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PubMedDate not supplied

[Echolaparoscopy in the staging of abdominal neoplasms. Prospective study].

OBJECTIVE: To evaluate the sensitivity, specificity, positive and negative predictive value and influence on surgical strategy of laparoscopy and laparoscopic ultrasound on staging of abdominal malignancies. MATERIAL AND METHODS: Prospective evaluation of laparoscopic ultrasound staging, according to the TNM classification, of 80 consecutive cases of abdominal malignancies in terms of sensitivity, specificity, positive and negative predictive value and influence on surgical strategy. Pathologic examination of final surgical specimens or laparoscopic biopsies was used as control. RESULTS: Laparoscopic ultrasound evaluation was carried out successfully in 95% of cases with no mortality and morbidity. Twenty one out of 76 patients (28%) had their stage changed based on laparoscopic ultrasound findings. Unnecessary laparotomy was avoided in 11 cases (14%) due to evidence of advanced disease at laparoscopic ultrasound. For pancreatic cancer laparoscopic ultrasound was more sensitive for TNM, specificity was higher just for nodal evaluation. For liver tumor laparoscopic staging revealed more sensitive for N and M evaluation. Laparoscopic ultrasound staging had low specificity and sensitivity for T evaluation, while it was more sensitive and specific than clinical staging for nodal and distant metastasis assessment respectively for gastric and colon cancer. CONCLUSION: Laparoscopic ultrasound staging is a safe, feasible and effective staging tool for several abdominal malignancies. The introduction of laparoscopic ultrasound probes overcomes the lack of tactile sensation proper of laparoscopy, allowing precise evaluation of both solid and deeply located abdominal structures. The use of laparoscopic ultrasound staging may help to reduce the number of unnecessary laparotomies.

Abdominal Neoplasms↗
PubMed2001

Inflammatory pseudotumor-like follicular dendritic cell tumor: a distinctive low-grade malignant intra-abdominal neoplasm with consistent Epstein-Barr virus association.

Follicular dendritic cell (FDC) tumors are uncommon neoplasms that can involve lymph nodes or extranodal sites. They can exhibit a broad spectrum of histologic appearances and behavior, but the intra-abdominal ones usually pursue an aggressive course. The purpose of this study was to characterize a distinctive variant of FDC tumor morphologically mimicking inflammatory pseudotumor through analysis of the clinicopathologic features of 11 cases. The patients included 10 women and one man (age range, 19-61 years; median age, 40 years) who presented with abdominal discomfort or pain. Six patients had systemic symptoms such as marked weight loss, fever, or malaise. All tumors occurred in intra-abdominal sites: liver (n = 7), spleen (n = 3), and peripancreatic region (n = 1). Of the nine patients with follow-up data, six were alive and well, one developed recurrence at 9 years, and two had repeated recurrences over many years. Grossly, the tumors were usually solitary and fleshy, punctuated by areas of hemorrhage and necrosis. Histologically, in a background of abundant lymphocytes and plasma cells were dispersed spindle or ovoid cells with vesicular nuclei and distinct nucleoli. The degree of nuclear atypia was variable, and some nuclei could be grotesque or resemble Reed-Sternberg cells. Focally, spindle cell fascicles could be formed. The atypical cells were immunoreactive for FDC markers such as CD21/CD35, CD23, and CNA.42. In situ hybridization for Epstein-Barr virus (EBV)-encoded RNA was positive in all cases, remarkably highlighting the spindle cells and their atypia. EBV-latent membrane protein-1 was expressed commonly, albeit often focally and weakly. Therefore, inflammatory pseudotumor-like FDC tumor represents a distinctive variant of FDC tumor that differs from conventional FDC tumor in the following aspects: marked female predominance; selective localization in intra-abdominal sites, especially the liver and spleen; frequent presence of systemic symptoms; indolent behavior despite an intra-abdominal location; dispersed distribution of tumor cells and prominent lymphoplasmacytic infiltration; and consistent association with EBV.

Abdominal Neoplasms↗
PubMedDate not supplied

Actinomycetoma masquerading as an abdominal neoplasm.

Despite the fact that infection accompanying actinomycotic organisms is relatively rare, the possibility of such infection should be kept in mind because the organism is known to be commensal in the oral cavity, lungs, and intestinal tract. Abdominal lesions may mimic a neoplasm in many ways--physical findings, clinical course, and roentgenographic changes. Since the bacterium is anaerobic and difficult to grow on culture, one may have to rely on histologic confirmation for diagnosis. The infection can usually be eradicated by large doses of antibiotic (penicillin) over an extended period of time.

