BACKGROUND: Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract and occur rarely in the duodenum. Splenic angiosarcoma is an aggressive neoplasm with an extremely poor ...BACKGROUND: Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract and occur rarely in the duodenum. Splenic angiosarcoma is an aggressive neoplasm with an extremely poor prognosis. METHODS: We report a case of a 70-year-old man hospitalized for abdominal pain in the upper quadrants, dyspepsia and nausea, previously treated for Hodgkin lymphoma 30 years ago. Abdominal CT showed a solid nodular lesion in the third portion of the duodenum, the presence of retropancreatic, aortic and caval lymph nodes, and four nodular splenic masses. 111 In-octreotide scintigraphy revealed pathological tissue accumulation in the duodenal region, and in the retropancreatic, retroduodenal, aortic and caval lymph nodes, suggesting a nonfunctioning neuroendocrine peripancreatic tumor. RESULTS: At exploratory laparotomy, an exophytic soft tumor was found originating from the third portion of the duodenum. Pancreas-preserving duodenectomy with duodenojejunostomy, splenectomy and lymphnodectomy of retropancreatic aortic and caval lymph nodes were performed. Pathological evaluation and immunohistochemical studies showed the presence of a duodenal gastrointestinal stromal tumor with low mitotic activity and a well-differentiated angiosarcoma localized to the spleen and invading lymph nodes.CONCLUSIONS: We speculated that the angiosarcoma and duodenal gastrointestinal stromal tumors of this patient were due to the treatment of Hodgkin lymphoma with radiotherapy 30 years ago. Pancreas-preserving segmental duodenectomy can be used to treat non-malignant neoplasms of the duodenum and avoid extensive surgery. Splenectomy is the treatment of choice for localized angiosarcomas but a strict follow-up is mandatory because of the possibility of recurrence.展开更多
BACKGROUND Many clinicians and surgeons are unfamiliar with the sclerosing angiomatoid nodular transformation(SANT),which is gaining recognition as a benign splenic tumor.We challenge that SANT is rare and whether sur...BACKGROUND Many clinicians and surgeons are unfamiliar with the sclerosing angiomatoid nodular transformation(SANT),which is gaining recognition as a benign splenic tumor.We challenge that SANT is rare and whether surgical intervention could be avoided through critical imaging review.AIM To evaluate the incidence of SANT among splenic tumors and the decisionmaking process of SANT management.METHODS Twenty hospitalized patients who underwent splenectomy in 2018 and 2019 in a tertiary university hospital were retrospectively reviewed,and their data on imaging,diagnosis,surgical indications,and courses were recorded.All pathology results were confirmed by pathologist.Discriminative features differentiating SANT from other non-SANT splenic tumors were descriptively analyzed in this case series.RESULTS Fourteen out of 20 patients who underwent splenectomy had splenic tumors,including 3 SANTs(21%splenic tumors),6 non-SANT benign lesions(43%),2 metastatic tumors,and 3 lymphomas.Hypointensity on T2-weighted magnetic resonance imaging(MRI),spoke wheel enhancing pattern in contrasted computed tomography or MRI,and cold spot(low fluorodeoxyglucose uptake)in positron emission tomography(PET)scan helped establish the diagnosis of SANT.Lymphoma,presenting with a hot spot on the PET scan were differentiated from SANT.Surgical indications were reformatted for splenic tumors.Splenectomy need not be performed in patients with typical imaging features of SANT.CONCLUSION SANT is not a rare disease entity in clinical practice.Splenectomy should not be routinely indicated as the only management option for SANT with typical imaging features.展开更多
