"Invisible" pancreatic masses identified by EUS by the "ductal cutoff sign".

Published on Mar 1, 2019in Endoscopic ultrasound5.628
· DOI :10.4103/EUS.EUS_49_15
Kimberly J Fairley2
Estimated H-index: 2
(GHS: Geisinger Health System),
David L. Diehl29
Estimated H-index: 29
(GHS: Geisinger Health System),
Amitpal S. Johal1
Estimated H-index: 1
(GHS: Geisinger Health System)
Sources
Abstract
: Making a tissue diagnosis of pancreatic adenocarcinoma is best accomplished by EUS and fine-needle aspiration (FNA) of the lesion. Typically, a dark, or "hypoechoic" mass will be seen, which presents an obvious target for FNA. For small lesions, computerized tomography (CT) may be negative, but the lesion is still almost always seen on EUS imaging. Rarely, a pancreatic mass will appear isoechoic on EUS imaging. We report three "invisible" pancreatic masses identified only by a cutoff in the pancreatic duct (PD) and/or common bile duct (CBD). No mass, isoechoic or otherwise, was seen. EUS-FNA was performed in the area of ductal narrowing, with a positive identification of adenocarcinoma in these cases.
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Cited By6
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#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Babu P. Mohan (UofU: University of Utah)H-Index: 6
Last. Pietro Fusaroli (UNIBO: University of Bologna)H-Index: 28
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OBJECTIVES It is still unclear whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses. Aim of this meta-analysis was to compare the diagnostic outcomes of these two techniques. METHODS We searched the PubMed/Medline and Embase database through October 2020 and identified 6 studies, of which 2 randomized controlled trials (recruiting 701 patients). We perform...
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#1Antonio FacciorussoH-Index: 21
#2Christian CotsoglouH-Index: 10
Last. Nicola MuscatielloH-Index: 23
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Background: Whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses remains unclear. The aim of this study was to compare these two techniques on a series of patients with solid pancreatic lesions. Methods: 362 patients underwent EUS-FNA (2008–2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103...
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#1Andrada SeiceanH-Index: 18
Last. Radu SeiceanH-Index: 10
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BACKGROUND Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) can visualize necrotic areas and vessels inside lesions. CH-EUS findings combined with EUS-guided fine-needle aspiration (EUS-FNA) improves diagnosis in pancreatic solid masses. CH-EUS can also guide EUS-FNA (CH-EUS-FNA), potentially improving the diagnostic rate of EUS-FNA, but such superiority has not been proved in prospective studies. We aimed to assess whether CH-EUS-FNA is superior to standard EUS-FNA for specific diagnos...
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#1Subba Rao V. Kanchustambam (Blackburn College)
#2Amit Sharma (William Harvey Hospital)
Last. Ameet Patel (King's College)
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Abstract Background/objectives Dilatation of the pancreatic duct and common bile duct, known as double duct sign (DDS), suggests sinister pathology at the periampullary region. Non-jaundiced patients with incidental DDS and otherwise normal cross-sectional imaging present a diagnostic dilemma to the multidisciplinary team (MDT). The primary aim of this review was to assess the diagnostic yield of endoscopic ultrasound (EUS) in detecting causal pathology in this patient population. Methods A syst...
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#1Peter Lee (UPenn: University of Pennsylvania)H-Index: 11
#2Georgios I. Papachristou (OSU: Ohio State University)H-Index: 48
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