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Pancreatic ultrasound

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https://www.readbyqxmd.com/read/28820145/endoscopic-ultrasound-guided-gastroenterostomy-are-we-ready-for-prime-time
#1
REVIEW
Mihai Rimbas, Alberto Larghi, Guido Costamagna
Interventional endoscopic ultrasonography (EUS) is currently becoming the less invasive therapeutic approach for the drainage of pancreatic fluid collections, of acute cholecystitis in patients unfit for surgery and for biliary drainage after failed endoscopic retrograde cholangiopancreatography. In addition, EUS-guided gastroenterostomy (EUS-GE) has recently emerged as a feasible procedure to treat patients with gastric outlet obstruction, as an alternative to surgery or to standard endoscopy when endoscopic stent placement is not possible...
July 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28815450/a-case-of-pancreatic-cancer-with-severe-vomiting-treated-by-endoscopic-ultrasound-guided-celiac-ganglia-neurolysis
#2
Asami Kawai, Masataka Kikuyama, Kohei Enokida, Shinya Kawaguchi, Naofumi Shirane, Shuzo Terada
A 50-year-old man with advanced pancreatic cancer was admitted for intractable severe vomiting 5-6 times a day, continuing over a week. He had been treated for advanced pancreatic cancer with chemotherapy for 6 months, and had undergone self-expandable metalic stent placement for obstructive jaundice due to the pancreatic cancer 4 months before admission. No abnormal findings suggesting gastrointestinal obstruction or brain metastasis were revealed on diagnostic imaging. We performed endoscopic ultrasound-guided celiac ganglia neurolysis twice by injecting ethanol into the celiac ganglion...
August 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28802565/the-safety-and-efficacy-of-an-alcohol-free-pancreatic-cyst-ablation-protocol
#3
Matthew T Moyer, Setareh Sharzehi, Abraham Mathew, John M Levenick, Brandy D Headlee, Jonathan T Blandford, Heather D Heisey, James H Birkholz, Brooke B Ancrile, Jennifer L Maranki, Niraj J Gusani, Thomas J McGarrity, Charles E Dye
BACKGROUND & AIMS: Endoscopic ultrasound (EUS)-guided chemoablation with ethanol lavage followed by infusion of paclitaxel, is effective for the treatment of mucinous pancreatic cysts. However, complications arise in 3%-10% of patients, presumably linked to the inflammatory effects of ethanol. We aimed to determine whether alcohol is required for effective pancreatic cyst ablation, if removing alcohol from the ablation process would improve complication rates, and whether a multi-agent chemotherapeutic cocktail could increase the rate of complete cyst resolution compared to the findings reported from previous trials using alcohol followed by paclitaxel alone...
August 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28802095/the-diagnostic-utility-of-merkel-cell-polyomavirus-immunohistochemistry-in-a-fine-needle-aspirate-of-metastatic-merkel-cell-carcinoma-of-unknown-primary-to-the-pancreas
#4
Long Li, Kyle Molberg, Naga Cheedella, Joel Thibodeaux, Stacy Hinson, Elena Lucas
Merkel cell carcinoma (MCC) is an aggressive skin tumor with a high tendency for metastases. We report a case of MCC initially presenting as axillary and pancreatic metastases. A 33-year-old HIV-positive Hispanic male presented with a history of a rapidly growing axillary mass. A needle core biopsy demonstrated an epithelioid neoplasm composed of small to medium-sized cells with high nuclear-cytoplasmic ratio, nuclear molding, and frequent mitotic figures. A subsequent PET scan revealed a 1.5 cm FDG avid mass in the pancreas...
August 12, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28795293/endoscopic-palliation-of-pancreatic-cancer
#5
REVIEW
Vishal B Gohil, Jason B Klapman
Pancreas cancer is a fourth-leading cause of cancer death in the USA and its incidence is rising as the population is aging. The majority of patients present at an advanced stage due to the silent nature of the disease and treatment have focused more on palliation than curative intent. Gastroenterologists have become integral in the multidisciplinary care of these patients with a focus on providing endoscopic palliation of pancreas cancer. The three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, and gastric outlet obstruction...
August 9, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28791329/clinical-impact-of-eus-treatment-of-walled-off-pancreatic-necrosis-with-dedicated-devices
#6
Ilaria Tarantino, Dario Ligresti, Fabio Tuzzolino, Luca Barresi, Gabriele Curcio, Antonino Granata, Mario Traina
BACKGROUND AND STUDY AIMS:  Walled-off pancreatic necrosis (WOPN) represents the major risk factor for sepsis-related multiple organ failure. Surgical debridement is an invasive approach associated with high rates of adverse events (AEs) and death. As an alternative, endoscopic ultrasound-guided cysto-gastro-anastomosis has emerged as an effective treatment for WOPNs. Recently a new dedicated-lumen apposing metal stent (LAMS) has been used with satisfactory results in treating peri-pancreatic fluid collections, including WOPNs...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28782747/laparoscopic-surgery-for-solitary-insulinoma-in-the-absence-of-ious
#7
Abhay Narendra Dalvi, Mahadeo Namdeo Garale, Yogesh Prabhakar Takalkar, Sameer Ashok Rege, Pinky Manoharlal Thapar, Lila Anurag, Nalini Samir Shah
BACKGROUND: Insulinomas are the most common pancreatic neuroendocrine neoplasms. In spite of adequate pre-operative localisation, conventional surgical methods rely on intraoperative palpation. Intraoperative ultrasonography (IOUS) is said to aid in accurate localisation, decreases morbidity. Laparoscopic removal of pancreatic endocrine neoplasms is beneficial due to magnification and minimal invasion; however, in the absence of IOUS, error of judgement may lead to conversion to open surgery, thereby relying on 'palpation method' to localise the tumour...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28782667/features-of-autoimmune-pancreatitis-associated-with-inflammatory-bowel-diseases
#8
Diane Lorenzo, Frédérique Maire, Carmen Stefanescu, Jean-Marc Gornet, Philippe Seksik, Mélanie Serrero, Barbara Bournet, Philippe Marteau, Aurelien Amiot, David Laharie, Caroline Trang, Benoit Coffin, Guy Bellaiche, Guillaume Cadiot, Catherine Reenaers, Antoine Racine, Stephanie Viennot, Arnaud Pauwels, Guillaume Bouguen, Guillaume Savoye, Anne-Laure Pelletier, Guillaume Pineton de Chambrun, Pierre Lahmek, Stéphane Nahon, Vered Abitbol
BACKGROUND & AIMS: Few people know of autoimmune pancreatitis (AIP), a rare disorder associated with inflammatory bowel diseases (IBD). We aimed to describe phenotype and outcomes of AIP in patients with AIP. METHODS: We performed a retrospective study of cases of AIP in IBD identified from the multi-center Groupe d'Etude Thérapeutique des Affections Inflammatoires du tube Digestif study, performed in Belgium and France from July 2012 through July 2015. Patients were diagnosed with AIP based on histological analysis of pancreatic resection specimens or samples collected by fine-need aspiration during endoscopic ultrasound...
August 3, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28778024/a-combination-of-radiation-and-the-hypoxia-activated-prodrug-evofosfamide-th-302-is-efficacious-against-a-human-orthotopic-pancreatic-tumor-model
#9
Carla Hajj, James Russell, Charles P Hart, Karyn A Goodman, Maeve A Lowery, Adriana Haimovitz-Friedman, Joseph O Deasy, John L Humm
This study was designed to investigate the effect of single-dose radiation therapy (RT) in combination with evofosfamide (TH-302), a hypoxia-activated prodrug, in a pre-clinical model of pancreatic cancer. AsPC1 tumors were implanted orthotopically in the pancreas of nude mice. Tumors were treated with 15 Gy of RT, using a 1 cm diameter field, and delivered as a continuous arc. Image-guidance to center the field on the tumor was based on CT imaging with intraperitoneal contrast. Evofosfamide (100 mg/kg, i.p...
July 21, 2017: Translational Oncology
https://www.readbyqxmd.com/read/28777155/a-splenic-igg4-sclerosing-angiomatoid-nodular-transformation-sant-treated-by-hemisplenectomy-a-radiologic-histochemical-and-immunohistochemical-study
#10
Raffaele Gaeta, Francescamaria Donati, Emanuele F Kauffmann, Daniela Campani
INTRODUCTION: Sclerosing angiomatoid nodular transformation (SANT) is a rare benign lesion of unknown origin for which total splenectomy is the standard treatment. CASE PRESENTATION: A 54-year-old man with a history of recurrent pancreatitis, bicuspid aortic valve, and aortic dissection underwent abdominal ultrasound, Computed tomography and magnetic resonance imaging, which revealed a 6-cm hypoechoic splenic mass diagnosed as cavernous hemangioma. Owing to his relevant past history, he was considered eligible for emisplenectomy and not for total excision, which is associated with long-term risks, especially infections...