AIM:To establish the safety and feasibility of laparoscopic splenectomy(LS) for littoral cell angioma(LCA).METHODS:From September 2003 to November 2013,27 patients were diagnosed with LCA in our institution.These pati...AIM:To establish the safety and feasibility of laparoscopic splenectomy(LS) for littoral cell angioma(LCA).METHODS:From September 2003 to November 2013,27 patients were diagnosed with LCA in our institution.These patients were divided into two groups based on operative procedure:LS(13 cases,Group 1) and open splenectomy(14 cases,Group 2).Data were collected retrospectively by chart review.Comparisons were performed between the two groups in terms of demographic characteristics(sex and age); operative outcomes(operative time,estimated blood loss,transfusion,and conversion); postoperative details(length of postoperative stay and complications); and follow-up outcome.RESULTS:LS was successfully carried out in all patients except one in Group 1,who required conversion to hand-assisted LS because of perisplenic adhesions.The average operative time for patients in Group 1 was significantly shorter than that in Group 2(127 ± 34 min vs 177 ± 25 min,P = 0.001).The average estimated blood loss in Group 1 was significantly lower than in Group 2(62 ± 48 m L vs 138 ± 64 m L,P < 0.01).No patient in Group 1 required a blood transfusion,whereas one in Group 2 required a transfusion.Two patients in Group 1 and four in Group 2 suffered from postoperative complications.All the complications were cured by conservative therapy.There were no deaths in our series.All patients were followed up and no recurrence or abdominal metastasis were found.CONCLUSION:LS for patients with LCA is safe and feasible,with preferable operative outcomes and longterm tumor-free survival.展开更多
Splenic hamartoma is a rare benign tumor,and although minimally invasive surgery may be suitable for this condition,there have only been 2 previous reports of laparoscopic surgery.Here we report the third case of sple...Splenic hamartoma is a rare benign tumor,and although minimally invasive surgery may be suitable for this condition,there have only been 2 previous reports of laparoscopic surgery.Here we report the third case of splenic hamartoma managed by laparoscopic splenectomy.A 37-year-old male was incidentally diagnosed by abdominal ultrasonography with a hypoechoic mass measuring 2.5 cm × 2.4 cm in the spleen.Color Doppler sonography showed multiple flow signals within the mass and contrast-enhanced computed tomography revealed strong enhancement of the lesion.On T1-and T2-weighted magnetic resonance images,the splenic mass was demonstrated as isointense and hyperintense respectively.Although a malignant tumor could not be ruled out,a hand-assisted laparoscopic splenectomy was performed because the splenic mass was limited in size and had not invaded adjacent organs.The pathological diagnosis was splenic hamartoma.The postoperative course was uneventful and the patient was discharged by the seventh postoperative day.Although splenic hamartomas have some specific imaging features,more reports and analyses of these cases are required to increase the reliability of the diagnosis and management.Hand-assisted laparoscopic splenectomy may play a pivotal role in the postoperative diagnosis and management of this condition.展开更多
Lymphangioma,a congenital malformation of the lymphatic system,is usually found in children,and generally occurs in the neck and mediastinum.It is rarely found in the spleen.The clinical features of splenic lymphangio...Lymphangioma,a congenital malformation of the lymphatic system,is usually found in children,and generally occurs in the neck and mediastinum.It is rarely found in the spleen.The clinical features of splenic lymphangioma typically include abdominal pain,nausea,and abdominal distention.Frequently,however, this condition is asymptomatic and is incidentally detected by abdominal ultrasonography or by an abdominal computed tomography(CT)scan.In this paper,we retrospectively describe a case of incidentally detected splenic lymphangioma in a 30-year-old woman with special abdominal contrast material-enhanced CT findings,which was accurately diagnosed by histopathology.The clinical and physical examinations related to the mass were negative.A few cases of splenic lymphangioma have been reported previously;however,the presentation of the mass and the enhancement pattern in the contrast medium-enhanced CT images were quite extraordinary.These findings had misled our abdominal radiologists to consider it as other neoplastic diseases of the spleen.展开更多
