Biomedical subjects
Publications and source records attributed to Mahmoud Haj.
Heterotopic pancreas (HP) is generally an asymptomatic lesion and is a rare cause of gastric outlet obstruction. We report such a case in which both upper gastrointestinal series and abdominal computerized tomography (CT) demonstrated an antral mass; surgical and histological results are also reported.
This article reports our experience using the advanced breast biopsy instrument (ABBI) system for excisional biopsy of mammographically visible nonpalpable breast lesions. Patients with nonpalpable mammographically detected breast lesions were evaluated as potential ABBI candidates. Selection criteria included noncystic lesions for which complete removal or large sampling was indicated, compressed thickness of the breast of more than 25 mm, and the patient's ability to lie prone for at least 1 hour. During the period August 1997-April 2000 (33 months), 284 patients were found to be potential ABBI candidates. Sixteen patients were subsequently excluded. Biopsies using the ABBI system were performed in 268 cases, yielding an overall technical success rate of 94.4%. The mammographic abnormalities included mass in 125 cases (46.6%), mass with calcifications in 63 cases (23.5%), and microcalcifications without a mass in 80 cases (29.8%). Histologically 56 specimens (20.9%) were malignant (mass in 30 cases, mass with calcifications in 12, and microcalcifications in 14) and 212 (79.1%) were benign. Carcinoma in situ was found in 17 cases (30.4%), invasive carcinoma in 35 cases (62.5%), tubular carcinoma in 2 cases (3.6%), metastatic intramammary lymph node of previously unknown malignant melanoma in 1 case, and malignant lymphoma in 1 case. Open reexcision was performed in 54 cases with primary breast cancer. The histologic investigation revealed that in 26 (48.15%) cases the mammographic lesion was completely excised and in 28 (51.85%) cases the margins involved malignant residue and/or other foci of carcinoma. There were complications in 17 cases: wound infection in 2, ecchymosis in 9, seroma in 5, and a large immediate hematoma in 1 patient. Only the latter patient required immediate revision and drainage; the remainder underwent successful conservative treatment. Most nonpalpable breast lesions, if selected properly, are accessible for ABBI procedure. The biopsy causes minimal complications and minimal distortion of the breast architecture. Should relumpectomy be needed after the ABBI procedure, the tunnel of the cannula path is easily recognized, leaving no need for needle localization.
Inflammatory pseudotumor (IP) is a benign lesion that can affect any tissue in the body and which may be confused clinically and in imaging for malignancy. Despite the widespread performance of breast biopsy, the finding of inflammatory pseudotumor of the breast is exceedingly rare. Excision of the tumor is the treatment of choice, but there is a relatively high rate of recurrence. The aim of this report is to describe the clinical, imaging, and pathologic features in a case of breast IP, the first reported case in a postpartum woman still nursing her infant.
Recent unilateral decrease in visual acuity of a 72-year-old woman was the background of a comprehensive medical investigation that led to the definitive diagnosis of metastatic pancreatic carcinoma. Visual improvement was achieved after ocular irradiation but the patient died two months later because of bilateral pneumonia and sepsis. Ocular metastasis from advanced carcinoma of various organs is well known and usually is an indicative sign of poor prognosis. Ocular metastases from pancreatic carcinoma are extremely rare, and to the best of our knowledge, it has not been reported previously in English. It should be emphasized that unilateral decrease in visual acuity must be thoroughly investigated.