination at our hospital showed a 5-cm tumor containing air, although CT at a previous hospital revealed an 8-cm tumor without air. Thus, a spontaneous rupture of the tumor into the duodenum was suspected. Subtotal stomach preserving pancreaticoduodenectomy with combined resection of the portal vein was performed. Contrast radiography of resected specimen showed the medium injected into the tumor leaking out from the 2nd portion of the duodenum. Histologically, the patient was diagnosed as SPN. Microscopic invasion to the portal vein and duodenum were also confirmed. She did not experience any postoperative complications and has remained well without any signs of recurrence during 2 years of follow-up. Although there have been 14 studies reporting ruptured SPN, this is the first report of SPN that spontaneously ruptured into the duodenum. An extremely rare case of SPN of the pancreatic head that spontaneously ruptured into the duodenum was reported.

A nine-year-old warmblood mare was presented with clinical signs of mild colic and fever. On percutaneous ultrasound of the abdomen, a mass was identified on the left side of the abdomen between the spleen and the stomach. During examination the following day, intra-abdominal blood was observed. On rectal examination, a mass was palpated in the pelvis. The presumptive diagnosis of hematoma with intra-abdominal bleeding was made. On consecutive ultrasounds and radiographs, the mass evolved in shape and other masses were identified in the liver and the lungs. No change was noticed in the pelvic mass. Cytology and histology of a tru-cut liver biopsy revealed abnormal, most likely neoplastic cells, whereas cytology of the abdominal and thoracic fluid did not reveal any neoplastic cells. Due to the presence of several rapidly growing masses, a neoplastic process was most likely. Because of the malignant character of the disease and the persistence of the clinical signs, euthanasia was suggested but refused by the owner. Supportive treatment was instituted. Initially, the general condition remained stable, after which the horse suddenly collapsed and died. Post-mortem examination revealed a primary neoplasm located in the pelvic cavity, as well as multiple disseminated masses within several tissues. The mass found in the liver had ruptured with loss of probably 50 liters hemorrhagic fluid within the abdominal cavity. Based on gross pathology, cytological and histological findings, a hemangiosarcoma was suspected. This diagnosis was confirmed using immunohistochemistry for von Willebrand factor. In this case report, the importance of differentiating hematoma from hemangiosarcoma in the horse is highlighted.

Background: Leiomyosarcoma is a non-encapsulated tumor, belonging to the group of soft tissue sarcomas and often invasive. This histological type comprises the most aggressive solid tumors and, because they respond poorly to therapy, are considered the worst prognosis. The dissemination of metastatic cells can occur mainly hematologically to the liver, lungs and bones or by direct invasion, but metastases to blood vessels are rare and surgery is the treatment of choice in most cases. This paper aims to report a rare case of tumor thrombus in the cranial mesenteric artery secondary to an intestinal leiomyosarcoma.Case: A 9-year-old female S.R.D dog presenting inappetence, evolving to anorexia, weight loss, anemia and vomiting for approximately 15 days was referred to the Hospital of Veterinary Clinics of the Federal University of Rio Grande do Sul. Previous therapy at another clinic with three blood transfusions did not promote reversal of anemia. Ultrasonographyrevealed a nodule in the small intestine of seven cm in diameter and in the hemogram a hypochromic macrocytic anemia. Thoracic radiography did not reveal metastases. After a new blood transfusion, the patient was referred to an exploratory laparotomy, where the nodule was identified in the small intestine, which was cyanotic and two nodules in the cranialmesenteric artery, partially obstructing the local blood flow. Resection and intestinal anastomosis were performed from the final portion of the duodenum to the cecum, with ligation of the mesenteric artery and the nodules were sent for histopathological analysis. The animal presented a gradual improvement of the condition, with the introduction of liquidfeeding on the second postoperative day. After these days, he presented hypochromic macrocytic anemia, with presence of Howell-Jolly corpuscle, spherocytes and icteric plasma, compatible with hemolytic anemia. Treatment with prednisone was started, with a worsening of the condition. The patient had generalized jaundice and died five days after surgery. Theanimal was referred to the necropsy in which it showed abdominal fluid of slightly reddish color, adherence of viscera (intestine, stomach and omentum). In the surgical area (enterectomy) there was purulent secretion on the points, the large intestine presented ecchymosis and petechiae on the mucosa. Histological examinations of the nodule and thrombus revealed malignant mesenchymal neoplasia formed by spindle cells with elongated nuclei, abundant eosinophilic cytoplasm and moderate anaplasia, interspersed by connective tissue, with areas of necrosis and neutrophilic infiltrate. The final diagnostic was intestinal leiomyosarcoma with mesenteric vessel metastasis and septicemia.Discussion: Because the tumor thrombus is located in the mesenteric artery, resection of a large part of the small intestine was necessary because this artery promotes the irrigation of this region. When this procedure is performed, a common complication is short bowel syndrome, necessitating a specific nutritional therapy. The animal probably developed hemolytic anemia by the successive blood transfusions that it underwent, causing in a worsening of the anemia and developing jaundice, not responding to the instituted therapy. In addition, there were rupture of the surgery points, extravasating fluid into the abdominal cavity, triggering a septicemia resulting in the death of the patient.Keywords: intestinal tumor, neoplasia, metastasis.

A group of several miscellaneous lesions may arise within one or more of the mediastinal compartments that are distinct from benign or malignant neoplasms, cysts, lymphadenopathy, and vascular lesions. Such entities cannot be classified as one specific disease type, and include extramedullary hematopoiesis and multiple types of herniations, specifically hiatal, paraesophageal and Morgagni hernias. Extramedullary hematopoiesis typically manifests as paravertebral masses that may exhibit fat attenuation or signal. Hiatal and paraesophageal hernias are common abnormalities in which the stomach herniates into the thorax through the esophageal hiatus. Morgagni hernias occur through an anterior diaphragmatic defect and typically contain omental fat but may also contain liver and bowel. As with other abnormalities of the mediastinum, these lesions may first be identified on chest radiography. However, correlation with pertinent clinical history and cross-sectional imaging, typically contrast-enhanced computed tomography, is necessary for definitive diagnosis.