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https://www.readbyqxmd.com/read/28315508/tumor-markers-in-pancreatic-cystic-fluids-for-diagnosis-of-malignant-cysts
#1
Alexandre Levy, Theodora Popovici, Phuong-Nhi Bories
BACKGROUND AND AIM: Early diagnosis of premalignant or malignant pancreatic cysts is essential to improve prognosis. Sampling of pancreatic cyst fluid by fine-needle aspiration during endoscopic ultrasonography (EUS) enables cytopathological examination combined with biochemical analysis. This study aimed to provide an aid based on biological markers for the preoperative management of patients with pancreatic cysts. METHODS: Pancreatic fluids obtained by EUS-guided fine-needle aspiration from 115 patients with cystic lesions were assayed for amylase, lipase, carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4...
March 3, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28315030/endoscopic-management-of-pancreatic-cysts
#2
REVIEW
Michael J Bartel, Massimo Raimondo
Management of pancreatic cystic lesions relies on patients' clinical presentation, imaging, and endoscopic ultrasound. Current research in basic science, radiology, and endoscopy is evolving and making progress in this condition which is relatively common in the general population. This review focuses on the recent endoscopic ultrasound approaches to the diagnosis of these pancreatic disorders.
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28287935/heterotopic-pancreas-histopathologic-features-imaging-findings-and-complications
#3
Maryam Rezvani, Christine Menias, Kumaresan Sandrasegaran, Jeffrey D Olpin, Khaled M Elsayes, Akram M Shaaban
Heterotopic pancreas is a congenital anomaly in which pancreatic tissue is anatomically separate from the main gland. The most common locations of this displacement include the upper gastrointestinal tract-specifically, the stomach, duodenum, and proximal jejunum. Less common sites are the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Uncomplicated heterotopic pancreas is typically asymptomatic, with the lesion being discovered incidentally during an unrelated surgery, during an imaging examination, or at autopsy...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28286093/needle-based-confocal-laser-endomicroscopy-for-the-diagnosis-of-pancreatic-cystic-lesions-an-international-external-interobserver-and-intraobserver-study-with-videos
#4
Somashekar G Krishna, William R Brugge, John M Dewitt, Pradermchai Kongkam, Bertrand Napoleon, Carlos Robles-Medranda, Damien Tan, Samer El-Dika, Sean McCarthy, Jon Walker, Mary E Dillhoff, Andrei Manilchuk, Carl Schmidt, Benjamin Swanson, Zarine K Shah, Phil A Hart, Darwin L Conwell
BACKGROUND AND AIMS: EUS-guided nCLE characteristics of common types of PCLs have been identified; however surgical histopathology was available in a minority of subjects. We sought to assess the performance characteristics of EUS-nCLE for differentiating mucinous from non-mucinous PCLs in a larger series of subjects with a definitive diagnosis. METHODS: Six endosonographers (nCLE experience >30 cases each) blinded to all clinical data, reviewed nCLE images of PCLs from 29 subjects with surgical (n=23) or clinical (n=6) correlation...
March 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28281482/laparoscopic-spleen-preserving-distal-pancreatectomy-for-a-primary-hydatid-cyst-mimicking-a-mucinous-cystic-neoplasia
#5
Tugan Tezcaner, Yahya Ekici, Onur Huseyin Aydın, Gonca Barit, Gökhan Moray
Pancreatic hydatid cysts are fairly rare. The disease can be encountered concurrently with systemic involvement or as an isolated pancreatic involvement. We report the first case of spleen-preserving laparoscopic distal pancreatectomy for a pancreatic hydatid cyst. There was no complication or recurrence. A 55-year-old woman was admitted to our centre with epigastric and back pain. Upper abdominal magnetic resonance imaging revealed a solitary cystic lesion with septations at the pancreatic tail level measuring 24 mm × 18 mm, which was initially thought to be a pancreatic mucinous cystic neoplasia...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28278438/diagnosis-of-autoimmune-pancreatitis-with-cholesterol-granuloma-mimicking-intraductal-papillary-mucinous-carcinoma-a-case-report
#6
Yusuke Takahashi, Naoyuki Yokoyama, Daisuke Sato, Tetsuya Otani, Koko Mitsuma, Hideki Hashidate
INTRODUCTION: Pancreatic cysts are often observed incidentally on abdominal computed tomography (CT). For cysts involving intracystic nodules, malignant neoplasms such as intraductal papillary-mucinous carcinoma (IPMC) should be suspected. In contrast, cholesterol granuloma (CG) rarely occurs in the pancreas, and CG-associated autoimmune pancreatitis (AIP) has not yet been reported. To our knowledge, this is the first reported case of AIP with CG mimicking IPMC. PRESENTATION OF CASE: A 56-year-old woman underwent abdominal CT for preoperative breast cancer screening...
