Multifocal serous cystadenoma of the pancreas synchronous with ampullary adenocarcinoma

Pancreatic cysts are common, but cystic tumors are uncommon. We report a rare case of serous cystadenoma of the pancreas synchronous with ampullary adenocarcinoma which supports a common etiopathogeny of these tumors. We discuss the differential diagnosis with mucinous cystadenoma which is potentially malignant and recall the microscopic and radiologic features

A Benign Tumor of the Sciatic Nerve: Case Report and Review of the Literature

Tumors arising from the sciatic nerve are a rare occurrence. A case is described of such a tumor developing as a large painless mass in the posterior right midthigh. The preoperative diagnosis was easily achieved by means of ultrasonography and computed tomography. Excision of the tumor, with preservation of the involved nerve, was performed. Microscopic examination showed a neurofibroma with however some features of a schwannoma. Problems of histological diagnosis and treatment are emphasized

Echographic Characterization of Carotid Plaques

The histology of the endarterectomy specimen was compared with the preoperative echopattern of 154 plaques. Thirty-four ultrasound images were of poor quality. The 120 adequate echographies revealed 22 dense hyperechogenic homogeneous plaques, 28 soft hypoechogenic homogeneous plaques, 53 inhomogeneous plaques, and 13 mixed plaques. According to the surface, lesions were subdivided as smooth (n = 63) or irregular (n = 57). Echography recognized fibrous plaques (dense homogeneous hyperechogeneous lesions), with a specificity of 87% and a sensitivity of 56%. Recent intraplaque haemorrhage is echographically apparent as a hypoechogenic area in 88% of cases, what corresponds to a specificity of 79% and a sensitivity of 75%. Echography proved to be more accurate than angiography in determining the presence or absence of ulceration. The ability to characterize the pathology of carotid atheroma by duplex scan make the clinicopathologic correlation of carotid plaques of practical importance

Fundic Argyrophil Cell Hyperplasia in Atrophic Gastritis: A Search for a Sensitive Diagnostic Method

Hypergastrinemia induces argyrophil cell hyperplasia in oxyntic mucosa (FACH) in patients with non-antral atrophic gastritis, with or without pernicious anemia. This proliferation favours the development of carcinoid tumours. In order to determine the most usual appropriate method to document FACH, we have studied 29 consecutive fundic biopsies from 26 patients with fundic chronic gastritis. The study encompassed gastrinemia levels, standard histology permitting the classification of chronic gastritis, demonstration of FACH by Grimelius stain, immunohistochemical studies using NSE, chromogranin A and by electron microscopy. The FACH was classified for each stain as slight, moderate or severe. The study displayed a relationship between the grade of gastritis and the density of argyrophil endocrine cells in oxyntic mucosa assessed by Grimelius stain (p < 0.0001) and chromogranin A (P < 0.01). There was also a relationship between the serum gastrin level and the density of argyrophil endocrine cells detected by these two stains (p < 0.001). A highly significant correlation was observed between Grimelius stain and chromogranin A (p < 0.0001). On the other hand, no significant correlation was noted with either NSE or electron microscopy. We conclude that Grimelius stain and immunohistochemical studies against chromogranin A were the best methods for the demonstration of FACH in atrophic gastritis. One of these two techniques is sufficient in current practice for defining the patients at risk for subsequent surveillance

Primary Cardiac Tumors: Myxoma of the Left Auricle

peer reviewe

Anatomo-Clinical Correlations of Carotid Plaques

Recently, much attention has been focused on pathologic plaque characteristics and their importance in producing cerebrovascular symptoms. There remains much controversy on the significance of plaque ulceration, mural thrombi, and intraplaque hemorrhage in symptomatic and asymptomatic patients. We investigated 110 plaques, and the only significant correlation with preoperative symptoms was the presence of fresh mural thrombus, mostly intraluminal, associated with stenosis. Exulceration without fresh thrombus, intraplaque hemorrhage with intact endothelium and recanalized thrombus were also found in a considerable number of asymptomatic patients