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Tarun Rustagi, Ferga C Gleeson, Suresh T Chari, Barham K Abu Dayyeh, Michael B Farnell, Prasad G Iyer, Michael L Kendrick, Randall K Pearson, Bret T Petersen, Elizabeth Rajan, Mark D Topazian, Mark J Truty, Santhi S Vege, Kenneth K Wang, Michael J Levy
BACKGROUND AND AIMS: Malignant vascular invasion usually results from gross direct infiltration from a primary tumor, and impacts cancer staging, prognosis, and therapy. However, patients may also develop a remote malignant thrombi (RMT), defined as a malignant intravascular thrombus located remote and noncontiguous to the primary tumor. Our aim was to compare the endoscopic ultrasound (EUS) and the computed tomography (CT) and magnetic resonance imaging (MRI) findings of RMT and impact on cancer staging and resectability...
October 20, 2016: Gastrointestinal Endoscopy
Rahul Pannala, Karyn M Hallberg-Wallace, Amber L Smith, Aziza Nassar, Jun Zhang, Matthew Zarka, Jordan P Reynolds, Longwen Chen
INTRODUCTION: The increasing use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology to examine pancreatic neoplasms has led to an increase in the diagnosis of metastases to the pancreas. Renal cell carcinoma (RCC) is the most common metastasis to the pancreas. Our study examines 33 cases of metastatic RCC to the pancreas sampled by EUS-FNA from four large tertiary care hospitals. MATERIALS AND METHODS: We searched the cytopathology database for RCC metastatic to the pancreas diagnosed by EUS-FNA from January 2005 to January 2015...
2016: CytoJournal
Masayuki Shibata, Hiroyuki Matsubayashi, Akiko Todaka, Hanako Kurai, Naoyuki Tsutsumi, Keiko Sasaki, Hiroyuki Ono
A 75-year-old Japanese man was referred to our hospital to undergo the examination of an enlarged peripancreatic lymph node. Computed tomography (CT) showed a lymph node 47 mm in size that was located above the pancreas head and beneath the liver. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the enlarged lymph node was performed, and an immunohistological examination of the sample confirmed a histological diagnosis of neuroendocrine carcinoma (NEC). The patient refused treatment with chemotherapy and instead chose to undergo observation...
2016: Internal Medicine
Marc Barthet, Geoffroy Vanbiervliet, Jean-Michel Gonzalez
No abstract text is available yet for this article.
September 2016: Endoscopy International Open
Yoon Suk Jung, Hyuk Lee, Kyungeun Kim, Jin Hee Sohn, Hong Joo Kim, Jung Ho Park
The current tissue sampling techniques for subepithelial tumors (SETs) of the gastrointestinal (GI) tract have limited diagnostic efficacy. We evaluated the diagnostic yield and safety of forceps biopsies after small endoscopic submucosal dissection (SESD biopsies) in the diagnosis of gastric SETs. A total of 42 patients with gastric SETs > 10 mm were prospectively enrolled between May 2013 and October 2014. A dual knife was used to incise the mucosa and submucosa and forceps biopsies were then introduced deep into the lesion...
November 2016: Journal of Korean Medical Science
Cristina Díaz Del Arco, J Ángel Díaz Pérez, Luis Ortega Medina, Javier Sastre Valera, M Jesús Fernández Aceñero
Neuroendocrine pancreatic tumors (PanNETs) are graded on the basis of their proliferative activity. Cytological samples are commonly the only samples available, but the determination of Ki-67 in cytology and its reliability as a measure of tumor mitotic activity is not well settled. We have retrospectively reviewed all the cases of FNA under EUS control of PanNETs in a 10-year period (2006-2016) in the Hospital Clínico San Carlos (Madrid). We identified 10 PanNET cases with histological correlation. Median age was 49...
September 29, 2016: Endocrine Pathology
Hany Sakr, Michael Cruise, Prabhleen Chahal, Claudiu Cotta, James Cook, Sricharan Chalikonda, Steven Rosenblatt, Fatima Hamadeh, Omar Al-Nourhji, Charles D Sturgis
Anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK+ LBCL) is a rare distinct type of non-Hodgkin's lymphoma that arises in association with alterations of the ALK gene. This distinct disease entity is typically associated with an aggressive clinical course and appears in light microscopic preparations as a monomorphic population of large, immunoblast-like cells. In this report, we describe a case of ALK+ LBCL diagnosed by transgastric endoscopic ultrasound-guided fine needle aspiration (EUS FNA) of splenic hilar lymph nodes...
