Direct intracystic biopsy and pancreatic cystoscopy through a 19-gauge needle EUS (with videos)
Background
Histologic diagnosis of cystic pancreatic lesions (CPLs) is often difficult because of the low sensitivity of FNA and brush cytology.
Objective
To discover whether obtaining biopsy samples from the cystic wall could increase the diagnostic yield of these lesions.
Design
A pilot study including 2 patients with CPLs.
Setting
Endoscopy unit in a tertiary-care hospital.
Patients
Two women with CPLs located at the pancreatic head.
Interventions
On EUS, biopsy forceps and a SpyGlass fiberoptic were passed through a 19-gauge needle to visualize and obtain samples from the cystic wall.
Main Outcome Measurements
The histologic assessment was based on the obtained biopsy samples.
Results
Both CPLs were considered to be mucinous cystoadenomas, because mucinous-like cylindric epithelium without cellular atypia was observed.
Limitations
Pilot study.
Conclusions
Obtaining biopsy samples from the wall of a CPL is now feasible. It represents a significant advantage in the diagnostic yield of this type of lesion.
Abbreviations: CPL, cystic pancreatic lesion, EUS-FNA, EUS-guided FNA
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
PII: S0016-5107(10)02060-2
doi:10.1016/j.gie.2010.08.036
© 2010 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
