摘要
Endoscopic ultrasonography(EUS)is a highly sensitive diagnostic method for the detection of small pancreatic carcinomas.Recently,there have been some reports describing the utility of contrast-enhanced harmonic EUS(CEH-EUS)which uses sonographic contrast agent for differentiation of a pancreatic mass.This report describes a case of small adenocarcinoma of the pancreas distinct from branch duct intraductal papillary mucinous neoplasm(IPMN)in which investigation by EUS took place every 6 mo and diagnosis was made accurately by additional CEH-EUS during the follow- up of the branch duct IPMN.A 68-year-old female was admitted to our hospital because of a branch duct IPMN in the pancreatic body.She had been followedup by EUS every 6 mo.However,after 2 years EUSdemonstrated a low echoic area distinct from the branch duct IPMN which was vaguely discernible by EUS,and accurate sizing and differential diagnosis were considered difficult on the EUS imaging.CHEUS with Sonazoid revealed a hypovascular tumor and we suspected small pancreatic carcinoma.The histopathological diagnosis was adenocarcinoma (10 mm)in the pancreatic tail,distinct from the branch duct IPMN of the pancreatic body.EUS and CEH-EUS may play an important role in the correct diagnosis of small pancreatic tumors,including synchronous and metachronous occurrence of IPMN and ductal adenocarcinoma of the pancreas.
Endoscopic ultrasonography (EUS) is a highly sensitive diagnostic method for the detection of small pancreatic carcinomas. Recently, there have been some reports describing the utility of contrast-enhanced harmonic EUS (CEH-EUS) which uses sonographic contrast agent for differentiation of a pancreatic mass. This report describes a case of small adenocarcinoma of the pancreas distinct from branch duct intraductal papillary mucinous neoplasm (IPMN) in which investigation by EUS took place every 6 mo and diagnosis was made accurately by additional CEH-EUS during the follow-up of the branch duct IPMN. A 68-year-old female was admitted to our hospital because of a branch duct IPMN in the pancreatic body. She had been followed-up by EUS every 6 too. However, after 2 years EUS demonstrated a low echoic area distinct from the branch duct IPMN which was vaguely discernible by EUS, and accurate sizing and differential diagnosis were considered difficult on the EUS imaging. CHEUS with Sonazoid revealed a hypovascular tumor and we suspected small pancreatic carcinoma. The histopathological diagnosis was adenocarcinoma (10 mm) in the pancreatic tail, distinct from the branch duct IPMN of the pancreatic body. EUS and CEH-EUS may play an important role in the correct diagnosis of small pancreatic tumors, including synchronous and metachronous occurrence of IPMN and ductal adenocarcinoma of the pancreas.
基金
Supported by The Japan Society for Promotion of Science
The Research and Development Committee Program of The Japan Society of Ultrasonics in Medicine
Japan Research Foundation for Clinical Pharmacology
Japanese Foundation forResearch and Promotion of Endoscopy
关键词
分支管道
胰腺癌
肿瘤
黏液
乳头
管内
导管
浸润性
Intraductal papillary mucinous adenoma
Small pancreatic cancer
Endoscopic ultrasonography
Contrast-enhanced harmonic endoscopic ultrasonography
Pancreatic cancer
Pancreas
Contrast enhanced endoscopic ultrasonography