September 30, 2016: Diagnostic Cytopathology
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Masaru Ueki, Norimasa Miura, Hajime Isomoto
Pancreatic cancer is the fifth leading cause of cancer death and has the lowest survival rate of any solid cancer. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is currently capable of providing a cytopathological diagnosis of pancreatic malignancies with a higher diagnostic power, with a sensitivity and specificity of 85%-89% and 98%-99%, compared to pancreatic juice cytology (PJC), whose sensitivity and specificity are only 33.3%-93% and 83.3%-100%. However, EUS-FNA is not effective in the cases of carcinoma in situ and minimally invasive carcinoma because both are undetectable by endoscopic ultrasonography, although PJC is able to detect them...
September 15, 2016: World Journal of Gastrointestinal Oncology
Nguyen Vo, David W Cohen, Mary E Dillhoff, Ming Jin
Pancreatic neuroendocrine neoplasia is categorized by grade, size, and functional status. Neuroendocrine microadenoma (NEMA) is defined as a neuroendocrine tumor (NET) that measures less than 0.5 cm in diameter. Multiple NEMAs are termed neuroendocrine adenomatosis (NEMAtosis). The surgical pathology and clinical aspects of pancreatic NEMAtosis have been reported, but there has been no report regarding EUS-FNA cytology of NEMAtosis. We report a case of NEMAtosis with cytologic correlation and illustrate the diagnostic challenges and potential pitfalls...
September 27, 2016: Diagnostic Cytopathology
Koki Hoshi, Atsushi Irisawa, Goro Shibukawa, Akane Yamabe, Mariko Fujisawa, Ryo Igarashi, Yoshitsugu Yoshida, Yoko Abe, Koh Imbe
BACKGROUND AND STUDY AIMS: Trainees are required to learn EUS-FNA using a model before working with a patient. The aim of the current study was to validate a new training model developed for EUS-FNA. PATIENTS AND METHODS: Several fresh chicken tenderloins were embedded as target lesions in the submucosal layer of an isolated porcine stomach. The stomach was fixed to a plate with nails, and was placed in a tub filled with water. The primary endpoint was feasibility of the newly developed model for EUS-FNA training, evaluated as follows: 1) visualization of the target lesion with blinding for lesion location; 2) penetrability of the needle; 3) sampling rate of macroscopic specimen; and 4) ROSE capability...
September 2016: Endoscopy International Open
Kook Hyun Kim, Kathleen McGreevy, Kristin La Fortune, Harvey Cramer, John DeWitt
BACKGROUND AND AIMS: The effect of EUS-guided pancreatic cyst ablation (PCA) on sonographic morphology and cyst fluid cytology is unknown. The aim of this study is to evaluate morphological, cytological and change in cyst fluid DNA after PCA. METHODS: In a prospective single center study, consecutive patients with suspected benign 10 to 50 mm pancreatic cysts underwent baseline EUS-FNA and EUS-PCA followed 2 to 3 months later by repeat EUS, cyst fluid analysis and possible repeat PCA...
September 17, 2016: Gastrointestinal Endoscopy
Robert A Mitchell, Dylan Stanger, Constantin Shuster, Jennifer Telford, Eric Lam, Robert Enns
Background. There is a high incidence of inconclusive cytopathology at initial EUS-FNA (endoscopic ultrasound-guided fine-needle aspiration) for suspected malignant pancreatic lesions. To obtain appropriate preoperative or palliative chemotherapy for pancreatic cancer, definitive cytopathology is often required. The utility of repeat EUS-FNA is not well established. Methods. A retrospective cohort study was conducted evaluating the yield of repeat EUS-FNA in determining a cytological diagnosis in patients who had undergone a prior EUS-FNA for diagnosis of suspected malignant pancreatic lesions with inconclusive cytopathology...