Ten compounds were isolated from the leaves of Rhizophora stylosa,one kind of mangrove plants distributed in the tropical and subtropical areas of the world.Their structures were identified as taraxerone(1),taraxero...Ten compounds were isolated from the leaves of Rhizophora stylosa,one kind of mangrove plants distributed in the tropical and subtropical areas of the world.Their structures were identified as taraxerone(1),taraxerol(2),β-sitosterol(3),careaborin(4),cis-careaborin(5),β-daucosterol(6),isovanillic acid(7),protocatechuic acid(8),astilbin(9) and rutin(10),among which compound 9 and 10 were reported in this plant for the first time.Of these compounds,compound 2 has been confirmed to have the abilities to inhibit the growth of Hela and BGC-823 with IC50 of 73.4 μmol·L-1 and 73.3 μmol·L-1,respectively.Compound 5 could inhibit the growth of BGC-823 and MCF-7 with IC50 of 45.9 μmol·L-1 and 116.0 μmol·L-1,respectively.Compound 9 and 10 were firstly reported to stimulate the proliferation of mice splenic lymphocytes markedly in a dose-dependent manner.展开更多
文摘BACKGROUND: Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract and occur rarely in the duodenum. Splenic angiosarcoma is an aggressive neoplasm with an extremely poor prognosis. METHODS: We report a case of a 70-year-old man hospitalized for abdominal pain in the upper quadrants, dyspepsia and nausea, previously treated for Hodgkin lymphoma 30 years ago. Abdominal CT showed a solid nodular lesion in the third portion of the duodenum, the presence of retropancreatic, aortic and caval lymph nodes, and four nodular splenic masses. 111 In-octreotide scintigraphy revealed pathological tissue accumulation in the duodenal region, and in the retropancreatic, retroduodenal, aortic and caval lymph nodes, suggesting a nonfunctioning neuroendocrine peripancreatic tumor. RESULTS: At exploratory laparotomy, an exophytic soft tumor was found originating from the third portion of the duodenum. Pancreas-preserving duodenectomy with duodenojejunostomy, splenectomy and lymphnodectomy of retropancreatic aortic and caval lymph nodes were performed. Pathological evaluation and immunohistochemical studies showed the presence of a duodenal gastrointestinal stromal tumor with low mitotic activity and a well-differentiated angiosarcoma localized to the spleen and invading lymph nodes.CONCLUSIONS: We speculated that the angiosarcoma and duodenal gastrointestinal stromal tumors of this patient were due to the treatment of Hodgkin lymphoma with radiotherapy 30 years ago. Pancreas-preserving segmental duodenectomy can be used to treat non-malignant neoplasms of the duodenum and avoid extensive surgery. Splenectomy is the treatment of choice for localized angiosarcomas but a strict follow-up is mandatory because of the possibility of recurrence.
文摘BACKGROUND Many clinicians and surgeons are unfamiliar with the sclerosing angiomatoid nodular transformation(SANT),which is gaining recognition as a benign splenic tumor.We challenge that SANT is rare and whether surgical intervention could be avoided through critical imaging review.AIM To evaluate the incidence of SANT among splenic tumors and the decisionmaking process of SANT management.METHODS Twenty hospitalized patients who underwent splenectomy in 2018 and 2019 in a tertiary university hospital were retrospectively reviewed,and their data on imaging,diagnosis,surgical indications,and courses were recorded.All pathology results were confirmed by pathologist.Discriminative features differentiating SANT from other non-SANT splenic tumors were descriptively analyzed in this case series.RESULTS Fourteen out of 20 patients who underwent splenectomy had splenic tumors,including 3 SANTs(21%splenic tumors),6 non-SANT benign lesions(43%),2 metastatic tumors,and 3 lymphomas.Hypointensity on T2-weighted magnetic resonance imaging(MRI),spoke wheel enhancing pattern in contrasted computed tomography or MRI,and cold spot(low fluorodeoxyglucose uptake)in positron emission tomography(PET)scan helped establish the diagnosis of SANT.Lymphoma,presenting with a hot spot on the PET scan were differentiated from SANT.Surgical indications were reformatted for splenic tumors.Splenectomy need not be performed in patients with typical imaging features of SANT.CONCLUSION SANT is not a rare disease entity in clinical practice.Splenectomy should not be routinely indicated as the only management option for SANT with typical imaging features.
