UNCINATE PROCESS OF PANCREAS CA FNA CHRISTOS KARALIS, MD. скачать в хорошем качестве

UNCINATE PROCESS OF PANCREAS CA FNA CHRISTOS KARALIS, MD.

It is always challenging to biopsy a lesion on the uncinate process of the pancreas. Because of the duodenal anatomy and motility the angle of approach and the major vessels of the area (Abdominal aorta, Inferior vena cava SMA and SMV) the tip of the scope is difficult to be positioned perfectly on the target and the needle is difficult to follow the curvature of the organ, to exit or to be visualized echogenically during the biopsy process. This is a patient who had a CT of the abdomen for abdominal pain and a 2 cm "solid" lesion was noted at the uncinate process of his pancreas. An EUS FNA was performed which revealed a solid like signal from the lesion but on FNA a thick liquid aspirate was obtained. Later on the pathology report revealed a crystallized protein rich material rich in neutrophils and histiocytes findings consistent with an old organized pseudo-cyst. The patient admitted that he had abdominal pains in the past that had been contributed to IBS but he never had a work-up done to look for other causes for his symptoms.