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pancreas cyst imaging

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https://www.readbyqxmd.com/read/28728311/clinical-approach-to-incidental-pancreatic-cystic-neoplasm-in-outpatient-clinics
#1
REVIEW
Young Sik Woo, Kyu Taek Lee
Cystic lesions of the pancreas are increasingly observed due to increased use of abdominal images. The malignant rate of pancreas cystic lesion varies widely between various types. Identification of malignant or high-risk lesions is important when determining the appropriate course of management. Using these image findings, including cyst size, presence of solid components, and pancreatic duct involvement, the 2012 International Association of Pancreatology (IAP) and the 2015 American Gastroenterological Association (AGA) guidelines provide a rationale in identifying higher risk patients requiring further workups using an endoscopic ultrasound (EUS)...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28682431/uptodate-in-the-assessment-and-management-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#2
D Pagliari, A Saviano, M L Serricchio, A A Dal Lago, M G Brizi, F Lanza, R Manfredi, A Gasbarrini, F Attili
Intraductal Papillary Mucinous Neoplasms (IPMNs) are the most common cystic tumors of the pancreas and are considered premalignant lesions. IPMNs are characterized by the papillary growth of the ductal epithelium with rich mucin production, which is responsible for cystic segmental or diffuse dilatation of the main pancreatic duct (MPD) and/or its branches. According to the different involvement of pancreatic duct system, IPMNs are divided into main duct type (MD-IPMN), branch duct type (BD-IPMN), and mixed type (MT-IPMN)...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28629555/evaluating-the-ability-to-detect-pancreatic-lesions-using-a-special-ultrasonography-examination-focusing-on-the-pancreas
#3
Miho Nakao, Kazuhiro Katayama, Junko Fukuda, Suetsumi Okagaki, Kozo Misu, Sayako Miyazaki, Noritoshi Matsuno, Reiko Ashida, Tatsuya Ioka, Yuri Ito, Kazuyoshi Ohkawa
PURPOSE: The ability to detect pancreatic cysts was compared between special ultrasonography (US) examination focusing on the pancreas (special pancreatic US) and routine upper abdominal ultrasonography to objectively assess the ability of the former to detect cysts. SUBJECTS AND METHODS: Of 3704 patients who underwent special pancreatic US at our hospital, 186 underwent routine upper abdominal US within six months, had pancreatic cysts, and underwent magnetic resonance imaging (MRI)...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28588880/estimation-of-the-prevalence-of-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-in-the-french-population-through-patients-waiting-for-liver-transplantation
#4
Lucie Laurent, Marie-Pierre Vullierme, Vinciane Rebours, Frédérique Maire, Olivia Hentic, Claire Francoz, François Durand, Philippe Ruszniewski, Philippe Lévy
BACKGROUND AND AIMS: Some studies have explored the prevalence of pancreatic cystic lesions (PCLs). Only one study based on magnetic resonance imaging (MRI) report examination focused specifically on intraductal papillary mucinous neoplasm (IPMN) in a European general population. The aim of this study was to evaluate the prevalence of IPMN in a population of patients who had MRI for a non-pancreatic disease. METHODS: We conducted a retrospective, single-center study...
June 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28567485/mucinous-nonneoplastic-cyst-of-the-pancreas-ct-and-mri-appearances
#5
Kousei Ishigami, Akihiro Nishie, Naoki Mochidome, Yoshiki Asayama, Yasuhiro Ushijima, Daisuke Kakihara, Daisuke Okamoto, Nobuhiro Fujita, Takao Ohtsuka, Yoshihiro Miyasaka, Tomoyuki Hida, Tomoharu Yoshizumi, Hiroshi Honda
PURPOSE: The purpose of this retrospective study was to evaluate imaging features of mucinous nonneoplastic cyst (MNNC) of the pancreas. MATERIALS AND METHODS: Three (0.9%) patients with MNNC of the pancreas were found in 335 surgically resected pancreatic cystic lesions. Three MDCT and two MRI/MRCP studies were retrospectively reviewed. RESULTS: Three cases of MNNC were found in the pancreatic neck, body, and tail, respectively. All the three cases were multilocular without communication with the main pancreatic duct (MPD), although upstream MPD dilatation was seen in two of the three cases...
