Intravascular papillary endothelial hyperplasia in the gallbladder - the first case in the gallbladder

Intravascular papillary endothelial hyperplasia (IPEH) jest rzadką, łagodną proliferacją komórek śródbłonka, związaną z organizacją skrzepliny. Rozwija się w naczyniach krwionośnych, malformacjach naczyniowych oraz w utkaniu łagodnych guzów naczyniowych. W obrazie mikroskopowym może imitować mięsaka naczyniowego. Pacjentkę w wieku 64 lat z 4-letnim wywiadem kamicy żółciowej przyjęto do kliniki z powodu kolki żółciowej. Usunięto kamiczy pęcherzyk żółciowy. W badaniu histopatologicznym usuniętego pęcherzyka wykazano obecność IPEH w pogrubiałej ścianie. Zgodnie z dostępną wiedzą autorzy prezentują pierwszy przypadek IPEH, który rozwinął się w naczyniach pęcherzyka żółciowego. Autorzy sądzą, że w opisywanym przypadku czynnik zapalny odegrał istotną rolę w nietypowej organizacji skrzepliny i rozwoju IPEH.Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign proliferation of endothelial cells associated with thrombus organization. It develops in blood vessels as vascular malformations, or benign vascular tumours. The histological picture may mimic vascular sarcoma. A 64 year old female patient with a 4 year history of cholelithiasis was admitted to the ward with signs of biliary colic. An enlarged gallbladder filled with calculi was removed. A histopathological examination of the excised gallbladder revealed intravascular papillary endothelial hyperplasia. In this paper, according to our knowledge, we present the first case of IPEH in vessels of the gallbladder. We believe that in this case an inflammatory factor played an important role in the pathogenesis and development of IPEH

Precursor lesions of early onset pancreatic cancer

Early onset pancreatic cancer (EOPC) constitutes less than 5% of all newly diagnosed cases of pancreatic cancer (PC). Although histopathological characteristics of EOPC have been described, no detailed reports on precursor lesions of EOPC are available. In the present study, we aimed to describe histopathological picture of extratumoral parenchyma in 23 cases of EOPCs (definition based on the threshold value of 45 years of age) with particular emphasis on two types of precursor lesions of PC: pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasms (IPMNs). The types, grades, and densities of precursor lesions of PC were compared in patients with EOPCs, in young patients with neuroendocrine neoplasms (NENs), and in older (at the age of 46 or more) patients with PC. PanINs were found in 95.6% of cases of EOPCs. PanINs-3 were found in 39.1% of EOPC cases. Densities of all PanIN grades in EOPC cases were larger than in young patients with NENs. Density of PanINs-1A in EOPC cases was larger than in older patients with PC, but densities of PanINs of other grades were comparable. IPMN was found only in a single patient with EOPC but in 20% of older patients with PC. PanINs are the most prevalent precursor lesions of EOPC. IPMNs are rarely precursor lesions of EOPC. Relatively high density of low-grade PanINs-1 in extratumoral parenchyma of patients with EOPC may result from unknown multifocal genetic alterations in pancreatic tissue in patients with EOPCs