State-of-the-Art Update of Pancreatic Cysts

Canakis, Andrew; Lee, Linda

doi:10.1007/s10620-021-07084-1

Cited by 10 publications

(17 citation statements)

References 142 publications

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Section: Discussionmentioning

confidence: 99%

“…By inserting a micro-forceps device through a 19-gauge needle, this technique enhances tissue sampling of PCL and thus leads to a more definitive diagnosis and decrease in interobserver variability. 13,14 A recent study showed that EUS-TTNB has a higher diagnostic yield in the preoperative assessment of PCL than the combination of EUS-FNA cytology and fluid CEA. 15 Pancreatic neoplastic cysts can be subclassified into two categories: mucinous (intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, and intraductal oncocytic papillary neoplasms) and non-mucinous (serous cystadenomas).…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic lymphoepithelial cyst with concurrent HIV infection: A case report and review of the literature

Oyedeji

Rodgers

Wrubel

et al. 2022

SAGE Open Medical Case Reports

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Pancreatic lymphoepithelial cysts are rare, benign, non-neoplastic unilocular or multilocular cystic lesions. These circumscribed pancreatic lesions are filled with keratinous material grossly and exhibit distinct microscopic features. Pancreatic lymphoepithelial cysts are like the more common lymphoepithelial cysts of the parotid glands, which have been associated with the diffuse infiltrative lymphocytosis syndrome often seen in patients with HIV infection. However, pancreatic lymphoepithelial cysts are rare and their association with HIV infection has not been established. The presence of secondary changes in non-neoplastic cysts such as goblet cell metaplasia that was present in our case is an important feature to be included in the differential diagnosis and not to be interpreted as a mucinous neoplasm, particularly on fine-needle aspiration specimen microscopic evaluation that would impact further management. Here we describe the diagnosis and treatment of lymphoepithelial cysts in a patient who was on highly active antiretroviral therapy for HIV infection and we provide a brief literature review. Defining the clinical characteristics of lymphoepithelial cysts in patients with HIV and determining accurate preoperative diagnostic procedures will be critical for establishing effective surgical and medical approaches to treating these cysts, which differ substantially from other more serious pancreatic cystic lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pancreatic lymphoepithelial cyst with concurrent HIV infection: A case report and review of the literature

Oyedeji

Rodgers

Wrubel

et al. 2022

SAGE Open Medical Case Reports

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“…Pancreatic cystic lesions (PCLs) have a prevalence rate of 2.4% to 24.3% in the asymptomatic adult population [ 1 , 2 ]. Common PCLs consist of five main subtypes, and each presents different disease courses and aggressiveness: (1) intraductal papillary mucinous neoplasm (IPMN), (2) mucinous cystic neoplasm (MCN), (3) serous cystic neoplasm (SCN), (4) cystic neuroendocrine tumor (NET), and (5) pseudocysts [ 3 ]. Differentiation among subtypes of PCLs is critical, as mucinous PLCs have higher cancer risk.…”

Section: Introductionmentioning

confidence: 99%

Deep-Learning-Enabled Computer-Aided Diagnosis in the Classification of Pancreatic Cystic Lesions on Confocal Laser Endomicroscopy

et al. 2023

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Accurate classification of pancreatic cystic lesions (PCLs) is important to facilitate proper treatment and to improve patient outcomes. We utilized the convolutional neural network (CNN) of VGG19 to develop a computer-aided diagnosis (CAD) system in the classification of subtypes of PCLs in endoscopic ultrasound-guided needle-based confocal laser endomicroscopy (nCLE). From a retrospectively collected 22,424 nCLE video frames (50 videos) as the training/validation set and 11,047 nCLE video frames (18 videos) as the test set, we developed and compared the diagnostic performance of three CNNs with distinct methods of designating the region of interest. The diagnostic accuracy for subtypes of PCLs by CNNs with manual, maximal rectangular, and U-Net algorithm-designated ROIs was 100%, 38.9%, and 66.7% on a per-video basis and 88.99%, 73.94%, and 76.12% on a per-frame basis, respectively. Our per-frame analysis suggested differential levels of diagnostic accuracy among the five subtypes of PCLs, where non-mucinous PCLs (serous cystic neoplasm: 93.11%, cystic neuroendocrine tumor: 84.31%, and pseudocyst: 98%) had higher diagnostic accuracy than mucinous PCLs (intraductal papillary mucinous neoplasm: 84.43% and mucinous cystic neoplasm: 86.1%). Our CNN demonstrated superior specificity compared to the state-of-the-art for the classification of mucinous PCLs (IPMN and MCN), with high specificity (94.3% and 92.8%, respectively) but low sensitivity (46% and 45.2%, respectively). This suggests the complimentary role of CNN-enabled CAD systems, especially for clinically suspected mucinous PCLs.

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“…Also, the fluid cytology has very low sensitivity, which often need the combination of methods to support the diagnosis. 1,4 The recent advances in EUS-like needle confocal laser endomicroscopy and through the needle biopsy (TTNB) sampling has led to an increase in appropriate characterization and diagnosis of the PCL. The ability to obtain tissue from the cystic wall or mural nodule by TTNB forceps can provide a histologic diagnosis for PCLs.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Histological Diagnosis of Pancreatic Cystic Neoplasms: Is Through the Needle Forceps Sampling the Answer?

Kumar

Rana

2022

Journal of Digestive Endoscopy

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Accurate preoperative diagnosis of pancreatic cystic lesions (PCLs) is a challenge as image-guided cytology has a very low sensitivity for its diagnosis. The recent advances in endoscopic ultrasound (EUS) such as needle confocal laser endomicroscopy and through the needle biopsy forceps has led to better characterization and diagnosis of the PCL. In this news and views, we discuss a prospective study that has evaluated the efficacy and safety of EUS-guided throughtheneedle biopsy sampling (EUS-TTNB) for diagnosis of PCLs.

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State-of-the-Art Update of Pancreatic Cysts

Cited by 10 publications

References 142 publications

Pancreatic lymphoepithelial cyst with concurrent HIV infection: A case report and review of the literature

Pancreatic lymphoepithelial cyst with concurrent HIV infection: A case report and review of the literature

Deep-Learning-Enabled Computer-Aided Diagnosis in the Classification of Pancreatic Cystic Lesions on Confocal Laser Endomicroscopy

Preoperative Histological Diagnosis of Pancreatic Cystic Neoplasms: Is Through the Needle Forceps Sampling the Answer?

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