scholarly journals Mass-Forming Portal Biliopathy Presenting as Extreme Wall-Thickening of the Common Bile Duct

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 623
Author(s):  
Jan Binne Hulshoff ◽  
Frans J. C. Cuperus ◽  
Robbert J. de Haas
Keyword(s):  
Bile Duct ◽  
Early Recognition ◽  
Early Stage ◽  
Treatment Options ◽  
Diagnostic Procedures ◽  
Biliary Tree ◽  
Wall Thickening ◽  
Vascular Compression ◽  
Bile Duct Wall ◽  
Portal Biliopathy

Portal biliopathy refers to biliary tree abnormalities in patients with peribiliary collateral vessels and non-neoplastic extrahepatic portal vein occlusion. These biliary abnormalities are caused by vascular compression and ischemic damage of the biliary tree, which can result in bile duct compression, stenosis, fibrotic strictures, bile duct dilation, and thickening of the bile duct wall. Portal biliopathy is difficult to distinguish from cholangiocarcinoma, IgG4-related disease, and sclerosing cholangitis. Although most patients are asymptomatic, portal biliopathy can lead to serious complications, such as recurrent cholangitis. This case illustrates the importance of including portal biliopathy in the differential diagnosis at an early stage, especially in patients with portal hypertension. With early recognition, the need for additional invasive diagnostic procedures such as biopsies is minimized. Pathogenesis, clinical presentation, diagnostics, and treatment options of portal biliopathy are described in the article.

scholarly journals The Diagnosis of Autoimmune Pancreatitis Using Endoscopic Ultrasonography

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1005
Author(s):  
Atsushi Kanno ◽  
Eriko Ikeda ◽  
Kozue Ando ◽  
Hiroki Nagai ◽  
Tetsuro Miwata ◽  
...  
Keyword(s):  
Bile Duct ◽  
Pancreatic Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Ultrasonography ◽  
Autoimmune Pancreatitis ◽  
Wall Thickening ◽  
Endoscopic Retrograde ◽  
Intraductal Ultrasonography ◽  
Bile Duct Wall ◽  
Duct Wall

Autoimmune pancreatitis (AIP) is characterized by enlargement of the pancreas and irregular narrowing of the main pancreatic duct. It is often associated with IgG4-related sclerosing cholangitis (IgG4-SC), in which the bile duct narrows. Although characteristic irregular narrowing of the pancreatic duct caused by endoscopic retrograde cholangiopancreatography is noted in AIP, it is difficult to differentiate between localized AIP and pancreatic carcinoma based on imaging of the pancreatic duct. While stenosis of the bile duct in IgG4-SC is characterized by longer-length stenosis than in cholangiocarcinoma, differentiation based on bile duct imaging alone is challenging. Endoscopic ultrasound (EUS) can characterize hypoechoic enlargement of the pancreas or bile duct wall thickening in AIP and IgG4-SC, and diagnosis using elastography and contrast-enhanced EUS are being evaluated. The utility of EUS-guided fine needle aspiration for the histological diagnosis of AIP has been reported and is expected to improve diagnostic performance for AIP. Findings in the bile duct wall from endoscopic retrograde cholangiopancreatography followed by intraductal ultrasonography are useful in differentiating IgG4-SC from cholangiocarcinoma. Diagnoses based on endoscopic ultrasonography play a central role in the diagnosis of AIP.

Common Bile Duct MALT Lymphoma: Case Report and Review of the Literature

2006 ◽  
Vol 72 (1) ◽  
pp. 85-88
Author(s):  
Justin Boccardo ◽  
Anjay Khandelwal ◽  
Dongjiu Ye ◽  
Bruce E. Duke
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Treatment Options ◽  
Partial Gastrectomy ◽  
Biliary Tree ◽  
Review Of The Literature ◽  
Helicobacter Pylori Treatment ◽  
Rare Diagnosis

We report a rare case of common bile duct mucosa-associated lymphoid tissue (MALT) lymphoma treated with pancreatico-duodenectomy with a partial gastrectomy. MALT lymphoma involving the biliary tree is extremely rare. Diagnosis is difficult and treatment options are controversial. Even though Helicobacter pylori treatment is effective in the early stages of the disease, surgery is still helpful especially when obstruction, perforation, or bleeding is present.

