The computed tomographic and histologic appearances in 34 cases of autopsy-confirmed metastatic tumors of the pancreas including secondary malignant lymphoma are discussed. In 18 (53.8%) the pancreas appeared abnormal on computed tomography, the lesions being classified into three types: In 8 cases there was diffuse enlargement of the pancreas; in 9 cases a localized mass; and one patient had multiple low attenuated nodules within the organ. Histologic investigation revealed that metastatic carcinoma involved the pancreatic lobules. The degree of infiltration in the interlobular connective tissue was related to the invasiveness of the tumors. In the majority of cases with diffuse infiltration the pancreatic lobules were destroyed and varying degrees of proliferation of malignant cells into the interlobular septa were documented. In patients with localized infiltration there was extensive invasion of the carcinoma within the pancreatic lobule. Dilatation of the pancreatic duct and/or organ-related symptoms were occasionally seen in these cases.

From 1990 to 1991, 40 patients with squamous cell carcinoma of the thoracic oesophagus were admitted to our institutions and chemotherapy (oil Bleomycin p.o. and CDDP d.i.v.) either combined with or without hyperthermia was performed, in a prospective randomized trial carried out to investigate the effects of hyperthermia. The two groups (group A, consisting of 20 patients given chemotherapy alone; and group B, made up of 20 given chemotherapy with hyperthermia) were comparable with regard to various prognostic factors. Following the above treatment regimens, an oesophagectomy was done in 16 and 17 patients from groups A and B, respectively. A subjective improvement of dysphagia was seen in 8 (40.0%), and in 14 patients (70.0%), while a radiographic improvement was recognized in 5 (25.0%) and 10 cases (50.0%) in groups A and B, respectively. In the resected specimen of 16 (group A) and 17 patients (group B), histopathological evidence of the effectiveness of the treatments were recognized in 3 (18.8%) and 7 (41.2%) from groups A and B, respectively. Excluding the cases of superficial carcinoma (T1 tumour), histologic effectiveness of the treatments were recognized in 2 (14.3%) and 7 (58.3%) in groups A and B, respectively (p < 0.05). There was no difference in the occurrence of side effects between the groups. Therefore, the clinical and pathological effects were favourable in the hyperthermia combined with chemotherapy group, especially in the cases with advanced oesophageal cancer.

Two cases of pancreatic lymphoepithelial cyst are presented. Abdominal ultrasonography and endoscopic ultrasonography demonstrated cysts containing keratinized material, indicative of this diagnosis.

Fourteen patients with benign symptomatic non-parasitic cysts of the liver were either surgically treated, had alcohol injected into the cysts, underwent deroofing of the cyst or in 5, a cystectomy was done. Alcohol was injected into 6 patients and there has been no recurrence for as long as 5 years and 8 months after the treatment. Liver dysfunction occurred in 3 patients given blood transfusion during the surgery and/or postoperative course, an elevated temperature (over 39C) occurred in one patient. Adverse effects of alcohol injections were minor and transient. Based on our experience, the injection of alcohol is an effective treatment for benign symptomatic cyst of the liver. When a malignancy is suspected on imaging and/or cytologic studies, or when alcohol administration is ineffective, then surgery is indicated.