Percutaneous transhepatic intraportal biopsy using gastroscope biopsy forceps for diagnosis of a pancreatic neuroendocrine neoplasm:A case report

BACKGROUND Pancreatic neuroendocrine neoplasms(PNENs)are a rare group of neoplasms originating from the islets of the Langerhans.Portal vein tumor thrombosis has been reported in 33%of patients with PNENs.While the histopathological diagnosis of PNENs is usually based on percutaneous biopsy or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA),these approaches may be impeded by gastric varices,poor access windows,or anatomically contiguous critical structures.Obtaining a pathological diagnosis using a gastroscope biopsy forceps via percutaneous transhepatic intravascular pathway is an innovative method that has rarely been reported.CASE SUMMARY A 72-year-old man was referred to our hospital for abdominal pain and melena.Abdominal contrast-enhanced magnetic resonance imaging revealed a wellenhanced tumor(size:2.4 cm×1.2 cm×1.2 cm)in the pancreatic tail with portal vein invasion.Traditional pathological diagnosis via EUS-FNA was not possible because of diffuse gastric varices.We performed a percutaneous transportal biopsy of the portal vein tumor thrombus using a gastroscope biopsy forceps.Histopathologic examination revealed a pancreatic neuroendocrine neoplasm(G2)with somatostatin receptors 2(+),allowing systemic treatment.CONCLUSION Intravascular biopsy using gastroscope biopsy forceps appears to be a safe and effective method for obtaining a histopathological diagnosis.Although welldesigned clinic trials are required to obtain more definitive evidence,this procedure may help improve the diagnosis of portal vein thrombosis and related diseases.

Comparative Analysis of the Value of Gastroscopic Biopsy and Surgical Pathology in the Diagnosis of Gastric Cancer

Objective:To explore and analyze the diagnostic value of gastroscopic biopsy and surgical pathology in improving the diagnostic accuracy of gastric cancer.Methods:From May 2019 to June 2020,80 patients with gastric cancer treated in Shuyang Xiehe Hospital were selected and divided into two groups,a control group and a study group,with 40 cases in each group,based on the examination method individually selected by the patients.The patients in the control group were investigated via gastroscopy,while those in the study group were investigated by surgical pathology.The diagnostic values of the two methods were compared and analyzed.Results:The diagnostic accuracy of patients in the study group was 100%,which was higher than that of the control group.The tissue type,lesion morphology,and cancer differentiation of the study group were better than those of the control group.There was significant difference between the two methods(P<0.05).Conclusion:Surgical and pathological examination can improve the diagnostic accuracy of gastric cancer,comprehensively analyze the patient’s condition,and provide corresponding theoretical basis for follow-up treatment,so that patients can obtain more active and effective treatment,reduce pain,and improve their quality of life.