Common Bile Duct Wall Thickening Due to Intramural Varices Diagnosed by Colour Doppler Ultrasound

2006 ◽  
Vol 27 (05) ◽  
pp. 483-486 ◽  
Author(s):  
I Grgurević ◽  
M Buljevac ◽  
M Kujundžić ◽  
M Vukelić-Marković ◽  
D Kardum ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Doppler Ultrasound ◽  
Wall Thickening ◽  
Colour Doppler ◽  
Bile Duct Wall ◽  
Colour Doppler Ultrasound ◽  
Duct Wall

Application of CT Image Scanning Technology Based on Iris Algorithm in Clinical Diagnosis of Patients with Hepatobiliary Stones

2021 ◽  
Vol 11 (1) ◽  
pp. 203-208
Author(s):  
Xianglei Wei ◽  
Ling Cui ◽  
Zhenhuan Li ◽  
Wang Yi ◽  
Xu Chen ◽  
...  
Keyword(s):  
Bile Duct ◽  
Tube Wall ◽  
Extrahepatic Bile Duct ◽  
Spiral Ct ◽  
Wall Thickening ◽  
Bile Duct Stones ◽  
Bile Duct Wall ◽  
Size Number ◽  
Venous Phase ◽  
Equal Density

Objective: To investigate the value of multi-slice spiral CT in the diagnosis of extrahepatic bile duct stones using Iris algorithm. Methods: 66 cases of extrahepatic bile duct stones underwent plain and enhanced multiline spiral CT. Observe the density, size, location and number of stones during the plain scan. According to the venous phase enhanced scan, the extrahepatic bile duct wall ≥2 mm was used as the thickening criterion to evaluate the stone density, size, number, and composition ratio of the site and its relationship with tube wall thickening. Results: A total of 57 cases of stones of different densities were found on CT. Nine cases of stones of equal density were not identified. Among the 56 cases with thickened wall, 87.50% (49/56) were concentric and 12.50% (7/56) were eccentric. The wall thickening occurred 62.50% (35/56) below the stone; 17.86% (10/56) was located on the level or above the stone, and 8.93% (5/56) was above the stone. 6 cases (6/56) (10.71%) showed extensive tube wall thickening, all caused by multiple stones. Conclusion: In the study of extrahepatic bile duct stones using the Iris algorithm, it was found that most concentric circular tube wall thickening occurred on or below the stone level. When plain CT scan does not show clear bile duct stones, and this phenomenon appears in the portal vein phase of enhanced scan, the possibility of stones should be considered.

Long-term survival of the nasal NK/T cell lymphoma

2008 ◽  
Vol 149 (17) ◽  
pp. 801-805
Author(s):  
Péter Rajnics ◽  
László Krenács ◽  
András Kenéz ◽  
Zoltán Járay ◽  
Enikő Bagdi ◽  
...  
Keyword(s):  
T Cell ◽  
Treatment Guidelines ◽  
Cell Lymphoma ◽  
Treatment Options ◽  
Diagnostic Procedures ◽  
T Cell Lymphoma ◽  
Term Survival ◽  
Barr Virus ◽  
Significant Difference ◽  
Nk T Cell

The nasal NK/T cell lymphoma is a rare, extranodal non-Hodgkin lymphoma in western civilizations, which has poor prognosis. The Epstein–Barr virus can be detected in tumor cells in nearly all cases. There are no definite treatment guidelines in our days. There is no significant difference in survival between radiotherapy and chemotherapy according to Asian studies. In this case study we show our diagnostic procedures, our treatment options and we present the summary of this illness based on the data found in the literature.

scholarly journals The APAC Score: A Novel and Highly Performant Serological Tool for Early Diagnosis of Hepatocellular Carcinoma in Patients with Liver Cirrhosis

2021 ◽  
Vol 10 (15) ◽  
pp. 3392
Author(s):  
Joeri Lambrecht ◽  
Mustafa Porsch-Özçürümez ◽  
Jan Best ◽  
Fabian Jost-Brinkmann ◽  
Christoph Roderburg ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
At Risk ◽  
Liver Cirrhosis ◽  
Early Stage ◽  
Treatment Options ◽  
Growth Factor Receptor ◽  
Serum Samples ◽  
Disease Etiology ◽  
Risk Patients ◽  
Scoring Tool

