Diagnosis of intraductal papillary mucinous neoplasm using endoscopic ultrasound guided microbiopsies: A case report

Charlotte Vestrup Rift, Bojan Kovacevic, John Gásdal Karstensen, Julie Plougmann, Pia Klausen, Anders Toxværd, Evangelos Kalaitzakis, Carsten Palnæs Hansen, Jane Preuss Hasselby, Peter Vilmann

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Abstract

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.

Original languageEnglish
JournalWorld Journal of Gastrointestinal Endoscopy
Volume10
Issue number7
Pages (from-to)125-129
ISSN1948-5190
DOIs
Publication statusPublished - 2018

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