May 31, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28552018/molecular-biomarkers-have-the-potential-to-improve-the-diagnostic-work-up-of-pancreatic-cystic-lesions
#6
Julie Isabelle Plougmann, Pia Klausen, John Gásdal Karstensen, Peter Vilmann, Jane Preuss Hasselby, Carsten Palnæs Hansen, Evangelos Kalaitzakis
Pancreatic cysts are increasingly diagnosed due to the widespread use of cross-sectional imaging, and some of these lesions harbor malignant potential. Mucinous cystic neoplasms and intraductal papillary mucinous neoplasms are the major premalignant cystic neoplasms of the pancreas. A variety of diagnostic tools are used to predict the malignant potential of these cysts, but specificity and sensitivity are limited. Thus, many patients undergo unnecessary operations for benign cysts. Balancing the risks of watchful waiting with those of operative management is key in managing these lesions...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28533111/management-of-incidental-pancreatic-cysts-a-white-paper-of-the-acr-incidental-findings-committee
#7
Alec J Megibow, Mark E Baker, Desiree E Morgan, Ihab R Kamel, Dushyant V Sahani, Elliot Newman, William R Brugge, Lincoln L Berland, Pari V Pandharipande
The ACR Incidental Findings Committee (IFC) presents recommendations for managing pancreatic cysts that are incidentally detected on CT or MRI. These recommendations represent an update from the pancreatic component of the JACR 2010 white paper on managing incidental findings in the adrenal glands, kidneys, liver, and pancreas. The Pancreas Subcommittee-which included abdominal radiologists, a gastroenterologist, and a pancreatic surgeon-developed this algorithm. The recommendations draw from published evidence and expert opinion, and were finalized by informal iterative consensus...
May 12, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28449429/pancreatic-lymphoepithelial-cysts-diagnosed-with-endosonography-guided-fine-needle-aspiration
#8
Youngmin Oh, Yonghyeok Choi, Seung Myoung Son, Jisun Lee, Yook Kim, Joung Ho Han, Seon Mee Park
Although lymphoepithelial cysts (LECs) of the pancreas are benign lesions, most of them have been treated with surgical resection due to diagnostic difficulty. We report a 66-year-old woman diagnosed with pancreatic LECs. Abdominal ultrasound revealed two masses in the pancreas, which were not visible on the abdominal computed tomography. In an abdominal magnetic resonance imaging, pancreas lesions showed solid tumors, which revealed a low signal intensity on T1-, moderate high signal intensity on T2 weighted images, and homogeneous delayed enhancement in the portal venous phase...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28444494/imaging-of-pancreatic-cystic-lesions-with-confocal-laser-endomicroscopy-an-ex-vivo-pilot-study
#9
Abdurrahman Kadayifci, Mustafa Atar, Michelle Yang, Carlos Fernandez-Del Castillo, Mari Mino-Kenudson, William R Brugge
BACKGROUND: The differential diagnosis of pancreatic cystic lesions (PCLs) is an increasingly common clinical challenge. Confocal laser endomicroscopy (CLE) may differentiate PCLs by imaging of the cyst wall. However, clinical experience is still limited, and better image definition and characterization of the cyst wall in a spectrum of cysts are needed. This experimental study aimed to expose detailed imaging characteristics of PCLs by CLE. METHODS: Patients who underwent surgery of a PCL were enrolled...