(1) Background: Surveillance of at-risk patients for hepatocellular carcinoma (HCC) is highly necessary, as curative treatment options are only feasible in early disease stages. However, to date, screening of patients with liver cirrhosis for HCC mostly relies on suboptimal ultrasound-mediated evaluation and α-fetoprotein (AFP) measurement. Therefore, we sought to develop a novel and blood-based scoring tool for the identification of early-stage HCC. (2) Methods: Serum samples from 267 patients with liver cirrhosis, including 122 patients with HCC and 145 without, were collected. Expression levels of soluble platelet-derived growth factor receptor beta (sPDGFRβ) and routine clinical parameters were evaluated, and then utilized in logistic regression analysis. (3) Results: We developed a novel serological scoring tool, the APAC score, consisting of the parameters age, sPDGFRβ, AFP, and creatinine, which identified patients with HCC in a cirrhotic population with an AUC of 0.9503, which was significantly better than the GALAD score (AUC: 0.9000, p = 0.0031). Moreover, the diagnostic accuracy of the APAC score was independent of disease etiology, including alcohol (AUC: 0.9317), viral infection (AUC: 0.9561), and NAFLD (AUC: 0.9545). For the detection of patients with (very) early (BCLC 0/A) HCC stage or within Milan criteria, the APAC score achieved an AUC of 0.9317 (sensitivity: 85.2%, specificity: 89.2%) and 0.9488 (sensitivity: 91.1%, specificity 85.3%), respectively. (4) Conclusions: The APAC score is a novel and highly accurate serological tool for the identification of HCC, especially for early stages. It is superior to the currently proposed blood-based algorithms, and has the potential to improve surveillance of the at-risk population.

scholarly journals Advances in Targeting Cutaneous Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2090
Author(s):  
Dimitri Kasakovski ◽  
Marina Skrygan ◽  
Thilo Gambichler ◽  
Laura Susok
Keyword(s):  
Cutaneous Melanoma ◽  
Clinical Investigation ◽  
Early Stage ◽  
Treatment Options ◽  
Treatment Resistance ◽  
Immune Checkpoint Blockade ◽  
Oncolytic Viruses ◽  
Cancer Site ◽  
Western World ◽  
Pharmacological Agents

To date, the skin remains the most common cancer site among Caucasians in the western world. The complex, layered structure of human skin harbors a heterogenous population of specialized cells. Each cell type residing in the skin potentially gives rise to a variety of cancers, including non-melanoma skin cancer, sarcoma, and cutaneous melanoma. Cutaneous melanoma is known to exacerbate and metastasize if not detected at an early stage, with mutant melanomas tending to acquire treatment resistance over time. The intricacy of melanoma thus necessitates diverse and patient-centered targeted treatment options. In addition to classical treatment through surgical intervention and radio- or chemotherapy, several systemic and intratumoral immunomodulators, pharmacological agents (e.g., targeted therapies), and oncolytic viruses are trialed or have been recently approved. Moreover, utilizing combinations of immune checkpoint blockade with targeted, oncolytic, or anti-angiogenic approaches for patients with advanced disease progression are promising approaches currently under pre-clinical and clinical investigation. In this review, we summarize the current ‘state-of-the-art’ as well as discuss emerging agents and regimens in cutaneous melanoma treatment.

scholarly journals Medication of Hydroxychloroquine, Remdesivir and Convalescent Plasma during the COVID-19 Pandemic in Germany—An Ethical Analysis

2021 ◽  
Vol 18 (11) ◽  
pp. 5685
Author(s):  
Katja Voit ◽  
Cristian Timmermann ◽  
Florian Steger
Keyword(s):  
Early Stage ◽  
Treatment Options ◽  
Drug Distribution ◽  
Experimental Treatment ◽  
Ethical Analysis ◽  
Ethical Principles ◽  
Ethical Challenges ◽  
Ethical Guidelines ◽  
Negative Effects ◽  
Experimental Drug

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions.

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