Colonic metastasis from other organs is very rare.Here we report the case of a 62-year-old man with a history of pancreatoduodenectomy for stage IIB pancreatic head cancer performed seven years back.He presented with ...Colonic metastasis from other organs is very rare.Here we report the case of a 62-year-old man with a history of pancreatoduodenectomy for stage IIB pancreatic head cancer performed seven years back.He presented with abdominal distension and pain.Under the preoperative diagnosis of bowel obstruction,surgical treatment was performed,and a circumferential lesion causing bowel obstruction of the ascending colon was detected.A right hemicolectomy with lymph node dissection was performed.The specimen showed a 5-cm wall thickening with a cobble-stone like appearance of the ascending colon,which morphologically appeared scirrhous.Histological examination revealed cancer nests invading from the subserosa to the muscular and submucosal layers of the colon.Immunohistochemical analysis of the tumor cells demonstrated positive staining for cytokeratin 7,but negative for cytokeratin 20,which was the same as the previous pancreatic cancer specimen.These pathological and immunohistochemical features strongly supported the diagnosis of colonic metastasis from the pancreas.Thereafter,the patient received systemic chemotherapy,but unfortunately,he died 14 mo after the surgery.展开更多
Non-Hodgkin lymphoma is a rare cause of biliary ob-struction. To the best of our knowledge, non-Hodgkin lymphoma in the peripancreatic region causing obstruc-tive jaundice with simultaneous portal vein (PV) inva-sion ...Non-Hodgkin lymphoma is a rare cause of biliary ob-struction. To the best of our knowledge, non-Hodgkin lymphoma in the peripancreatic region causing obstruc-tive jaundice with simultaneous portal vein (PV) inva-sion has not yet been reported. We present a 50-year-old patient with obstructive jaundice whose extrahepatic portal vein was obstructed by the invasion of a peripan-creatic non-Hodgkin lymphoma. The patient denied any other symptoms such as recurrent fever, night sweat and loss of body weight. Computed tomography (CT) revealed a 10 cm mass in the retroperitoneal space behind the head of the pancreas causing obstruction of the distal bile duct and the PV. A pylorus-preserving pancreaticoduodenectomy combined with a PV resection was performed. The PV was reconstructed using an au-tologous right internal jugular vein graft. The resected specimen showed endoluminal invasion of both the bile duct and the PV. Histological examination showed the mass consisting of diffuse sheets of large malignant lymphoid cells. These cells were positive for CD20 and CD79a, partially positive for CD10, and negative for CD3, CD4, CD5, CD8 and CD30. The pathologic diagno-sis was diffuse large B-cell type non-Hodgkin lymphoma and the patient was transferred to the Department of Hematology and Oncology for chemotherapy. He re-ceived four cycles of combined chemotherapy including cyclophosphamide, doxorubicin, vincristine and pred-nisone plus rituximab, and three cycles of intrathecal chemoprophylaxis including methotorexate, cytosine arbinoside and prednisone. The patient is alive with noevidence of the disease for 7 mo after operation and will receive additional courses of chemotherapy.展开更多
文摘Colonic metastasis from other organs is very rare.Here we report the case of a 62-year-old man with a history of pancreatoduodenectomy for stage IIB pancreatic head cancer performed seven years back.He presented with abdominal distension and pain.Under the preoperative diagnosis of bowel obstruction,surgical treatment was performed,and a circumferential lesion causing bowel obstruction of the ascending colon was detected.A right hemicolectomy with lymph node dissection was performed.The specimen showed a 5-cm wall thickening with a cobble-stone like appearance of the ascending colon,which morphologically appeared scirrhous.Histological examination revealed cancer nests invading from the subserosa to the muscular and submucosal layers of the colon.Immunohistochemical analysis of the tumor cells demonstrated positive staining for cytokeratin 7,but negative for cytokeratin 20,which was the same as the previous pancreatic cancer specimen.These pathological and immunohistochemical features strongly supported the diagnosis of colonic metastasis from the pancreas.Thereafter,the patient received systemic chemotherapy,but unfortunately,he died 14 mo after the surgery.
文摘Non-Hodgkin lymphoma is a rare cause of biliary ob-struction. To the best of our knowledge, non-Hodgkin lymphoma in the peripancreatic region causing obstruc-tive jaundice with simultaneous portal vein (PV) inva-sion has not yet been reported. We present a 50-year-old patient with obstructive jaundice whose extrahepatic portal vein was obstructed by the invasion of a peripan-creatic non-Hodgkin lymphoma. The patient denied any other symptoms such as recurrent fever, night sweat and loss of body weight. Computed tomography (CT) revealed a 10 cm mass in the retroperitoneal space behind the head of the pancreas causing obstruction of the distal bile duct and the PV. A pylorus-preserving pancreaticoduodenectomy combined with a PV resection was performed. The PV was reconstructed using an au-tologous right internal jugular vein graft. The resected specimen showed endoluminal invasion of both the bile duct and the PV. Histological examination showed the mass consisting of diffuse sheets of large malignant lymphoid cells. These cells were positive for CD20 and CD79a, partially positive for CD10, and negative for CD3, CD4, CD5, CD8 and CD30. The pathologic diagno-sis was diffuse large B-cell type non-Hodgkin lymphoma and the patient was transferred to the Department of Hematology and Oncology for chemotherapy. He re-ceived four cycles of combined chemotherapy including cyclophosphamide, doxorubicin, vincristine and pred-nisone plus rituximab, and three cycles of intrathecal chemoprophylaxis including methotorexate, cytosine arbinoside and prednisone. The patient is alive with noevidence of the disease for 7 mo after operation and will receive additional courses of chemotherapy.
