Accessorial spleen within the pancreatic tail as differential diagnosis to pancreatic tumour

2016 ◽  
Vol 37 (S 01) ◽  
Author(s):  
S Guth ◽  
M Höpfner ◽  
C Gocke ◽  
A Guthoff
Keyword(s):  
Differential Diagnosis ◽  
Pancreatic Tail ◽  
Pancreatic Tumour

scholarly journals Epithelial cyst arising in an intrapancreatic accessory spleen: a case report of robotic surgery and review of minimally invasive treatment

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tomokatsu Kato ◽  
Yoichi Matsuo ◽  
Goro Ueda ◽  
Yoshinaga Aoyama ◽  
Kan Omi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Minimally Invasive ◽  
Distal Pancreatectomy ◽  
Accessory Spleen ◽  
Cystic Neoplasm ◽  
Epithelial Cyst ◽  
Robot Assisted ◽  
Invasive Treatment ◽  
Intrapancreatic Accessory Spleen ◽  
Pancreatic Tail

Abstract Background An epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is rare. We report a case of ECIPAS that was treated with robot-assisted distal pancreatectomy with splenectomy. Case presentation The case was a 59-year-old woman who was referred to our hospital after a pancreatic tail tumor was found on computed tomography prior to surgery for small bowel obstruction at another hospital. A cystic lesion in the pancreatic tail was discovered and evaluated by magnetic resonance imaging and endoscopic ultrasonography. Based on clinical and radiological features, mucinous cystic neoplasm was included in the differential diagnosis. The patient underwent robot-assisted distal pancreatectomy with splenectomy. The postoperative course was uneventful. Pathological evaluation revealed a 20-mm ECIPAS in the pancreatic tail. Conclusions If a pancreatic tail tumor is present, ECIPAS should be included in the differential diagnosis. However, preoperative diagnosis is difficult, and a definitive diagnosis is often not obtained until after surgery. Surgery should be minimally invasive. Laparoscopic distal pancreatectomy has become a standard surgical procedure because it is minimally invasive. Robot-assisted surgery is not only minimally invasive, but also advantageous, because it has a stereoscopic magnifying effect and allows the forceps to move smoothly. Robot-assisted distal pancreatectomy may be a good option, when performing surgery for a pancreatic tail tumor.

scholarly journals Pancreatic nodule positive for 68-Ga-DOTAPEPTIDE-PET: NET or ectopic spleen? The importance of a good differential diagnosis

2020 ◽  
Vol 8 (5) ◽  
pp. 307-312
Author(s):  
Francesco Serra ◽  
Gianluca De Matteis ◽  
Sara Delfanti ◽  
Monica Feltri ◽  
Alessandro Vanoli ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Medical Literature ◽  
Accessory Spleen ◽  
Splenic Tissue ◽  
High Rate ◽  
Laboratory Findings ◽  
Pancreatic Tail ◽  
Ectopic Spleen ◽  
Pubmed Database ◽  
Ct And Mri

Abstract Background Accessory spleen is a congenital defect in which splenic tissue is present outside the spleen. In 20% of cases, accessory spleen is localized within the pancreatic tail, a condition known as IPAS. The identification of this benign anomaly, which affects about 2% of general population, is not easy because it is often mistaken for a pNET which is more common, at around 5%. A 68-Ga-DOTAPEPTIDE-PET normally identifies pNETs with high rate of sensitivity and specificity, but in some conditions, it produces false positives, including IPAS. Materials and tools A clinical case we recently encountered, prompted us to review the available medical literature on the topic. Typing “intrapancreatic accessory spleen” into PubMed database and limiting research to the last 10 years yielded 121 results from which we selected the most relevant articles for decision-making, with a brief explanation of the reasons for selecting those. Our analysis focused on the most critical and least descriptive articles, those which clearly indicated the importance of differential diagnosis by promoting the use of advanced investigations in case of pancreatic nodule suspected for IPAS. Ultimately, our objective was to update the available guidelines recommendations. Discussion and conclusions Despite concern in the medical literature, a differential IPAS diagnosis is still subordinate to other clinical, radiological, nuclear medicine, and cytological criteria. After reviewing the literature, we recommend that IPAS should always be considered as a possibility before diagnosis of pNET is made. IPAS should be suspected in the presence of the following findings: asymptomatic pancreatic nodule found incidentally, absence of laboratory findings of NETs, localization in the pancreatic tail, between 1 and 3 cm in size with well-defined margins, homogeneous enhancement, and similar attenuation to the spleen on CT and MRI. In these cases, the use of advanced investigations beyond 68-Ga-DOTAPEPTIDE-PET must be systematic. The recognition of IPAS is not only a diagnostic refinement, but it also avoids unnecessary surgery for the patient. 

