A percutaneous biopsy technique for patients with suspected biliary or pancreatic cancer without a radiographic mass

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ID: 118552
2014
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Abstract
Background: Treatment of malignant pancreatic and/or biliary strictures requires tissue diagnosis. Since cytologic brushings at endoscopic retrograde cholangiopancreatography (ERCP) of these strictures has a poor sensitivity for malignancy (30–83%) (see ME Ryan. Gastrointestinal Endoscopy 1991;37(2):139–143; and MB Cohen, Wittchow RJ, Johlin FC, et al. Mod Pathol 1995;8:498–502), tissue diagnosis must be obtained by another route. We report our experience of percutaneous biopsy of malignant pancreatic and/or biliary strictures even when no radiographic mass is present. Methods: At ERCP, five patients demonstrated pancreatic and/or biliary duct strictures, had atypical cytological brushings, and had their strictures stented. No mass to account for the strictures could be identified on CT. These five patients underwent percutaneous biopsy of the peri-stent material by CT within 10 days of the ERCP. Results: Two patients had adenocarcinoma of the pancreas. One patient had malignant lymphoma and another had cholangiocarcinoma. One patient had inflammatory cells and was followed. Conclusions: If the diagnosis of malignancy cannot be made at the time of the ERCP sampling, then our experience suggests that a percutaneous biopsy should be performed even if a mass is not present using the stent as a target.
Reference Key
pelsang2014abdominala Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors R. E. Pelsang;F. C. Johlin;R. E. Pelsang;F. C. Johlin;
Journal abdominal imaging
Year 2014
DOI
doi:10.1007/s002619900195
URL
https://link.springer.com/article/10.1007/s002619900195
Keywords
hepatology gastroenterology imaging / radiology

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