March 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28260136/cells-of-origin-of-pancreatic-neoplasms
#7
REVIEW
Junpei Yamaguchi, Yukihiro Yokoyama, Toshio Kokuryo, Tomoki Ebata, Masato Nagino
Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignant disease associated with poor prognosis, despite recent medical advances. It is of great importance to understand the initial events and cells of origin of pancreatic cancer to prevent the development and progression of PDAC. There are three distinct precursor lesions that develop into PDAC: pancreatic intraepithelial neoplasms (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs). Studies on genetically engineered mouse models have revealed that the initiation and development of these lesions largely depend on genetic alterations...
March 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28258561/a-resected-case-of-two-branch-duct-type-intraductal-papillary-mucinous-neoplasms-showing-different-clinical-courses-after-a-two-year-follow-up
#8
Hideki Shibata, Nobuyuki Ohike, Tomoko Norose, Tomohide Isobe, Reika Suzuki, Hideyuki Imai, Akira Shiokawa, Masafumi Takimoto, Akihiro Tabuchi, Yuichi Takano, Eiichi Yamamura, Masatsugu Nagahama, Nobuyuki Takeyama, Kazuaki Yokomizo, Hiroki Mizukami, Jun-Ichi Tanaka, Takeshi Aoki, Masahiko Murakami
The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN (b), 16 mm in size] and tail [BD-IPMN (t), 13 mm in size] without a "high-risk stigmata" or "worrisome features". He subsequently received follow-up by MRCP every 6 months...
March 3, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28258323/is-the-combination-of-mr-and-ct-findings-useful-in-determining-the-tumor-grade-of-pancreatic-neuroendocrine-tumors
#9
Fumihito Toshima, Dai Inoue, Takahiro Komori, Kotaro Yoshida, Norihide Yoneda, Tetsuya Minami, Osamu Matsui, Hiroko Ikeda, Toshifumi Gabata
PURPOSE: To retrospectively elucidate the findings useful in determining the tumor grade of pancreatic neuroendocrine tumors (PNETs) by combined assessment of magnetic resonance (MR) and dynamic computed tomography (CT) images. MATERIALS AND METHODS: Eighty-nine patients with PNETs (96 lesions) were included, and classified as G1, 59; G2, 29; and G3, 8 lesions. Image analysis included lesion diameter, shape, enhancement pattern on arterial phase (AP) and delayed phase CT images, calcification, cystic portion, main pancreatic duct dilatation, signal-intensity on T1-, T2-weighted MR images, and appearance of apparent diffusion coefficient (ADC)...
March 3, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28255733/natural-courses-of-branch-duct-intraductal-papillary-mucinous-neoplasm
#10
Taeheon Lee, Hong Joo Kim, Soo-Kyung Park, Hyo-Joon Yang, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi
PURPOSE: The study was done to elucidate the clinico-radiologic predictive factors for cancerous change detected by disease progression (PD) mainly defined by interval increase in cyst size and change of cyst morphology, for branch duct intraductal papillary mucinous neoplasm (BD-IPMN) patients with relatively long-term follow-up. METHODS: Retrospective analysis of medical records and imaging findings were performed on 107 patients with BD-IPMN enrolled from July 2005 to May 2013, in whom the communication between the cystic lesion and pancreatic duct was confirmed by either endoscopic ultrasonography (EUS), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP)...
March 2, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28250896/endoscopy-guided-ablation-of-pancreatic-lesions-technical-possibilities-and-clinical-outlook
#11
REVIEW
Marianna Signoretti, Roberto Valente, Alessandro Repici, Gianfranco Delle Fave, Gabriele Capurso, Silvia Carrara
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28246486/pancreatic-endometrial-cyst-mimics-mucinous-cystic-neoplasm-of-the-pancreas
#12
Michael A Mederos, Nicole Villafañe, Sadhna Dhingra, Carlos Farinas, Amy McElhany, William E Fisher, George Van Buren Ii
Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28243046/single-dose-intra-procedural-ceftriaxone-during-endoscopic-ultrasound-fine-needle-aspiration-of-pancreatic-cysts-is-safe-and-effective-results-from-a-single-tertiary-center
#13
Amir Klein, Rose Qi, Shyam Nagubandi, Eric Lee, Vu Kwan
BACKGROUND: Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) is universally used for the investigation and diagnosis of pancreatic cystic lesions (PCL). Infectious complications following EUS-FNA of PCL are rare. Antibiotic prophylaxis to reduce the risk of infection is recommended; however, there is no consensus on the optimal regimen or route of administration. Potential advantages of a single-dose intravenous (IV) antibiotic over a prolonged oral regimen include simplicity, guaranteed delivery and fewer antibiotic related adverse events, but there are only limited data to support this...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28237644/surgery-for-pancreatic-neoplasms-how-accurate-are-our-surgical-indications
#14
David Jérémie Birnbaum, Sébastien Gaujoux, Julie Berbis, Safi Dokmak, Pascal Hammel, Marie Pierre Vullierme, Philippe Lévy, Alain Sauvanet
BACKGROUND: Accurate preoperative diagnosis is critical for the determination of appropriate surgical indications. The aim of this study was to assess the accuracy of preoperative diagnosis and indications for operative therapy for presumed pancreatic neoplasms. METHODS: From 2005 to 2013, 851 patients underwent pancreatectomies for presumed pancreatic neoplasms. A formal preoperative diagnosis was established during a multidisciplinary tumor board and compared to the final pathologic examination...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28236434/acinar-cell-cystadenoma-a-challenging-cytology-diagnosis-facilitated-by-moray-%C3%A2-micro-forceps-biopsy
#15
Athena L Chen, Joseph Misdraji, William R Brugge, Cristina R Ferrone, Martha B Pitman
Acinar cell cystadenoma is a rare, benign cystic lesion of the pancreas. There have been only a few retrospective reports on its cytological features. We present the first case of acinar cell cystadenoma in a 65-year-old woman, diagnosed pre-operatively by pancreatic cyst fluid cytology and Moray(®) micro-forceps biopsy. We emphasize possible diagnostic pitfalls of acinar cell cystadenoma cyst fluid cytology and suggest useful morphologic, immunohistochemical, and other clues to aid in diagnosis. Diagn. Cytopathol...
