Inflammatory myofibroblastic tumor of the pancreatic neck:A case report and review of literature

BACKGROUND Pancreatic inflammatory myofibroblastic tumor(IMT)is a relatively rare disease that is often confused with pancreatic cancer or pancreatic neuroendocrine tumors.The histological features of IMTs show that tissue from this type of tumor contains an intermingling of fibroblast and myofibroblast proliferation,accompanied by a varying degree of inflammatory cell infiltration.CASE SUMMARY The management of an IMT occurring at the neck of the pancreas is presented in this paper.A 66-year-old female patient was diagnosed with a pancreatic neck mass after a series of tests.The patient underwent enucleation of the pancreatic neck tumor after a pathological diagnosis of IMT.Previous research on the clinical features,pathological diagnosis and treatment of pancreatic IMTs was reviewed.Compared with previous reports,this is a unique case of enucleation of a pancreatic IMT.CONCLUSION The enucleation of pancreatic IMTs may be a safe and efficient surgical method for managing such tumors with a better prognosis.Further cases are required to explore surgical measures for pancreatic IMTs.

ACE2 and TMPRSS2 Expression in Hepatocytes of Chronic HBV Infection Patients

Background:Pre-existing liver disease is a risk factor for the worse prognosis of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.We aimed to evaluate whether chronic hepatitis B(CHB)and hepatocellular carcinoma(HCC)affect the expression of viral receptor angiotensin-converting enzyme 2(ACE2)and transmembrane serine protease 2(TMPRSS2)in the liver.Methods:Twelve pairs of matched liver tissues of HCC and para-carcinoma were collected from the First Affiliated Hospital of Zhejiang University School of Medicine.And 20 liver biopsies from CHB patients were collected from Peking University People’s Hospital.The expression of ACE2 and TMRPSS2 were detected using immunofluorescence staining,western blot,and RT-qPCR.The effects of hepatitis B virus(HBV)replication or interferon on ACE2 and TMPRSS2 expression were tested in hepatic cell lines.Results:The mRNA expression of TMPRSS2 in HCC tissues was six-fold higher than that of para-carcinoma tissues(P=0.002),whereas that of ACE2 was not statistically different between HCC and para-carcinoma tissues.Hepatocellular ACE2 expression was detected in 35%(7/20)of CHB patients and mostly distributed in the inflammatory areas.However,there was no difference in TMPRSS2 expression between areas with or without inflammation.IFN-α2b slightly induced ACE2 expression(2.4-fold,P=0.033)in HepG2 cells but not in Huh-7,QSG-7701,and L-02 cells.IFN-α2b did not affect TMPRSS2 expression in these cell lines.In addition,HBV replication did not alter ACE2 expression in HepAD38 cells.Conclusions:Although HBV replication does not directly affect the expression of ACE2 and TMPRSS2,intrahepatic inflammation and carcinogenesis may increase their expression in some patients,which,in turn,may facilitate SARS-CoV-2 infection in hepatocytes.