Endosonography in the diagnosis and management of pancreatic cysts

World Journal of Gastrointestinal Endoscopy
Vivek Kadiyala, Linda S Lee

Abstract

Rapid advances in radiologic technology and increased cross-sectional imaging have led to a sharp rise in incidental discoveries of pancreatic cystic lesions. These cystic lesions include non-neoplastic cysts with no risk of malignancy, neoplastic non-mucinous serous cystadenomas with little or no risk of malignancy, as well as neoplastic mucinous cysts and solid pseudopapillary neoplasms both with varying risk of malignancy. Accurate diagnosis is imperative as management is guided by symptoms and risk of malignancy. Endoscopic ultrasound (EUS) allows high resolution evaluation of cyst morphology and precise guidance for fine needle aspiration (FNA) of cyst fluid for cytological, chemical and molecular analysis. Initially, clinical evaluation and radiologic imaging, preferably with magnetic resonance imaging of the pancreas and magnetic resonance cholangiopancreatography, are performed. In asymptomatic patients where diagnosis is unclear and malignant risk is indeterminate, EUS-FNA should be used to confirm the presence or absence of high-risk features, differentiate mucinous from non-mucinous lesions, and diagnose malignancy. After analyzing the cyst fluid for viscosity, cyst fluid carcinoembryonic antigen, amylase, and cyst w...Continue Reading

Citations

Aug 30, 2016·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Divyanshoo R KohliRavi Vachhani
Oct 22, 2016·European Journal of Gastroenterology & Hepatology·Přemysl FričMiroslav Zavoral
May 29, 2018·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Luca BarresiAlberto Larghi
Sep 29, 2018·Expert Review of Gastroenterology & Hepatology·Roberta Elisa Rossi, Sara Massironi
Nov 12, 2019·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Takuji IwashitaMasahito Shimizu
Jan 27, 2016·World Journal of Gastroenterology : WJG·Austin L Chiang, Linda S Lee
Apr 25, 2018·BMC Gastroenterology·Martino GerosaUgo Cioffi
Apr 25, 2018·Case Reports in Gastrointestinal Medicine·Silke FrançoisFazia Mana
Jun 1, 2019·World Journal of Gastroenterology : WJG·César Vivian Lopes
Jun 25, 2021·World Journal of Gastroenterology : WJG·Hiroki SatoYusuke Mizukami

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