February 25, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28218999/assessment-of-morbidity-and-mortality-associated-with-eus-guided-fna-for-pancreatic-cystic-lesions-a-system-review-and-meta-analysis
#16
REVIEW
Huiyun Zhu, Fei Jiang, Jianwei Zhu, Yiqi Du, Zhendong Jin, Zhaoshen Li
BACKGROUND AND AIM: With increased availability of imaging technology, detection of pancreatic cystic lesions (PCLs) is on the rise. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) improves the diagnosis accuracy of PCLs. Systematic evaluation of morbidity and mortality associated with EUS-FNA for PCLs has not been performed. We conducted a systematic review and meta-analysis of morbidity and mortality associated with EUS-FNA. METHODS: A literature search for relevant English-language articles was conducted on PubMed and EMBASE databases...
February 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28218203/cystic-dystrophy-of-the-duodenal-wall-a-rare-but-need-to-know-disease
#17
Lydia Plana Campos, Carlos Alventosa Mateu, Javier Sempere García-Argüelles, Ana Belén Durá Ayet, Inma Bort Pérez, Patricia Suárez Callol
Cystic dystrophy of the duodenal wall (CDDW) is a serious but uncommon complication of heterotopic pancreatic tissue characterized by increased duodenal wall thickness associated with intraparietal cystic lesions. It is mainly observed in middle-aged male patients with alcoholic chronic pancreatitis. Clinical symptoms are usually nonspecific and it is important to take them into account in patients with the abovementioned history. Imaging techniques have been useful for diagnosis, especially endoscopic ultrasound (EUS), to visualize cystic lesions in the wall...
January 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28218197/role-of-contrast-harmonic-endoscopic-ultrasound-in-pancreatic-cystic-lesions
#18
REVIEW
Marta Serrani, Andrea Lisotti, Giancarlo Caletti, Pietro Fusaroli
Incidental pancreatic cysts (PCs) are frequently encountered in the general population often in asymptomatic patients who undergo imaging tests to investigate unrelated conditions. The detection of a PC poses a significant clinical dilemma, as the differential diagnosis is quite broad ranging from benign to malignant conditions. Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) has been reported to be an accurate tool in the differential diagnosis; however, its sensitivity is suboptimal and false negative results do occur...
January 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28211072/the-diagnosis-of-pancreatic-mucinous-cystic-neoplasm-and-associated-adenocarcinoma-in-males-an-eight-institution-study-of-349-patients-over-15-years
#19
Cecilia G Ethun, Lauren M Postlewait, Mia R McInnis, Nipun Merchant, Alexander Parikh, Kamran Idrees, Chelsea A Isom, William Hawkins, Ryan C Fields, Matthew Strand, Sharon M Weber, Clifford S Cho, Ahmed Salem, Robert C G Martin, Charles R Scoggins, David Bentrem, Hong J Kim, Jacquelyn Carr, Syed A Ahmad, Daniel E Abbott, Gregory Wilson, David A Kooby, Shishir K Maithel
BACKGROUND: Per WHO, 2000 classification, pancreatic mucinous cystic neoplasms (MCN) are defined by presence of ovarian stroma, and are primarily located in the pancreatic body/tail of females. The incidence of MCN and associated malignancy in males, since, standardization of MCN diagnostic-criteria is unknown. METHODS: MCN resections from 2000 to 2014 at eight institutions of the Central-Pancreas-Consortium were included, and divided into early (2000-2007) and late (2008-2014) time-periods...
February 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28197897/middle-segment-preserving-pancreatectomy-for-metachronous-intraductal-papillary-mucinous-neoplasm-after-pancreatoduodenectomy-a-case-report
#20
Mihoko Yamada, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhiko Uesaka
Total pancreatectomy has occasionally been performed to treat patients with multiple lesions (such as intraductal papillary mucinous neoplasm (IPMN)) or patients who have undergone repeated pancreatic resection. However, deficiencies of the exocrine and endocrine functions worsen patients' quality of life. Recently, there have been several case reports citing middle segment-preserving pancreatectomy (MSPP) as a safe procedure and beneficial with respect to preservation of the exocrine and endocrine functions...
December 2017: Surgical Case Reports
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