Tumor Diagnosis

1982 ◽  
Vol 40 ◽  
pp. 262-265
Author(s):  
Bruce Mackay
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Differential Diagnosis ◽  
Light Microscopy ◽  
Clinical Examination ◽  
Ultrastructural Study ◽  
Diagnostic Procedures ◽  
Specific Diagnosis ◽  
Transmission Electron ◽  
Microscopic Diagnosis

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

The Effect of Sensori-Neural Hearing Loss on Threshold-Duration Functions

1968 ◽  
Vol 11 (4) ◽  
pp. 842-852 ◽  
Author(s):  
H. N. Wright
Keyword(s):  
Hearing Loss ◽  
Differential Diagnosis ◽  
Time Constant ◽  
Present Series ◽  
Auditory Disorders ◽  
Threshold Duration

Previous findings on the threshold for tones as a function of their duration have suggested that such functions may be systematically affected by sensori-neural hearing losses of cochlear origin. The present series of investigations was designed to explore this relation further and to determine also whether the amount of hearing loss present has any effect upon the results which are obtained. Preliminary studies were also carried out on a conductively impaired listener to indicate whether hearing losses of this type affect the threshold-duration function. The results indicate that the threshold-duration function is systematically affected by sensori-neural hearing losses of cochlear origin. This effect is manifested by a progressive shortening of the time constant relating threshold to duration and is not uniquely related to the amount of hearing loss present. The results obtained from the conductively impaired listener suggested that this type of hearing loss has no effect on the threshold-duration function, thereby implying that such functions may contribute significantly to the differential diagnosis of auditory disorders.

POST-TRANSFUSION PURPURA VS. HEPARIN-INDUCED THROMBOCYTOPENIA: DIFFERENTIAL DIAGNOSIS IN CLINICAL PRACTICE

2000 ◽  
Vol 10 (4) ◽  
pp. 323-324 ◽  
Author(s):  
F. Araujo ◽  
J. J. Sa ◽  
V. Araujo ◽  
M. Lopes ◽  
L. M. Cunha-Ribeiro
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Heparin Induced Thrombocytopenia

A Historical Review of Complex Regional Pain Syndrome in the “Guides Library”

2009 ◽  
Vol 14 (6) ◽  
pp. 1-9
Author(s):  
Robert J. Barth
Keyword(s):  
Differential Diagnosis ◽  
Complex Regional Pain Syndrome ◽  
Reflex Sympathetic Dystrophy ◽  
International Association ◽  
Historical Review ◽  
Pain Syndrome ◽  
Sixth Edition

Abstract Complex regional pain syndrome (CRPS) is a controversial, ambiguous, unreliable, and unvalidated concept that, for these very reasons, has been justifiably ignored in the “AMA Guides Library” that includes the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), the AMA Guides Newsletter, and other publications in this suite. But because of the surge of CRPS-related medicolegal claims and the mission of the AMA Guides to assist those who adjudicate such claims, a discussion of CRPS is warranted, especially because of what some believe to be confusing recommendations regarding causation. In 1994, the International Association for the Study of Pain (IASP) introduced a newly invented concept, CRPS, to replace the concepts of reflex sympathetic dystrophy (replaced by CRPS I) and causalgia (replaced by CRPS II). An article in the November/December 1997 issue of The Guides Newsletter introduced CRPS and presciently recommended that evaluators avoid the IASP protocol in favor of extensive differential diagnosis based on objective findings. A series of articles in The Guides Newsletter in 2006 extensively discussed the shortcomings of CRPS. The AMA Guides, Sixth Edition, notes that the inherent lack of injury-relatedness for the nonvalidated concept of CRPS creates a dilemma for impairment evaluators. Focusing on impairment evaluation and not on injury-relatedness would greatly simplify use of the AMA Guides.

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