Endoscopic Supply Chain Management and Optimization.

Endoscopy is a procedural specialty that incurs significant cost through its high usage of consumables. Thus, supply chain management and optimization in endoscopy can improve value-based care, by identifying areas of cost saving in device procurement. Creating a multidisciplinary supply chain management team, such as multidisciplinary endoscopic device committee (MEDC), suggests a way to optimize supply chain.

Fibrous Extracellular Spheroids in an Endoscopic Ultrasound-Guided Pancreatic Fine Needle Aspiration Correlating to a Gyriform Pancreatic Endocrine Tumor with a Unique Cobblestone Pavement Growth Pattern.

Pancreatic neuroendocrine neoplasms (PanNENs) are uncommon tumors. Fine needle aspiration (FNA) samples from PanNENs are typically of high cellularity and lack necrosis. In cytology slides from these tumors, dyscohesive cells are usually reported with variably round to oval to plasmacytoid forms exhibiting coarsely granular chromatin and showing immunoreactivity for synaptophysin.

A minimally invasive treatment for early GI cancers.

Endoscopic submucosal dissection (ESD) allows curative resection of early malignant gastrointestinal (GI) lesions, potentially avoiding open surgery. Unfortunately, awareness of this technique is low, and many patients undergo surgery without consideration of ESD. This article reviews the indications for ESD and its advantages and limitations, and guides internists in their approach to patients with early GI cancer.