title: A single-center experience of endoscopic ultrasonography for enlarged pancreas on computed tomography.
abstract: OBJECTIVE
  The clinical significance of "fullness" or enlargement of the pancreas (FP/EP) is not well established. The objective of this study was to report our experience with endoscopic ultrasonography (EUS) in evaluating patients referred for FP/EP found on computed tomography (CT).
  
  
  METHODS
  Patients referred to our center for EUS evaluation of FP/EP between January 1998 and December 2003 were studied. Patient demographics, clinical history, endoscopic findings, and follow-up were recorded. Multivariate analysis was used to identify predictors of pancreatic malignancy.
  
  
  RESULTS
  A total of 50 patients: 46% (23/50) male, mean age 59 years (range, 18-90) made up our studied population. EUS demonstrated normal findings in 42% (21/50), prominent ventral anlage (embryologic variant) in 14% (7/50), and chronic pancreatitis in 22% (11/50). In 22% (11/50), a suspicious mass was noted and fine-needle aspiration (FNA) was performed. Cytology revealed chronic inflammation in 7 patients, while adenocarcinoma was found in the remaining 4. Median follow-up was 27 months, and the diagnosis did not change in any of the 50 patients. There were no procedure-related complications. After multivariant regression analysis, the factors that were statistically associated with malignancy were a CA19-9 level >300 (P = .0002) and weight loss (P < .006).
  
  
  CONCLUSIONS
  The majority of patients presenting with FP/EP had benign disease, but 8% had pancreatic cancer. Elevated CA19-9 and weight loss were predictive of pancreatic malignancy. EUS and EUS-FNA are safe and accurate diagnostic tests and can play an important role in evaluating patients with FP/EP.
authors.affiliation: Department of Gastroenterology, Duke University Medical Center, Durham, North Carolina 27710, USA. sammyho01@yahoo.com
authors.forename: Sammy
authors.initials: S
authors.lastname: Ho
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Bonasera
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Pollack
authors.forename: James
authors.initials: J
authors.lastname: Grendell
authors.forename: Martin
authors.initials: M
authors.lastname: Feuerman
authors.forename: Frank
authors.initials: F
authors.lastname: Gress
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed