ObjectiveTo analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP). MethodsEight patients with SPTP received triple phasic contrast-enhanced CT, and its consistency with pathological findings was analyzed. ResultsSPTP manifested as a solitary and exogenous mass, with a heterogeneous pattern composed of solid and polycystic parts. The shape of SPTP was spherical in four patients, oval in two patients, and shallow lobulation in another two patients. In contrast-enhanced phase images, the solid parts showed mild to moderate enhancement in both arterial and portal phases. Complete capsule was showed in seven patients, and nodules were found in the wall of mass in five patients. Hemorrhage was seen in two patients and calcification was showed in five patients. The dilation of pancreatic duct was found in one patient, liver metastases was showed in one patient, and the invasion of tumor to posterior gastric wall was found in one patient. Pseudopapillary structure, hemorrhage, necrosis, and cystic degeneration were showed in all patients by histological study. ConclusionSPTP has certain characteristic CT imaging manifestations consistent with histological features, which is helpful for the diagnosis and differential diagnosis of SPTP.
Objective To discuss the clinical manifestations, diagnosis, and treatment of hepatoid adenocarcinoma of the stomach. Methods By summarizing the multi-disciplinary team results of 1 patient with hepatoid adenocarcinoma of the stomach, who underwent surgery in West China Hospital in October 2017, as well as reviewing the related literatures, to explore the clinicopathological features of hepatoid adenocarcinoma of the stomach. Results The clinical features of hepatoid adenocarcinoma of the stomach were often accompanied by early liver metastasis and alpha fetoprotein (AFP) significantly increased, which were easily misdiagnosed as primary hepatocellular carcinoma. The histopathological features of hepatoid adenocarcinoma of the stomach were characterized by two structures: hepatocellular carcinoma and adenocarcinoma. Conclusion Hepatoid adenocarcinoma of the stomach is a special type of gastric adenocarcinoma, and radical operation is the main treatment, but the prognosis of it is poor.
ObjectiveTo explore the clinical, imaging, and pathological features of patients with synchronous double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma (sdpHCC-ICC), to enhance our understanding of the disease and reduce the rate of misdiagnosis and missed diagnosis.MethodsThe clinical, imaging, and pathological data of patients who were histologically confirmed as sdpHCC-ICC in West China Hospital of Sichuan University between January 1st 2014 and December 31st 2018 were studied retrospectively.ResultsA total of 11 patients with sdpHCC-ICC were screened for the study, of which 10 were male and 1 was female. The median age of patients was 55.6 years (ranged from 47 to 73 years). Eight patients were chronically infected with hepatitis B virus. Both increased alpha-fetoprotein and carbohydrate antigen 19-9 were observed in 8 patients. Contrast enhanced CT was performed in 8 cases, color doppler ultrasound in 4 cases, enhanced MRI in 3 cases, and contrast-enhanced ultrasound in 1 case. Among them, one solitary lesion was found in 2 patients, and two or more lesions were observed in 9 patients. Most of the patients had typical imaging performance of hepatocellular carcinoma (HCC): 8 patients showed strong enhancement of HCC during the hepatic arterial phase and progressive hyper-attenuation on venous and delayed phases, 1 patient showed peripheral rim enhancement in the arterial phase of intrahepatic cholangiocarcinoma (ICC) in another lesion could be observed at the same time. None of the 11 patients with sdpHCC-ICC was diagnosed accurately before operation. All patients underwent surgical treatment. HCC lesions were distributed in all parts of the liver, while ICC lesions were located in the right lobe of the liver in 10 cases. The median diameter of HCC and ICC was 3.5 cm and 2.1 cm, respectively. All of them were confirmed by hematoxylin-eosin staining and immunohistochemistry.ConclusionsThe clinical characteristics of sdpHCC-ICC are usually atypical. It is difficult to make an accurate preoperative diagnosis. Tumor markers may be valuable to the diagnosis of sdpHCC-ICC. The definite diagnosis of sdpHCC-ICC depends on pathological examination.