Direct intracystic biopsy and pancreatic cystoscopy through a 19-gauge needle EUS (with videos).
BACKGROUND
Histologic diagnosis of cystic pancreatic lesions (CPLs) is often difficult because of the low sensitivity of FNA and brush cytology.


OBJECTIVE
To discover whether obtaining biopsy samples from the cystic wall could increase the diagnostic yield of these lesions.


METHODS
A pilot study including 2 patients with CPLs.


METHODS
Endoscopy unit in a tertiary-care hospital.


METHODS
Two women with CPLs located at the pancreatic head.


METHODS
On EUS, biopsy forceps and a SpyGlass fiberoptic were passed through a 19-gauge needle to visualize and obtain samples from the cystic wall.


METHODS
The histologic assessment was based on the obtained biopsy samples.


RESULTS
Both CPLs were considered to be mucinous cystoadenomas, because mucinous-like cylindric epithelium without cellular atypia was observed.


CONCLUSIONS
Pilot study.


CONCLUSIONS
Obtaining biopsy samples from the wall of a CPL is now feasible. It represents a significant advantage in the diagnostic yield of this type of lesion.
Endoscopy Unit, Hospital General Universitario de Alicante, Alicante, Spain.
Jose R
JR
Aparicio
Juan
J
Martínez
Maria
M
Niveiro
Antonio
A
Cabezas
Francisco
F
Ruiz
Enrique
E
De Madaria
Juan A
JA
Casellas
D000368:Aged; D044963:Biopsy, Fine-Needle / Q000295:instrumentation*; D003537:Cystadenoma / Q000473:pathology*; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D019160:Endosonography / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D010195:Pancreatitis / Q000209:etiology; D010865:Pilot Projects; D018084:Ultrasonography, Interventional / Q000295:instrumentation*