ObjectiveTo explore the etiological agent, clinical manifestations, imaging findings, pathologic characteristics, diagnosis, treatment, and prognosis of xanthogranulomatous cholecystitis(XGC). MethodThe clinical data of 48 patients with XGC diagnosed by postoperative pathology from January 2003 to December 2012 were collected and analyzed. ResultsIn these 48 patients with XGC, the clinical manifestations included 40(83.3%)patients with upper right abdominal pain, 18(37.5%)patients with jaundice, 12(25.0%)patients with fever. B ultrasound examination was performed in 45 cases, in which 42 cases were diagnosed with cholecystitis, 38 cases together with cholecystolithiasis, 15 cases together with cholecystolithiasis and gallbladder neoplasm, and 3 cases together with choledocholith with bile duct dilatation. CT was performed in 30 cases, in which 25 cases were diagnosed with cholecystitis together with cholecystolithiasis, 11 cases were diagnosed with gallbladder neoplasm. MRI was performed in 22 cases, in which 18 cases were diagnosed with cholecystitis together with cholecystolithiasis, 4 cases were diagnosed with gallbladder carcinoma. Thirty-three cases were treated with open cholecystectomy, 9 patients with laparoscopic cholecystectomy, 4 patients with cholecystectomy plus choledocholithotomy and T-tube drainage, 2 patients with cholecystectomy plus partial hepatectomy. All the patients were diagnosed with XGC by postoperative pathology and recovered well without recurrence and canceration. ConclusionsXGC is a kind of benign and invasive disease without specific clinical manifestation. Bultrasound, CT, or MRI play an important role in diagnosis, but final diagnosis is mainly based on pathological detection, and surgery is the most effective treatment. The prognosis of XGC is favorable if gallbladder is completely resected.
Objective To summary the pathogenic site, clinical manifestations, endoscopic and radiographic features, pathologic characteristics, diagnosis, treatment, and prognosis of gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN). Methods Clinical data of 70 cases of GEP-NEN who were treated in Nanjing Drum Tower Hospital from Jan. 2003 to Dec. 2012 were collected and retrospectively analyzed. Results Of the 70 cases, 35 cases(50.0%) were in pancreas, 18 cases(25.7%) were in rectum, 10 cases(14.3%) were in stomach, and 7 cases(10.0%) were in appendix; 55 cases(78.6%) were nonfunctional tumors, while 15 cases(21.4%) were functional; 50 cases(71.4%) were neuroendocrine tumor, 15 cases(21.4%) were neuroendocrine carcinoma, and 5 cases(7.2%) were mixed adenoendocrine carcinoma; 43 cases(61.4%) were in grade 1, 7 cases(10.0%) were in grade 2, and 20 cases(28.6%) were in grade 3 respectively. The detection rate of endoscopy, type-B ultrasonic, CT, and MRI were 90.0%(27/30), 67.9% (19/28), 86.0%(43/50), and 70.0%(7/10) respectively. A total of 67 patients(95.7%) were underwent surgery, including endoscopic resection, and 3 cases (4.3%) didn't receive surgery. Forty cases were followed-up for 6 months to 9 years(the median survival time was 3 years), and the 1-, 3-, and 5-year survival rates were 82.5%(33/40), 47.5%(19/40), and 35.0%(14/40) respectively. Conclusion GEP-NEN occurs mainly in pancreas, and the clinical manifestations are variable. Endoscopy and radiographic examination methods play an important role in diagnosis of GEP-NEN, but final diagnosis is mainly based on pathological detection. Surgery is the main treatment method for it.