April 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28404017/dna-testing-of-pancreatic-cyst-fluid-is-it-ready-for-prime-time
#10
REVIEW
Aatur D Singhi, Marina N Nikiforova, Kevin McGrath
Pancreatic cysts are a clinical quandary in both diagnosis and management. Although many cysts, such as pseudocysts and serous cystadenomas, are benign and can be monitored clinically, mucinous cysts, such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, have the potential to progress to pancreatic cancer. Considering the poor prognosis of pancreatic cancer, the detection of a pancreatic cyst can be a source of anxiety for both the patient and physician. This diagnosis in turn can lead to expensive, invasive, and even harmful surveillance and treatment options...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28375947/chronic-pancreatitis-like-change-in-brca2-mutation-carriers
#11
Meir Mizrahi, Jennifer F Tseng, Daniel Wong, Nadine Tung, Mariam F Eskander, Tyler M Berzin, Douglas K Pleskow, Mandeep S Sawhney
OBJECTIVES: Pancreatic intraepithelial neoplasia lesions can appear as chronic pancreatitis-like changes on endoscopic ultrasound (EUS). The aim of our study was to determine if BRCA2 mutation carriers were more likely than noncarriers to demonstrate chronic pancreatitis-like changes on EUS. METHODS: Patients with BRCA2 mutations referred for EUS were identified (cases) from an endoscopy database. Controls were matched with cases in a 2:1 ratio for sex, date EUS was performed, endoscopist, and echoendoscope...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28316328/reoperation-after-cyst-excision-with-hepaticojejunostomy-for-choledochal-cysts-our-experience-in-18-cases
#12
Qingfeng Sheng, Zhibao Lv, Weijue Xu, Xianmin Xiao, Jiangbin Liu, Yibo Wu
BACKGROUND Complete cyst excision with biliary reconstruction is the treatment of choice for choledochal cyst (CC). The aim of this article is to review our experience in patients who underwent reoperation between January 1995 and December 2014. MATERIAL AND METHODS The records of 18 patients (female/male, 15/3) were retrospectively analyzed including age, sex, cyst type, initial procedure, lab and imaging findings, indications for reoperation, intraoperative findings, and results of reoperation. The median follow-up period was 6 years...
March 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28281172/needle-based-confocal-laser-endomicroscopy-for-evaluation-of-cystic-neoplasms-of-the-pancreas
#13
Abdurrahman Kadayifci, Mustafa Atar, Omer Basar, David G Forcione, William R Brugge
BACKGROUND: The accurate diagnosis of cystic neoplasms of the pancreas (CNP) with current diagnostic methods is limited. Endoscopic ultrasound (EUS)-guided needle-based confocal laser endomicroscopy (nCLE) is a new technique which can obtain images from the cyst wall during EUS-fine needle aspiration (EUS-FNA). The aim of this study was to assess the safety, feasibility, and diagnostic value of nCLE for CNP. METHODS: Patients who underwent EUS-FNA to evaluate a CNP larger than 2 cm were enrolled...
May 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28246486/pancreatic-endometrial-cyst-mimics-mucinous-cystic-neoplasm-of-the-pancreas
#14
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/28196017/endoscopic-ultrasonography-may-select-subjects-having-asymptomatic-chronic-pancreatic-hyperenzymemia-who-require-a-stricter-follow-up
#15
Filippo Antonini, Valerio Belfiori, Nico Pagano, Elisabetta Buscarini, Samuele De Minicis, Massimiliano Lo Cascio, Barbara Marraccini, Simona Piergallini, Pamela Rossetti, Elena Andrenacci, Giampiero Macarri, Raffaele Pezzilli
OBJECTIVES: We have previously shown that at least 50% of patients with asymptomatic chronic pancreatic hyperenzymemia (ACPH) may develop morphological pancreatic alterations. Endoscopic ultrasonography (EUS) may detect small lesions, and its sensitivity seems to be higher than other imaging techniques. The aim of this study was to evaluate whether EUS may modify the management of patients having ACPH. METHODS: In 2 referral centers for pancreatic disease, a retrospective analysis of prospectively enrolled patients with ACPH was conducted...
April 2017: Pancreas
https://www.readbyqxmd.com/read/28144718/diagnostic-performance-and-imaging-features-for-predicting-the-malignant-potential-of-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-a-comparison-of-eus-contrast-enhanced-ct-and-mri
#16
Seo-Youn Choi, Jung Hoon Kim, Mi Hye Yu, Hyo Won Eun, Hae Kyung Lee, Joon Koo Han
PURPOSE: To compare diagnostic performance for prediction of malignant potential in IPMNs between EUS, contrast-enhanced CT and MRI. MATERIALS AND METHODS: 76 patients with IPMN (benign = 37, malignant = 39) underwent EUS, contrast-enhanced CT, and MRI. EUS was analyzed based on formal reports and contrast-enhanced CT and MRI were retrospectively analyzed by two radiologists according to the consensus guidelines 2012. Diagnostic performance and imaging features of malignant IPMNs were analyzed using ROC analysis and multivariate analyses...
