BACKGROUND Pancreatic paragangliomas(PPGL)are rare benign neuroendocrine neoplasms but malignancy can occur.PPGL are often misdiagnosed as pancreatic neuroendocrine tumor or pancreatic adenocarcinoma.CASE SUMMARY We r...BACKGROUND Pancreatic paragangliomas(PPGL)are rare benign neuroendocrine neoplasms but malignancy can occur.PPGL are often misdiagnosed as pancreatic neuroendocrine tumor or pancreatic adenocarcinoma.CASE SUMMARY We reviewed 47 case reports of PPGL published in PubMed to date.Fifteen patients(15/47)with PPGL underwent endoscopic ultrasound-guided fine needle aspiration(EUS-FNA).Only six(6/15)were correctly diagnosed as PPGL.All patients with PPGL underwent surgical resection except three(one patient surgery was aborted because of hypertensive crisis,two patients had metastasis or involvement of major vessels).Our patient remained on close surveillance as she was asymptomatic.CONCLUSION Accurate preoperative diagnosis of PPGL can be safely achieved by EUS-FNA with immunohistochemistry.Multidisciplinary team approach should be considered to bring the optimal results in the management of PPGL.展开更多
Background: Attention deficit hyperactivity disorder (ADHD) was long considered to be limited to children and adolescents, but it is now known that ADHD symptoms may persist into adulthood. It is plausible that the et...Background: Attention deficit hyperactivity disorder (ADHD) was long considered to be limited to children and adolescents, but it is now known that ADHD symptoms may persist into adulthood. It is plausible that the etiology of ADHD is not one-dimensional, but instead involves various neuroanatomical and neurochemical systems, with the causes of the main abnormalities believed to be catecholaminergic. Iodine-123-labeled meta-iodobenzylguanidine (123I-MIBG) is a physiological analogue of norepinephrine (NE). To the best of our knowledge, there are no reports about the abnormalities of MIBG scintigraphy in patients with ADHD. The cases presented are male adult patients with different comorbid psychiatric disorders. Case presentation: The cases presented are male adult patients with different psychiatric disorders. Case 1 was a 52-year-old male residential construction foreman, who had been diagnosed with acute schizophrenia-like psychotic disorder. 123I-MIBG planar and SPECTs of the studies were performed at 20 min (early phase) and 3 h (late phase) after intravenous injection of 111 MBq. Planar images were processed to determine the heart (H) to mediastinum (M) ratio (H/M). The early and late H/M ratios were 1.22 and 1.07, respectively. Case 2 was a 52-year-old male civil servant who was diagnosed with adjustment disorder. The early and late H/M ratios were 1.98 and 2.08, respectively. Conclusion: Clinical studies make it clear that symptoms of ADHD are more heterogenous and subtle in adults than children. Adult ADHD is significantly commorbid with wide range of other 12-month disorders. MIBG imaging can be useful to diagnose patients with preexisting psychiatric disorders and ADHD. It might be possible to diagnose objectively though the psychiatric statuses resemble or coexist with other psychiatric disorders. Needless to say, further research is important.展开更多
文摘BACKGROUND Pancreatic paragangliomas(PPGL)are rare benign neuroendocrine neoplasms but malignancy can occur.PPGL are often misdiagnosed as pancreatic neuroendocrine tumor or pancreatic adenocarcinoma.CASE SUMMARY We reviewed 47 case reports of PPGL published in PubMed to date.Fifteen patients(15/47)with PPGL underwent endoscopic ultrasound-guided fine needle aspiration(EUS-FNA).Only six(6/15)were correctly diagnosed as PPGL.All patients with PPGL underwent surgical resection except three(one patient surgery was aborted because of hypertensive crisis,two patients had metastasis or involvement of major vessels).Our patient remained on close surveillance as she was asymptomatic.CONCLUSION Accurate preoperative diagnosis of PPGL can be safely achieved by EUS-FNA with immunohistochemistry.Multidisciplinary team approach should be considered to bring the optimal results in the management of PPGL.
文摘Background: Attention deficit hyperactivity disorder (ADHD) was long considered to be limited to children and adolescents, but it is now known that ADHD symptoms may persist into adulthood. It is plausible that the etiology of ADHD is not one-dimensional, but instead involves various neuroanatomical and neurochemical systems, with the causes of the main abnormalities believed to be catecholaminergic. Iodine-123-labeled meta-iodobenzylguanidine (123I-MIBG) is a physiological analogue of norepinephrine (NE). To the best of our knowledge, there are no reports about the abnormalities of MIBG scintigraphy in patients with ADHD. The cases presented are male adult patients with different comorbid psychiatric disorders. Case presentation: The cases presented are male adult patients with different psychiatric disorders. Case 1 was a 52-year-old male residential construction foreman, who had been diagnosed with acute schizophrenia-like psychotic disorder. 123I-MIBG planar and SPECTs of the studies were performed at 20 min (early phase) and 3 h (late phase) after intravenous injection of 111 MBq. Planar images were processed to determine the heart (H) to mediastinum (M) ratio (H/M). The early and late H/M ratios were 1.22 and 1.07, respectively. Case 2 was a 52-year-old male civil servant who was diagnosed with adjustment disorder. The early and late H/M ratios were 1.98 and 2.08, respectively. Conclusion: Clinical studies make it clear that symptoms of ADHD are more heterogenous and subtle in adults than children. Adult ADHD is significantly commorbid with wide range of other 12-month disorders. MIBG imaging can be useful to diagnose patients with preexisting psychiatric disorders and ADHD. It might be possible to diagnose objectively though the psychiatric statuses resemble or coexist with other psychiatric disorders. Needless to say, further research is important.
