• 78 year old female presented with history of chronic diarrhea and significant weight loss since 2 months
  • Known case of chronic pancreatitis
  • CT Abdomen – Dilated MPD with suspicious enhancing lesion in the head of pancreas
  • EUS – An irregular solid-cystic lesion (16 mm X 14 mm) was seen in the head of pancreas with mural nodules.
  • Pancreatic parenchyma appeared atrophied in the head and body region.
  • MPD appeared dilated (7 mm) in the body and tail region
  • EUS guided FNA was performed with 22 G needle under color Doppler guidance
  • EUS guide FNA cytology was suggestive of low grade cystic neoplasm

EXPERT COMMENTS –

  • Contrast harmonic -EUS can differentiate between benign and malignant pancreatic nodule
  • Elderly male with history of chronic pancratitis are at significantly higher risk to develop malignancy
  • EUS in combination with EUS guided FNA has 100 % sensitivity and specificity to diagnose the pancreatic  solid-cystic neoplasms.
An irregular solid-cystic lesion was seen in the head of pancreas

An irregular solid-cystic lesion was seen in the head of pancreas

An irregular solid-cystic lesion was seen in the head of pancreas – with Doppler imaging

An irregular solid-cystic lesion was seen in the head of pancreas – with Doppler imaging

 

 

 

 

 

 

 

 

 

 

EUS FNA was performed (two pass) from the suspicious lesion

EUS FNA was performed (two pass) from the suspicious lesion

Fish mouth appearance of ampulla typical of Mucinous cystic neoplasms

Fish mouth appearance of ampulla typical of Mucinous cystic neoplasms

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