review of literature on clinical pancreatology - The Pancreapedia

Quantum dotsIt was reported the successful use <strong>of</strong> non-cadmium-based quantum dots (QDs) as highlyefficient and nontoxic optical probes for imaging live pancreatic cancer cells. Indiumphosphide (core)-zinc sulfide (shell), or InP/ZnS, QDs with high quality and brightluminescence were prepared by a hot colloidal synthesis method in nonaqueous media. Thesurfaces <strong>of</strong> these QDs were then functionalized with mercaptosuccinic acid to make themhighly dispersible in aqueous media. Further bioconjugation with pancreatic cancer specificmonoclonal antibodies, such as anticlaudin 4 and antiprostate stem cell antigen (anti-PSCA),to the functionalized InP/ZnS QDs, allowed specific in vitro targeting <strong>of</strong> pancreatic cancer celllines (both immortalized and low passage ones). The receptor-mediated delivery <strong>of</strong> thebioconjugates was further confirmed by the observation <strong>of</strong> poor in vitro targeting innonpancreatic cancer based cell lines which are negative for the claudin-4-receptor. Theseobservations suggest the immense potential <strong>of</strong> InP/ZnS QDs as non-cadmium-based safeand efficient optical imaging nanoprobes in diagnostic imaging, particularly for early detection<strong>of</strong> cancer [446].Differential diagnosisBronchogenic carcinomaHyperamylasemia in patients with bronchogenic carcinoma has been reported rarely. Onereport described a case <strong>of</strong> lung adenocarcinoma coexisting with hyperamylasemia in a 67-year-old man. Abdominal computed tomograhy and ultrasonography demonstrated a normalpancreas. A mutational analysis <strong>of</strong> the EGFR gene indicated an in-frame deletion at exon 19.He underwent treatment with gefitinib. Chest radiography follow-up showed a partialresponse and the amylase level also decreased to normal [447].Hydatide cystPrimary hydatid disease <strong>of</strong> the pancreas is very rare. It was reported a 33-year-old femalewho was admitted to the hospital with abdominal discomfort due to the pancreatic mass. Adiagnosis <strong>of</strong> a pancreatic cystic mass was established through abdominal ultrasonographyand computed tomography scan. Hydatid disease as well as a cystic neoplasm <strong>of</strong> thepancreas was both thought in the differential diagnosis. Distal pancreatectomy withsplenectomy was performed. The histopathologic evaluation <strong>of</strong> the specimen revealed ahydatid cyst affecting the tail <strong>of</strong> the pancreas. Hydatid disease should be considered in thedifferential diagnosis <strong>of</strong> all cystic masses <strong>of</strong> the pancreas, especially in endemic regions[448].GISTDiagnosis by endoscopic ultrasound <strong>of</strong> a large aberrant pancreas mimicking malignantgastrointestinal stromal tumor <strong>of</strong> the stomach was described in a case report [449].Chronic pancreatitisDistinguishing chronic pancreatitis from pancreatic ductal adenocarcinoma (PDAC) is a wellknownchallenge, at both the clinical and the morphologic level. Findings that are specific toPDAC are the presence <strong>of</strong> duct structures in perineural and vascular spaces and ("naked")ducts in fatty tissue. However, these findings are only observed in specimens containingextrapancreatic tissue. The features that are suggestive <strong>of</strong> PDAC in specimens from thepancreas include haphazard distribution <strong>of</strong> ductlike structures (i.e. loss <strong>of</strong> a lobular pattern),