Tumors of the liver, bile duct, and pancreas.
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Bile Duct Neoplasms↗
Biomedical subjects
C Charnsangavej
Publications and source records attributed to C Charnsangavej.
Pancreatic cancer: current concepts in imaging for diagnosis and staging.
Because of its late clinical presentation, pancreatic cancer remains the fourth most common cause of cancer death. Surgery is the only option for cure, and advancements in surgical technique and neoadjuvant therapy have the potential to increase the number of patients who could undergo surgery for potential cure. Accurate diagnosis and staging of pancreatic ductal carcinoma are therefore of great importance. This paper reviews the state of the art for such diagnostic modalities as computed tomography, magnetic resonance imaging, endoscopic ultrasound, positron emission tomography, and laparoscopic surgery and laparoscopic ultrasound for diagnosis and staging of pancreatic cancer. Currently, accurate diagnosis and staging probably require the use of a combination of techniques, including multiphase helical or multidetector computed tomography and/or dynamically enhanced magnetic resonance imaging with endoscopic ultrasound with fine-needle aspiration. The role of positron emission tomography still needs to be determined. The role of laparoscopic surgery and laparoscopic ultrasound may be limited in those institutions with state-of-the-art imaging techniques.
Diagnosis, Differential↗
Angiosarcoma. Diagnosis and clinical course.
The findings at radiography, computed tomography and angiography and the clinical course of 30 cases of angiosarcoma were reviewed. The variety of primary sites results in a multitude of findings but the most common finding was that of a hypervascular soft tissue mass seen on CT and angiography. Additional findings of well demarcated cortical defects in long bones were also frequently noted. The general clinical behavior of these aggressive malignant tumors was also reviewed and it was noted that they had a deceptively benign presentation.
Adult↗
Inferior phrenic artery embolization in the treatment of hepatic neoplasms.
Twenty-nine inferior phrenic artery embolizations were performed in 20 patients with primary or metastatic hepatic neoplasms. All patients had interruption of their hepatic arteries by previous infusion of chemotherapy, hepatic arterial embolization or surgical ligation. In one patient, bilateral pleural effusions developed following embolization of the inferior phrenic artery. No other severe complications occurred. Inferior phrenic artery embolization is a safe procedure and permits the continuation of transcatheter treatment of hepatic neoplasms.
Adult↗
Fine needle aspiration cytology of primary and metastatic lesions of the adrenal gland. A series of 188 biopsies with radiologic correlation.
OBJECTIVE: To determine the efficacy of fine needle aspiration (FNA) in the diagnosis of primary and metastatic lesions of the adrenal gland in conjunction with the radiologic size of the lesion. STUDY DESIGN: One hundred eighty-eight FNA biopsies performed between 1988 and 1992 with a diagnostic rate of 86% (161 cases) were reviewed and correlated with the radiologically (computed tomography, ultrasound) measured size of the lesion and follow-up. RESULTS: Eighty-one cases (43%) were primary adrenal lesions, and 80 (43%) were metastatic tumors. Three large cell lymphomas and two adrenal histoplasmoses were also noted. The most common primary site of metastatic tumors was the lung; these 55 cases (29%) included 47 adenocarcinomas and 3 small cell, 2 large cell and 3 squamous cell carcinomas. The other metastatic tumors were 5 melanomas, 7 renal cell carcinomas and 1 mixed müllerian tumor. The size of the metastatic tumors averaged 5.1 +/- 2.5 cm (+/- SD) and ranged from 1.5 to 10 cm in greatest diameter. Benign cortical nodules (61 cases, 32%) were the most common primary adrenal lesion, followed, in decreasing frequency, by 11 cortical neoplasms/carcinomas, 5 pheochromocytomas and 1 myelolipoma. The benign cortical nodules/adenomas measured an average of 2.4 +/- 0.8 cm in greatest diameter and ranged from 1 to 4 cm. The cortical neoplasm/carcinoma sizes ranged from 4 to 12 cm. CONCLUSION: These data suggest that FNA in conjunction with the radiologically measured size of adrenal lesions is a specific and sensitive method of evaluating primary and metastatic lesions of the adrenal gland. It is also an important diagnostic tool in cancer staging, obviating open surgical procedures for many patients.
Adrenal Cortex↗