EUS-guided fine needle aspiration of pancreatic cysts: A retrospective analysis of complications and their predictors

Lee, Linda; Saltzman, John R.; Bounds, Brenna C.; Poneros, John M.; Brugge, William R.; Thompson, Christopher C.

doi:10.1016/s1542-3565(04)00618-4

Cited by 200 publications

(128 citation statements)

References 24 publications

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“…Its role in diagnosing benign and malignant pancreatic tumors and cysts has been well established, and therapeutic applications such as celiac plexus neurolysis and drainage of pseudocysts are now common [1][2][3][4] . EUS is also being used more frequently to diagnose chronic pancreatitis (CP).…”

Section: Introductionmentioning

confidence: 99%

Relationship between Patient Symptoms and Endosonographic Findings in Chronic Pancreatitis

2009

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Section: Introductionmentioning

confidence: 99%

Relationship between Patient Symptoms and Endosonographic Findings in Chronic Pancreatitis

2009

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“…The strength of EUS is its ability to detect and aspirate small cystic lesions with a high level of safety [38]. EUS is more accurate in the evaluation of lesions less than 3 cm in diameter [39].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Cystic pancreatic lesions: Can we diagnose them accurately what to look for? FNA marker molecular analysis resection, surveillance, or endoscopic treatment?

Brugge

2006

Endoscopy

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IntroductionCystic lesions of the pancreas consist of a spectrum of benign, pre-malignant, and malignant malignancies. In the past, cystic neoplasms of the pancreas were thought to be relatively rare, but the widespread use of cross sectional imaging has dramatically increased ability to detect these lesions. Although the vast majority of pancreatic cysts are discovered incidentally, large or invasive lesions may produce sufficient symptoms to cause the patient to seek medical attention.Cystic neoplasms are often confused or misdiagnosed as pseudocysts or peripancreatic collections of inflammatory fluid that may morphologically mimic cystic neoplasms. Furthermore, the presenting symptoms of pseudocysts may be identical to the symptoms associated with cystic neoplasms.Cystic neoplasms of the pancreas are traditionally organized by the type of lining epithelium since this feature dominates the risk of malignancy and management [1] ( Table 1). There are three types of mucinous lesions, benign mucinous cystadenomas, malignant mucinous cystic lesions, and intra-ductal papillary mucinous neoplasms (IPMNs). The non-mucinous lesions include serous cystadenomas, cystic endocrine tumors and other rare lesions. PrevalenceThe prevalence of pancreatic cysts has been examined with autopsy examinations of the pancreas in adults without known pancreatic disease. The prevalence of pancreatic cysts found at autopsies in Japan was approximately 73 of 300 autopsies (24.3 %) cases [2]. The prevalence of cysts increased with increasing age of the patient. The cysts were located throughout the pancreatic parenchyma and were not related to chronic pancreatitis. The epithelium of the cysts displayed a spectrum of neoplastic change, including atypical hyperplasia (16.4 %); carcinoma in situ (3.4 %).

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“…They allow differentiation of pseudocysts from cystic tumors as well as serous from mucinous neoplasms. The following imaging investigations are used in diagnosis of pancreatic cysts: transabdominal ultrasonography (TUS), contrast enhanced transabdominal ultrasonography (CEUS), computed tomography (CT), magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), EUS (endoscopic ultrasonography) [3,5,17,18,19,28,[36][37][38][39][40][41][42][43][44].…”

Section: Radiological Investigationsmentioning

confidence: 99%

Pancreatic cysts: etiology, diagnosis and management

Jabłońska

2014

Open Medicine

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AbstractPancreatic cysts involve a wide spectrum of pathologies from post-inflammatory cysts to malignant neoplasms. Pancreatic pseudocysts, serous cystadenomas, mucinous cystadenomas, intraductal papillary mucinous neoplasms (IPMNs) and solid pseudopapillary tumors occur most frequently. Differential diagnosis involves the following imaging investigations: transabdominal ultrasonography (TUS), contrast enhanced ultrasonography (CEUS) and endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance (MR) and magnetic resonance cholangiopancretography (MRCP), endoscopic retrograde cholangiopancretography (ERCP). The cyst fluid cytology is performed in difficult differential diagnosis between pseudocysts and benign and potentially malignant or malignant tumors. Most frequently, viscosity, amylase, CEA and CA 19-9 levels are determined. Imaging findings should be correlated with cytology. The management depends on the cyst type and size. Small asymptomatic pseudocysts, serous cystadenomas and branchduct IPMNs should be carefully observed, whereas symptomatic large or uncertain serous cystadenomas and cystadenocarcinomas, mucinous cystadenomas and cystadenocarcinomas, main-duct IPMNs and large branch-duct IPMNs with malignant features, serous and mucinous cystadenocarcinomas, and solid pseudopapillary tumors require surgery. Pseudocysts are usually drained. Percutaneous / EUS-guided or surgical cyst drainage can be performed. Complicated and uncertain pseudocysts and cystic tumors need surgical resection. The type of surgery depends on cyst location and size and includes proximal, central, distal, total pancreatectomies and enucleation.

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EUS-guided fine needle aspiration of pancreatic cysts: A retrospective analysis of complications and their predictors

Cited by 200 publications

References 24 publications

Relationship between Patient Symptoms and Endosonographic Findings in Chronic Pancreatitis

Relationship between Patient Symptoms and Endosonographic Findings in Chronic Pancreatitis

Cystic pancreatic lesions: Can we diagnose them accurately what to look for? FNA marker molecular analysis resection, surveillance, or endoscopic treatment?

Pancreatic cysts: etiology, diagnosis and management

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