Ivo Andrea Bergamo-Andreis

Serous cystadenoma of the pancreas : Report of 30 cases with emphasis on the imaging findings

PURPOSE Our goal was to evaluate retrospectively 30 cases of serous cystadenoma (SCA) to determine its main imaging features as well as to discuss the differential diagnosis problems versus the other cystic lesions of the pancreas. METHOD Thirty SCAs were analyzed; they were all benign lesions, proven at surgery. Twenty-three tumors were evaluated with US, 26 with CT, and 5 with MRI. RESULTS Three different morphostructural patterns were identified: microlacunar (n = 19), mixed (n = 6), and macrolacunar (n = 5). The diagnosis of SCA, possible in either the microlacunar or the mixed patterns, was achieved in 74% of cases with US (17/23) and in 61.5% with CT (16/26). Among the 19 patients evaluated with both modalities, the joint information allowed a correct diagnosis in 16 cases (84%). The five macrolacunar tumors were undistinguishable from other cystic masses of the pancreas. CONCLUSION The diagnosis of SCA can be considered certain in the microlacunar, likely in the mixed, and not possible in the macrolacunar type.

Relation of body fat distribution in men and degree of coronary narrowings in coronary artery disease

This study evaluates the relation between body fat distribution and severity of coronary artery disease (CAD). The study sample comprised 33 patients with angiographically demonstrated CAD and 10 angiographically normal control subjects. Body fat distribution was estimated by computed tomography and degree of coronary narrowings by angiographic score. Body weight, body mass index and total and subcutaneous abdominal adipose tissue areas showed no statistical differences in the 2 groups; visceral abdominal adipose tissue area and the visceral to subcutaneous abdominal adipose tissue area ratio were significantly higher in patients with CAD (p < 0.05). There was a significant correlation between visceral fat and triglycerides, apoprotein B and sum of glucose and insulin during glucose oral tolerance test. Sum of insulin during glucose oral tolerance test, visceral abdominal adipose tissue area and visceral/subcutaneous abdominal adipose tissue area ratio correlated significantly with severity of CAD, as evaluated by coronary score in all subjects and in CAD patients alone. Stepwise multiple regression analysis using the coronary score as the dependent variable and anthropometric and metabolic parameters as independent variables shows that in all subjects and in CAD patients alone, visceral/subcutaneous abdominal adipose-tissue area ratio entered the regression first and the sum of insulin during glucose oral tolerance test second. The results suggest that visceral abdominal adipose tissue area and visceral to subcutaneous abdominal adipose tissue area ratio may be cardiovascular risk factors.

Interrelationships between intraabdominal fat and total serum testosterone levels in obese women

Thirty-six women aged 18 to 52 years with body mass indexes (BMIs) between 27 and 52 were studied. Visceral and subcutaneous fat areas and body fat were evaluated by computerized tomography with a single scan at the IV-V lumbar vertebra level. Glucose, insulin, and C-peptide levels were measured before and after a glucose load. Total and free serum testosterone and 24-hour urinary cortisol excretion were measured. A stepwise multiple regression equation showed the visceral to subcutaneous fat area ratio to be the most powerful predictor for glucose alterations both during fasting and after a glucose load, and showed BMI to be the most powerful predictor for insulin and C-peptide levels. Total serum testosterone, after matching for age and BMI, demonstrates a significant negative correlation with visceral fat area. We conclude that in obese women, as in men, intraabdominal fat negatively correlates with serum testosterone levels.

Spontaneous rupture of a pancreatic pseudocyst into the portal vein

Spontaneous rapture of a pancreatic pseudocyst into the portal vein is described. This has been previously reported in only five cases. Diagnosis was made by computed tomography (CT) and was confirmed by CT-guided transhepatic portography.