May 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28126546/management-of-undifferentiated-solitary-mucinous-cystic-lesion-of-the-pancreas-a%C3%A2-clinical-dilemma
#17
Alexandra M Roch, Katherine Bigelow, Christian M Schmidt, Rosalie A Carr, Andrea L Jester, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
BACKGROUND: Management of solitary mucinous cystic lesions of the pancreas (MCLs) relies on correct differentiation between branch duct intraductal papillary mucinous neoplasm (BD-IPMN) and mucinous cystic neoplasm (MCN). Current international consensus guidelines recommend resection for MCN, and unifocal BD-IPMN can be followed in the absence of worrisome features/high-risk stigmata. We hypothesized that preoperative differentiation of solitary MCLs is suboptimal, and that all solitary MCLs should be treated similarly...
January 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28117220/pancreatic-cysts-diagnostic-accuracy-and-risk-of-inappropriate-resections
#18
N de Pretis, S Mukewar, A Aryal-Khanal, Y Bi, N Takahashi, S Chari
BACKGROUND: Pancreatic cystic neoplasms (PCN) frequently undergo surgery, given malignant potential. Pancreatic cyst surgery is associated with significant rates of morbidity and mortality. It is crucial to accurately characterize these lesions pre-operatively to avoid unnecessary surgery in patients with benign pancreatic cysts. AIM: We aimed to assess the correlation between pre-operative (pre-op) diagnosis based on imaging and clinical presentation, and post-operative (post-op) diagnosis based on histopathology in patients undergone pancreatic cyst surgery...
March 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28099258/patient-preferences-for-management-of-cystic-neoplasms-of-the-pancreas-a-cross-sectional-survey-study
#19
Dhruv Verma, Karl K Kwok, Bechien U Wu
OBJECTIVE: The aim of this study was to determine how patient anxiety, knowledge, and cancer worry influence preferences for management of pancreatic cysts. METHODS: We performed a prospective, cross-sectional study using a disease-specific survey instrument. We included patients older than 18 years who were diagnosed with a pancreatic cyst. A telephone survey instrument was developed to assess baseline anxiety using the Hospital Anxiety and Depression Scale (HADS), knowledge regarding pancreatic cysts, cancer worry, and patient preferences using a standard gamble...
March 2017: Pancreas
https://www.readbyqxmd.com/read/28079542/development-and-validation-of-a-multi-institutional-preoperative-nomogram-for-predicting-grade-of-dysplasia-in-intraductal-papillary-mucinous-neoplasms-ipmns-of-the-pancreas-a-report-from-the-pancreatic-surgery-consortium
#20
Marc A Attiyeh, Carlos Fernández-Del Castillo, Mohammad Al Efishat, Anne A Eaton, Mithat Gönen, Ruqayyah Batts, Ilaria Pergolini, Neda Rezaee, Keith D Lillemoe, Cristina R Ferrone, Mari Mino-Kenudson, Matthew J Weiss, John L Cameron, Ralph H Hruban, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Christopher L Wolfgang, Peter J Allen
OBJECTIVE: Previous nomogram models for patients undergoing resection of intraductal papillary mucinous neoplasms (IPMNs) have been relatively small single-institutional series. Our objective was to improve upon these studies by developing and independently validating a new model using a large multiinstitutional dataset. SUMMARY BACKGROUND DATA: IPMNs represent the most common radiographically identifiable precursor lesions of pancreatic cancer. They are a heterogenous group of neoplasms in which more accurate markers of high-grade dysplasia or early invasive carcinoma could help avoid unnecessary surgery in 1 case and support potentially curative intervention (resection) in another...
September 20, 2016: Annals of Surgery
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