文摘AIM:To establish the safety and feasibility of laparoscopic splenectomy(LS) for littoral cell angioma(LCA).METHODS:From September 2003 to November 2013,27 patients were diagnosed with LCA in our institution.These patients were divided into two groups based on operative procedure:LS(13 cases,Group 1) and open splenectomy(14 cases,Group 2).Data were collected retrospectively by chart review.Comparisons were performed between the two groups in terms of demographic characteristics(sex and age); operative outcomes(operative time,estimated blood loss,transfusion,and conversion); postoperative details(length of postoperative stay and complications); and follow-up outcome.RESULTS:LS was successfully carried out in all patients except one in Group 1,who required conversion to hand-assisted LS because of perisplenic adhesions.The average operative time for patients in Group 1 was significantly shorter than that in Group 2(127 ± 34 min vs 177 ± 25 min,P = 0.001).The average estimated blood loss in Group 1 was significantly lower than in Group 2(62 ± 48 m L vs 138 ± 64 m L,P < 0.01).No patient in Group 1 required a blood transfusion,whereas one in Group 2 required a transfusion.Two patients in Group 1 and four in Group 2 suffered from postoperative complications.All the complications were cured by conservative therapy.There were no deaths in our series.All patients were followed up and no recurrence or abdominal metastasis were found.CONCLUSION:LS for patients with LCA is safe and feasible,with preferable operative outcomes and longterm tumor-free survival.
文摘Splenic hamartoma is a rare benign tumor,and although minimally invasive surgery may be suitable for this condition,there have only been 2 previous reports of laparoscopic surgery.Here we report the third case of splenic hamartoma managed by laparoscopic splenectomy.A 37-year-old male was incidentally diagnosed by abdominal ultrasonography with a hypoechoic mass measuring 2.5 cm × 2.4 cm in the spleen.Color Doppler sonography showed multiple flow signals within the mass and contrast-enhanced computed tomography revealed strong enhancement of the lesion.On T1-and T2-weighted magnetic resonance images,the splenic mass was demonstrated as isointense and hyperintense respectively.Although a malignant tumor could not be ruled out,a hand-assisted laparoscopic splenectomy was performed because the splenic mass was limited in size and had not invaded adjacent organs.The pathological diagnosis was splenic hamartoma.The postoperative course was uneventful and the patient was discharged by the seventh postoperative day.Although splenic hamartomas have some specific imaging features,more reports and analyses of these cases are required to increase the reliability of the diagnosis and management.Hand-assisted laparoscopic splenectomy may play a pivotal role in the postoperative diagnosis and management of this condition.
文摘Lymphangioma,a congenital malformation of the lymphatic system,is usually found in children,and generally occurs in the neck and mediastinum.It is rarely found in the spleen.The clinical features of splenic lymphangioma typically include abdominal pain,nausea,and abdominal distention.Frequently,however, this condition is asymptomatic and is incidentally detected by abdominal ultrasonography or by an abdominal computed tomography(CT)scan.In this paper,we retrospectively describe a case of incidentally detected splenic lymphangioma in a 30-year-old woman with special abdominal contrast material-enhanced CT findings,which was accurately diagnosed by histopathology.The clinical and physical examinations related to the mass were negative.A few cases of splenic lymphangioma have been reported previously;however,the presentation of the mass and the enhancement pattern in the contrast medium-enhanced CT images were quite extraordinary.These findings had misled our abdominal radiologists to consider it as other neoplastic diseases of the spleen.
文摘Ten compounds were isolated from the leaves of Rhizophora stylosa,one kind of mangrove plants distributed in the tropical and subtropical areas of the world.Their structures were identified as taraxerone(1),taraxerol(2),β-sitosterol(3),careaborin(4),cis-careaborin(5),β-daucosterol(6),isovanillic acid(7),protocatechuic acid(8),astilbin(9) and rutin(10),among which compound 9 and 10 were reported in this plant for the first time.Of these compounds,compound 2 has been confirmed to have the abilities to inhibit the growth of Hela and BGC-823 with IC50 of 73.4 μmol·L-1 and 73.3 μmol·L-1,respectively.Compound 5 could inhibit the growth of BGC-823 and MCF-7 with IC50 of 45.9 μmol·L-1 and 116.0 μmol·L-1,respectively.Compound 9 and 10 were firstly reported to stimulate the proliferation of mice splenic lymphocytes markedly in a dose-dependent manner.