Pancreatic neuroendocrine carcinoma in a pregnant woman:A case report and review of the literature

BACKGROUND Portal venous thromboembolism caused by malignant pancreatic neuroendocrine tumor metastasis,as the initial presentation of portal hypertension and upper gastrointestinal bleeding,is a rare entity.To our knowledge,there are no reports of this entity in pregnant women.We describe a case of pancreatic neuroendocrine carcinoma during pregnancy with hematemesis and hematochezia as the initial presentation and review the literature to analyze the demographic,clinical,and pathological features to provide a reference for clinical diagnosis and treatment.CASE SUMMARY A 40-year-old woman presented with hematemesis and hematochezia at 26-wk gestation;she had no other remarkable medical history.The physical examination revealed normal vital signs,an anemic appearance,and lower abdominal distension.Abdominal color Doppler ultrasonography showed portal vein thrombosis,splenomegaly,intrauterine pregnancy,and intrauterine fetal death.Esophagogastroduodenoscopy revealed esophageal and gastric varicose veins and portal hypertensive gastropathy.Contrast-enhanced computed tomography demonstrated multiple emboli formation in the portal and splenic veins,multiple round shadows in the liver with a slightly lower density,portal vein broadening,varicose veins in the lower esophagus and gastric fundus,splenomegaly,bilateral pleural effusion,ascites and pelvic effusion,broadening of the common bile duct,and increased uterine volume.According to the results of Positron emission tomography-computed tomography and immunohistochemical staining,the final diagnoses were that the primary lesion was a pancreatic neuroendocrine tumor and that there were secondary intrahepatic metastases and venous cancer thrombogenesis.CONCLUSION Upper gastrointestinal bleeding in a pregnant woman may be caused by portal hypertension due to a malignant pancreatic neuroendocrine tumor.

Esophageal tuberculosis complicated with intestinal tuberculosis: A case report

BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but there are few reports of ET complicated with ITB. We report a case of secondary ET complicated with ITB in a previously healthy patient.CASE SUMMARY A 27-year-old female was hospitalized for progressive dysphagia, retrosternal pain, acid regurgitation, belching, heartburn, and nausea. Upper gastrointestinal endoscopy showed a mid-esophageal ulcerative hyperplastic lesion. Endoscopic ultrasonography showed a homogeneous hypoechoic lesion, with adjacent enlarged lymph nodes. Biopsy histopathology showed inflammatory exudation,exfoliated epithelial cells and interstitial granulation tissue proliferation.Colonoscopy revealed a rat-bite ulcer in the terminal ileum and a superficial ulcer in the ascending colon, near the ileocecal region. The ileum lesion biopsy showed focal granulomas with caseous necrosis. Polymerase chain reaction for Mycobacterium tuberculosis was positive in the esophageal and ileum lesion biopsies. The T-cell spot tuberculosis test was also positive. The patient was diagnosed with secondary ET infiltrated by mediastinal lymphadenopathy and complicated with ITB, possibly from the Mycobacterium tuberculosis-infected esophageal lesion. After 2 mo of anti-tuberculosis therapy, her symptoms improved significantly, and upper gastrointestinal endoscopy showed healing ulcers.CONCLUSION When dysphagia or odynophagia occurs in patients at high-risk for tuberculosis,ET should be considered.

SYNTHESIS AND CHARACTERISTICS OF A CHELATING RESIN AS AN EXTRACTANT AND CHROMOGENIC REAGENT OF HEAVY METAL IONS IN SOLID PHASE EXTRACTION

A new chelating resin （CPS-DMA-SABA） was synthesized with the chloromethylated crossqinked polystyrene porous beads （CPS） as raw materials, which were bonded with salicylidene-o-aminobenzoic acid （SABA） on the surface via a quaternary ammonium unit as a linker. The results showed that CPS-DMA-SABA would easily change into a zwitterionic chelating resin （CPS-DMA-SABZ） when washed with distilled water. CPS-DMA-SABA was characterized by elemental analysis, infrared spectra and thermo-gravimetric analysis. The ion sorption capacities of CPS-DMA-SABA were found to be 1916 μg/g for Zn2＋ withpH at 4.5, 1620μg/g for Cu2＋ with pH at 6.2, 1291 μg/g for Ni2＋ withpH at 6.6 and 780 μg/g for Cr3＋ withpH at 5.5, respectively. The experiments showed CPS-DMA-SABA also changed its color when meeting with the metal ion in the aqueous solution. As a consequence, CPS-DMA-SABA can not only be used as a solid phase extractant but also an indicator for confirming the heavy metal ion in solutions.

Enrichment of trace cerium subgroup rare earths by means of ion flotation

The possibility of ion flotation of cerium subgroup rare earths (Ce-subgroup) was explored. Various factors affecting the flotation efficiency were investigated. The results showed that, by using sodium tetradecyl sulfate as the collector of trace Ce-subgroup and frother, over 95% of Ce-subgroup at ng/g levels could be separated from pH 2.3 media in 10--15 min. The proposed method has been applied to the determination of Ce-subgroup in a polluted farmland soil reference material (GBW 08303) with satisfactory results.