Abdominal Neoplasms↗
PubMed2000

Laparoscopic ultrasound enhances diagnostic laparoscopy in the staging of intra-abdominal neoplasms.

Routine laparoscopy and laparoscopic ultrasound (LUS) for staging intra-abdominal malignancies remains controversial. Thus, we undertook a prospective study to assess the value of preoperative laparoscopy with LUS for patients with intra-abdominal tumors judged resectable by preoperative studies. Laparoscopy was successfully performed in 76 of 77 patients, and 60 underwent LUS. Of 33 patients with presumed pancreatic cancer, laparoscopic findings changed the operative management of 11 patients, and LUS altered the management of an additional 6 patients. Laparotomy was avoided in 9 patients (27%). Among 14 patients with hepatobiliary tumors, laparotomy was avoided in 9 patients in whom laparoscopy and/or LUS revealed either benign or advanced disease. Operative management was altered in 4 of 18 patients with gastric or esophageal cancer by laparoscopic findings. LUS did not add to the management of these patients. Of 12 patients with presumed intra-abdominal lymphoma, 9 were diagnosed with lymphoma and 3 with benign disease, without laparotomy in all but 1 case. Laparoscopy and LUS are valuable tools for evaluating the resectability of pancreatic and hepatobiliary tumors. Laparoscopy, and to a lesser degree LUS, greatly facilitates diagnosing patients with intra-abdominal lymphomas and spares an occasional patient with esophagogastric carcinoma from undergoing laparotomy.

Carcinoma↗
PubMed1997

[Missed abdominal neoplasms during laparoscopic cholecystectomy and herniorrhaphy--analysis of material].

UNLABELLED: The authors present 9 cases of overlooking abdomen cavity neoplasma during laparoscopic cholecystectomy (L. Ch.) 8 patients had L. Ch. in other laparoscopic centers. Localisation of the tumors concerned: head of pancreas in 3 cases, posterior wall of stomach in 3 patients and splecic flexurae of colon in 2 cases. Patient was reoperated because of: painless jaundice in 3 cases, bleeding from upper part of digestive tract in 3 cases, acute or subacute intestinal obstruction in 2 cases. The period of time between the L. Ch. and a reoperation was: 2 weeks up to 2 months in patients with tumor of large or small bowel, 1 month up to 1 year in patients with head of pancreas carcinoma and 2 months up to 14 months in patients with stomach neoplasma. None of the patients complained about symptoms of neoplastic illness before the L. Ch. Small, deeply located or unapproachable for the examination tumors of an abdominal cavity might be easily overlooked during L. Ch. CONCLUSIONS: 1. Perhaps better anamnesis and more extensive diagnostic procedures (G. endoscopy, ERCP, CT) might have caused earlier discovery of the malignancies in some of these patients. 2. During laparoscopic control of abdomen cavity overlooking of neoplastic illness, particularly in patients aged over 40 is possible.

Abdominal Neoplasms↗
PubMed1987

Muramyl tripeptide: an effective immunotherapy in the surgical setting for pediatric abdominal neoplasms.

A potential complication of intraperitoneal neoplasms is the occurrence of peritoneal metastases. This experiment hypothesizes that resident peritoneal macrophages, activated by muramyl tripeptide (MTP-PE), will destroy peritoneal tumor. MTP-PE is a lipophilic derivative of the mycobacteria cell wall component responsible for induction of cellular immunity and activation of macrophages to a tumoricidal state. A transplantable murine fibrosarcoma, MCA-F was utilized. Murine hosts were challenged intraperitoneally with 5 X 10(3) MCA-F cells. Treatment with MTP-PE micelles or liposome-encapsulated MTP-PE was initiated 48 hours prechallenge and on the day of tumor challenge and continued at 72 hour intervals for the subsequent 21 days. Hosts were observed for survival. At 45 days after tumor challenge, all untreated control animals had succumbed to overwhelming neoplastic disease. In contrast, 30% of the mice treated with liposome-encapsulated MTP-PE (P less than .05) and 50% of the animals treated with MTP-PE micelles (P less than .001) remained alive at 60 days. Followed for 120 days, 20% of MTP-PE micelle treated mice are long-term survivors. These results suggest that control of intraperitoneal seedings may be achieved with MTP-PE when the tumor burden is small.

Abdominal Neoplasms↗