Diagnosis and fine needle aspiration of intraductal papillary mucinous tumor by endoscopic ultrasound.
A recently established clinical entity, intraductal papillary mucinous tumor (IPMT) of the pancreas embraces a spectrum of pathology ranging from benign to malignant disease. IPMT must be differentiated from other cystic neoplasms of the pancreas, as well as inflammatory cystic lesions. As the pancreas lies in close proximity to the gastric and duodenal walls, endoscopic ultrasonography (EUS) is ideally suited for imaging the pancreas. Additionally, EUS facilitates fine needle aspiration of pancreatic cysts and/or a dilated pancreatic duct for cytologic and tumor marker analysis. This article presents a brief history of IPMT, differential diagnosis, current imaging modalities, findings of cytologic and tumor marker analysis, prognosis, and treatment strategy. Special emphasis is dedicated to the role of EUS, as well as EUS with fine needle aspiration.
Bounds
Brenna Casey
BC
Massachusetts General Hospital, 55 Fruit Street, Blake 4/GI Unit, Boston, MA 02114, USA. Bbounds@partners.org
D002288:Adenocarcinoma, Mucinous / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D019160:Endosonography / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards; D010190:Pancreatic Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D018300:Papilloma, Intraductal / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods* / Q000592:standards