TY - JOUR

T1 - Diagnosis of intraductal papillary mucinous neoplasm using endoscopic ultrasound guided microbiopsies

T2 - A case report

AU - Rift, Charlotte Vestrup

AU - Kovacevic, Bojan

AU - Karstensen, John Gásdal

AU - Plougmann, Julie

AU - Klausen, Pia

AU - Toxværd, Anders

AU - Kalaitzakis, Evangelos

AU - Hansen, Carsten Palnæs

AU - Hasselby, Jane Preuss

AU - Vilmann, Peter

PY - 2018

Y1 - 2018

N2 - Pancreatic cysts are increasingly diagnosed due to expanding use of cross-sectional imaging, but current diagnostic modalities have limited diagnostic accuracy. Recently, a novel through-the-needle microbiopsy forceps has become available, offering the possibility of obtaining cyst-wall biopsies. We present a case of 41-year-old male with chronic pancreatitis and a 2-cm pancreatic cyst, initially considered a pseudocyst. Subsequently, endoscopic ultrasound guided microbiopsies were successfully obtained, which surprisingly revealed an intraductal papillary mucinous neoplasm of mixed subtype with low grade dysplasia. In conclusion, obtaining biopsies from the wall of the pancreatic cystic lesions with this novel instrument is feasible and, as demonstrated in this case, can possibly alter the clinical outcome. Microbiopsies offered enough cellular material, allowing supplemental gene mutation analysis, which combined with other modalities could lead to a more individual approach when treating pancreatic cysts. However, prospective studies are warranted before routine clinical implementation.

AB - Pancreatic cysts are increasingly diagnosed due to expanding use of cross-sectional imaging, but current diagnostic modalities have limited diagnostic accuracy. Recently, a novel through-the-needle microbiopsy forceps has become available, offering the possibility of obtaining cyst-wall biopsies. We present a case of 41-year-old male with chronic pancreatitis and a 2-cm pancreatic cyst, initially considered a pseudocyst. Subsequently, endoscopic ultrasound guided microbiopsies were successfully obtained, which surprisingly revealed an intraductal papillary mucinous neoplasm of mixed subtype with low grade dysplasia. In conclusion, obtaining biopsies from the wall of the pancreatic cystic lesions with this novel instrument is feasible and, as demonstrated in this case, can possibly alter the clinical outcome. Microbiopsies offered enough cellular material, allowing supplemental gene mutation analysis, which combined with other modalities could lead to a more individual approach when treating pancreatic cysts. However, prospective studies are warranted before routine clinical implementation.

U2 - 10.4253/wjge.v10.i7.125

DO - 10.4253/wjge.v10.i7.125

M3 - Journal article

C2 - 30079140

VL - 10

SP - 125

EP - 129

JO - World Journal of Gastrointestinal Endoscopy

JF - World Journal of Gastrointestinal Endoscopy

SN - 1948-5190

IS - 7

ER -