August 2, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/28772284/diagnostic-value-of-ca19-9-circulating-tumour-dna-and-circulating-tumour-cells-in-patients-with-solid-pancreatic-tumours
#11
David Sefrioui, France Blanchard, Emmanuel Toure, Paul Basile, Ludivine Beaussire, Claire Dolfus, Anne Perdrix, Marianne Paresy, Michel Antonietti, Isabelle Iwanicki-Caron, Raied Alhameedi, Stephane Lecleire, Alice Gangloff, Lilian Schwarz, Florian Clatot, Jean-Jacques Tuech, Thierry Frébourg, Fabrice Jardin, Jean-Christophe Sabourin, Nasrin Sarafan-Vasseur, Pierre Michel, Frédéric Di Fiore
BACKGROUND: The direct comparison of CA19.9, circulating tumour cells (CTCs) and circulating tumour DNA (ctDNA) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has never been performed for the diagnosis of solid pancreatic tumours (SPTs). METHODS: We included 68 patients with a SPT referred for EUS-FNA. CTCs were analysed using size-based platform and ctDNA using digital PCR. The sensitivity, specificity, negative and positive predictive values were evaluated for each marker and their combination...
August 3, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28771447/chronic-pancreatitis
#12
Dennis Yang, Chris E Forsmark
PURPOSE OF REVIEW: Summarize key clinical advances in chronic pancreatitis reported in 2016. RECENT FINDINGS: Early diagnosis of chronic pancreatitis remains elusive. Recent studies suggest that endoscopic ultrasound may be less accurate than previously thought and new MRI techniques may be helpful. Genetic predisposition may independently affect the clinical course of chronic pancreatitis and the risk for pancreatic cancer. Cigarette smoking may have a greater negative impact on chronic pancreatitis than previously thought and moderate alcohol consumption may be protective...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28770404/validation-of-the-american-gastroenterological-association-guidelines-on-management-of-intraductal-papillary-mucinous-neoplasms-more-than-5%C3%A2-years-of-follow-up
#13
Koh Imbe, Naoyoshi Nagata, Yuya Hisada, Yusuke Takasaki, Katsunori Sekine, Saori Mishima, Akihito Kawazoe, Tsuyoshi Tajima, Takuro Shimbo, Mikio Yanase, Junichi Akiyama, Kazuma Fujimoto, Naomi Uemura
OBJECTIVES: Recent guidelines suggest that imaging surveillance be conducted for 5 years for patients with at most one high-risk feature. If there were no significant changes, surveillance is stopped. We sought to validate this follow-up strategy. METHODS: In study 1, data were analysed for 392 patients with intraductal papillary mucinous neoplasms (IPMNs) and at most one high-risk feature who were periodically followed up for more than 1 year with imaging tests...
August 2, 2017: European Radiology
https://www.readbyqxmd.com/read/28767594/retroperitoneal-bronchogenic-cyst-resembling-an-adrenal-tumor-with-high-levels-of-serum-carbohydrate-antigen-19-9-a-case-report
#14
Min Wang, Xu He, Xia Qiu, Chuan Tian, Jian Li, Mingnan Lv
RATIONALE: Retroperitoneal bronchogenic cysts without specific clinical manifestations are extremely rare and difficult to diagnose preoperatively and are easily misdiagnosed as left adrenal or pancreatic tumors. PATIENT CONCERNS: A 48-year-old woman with the chief complaint of obscure epigastric pain for 1 month and with no other gastrointestinal symptoms and no significant medical history. The patient had signed informed consent for publication of this case report...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28765979/utility-of-transabdominal-ultrasound-for-surveillance-of-known-pancreatic-cystic-lesions-prospective-evaluation-with-mri-as-reference-standard
#15
Maryellen R M Sun, Corinne D Strickland, Bahar Tamjeedi, Alexander Brook, Koenraad J Mortele, Olga R Brook, Robert A Kane, Bettina Siewert
OBJECTIVES: To prospectively assess the utility of transabdominal ultrasound in surveillance of known pancreatic cystic lesions (PCL) using same day MRI as reference standard. METHODS: In an IRB-approved study with written informed consent, patients with known PCL underwent pancreas US on same day as surveillance MRI. US was performed blinded to same date MRI results. Transverse (TR), antero-posterior (AP), cranio-caudal (CC), and longest any plane diameter, were measured for each PCL at US and MRI...
