| Theme |
IPMT ; Intraductal Papillary-Mucinous Tumor |
| Title |
EUS-Guided Fine-Needle Aspiration Biopsy (EUS-FNAB) for Pancreatic Cystic Lesion |
| Author |
Kuniyuki Takahashi |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Kenji Yamao |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Akira Sawaki |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Nobumasa Mizuno |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Yasuhiro Simizu |
Gastroenterological Surgery, Aichi Cancer Center Hospital |
| Author |
Taku Koshikawa |
Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital |
| Author |
Akio Yanagisawa |
Department of Pathology, Kyoto Prefectural University of Medicine |
| [ Summary ] |
Pancreatic cystic lesions include inflammatory cysts (pseudocysts) and neoplastic cysts (SCT, IPMN, MCN). Differential diagnosis is sometimes difficult with imaging modalities alone. The aim of this study is to evaluate the utility of cystic fluid analysis obtained by EUS-FNAB or resected specimens, with special reference to cytology, amylase enzymes, and tumor markers (CEA, CA 19-9, CA 125) to differentiate pancreatic cystic lesions. Although amylase concentrations of pseudocysts is not significant, they are higher than those of other cystic lesions. CEA of the cystic fluid tends to be higher with IPMN and MCN. Both amylase enzymes and tumor makers tend to be lower with SCT. The sensitivity of EUS-FNAB and post operative cystic fluid analysis for malignancy is 42.8 %. We should not perform EUS-FNAB via the gastric wall into suspected mucinous cystic lesions because of the possibility of malignant seeding. EUS-FNAB for pancreatic cystic lesions may be beneficial for differential diagnosis if we take into account its indications and risks. |