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US Quiz September 2019

Case Report We present the case of a 71-year-old female patient with past medical history remarkable for a pancreatic head cystic lesion diagnosed in 2009. It was a 24mm multilocular cystic lesion with a central scar, that remained  asymptomatic and stable in size until 2015, when follow-up was lost. In 2019 the patient developed new onset jaundice, choluria and acolia. An abdominal ultrasound was performed and revealed a 47x45mm heterogeneous mass in the pancreatic head, associated with de-novo common bile duct dilatation (CBD, 17mm in the liver hilum) (Fig. 1). Figure 1. Abdominal ultrasound: heterogeneous pancreatic head mass. Magnetic resonance cholangiopancreatography (MRCP) showed a multilocular pancreatic head cystic lesion, measuring 60x70x57mm (Fig. 2) and apparently communicating with the main pancreatic duct (MPD). There was also CBD and intrahepatic bile duct dilation. Figure 2. MRCP: multilocular pancreatic head cystic lesion, apparently communicating with the MPD, and CBD and intrahepatic bile duct dilation. Endoscopic ultrasound (EUS) documented a predominantly microcystic lesion located in the head of the pancreas, measuring 53x46mm, with a few macrocysts and pseudo-solid areas, compressing the CBD and the superior mesenteric vein,  and without vascular invasion or Wirsung dilatation (Fig. 3). Fine needle aspiration (FNA) of the macrocyst and of a pseudo-solid area was performed. Cyst fluid biochemistry analysis revealed a high amilase level (54085 UI/L) and a normal CEA (2 ng/mL). Figure 3. EUS: predominantly microcystic pancreatic lesion located in the head of the pancreas, with a few macrocysts and pseudo solid areas.   Quiz   Discussion EUS-FNA cytology showed cuboidal cells, […]

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GRUPUGE Prizes 2019

GRUPUGE Prizes at the Portuguese Digestive Week 2019: click here.

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GRUPUGE RECOMMENDATIONS

2020 – GRUPUGE PERSPECTIVE: INTERVENTIONAL ENDOSCOPIC ULTRASOUND IN BILIOPANCREATIC DISEASES 2019 – ENDOSCOPIC ULTRASOUND IN ONCOLOGY 2015 – EUS-FNA & THERAPEUTIC PROCEDURES

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