J Ayub Med Coll Abbottabad
Pakistan Institute of Medical Sciences, Islamabad-Pakistan.
Published: November 2024
Background: Pancreatic cystic lesions are increasingly diagnosed these days due to better imaging techniques. It is important to detect the lesions and perform a detailed analysis as some of them are potentially malignant.
Methods: From April 2023 to September 2023, all patients with recurrent and/ or persistent abdominal pain lasting for more than a week were assessed in the gastroenterology department of Pak-Emirates military hospital, Rawalpindi. Detailed history and examination was done. Relevant laboratory tests and an ultrasound abdomen were also carried out. Those with pancreatic lesions on ultrasound abdomen underwent EUS (endoscopic ultrasound). Amongst those undergoing EUS, 88 patients were found to have cystic pancreatic lesions. These 88 patients underwent detailed assessment with EUS-FNA (endoscopic ultrasound - fine needle aspiration) so that these pancreatic cysts could be characterized. Only some of the patients undergoing EUS-FNA had one or more of the worrisome features (solid component within the cyst, main pancreatic duct >5 mm in size, symptoms related to the cyst, family history of pancreatic cancer), and later underwent surgical resection. EUS was done with the patient in the left lateral decubitus position under intravenous sedation with midazolam. During the procedure, the patient was monitored using the cardiac monitor. Images of the pancreas, gallbladder and bile tree were obtained with the echoendoscope in the stomach and duodenum. Informed consent for the study and the endoscopic procedure was obtained from all patients. The study protocol was approved by the hospital ethics committee.
Results: The study population included 50 females and 38 males. Many of these patients had one or more episodes of pancreatitis in the recent past. Most cystic lesions were found in the pancreatic body. The largest number of lesions were due to pancreatic pseudocysts. EUS was performed successfully in all patients. Findings have been summarised in the table according to gender.
Conclusions: Identifying pancreatic cystic neoplasms is important since some have malignant potential. In that regard, EUS-FNA is a useful diagnostic modality and it can influence the management plan.
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http://dx.doi.org/10.55519/JAMC-01-12832 | DOI Listing |
Ann Surg
January 2025
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Objective: To investigate the clinicopathological features and long-term outcomes of cystic and solid pancreatic neuroendocrine tumors (PanNETs).
Summary Background Data: PanNETs uncommonly present as cystic lesions. Whether cystic PanNETs represent a distinct clinical entity compared to solid PanNETs is controversial.
BMJ Case Rep
January 2025
Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.
A girl in early adolescence presented with complaints of abdominal pain lasting for 4 months, along with a palpable lump in the epigastric region. A CT scan revealed a large solid-cystic mass lesion measuring 9.5×10.
View Article and Find Full Text PDFGut Liver
January 2025
Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Background/aims: Pathological evaluation is crucial for diagnosing biliary lesions and determining appropriate treatment strategies. However, tissue sampling via the transpapillary route can be difficult. In this study, we aimed to assess the efficacy and safety of a novel tapered-tip sheath system for tissue sampling from biliary strictures.
View Article and Find Full Text PDFWorld J Gastroenterol
January 2025
Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia 71122, Italy.
Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans, with few patients presenting with abdominal pain or other symptoms. The accurate diagnosis of cysts is important as management depends on the type (neoplastic or non-neoplastic). Cross-sectional imaging is fast being replaced with endoscopic ultrasound (EUS) and various techniques based on that such as EUS-guided fine needle aspiration, EUS-guided needle confocal laser endomicroscopy, EUS-through-the-needle biopsy, and contrast-enhanced EUS.
View Article and Find Full Text PDFIntroduction: A pancreatic neuroendocrine tumour (NET) originates from the neuroendocrine cells responsible for producing and releasing hormones. They are uncommon findings, mainly seen arising from the head of the pancreas and their appearances may vary among different imaging modalities.
Case Report: Interesting case of an asymptomatic patient with an incidental finding of a pancreatic lesion and its variable appearances across different modalities and final histology findings.
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