| Theme |
Intraductal Papillary Mucinous Neoplasm (IPMN) |
| Title |
Endoscopic Examination Techniques for Intramucosal Papillary Mucinous Neoplasms |
| Author |
Taketo Yamaguchi |
Department of Gastroenterology, Chiba Cancer Center |
| Author |
Tarou Hara |
Department of Gastroenterology, Chiba Cancer Center |
| Author |
Nami Ohyama |
Department of Gastroenterology, Chiba Cancer Center |
| Author |
Kentarou Sudou |
Department of Gastroenterology, Chiba Cancer Center |
| Author |
Kazuyoshi Nakamura |
Department of Gastroenterology, Chiba Cancer Center |
| Author |
Tadamichi Denda |
Department of Gastroenterology, Chiba Cancer Center |
| [ Summary ] |
Intraductal papillary mucinous neoplasms (IPMN) of the pancreas usually grow slowly and have good prognoses. However, they sometimes progress rapidly with poor prognoses. Although various imaging diagnosis modalities have been used to differentiate between benign IPMNs and malignant ones, it is not always easy to produce a definite diagnosis based on these modalities. Endoscopic examination techniques for IPMNs include ERCP, cytological examination using pancreatic juice, endoscopic ultrasonography (EUS), and peroral pancreatoscopy (POPS). Characteristic findings of duodenal papilla on ERCP facilitate definite diagnosis of IPMN, however differentiation of benign IPMTs from malignant ones is often difficult using only ERCP. Cytological examination using pancreatic juice is sometimes complicated but leads to a firm diagnosis of malignant IPMN. The collection of pancreatic juice with POPS produces a better diagnostic cytological values. EUS is comparatively less invasive and is utilized as a screening test or for precise examinations. The recent development of contrast EUS using Sonazoid a contrast agent, enables clear depiction of mural nodule in IPMN patients. POPS allows precise assessment of protruding IPMN lesions. Furthermore, these findings can produce more detail by using narrow band imaging (NBI) POPS. Correct diagnosis and treatment strategies for IPMNs may be reliably carried out with the above mentioned endoscopic examinations. |