Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration

Ardengh, José Celso; Lopes, César Vivian; Lima, Luiz Felipe Pereira de; Oliveira, Juliano Rodrigues de; Venco, Filadelfio; Santo, Giulio Cesare; Modena, José Luiz Pimenta

doi:10.3748/wjg.v13.i22.3112

Cited by 81 publications

(61 citation statements)

References 29 publications

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“…In our series, PS was found in 0.6% of the patients with pancreatic nodules submitted to EUS-FNA. Although a benign lesion, PS can mimic a pancreatic neoplasm, and the differential diagnosis comprises pancreatic carcinoma, NET, solid-cystic papillary tumor and metastases (2) . Pancreatic NETs are rare, accounting for less than 10% of the pancreatic solid tumors, and are often located in the A B FIGURE 3.…”

Section: Discussionmentioning

confidence: 99%

“…As an on-site cytopathologist was not available in our routine, the specimens were considered satisfactory in the presence of non-hemorrhagic small tissue filaments or tissue core samples. The specimens were sent to pathologist with expertise in pancreatic pathology (FV), and prepared according to a previously described cell block technique (2) . Diagnosis of PS was based on demonstration of aggregates of splenic tissue, with red and white pulp, scarce pancreatic acinar tissue, and, in the presence of specimens enough for analysis, immunohistochemical studies for synaptofisin and chromogranin-A.…”

Section: Methodsmentioning

confidence: 99%

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Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Ardengh¹,

Lopes

Kemp

et al. 2013

Arq. Gastroenterol.

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-Context -Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm. Objective -To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic nodules suspicious for pancreatic splenosis. Method -From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed. Results -A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6%) cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7), young (mean age: 42 years) and asymptomatic (8). Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients. Conclusion -Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Ardengh¹,

Lopes

Kemp

et al. 2013

Arq. Gastroenterol.

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“…The presence of stents (either plastic or metallic) usually does not impede EUS-FNA [71][72][73], although the stent has to be placed at least one day before performing EUS-FNA [72]. There is no difference in diagnostic accuracy between lesions less or more than 3 cm in diameter [74], although one study found sensitivity as low as 40% for tumors less than 1 cm in diameter [75].…”

Section: Endoscopic Ultrasound Fine-needle Aspirationmentioning

confidence: 99%

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Seicean¹

2014

Pancreatic Cancer - Insights Into Molecular Mechanisms and Novel Approaches to Early Detection and Treatment

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“…Reported sensitivity and accuracy for malignancy ranges from 75 to 92% and from 79 to 92%, respectively (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). This accuracy may be even higher using on-site evaluation of the sample by an experienced pathologist (34).…”

Section: Introductionmentioning

confidence: 99%

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

Iglesias‐García

Lindkvist

Lariño‐Noia³

et al. 2012

Rev. esp. enferm. dig.

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Differential diagnosis of solid pancreatic lesions remains as an important clinical challenge, mainly for the differentiation between mass forming chronic pancreatitis, autoimmune pancreatitis and pancreatic adenocarcinoma. Endoscopic ultrasound (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) can all provide valuable and complementary information in this setting. Among them, EUS has the unique ability to obtain specimens for histopathological diagnosis and can therefore play a crucial role in the evaluation patients with inconclusive findings on initial examinations. Nowadays, new developed techniques associated to EUS, like elastography and contrast enhancement, have shown promising results for the differential diagnosis of these pancreatic lesions.Key words: Endoscopic ultrasound. CT scan. MRI. Pancreatic tumors. INTRODUCTIONDifferential diagnosis of solid pancreatic masses remains a challenge, despite recent advances in different diagnostic procedures. In this article, the role of endoscopic ultrasound (EUS) including EUS-guided FNA, elastography and contrast enhancement will be reviewed in relation to computer tomography (CT), magnetic resonance tomography (MRI) and magnetic resonance cholangiopancreatography (MRCP). Differential diagnosis between malignant lesions and mass-forming chronic pancreatitis or focal autoimmune pancreatitis will be discussed. Tumor staging and evaluation of resectability of these pancreatic lesions will not be evaluated. Other imaging techniques, like PET-scan or octreoscan will not be analyze, because their usefulness in this context is unclear.Differential diagnosis between malignant pancreatic lesions (pancreatic cancer, pancreatic metastasis) and massforming chronic pancreatitis CT scan is the most widely spread imaging modality for evaluation of pancreatic solid masses and considered as the most comprehensive tool for diagnosis and surgical staging of pancreatic malignancies (1). CT technology has significantly advanced over the last years, multidetector helical CT scan allows for very thin sliced cuts, providing a higher image resolution and faster image acquisition (Fig. 1) Vol. 104. N.° 6, pp. 315-321, 2012 Disclosures: Dr. Julio Iglesias-García is international advisor of Cook-Medical. Dr. J. Enrique Domínguez-Muñoz is international advisor of Pentax Medical Company.Received: 27-03-201227-03- Accepted: 20-04-2012 Correspondence: Julio Iglesias-García. Department of Gastroenterology.

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Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration

Cited by 81 publications

References 29 publications

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

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