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The pancreas
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Cystic tumours of the pancreas may be serous or mucinous. Serous cystadenomas are typically found in older women, and are large aggregations of multiple small cysts, almost like bub- blewrap. They are benign. Mucinous tumours, on the other hand, have the potential for malignant transformation. They include mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs). MCNs are seen in perimenopausal women, show up as multilocular thick-walled cysts in the pancreatic body or tail, and, histologically, contain an ovarian-type stroma. IPMNs are more common in the pancreatic head and in older men, but an IPMN arising from a branch duct can be difficult to distinguish from an MCN. IPMNs arising within the main duct are often multifocal and have a greater tendency to prove malignant. Thick mucus seen extruding from the ampulla at ERCP is diagnostic of a main duct IPMN. Mucinous tumours can be confused with pseudocysts (see Summary box 68.8). Occasionally, lymphoepithelial cysts, lymphangiomas, dermoid cysts and intestinal duplication cysts can show up in the pancreas. Solid pseudopapillary tumour is a rare, slowly progressive but malignant tumour, seen in women of childbearing age, and manifests as a large, part-solid, part-cystic tumour.
Pancreatic disorders in children
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Christian J Streck Jr, Andre Hebra
Pancreatic massesDuctal adenocarcinomaAcinar cell carcinomaCongenital pancreatic cystSolid pseudopapillary tumourIntraductal papillary mucinous neoplasmMucinous cystadenomaLymphomaRhabdomyosarcomaAcquired pancreatic pseudocystLymphomaPancreaticoblastoma
Other Pancreatic Disorders
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
Kathy D. Chen, Sohail Z. Husain
Solid-cystic papillary tumor is also known as solid pseudopapillary tumor or Frantz’s tumor. It is found in greater proportions among females and Asian and African ethnic groups. The mean age of presentation is 26 years, and one-fifth of all cases occur in children. Patients typically present with a palpable abdominal mass. Ultrasound and CT scan demonstrate a large, well-defined solid lesion in the head of the pancreas. Treatment is surgical resection, and children have a better prognosis than adults due to a lower likelihood of metastasis and local invasion.
Comparison of 22-gauge standard fine needle versus core biopsy needle for endoscopic ultrasound-guided sampling of suspected pancreatic cancer: a randomized crossover trial
Published in Scandinavian Journal of Gastroenterology, 2018
Dong Hyo Noh, Kyu Choi, Seonhye Gu, Juhee Cho, Kee-Taek Jang, Young Sik Woo, Kyu Taek Lee, Jong Kyun Lee, Kwang Hyuck Lee
Although most of solid pancreatic masses are pancreatic ductal adenocarcinoma, because they include a wide variety of diseases such as pancreatic neuroendocrine tumor, lymphoma, solid pseudopapillary tumor, pancreatitis and metastatic cancer; it is preferred to examine the same patient with different diagnostic tests. According to a randomized crossover trial, 22G FNB needle had comparable diagnostic yield to that of 22G FNA needle (90% vs. 92.5%; p = .68) [11]. However, they compared one 22G FNB needle pass to two 22G FNA needle passes which could affect the results. This randomized crossover trial aimed to compare the diagnostic yield of same needle passes with 22G FNA and FNB needles for EUS-guided sampling in patients with suspected unresectable pancreatic cancer. We also compared cytological and histological quality of specimen and complication rate of each needle.
Diagnostic yield of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions after inconclusive percutaneous ultrasound-guided tissue acquisition
Published in Scandinavian Journal of Gastroenterology, 2020
Marco Le Grazie, Maria Cristina Conti Bellocchi, Laura Bernardoni, Pietro Fusaroli, Erminia Manfrin, Socrate Pallio, Armando Gabbrielli, Stefano Francesco Crinò
Nine patients underwent surgical resection during follow-up. Thirty-nine non-resected patients were followed up for a median time of 12 months (IQR 8–16). The final diagnoses were PDAC in 34 (72%) cases, flogistic/benign in 7 (15%) cases, neuroendocrine tumor (NET) in 4 (8%) cases, solid pseudopapillary tumor in 2 (4%) cases, and metastasis in 1 (2%) case. Table 1 shows the clinical features of included SPLs and technical aspects regarding US-guided TA and EUS-guided TA.