August 1, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28764995/magnetically-responsive-microbubbles-as-delivery-vehicles-for-targeted-sonodynamic-and-antimetabolite-therapy-of-pancreatic-cancer
#16
Yingjie Sheng, Estelle Beguin, Heather Nesbitt, Sukanta Kamila, Joshua Owen, Lester C Barnsley, Bridgeen Callan, Christopher O'Kane, Nikolitsa Nomikou, Rifat Hamoudi, Mark A Taylor, Mark Love, Paul Kelly, Declan O'Rourke, Eleanor Stride, Anthony P McHale, John F Callan
Magnetically responsive microbubbles (MagMBs), consisting of an oxygen gas core and a phospholipid coating functionalised with Rose Bengal (RB) and/or 5-fluorouracil (5-FU), were assessed as a delivery vehicle for the targeted treatment of pancreatic cancer using combined antimetabolite and sonodynamic therapy (SDT). MagMBs delivering the combined 5-FU/SDT treatment produced a reduction in cell viability of over 50% when tested against a panel of four pancreatic cancer cell lines in vitro. Intravenous administration of the MagMBs to mice bearing orthotopic human xenograft BxPC-3 tumours yielded a 48...
July 29, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28755102/non-surgical-ablative-therapies-for-inoperable-benign-insulinoma
#17
REVIEW
C Mele, A Brunani, B Damascelli, V Tichà, L Castello, G Aimaretti, M Scacchi, P Marzullo
PURPOSE: Benign insulinoma is the most common functioning neuroendocrine tumor of the pancreas. The gold-standard therapeutic approach for insulinoma is surgery, which allows for tumor removal, histology and immunochemical analyses. If surgery is not feasible, minimally invasive ablative procedures performed by interventional radiology can lead to partial or complete remission of hormone hypersecretion and tumor control in insulinoma patients. METHODS: We performed a review of existing literature on non-chemotherapeutic/radioactive ablative techniques employed for the treatment of benign, otherwise inoperable, pancreatic insulinoma...
July 28, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28752676/fine-needle-aspiration-findings-of-a-rare-hematopoietic-neoplasm-presenting-as-obstructive-jaundice
#18
Jessica Tracht, Ali M Ahmed, Frida Rosenblum Donath
A 51-year-old female who presented with obstructive jaundice was found to have masses in the pancreatic head and tail as well as suspicious liver and periaortic masses on imaging. Aspiration cytology of the pancreatic tail mass showed abundant large single cells with vacuolated eosinophilic cytoplasm, marked nuclear pleomorphism, large bizarre irregular nuclei, binucleation, and prominent nucleoli. Numerous cells also showed intracytoplasmic black to brown pigmentation. A cell block was obtained and extensive immunohistochemical staining was performed...
July 27, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28750500/endoscopic-ultrasound-core-needle-for-diagnosing-of-solid-pancreatic-lesions-is-rapid-on-site-evaluation-really-necessary
#19
Monica Arena, Leonardo H Eusebi, Rinaldo Pellicano, Maria A Palamara, Giuseppe Iabichino, Pierluigi Consolo, Sharmila Fagoonee, Enrico Opocher, Matteo Barabino, Carmelo Luigiano
INTRODUCTION: Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) has a crucial role in the diagnosis of solid pancreatic lesions and rapid on-site evaluation (ROSE) can increase its diagnostic yield. Rapid on-site evaluation is not always available and after EUS-FNA provides a cytology specimen with scant cellularity. Fine needle biopsy (FNB) specimens containing core tissue may theoretically overcome the limitations of EUS-FNA sampling. It could be hypothesized that EUS-FNB without ROSE could achieve the same adequacy and accuracy of EUS-FNB with ROSE...
July 27, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28742542/clinical-practice-guidelines-for-cryosurgery-of-pancreatic-cancer-a-consensus-statement-from-the-china-cooperative-group-of-cryosurgery-on-pancreatic-cancer-international-society-of-cryosurgery-and-asian-society-of-cryosurgery
#20
Lihua He, Lizhi Niu, Nikolai N Korpan, Sajio Sumida, Yueyong Xiao, Jiaping Li, Barlian Sutedja, Youyong Lu, Jiansheng Zuo, Jianguo Liu, Kecheng Xu
Pancreatic cancer (PC), one of the most lethal malignancies, accounts for 8% to 10% of digestive system cancers, and the incidence is increasing. Surgery, chemotherapy, and radiotherapy have been the main treatment methods but are not very effective. Cryosurgery was first used in 1984 for treatment of locally advanced PC and has since become a considerable treatment for most cases of unresectable PC. During the past decade, cryosurgery has been applied in some hospitals in China, and the newly developed technique of computed tomography- and/or ultrasound-guided percutaneous cryosurgery has shown better results than chemotherapy in cases of unresectable locally advanced PC, with the 1-year survival rate reported to be more than 50%...
July 24, 2017: Pancreas
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