2016: Canadian Journal of Gastroenterology & Hepatology
Shigeru Horiguchi, Hironari Kato, Hidenori Shiraha, Koichiro Tsutsumi, Naoki Yamamoto, Kazuyuki Matsumoto, Takeshi Tomoda, Daisuke Uchida, Yutaka Akimoto, Syou Mizukawa, Takehiro Tanaka, Koichi Ichimura, Akinobu Takaki, Takahito Yagi, Hiroyuki Okada
BACKGROUND AND AIM: Pathological grading is important in defining the therapeutic strategy in pancreatic neuroendocrine neoplasm (PNEN), but is difficult for unresectable cases. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is useful in the diagnosis of PNEN, but its usefulness for pathological grading is not well established. No studies have examined the diagnostic ability of dynamic computed tomography (CT) for pathological grading of PNEN. We investigated the usefulness of EUS-FNA and dynamic CT in the diagnosis and pathological grading of PNEN...
September 16, 2016: Journal of Gastroenterology and Hepatology
John Gásdal Karstensen, Peter Vilmann
No abstract text is available yet for this article.
October 2016: Gastrointestinal Endoscopy
Katrina Collins, Tinera Buckley, Kevin Anderson, Michael Karasik, Saverio Ligato
Perivascular epithelioid cell tumors (PEComas) of the pancreas are extremely rare mesenchymal tumors and to our knowledge, only 17 cases have been reported in the English literature to date. We report our experience with a new case of primary pancreatic PEComa diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) complemented by tissue cell block and immunohistochemistry. The patient was a 54-year-old female whose chief complaint was intermittent severe right upper quadrant abdominal pain...
September 15, 2016: Diagnostic Cytopathology
Lyn A Smith, Colin J McKay
The widespread use of cross-sectional imaging has led to an increased frequency of incidentally detected pancreatic cysts. Neoplastic cysts such as mucinous lesions and solid pseudo-papillary neoplasms have malignant potential and therefore the early detection of these lesions presents an opportunity for prevention or early detection and management of pancreatic adenocarcinoma. Serous neoplastic lesions and non-neoplastic pancreatic cysts such as pseudocysts or walled off pancreatic necrosis and are not associated with malignant potential...
December 2016: Minerva Medica
Se Hun Oh, Jong Kyun Lee, Kyu Taek Lee, Kwang Hyuck Lee, Young Sik Woo, Dong Hyo Noh
Background/Aims: The objective of this study was to investigate the value of cyst fluid carcinoembryonic antigen (CEA) in combination with cytology and viscosity for the differential diagnosis of pancreatic cysts. Methods: We retrospectively reviewed our data for patients who underwent endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and cyst fluid analysis. We investigated the sensitivity, specificity and accuracy of the combination of cyst fluid CEA, cytology and viscosity testing...
September 9, 2016: Gut and Liver
Omar Banafea, Fabian Pius Mghanga, Jinfang Zhao, Ruifeng Zhao, Liangru Zhu
BACKGROUND: Previous studies have demonstrated that endoscopic ultrasound-fine needle aspiration (EUS-FNA) is a reliable tool for diagnosing pancreatic lesions; however, the reported sensitivity and specificity vary greatly across studies. The aim of this study was to pool the existing literature and assess the overall performance of EUS-FNA in the diagnosis of solid pancreatic lesions. METHODS: A systematic search of MEDLINE, Cochrane Database for Systematic Reviews, and EMBASE was performed to identify original and review articles published between January 1995 and January 2014 that reported the accuracy of EUS-FNA in the diagnosis of pancreatic masses...
2016: BMC Gastroenterology
Jonathan I Chang, Karl K Kwok
No abstract text is available yet for this article.
September 2016: American Journal of Gastroenterology
Marc Giovannini, Fabrice Caillol, Geneviève Monges, Flora Poizat, Anne-Isabelle Lemaistre, Bertrand Pujol, Damien Lucidarme, Laurent Palazzo, Bertrand Napoléon
BACKGROUND AND STUDY AIMS: The differential diagnosis of solid pancreatic masses by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently suboptimal in centers that are not equipped with rapid on-site evaluation. Needle-based confocal laser endomicroscopy (nCLE) enables real-time in vivo microscopic imaging during endoscopy. This study aimed to describe nCLE interpretation criteria for the characterization of pancreatic masses, with histopathological correlation, and to perform the first validation of these criteria...
October 2016: Endoscopy
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