BACKGROUND Endometrial cancer is a kind of well-known tumors of female genitourinary system.Cervical stromal invasion is an adverse factor for poor prognosis of endometrial cancer.There is still controversy regarding ...BACKGROUND Endometrial cancer is a kind of well-known tumors of female genitourinary system.Cervical stromal invasion is an adverse factor for poor prognosis of endometrial cancer.There is still controversy regarding the use of magnetic resonance imaging(MRI)in the diagnosis of cervical stromal invasion of endometrial cancer.The diagnosis of cervical stromal invasion varies significantly between different observers and institutions.We present a limited case series of the particular pattern of endometrial cancer,which infiltrates the cervical stroma and is often overlooked.CASE SUMMARY We present three cases of endometrial carcinoma with cervical stromal invasion with cancer-free uterine cavity.One patient,a reproductive-aged woman,exhibited irregular menstruation and was diagnosed with endometrial polyps by hysteroscopy and segmental curettage.A MRI scan revealed polypoid nodules within the internal cervical orifice.The other two cases were postmenopausal women who presented with abnormal vaginal bleeding.Hysteroscopy and segmental curettage suggested atypical hyperplasia of the endometrium.MRI scans did not detect any malignant signs in the endometrium.In one case,a nonthickened endometrium was observed,while in another,hyperplasia of the endometrium was seen.Notably,none of these patients had malignant tumors identified in the uterine cavity via MRI scans.However,postoperative pathological results following hysterectomy consistently indicated cervical stromal invasion.CONCLUSION Cervical stromal invasion is easily missed if no cancer is found in the uterine body on MRI.Immunohistochemistry of endoscopic curettage specimens should be conducted to avoid underestimation of the disease.展开更多
BACKGROUND Autoimmune pancreatitis(AIP)is a particular type of chronic pancreatitis,and steroid treatment of AIP is effective.Spontaneous remission(SR)of AIP without steroids is relatively rare.The international conse...BACKGROUND Autoimmune pancreatitis(AIP)is a particular type of chronic pancreatitis,and steroid treatment of AIP is effective.Spontaneous remission(SR)of AIP without steroids is relatively rare.The international consensus for the treatment of autoimmune pancreatitis suggests that patients with AIP with obstructive jaundice,abdominal pain,and back pain related to the pancreas or the bile duct should be treated with steroids;most asymptomatic patients with AIP may improve without steroids.However,in our clinical work,we found that the clinical characteristics of AIP patients with SR vary.Four of these cases are described here.In addition,to our knowledge,there is no previously published report of dynamic imaging before and after SR of AIP at present.CASE SUMMARY We present the cases of four patients with AIP(two females and two males)in which the AIP improved spontaneously without steroid treatment.Two patients were asymptomatic,one patient had abdominal pain with obstructive jaundice,and one patient had intermittent right upper abdominal pain.Three patients presented with localized pancreatic enlargement and one with diffuse pancreatic enlargement.In addition to the pancreatic lesions,bile duct involvement was seen in two patients,and no extra-pancreatic organ involvement was found in the other two patients.The serum IgG4 level of all patients was more than twice the normal level.After SR in the four patients,the affected pancreases exhibited three types of image features:Return to normal,progressive fibrosis,and atrophy and calcification.CONCLUSION The clinical features of SR in our four patients with AIP differ,but the imaging findings share some characteristics.After SR,in some cases the affected pancreas could return to normal,although some patients suffer from progressive fibrosis and atrophy as well as calcification.展开更多
文摘BACKGROUND Endometrial cancer is a kind of well-known tumors of female genitourinary system.Cervical stromal invasion is an adverse factor for poor prognosis of endometrial cancer.There is still controversy regarding the use of magnetic resonance imaging(MRI)in the diagnosis of cervical stromal invasion of endometrial cancer.The diagnosis of cervical stromal invasion varies significantly between different observers and institutions.We present a limited case series of the particular pattern of endometrial cancer,which infiltrates the cervical stroma and is often overlooked.CASE SUMMARY We present three cases of endometrial carcinoma with cervical stromal invasion with cancer-free uterine cavity.One patient,a reproductive-aged woman,exhibited irregular menstruation and was diagnosed with endometrial polyps by hysteroscopy and segmental curettage.A MRI scan revealed polypoid nodules within the internal cervical orifice.The other two cases were postmenopausal women who presented with abnormal vaginal bleeding.Hysteroscopy and segmental curettage suggested atypical hyperplasia of the endometrium.MRI scans did not detect any malignant signs in the endometrium.In one case,a nonthickened endometrium was observed,while in another,hyperplasia of the endometrium was seen.Notably,none of these patients had malignant tumors identified in the uterine cavity via MRI scans.However,postoperative pathological results following hysterectomy consistently indicated cervical stromal invasion.CONCLUSION Cervical stromal invasion is easily missed if no cancer is found in the uterine body on MRI.Immunohistochemistry of endoscopic curettage specimens should be conducted to avoid underestimation of the disease.
文摘BACKGROUND Autoimmune pancreatitis(AIP)is a particular type of chronic pancreatitis,and steroid treatment of AIP is effective.Spontaneous remission(SR)of AIP without steroids is relatively rare.The international consensus for the treatment of autoimmune pancreatitis suggests that patients with AIP with obstructive jaundice,abdominal pain,and back pain related to the pancreas or the bile duct should be treated with steroids;most asymptomatic patients with AIP may improve without steroids.However,in our clinical work,we found that the clinical characteristics of AIP patients with SR vary.Four of these cases are described here.In addition,to our knowledge,there is no previously published report of dynamic imaging before and after SR of AIP at present.CASE SUMMARY We present the cases of four patients with AIP(two females and two males)in which the AIP improved spontaneously without steroid treatment.Two patients were asymptomatic,one patient had abdominal pain with obstructive jaundice,and one patient had intermittent right upper abdominal pain.Three patients presented with localized pancreatic enlargement and one with diffuse pancreatic enlargement.In addition to the pancreatic lesions,bile duct involvement was seen in two patients,and no extra-pancreatic organ involvement was found in the other two patients.The serum IgG4 level of all patients was more than twice the normal level.After SR in the four patients,the affected pancreases exhibited three types of image features:Return to normal,progressive fibrosis,and atrophy and calcification.CONCLUSION The clinical features of SR in our four patients with AIP differ,but the imaging findings share some characteristics.After SR,in some cases the affected pancreas could return to normal,although some patients suffer from progressive fibrosis and atrophy as well as calcification.
