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Stanisław Milnerowicz, Marta Strutyńska-Karpińska and Ewa Nienartowicz

Duodenal Diverticulum Mimicking Duodenal Stromal Tumor

A patient with duodenal diverticulitis who was initially misdiagnosed with stromal tumor of the duodenum is presented. This case is of interest because it illustrates difficulties in the interpretation of auxiliary investigations and the choice of the best treatment option. US and CT images revealed two large ovoid masses of fluid density in the duodenal wall which may have suggested stromal tumor of the duodenum as well as periampullary cystic neoplasm, the more so because intramural tumor of the duodenum was seen in duodenoscopy. A similar picture may also be seen in duodenal diverticula, especially in diverticula which are not filled with gas or a combination of fluid and gas. This case demonstrates one such entity.

Open access

Marta Karpińska, Mirosław Nienartowicz, Alicja Markowska-Woyciechowska and Katarzyna Budrewicz-Czapska

Heterotopic Pancreas in the Stomach (Type II According to Heinrich) - Literature Review and Case Report

Heterotopic pancreas is a rare congenital disorder characterized by the presence of normal pancreatic tissue located outside the pancreas. The most common locations include the duodenum, stomach, and jejunum. Most cases of heterotopic pancreas are asymptomatic. However, the development of clinical symptoms depends on the size, location and pathological changes similar to those observed in case of the normal pancreas. The Authors presented a case of multiple stomach heterotopic pancreatic lesions in an adult male patient. The atypical clinical presentation including non-specific endoscopic and CT images were responsible for the misdiagnosis before surgery. The patient underwent surgery. The tumor located in the posterior wall of the body of the stomach was excised by wedge resection. The postoperative course proved uneventful. Proper diagnosis was established on the basis of the histopathological examination of the resected tumor: heterotopic pancreas-multiple lesions, type II, according to Heinrich. The presented case report demonstrated that heterotopic pancreas should always be considered in the differential diagnosis of gastric tumors.

Open access

Piotr Kołaczek, Mirosława Kupryjanowicz, Monika Karpińska-Kołaczek, Marta Szal, Hanna Winter, Weronika Danel, Katarzyna Pochocka-Szwarc and Renata Stachowicz-Rybka

ABSTRACT

The development of vegetation in the Skaliska Basin has been reconstructed on the basis of palynological analysis and radiocarbon dating (AMS technique) of 6 sites from the late phase of the Bolling- Allerod interstadial complex to modern times. Although the area covers 90 km2, the mosaic character of habitats led to the development of different patterns of vegetation changes during the Late Glacial and Holocene. Only one site located in the eastern part of the Skaliska Basin reflected the ‘pine phase’ of Allerod, and this is the oldest data on vegetation in the Skaliska Basin. Interesting discrepancies were recorded during the Younger Dryas when patches of shrublands with Juniperus were distinct around some of the sites, while steppe with Artemisia was common in others. The beginning of the Holocene brought an expansion of birch-pine forest, but around 9600 cal. BC a cold oscillation took place which was reflected in an increase in birch in the woodlands in the western and eastern part of the Skaliska Basin. In the Preboreal chronozone elm (Ulmus) also expanded in the area but its appearance was non-synchronous. The vegetation of the Boreal chronozone was similar in the whole area and the most characteristic feature was the rapid expansion of hazel (Corylus avellana) which displaced Betula from the most of its sites. At that time a distinct redeposition of pollen material in the Parchatka river valley was detected which was probably the effect of an increase in fluvial activity of the river (humid oscillation). The following stage of vegetation development was climax woodlands with Tilia cordata, Ulmus, Quercus, Corylus avellana, and Alnus in damp places. At the beginning of the Subboreal chronozone the expansion of Quercus took place, which was subsequently replaced by Picea abies and partly Carpinus betulus. The pattern of Picea abies expansion distinctly presents two maxima which is characteristic of many sites in the north-eastern Poland. The Subatlantic chronozone is represented only by the profile from the Skaliski Forest, where, because of sandy ground, Pinus sylvestris was the dominant element. Human impact was poorly reflected through the rare occurrence of pollen grains of Cerealia type in the pollen profiles spanning the time from the Subboreal chronozone to modern times. In most profiles AMS dating produced age discrepancies, which limited the possibility of establishment of a detailed chronology. However, dates obtained from the material contaminated by mixture of glycerine, thymol and ethyl alcohol, pretreated by alcohol, showed reliable results in most cases.