Document Detail

A percutaneous biopsy technique for patients with suspected biliary or pancreatic cancer without a radiographic mass.
MedLine Citation:
PMID:  9107656     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Treatment of malignant pancreatic and/or biliary strictures requires tissue diagnosis. Since cytologic brushings at endoscopic retrograde cholangiopancreatography (ERCP) of these strictures has a poor sensitivity for malignancy (30-83%) (see ME Ryan. Gastrointestinal Endoscopy 1991;37(2):139-143; and MB Cohen, Wittchow RJ, Johlin FC, et al. Mod Pathol 1995;8:498-502), tissue diagnosis must be obtained by another route. We report our experience of percutaneous biopsy of malignant pancreatic and/or biliary strictures even when no radiographic mass is present. METHODS: At ERCP, five patients demonstrated pancreatic and/or biliary duct strictures, had atypical cytological brushings, and had their strictures stented. No mass to account for the strictures could be identified on CT. These five patients underwent percutaneous biopsy of the persistent material by CT within 10 days of the ERCP. RESULTS: Two patients had adenocarcinoma of the pancreas. One patient had malignant lymphoma and another had cholangiocarcinoma. One patient had inflammatory cells and was followed. CONCLUSIONS: If the diagnosis of malignancy cannot be made at the time of the ERCP sampling, then our experience suggests that a percutaneous biopsy should be performed even if a mass is not present using the stent as a target.
R E Pelsang; F C Johlin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Abdominal imaging     Volume:  22     ISSN:  0942-8925     ISO Abbreviation:  Abdom Imaging     Publication Date:    1997 May-Jun
Date Detail:
Created Date:  1997-07-10     Completed Date:  1997-07-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9303672     Medline TA:  Abdom Imaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  307-10     Citation Subset:  IM    
Department of Radiology, University of Iowa College of Medicine, Iowa City 52242, USA.
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MeSH Terms
Biliary Tract Neoplasms / pathology*,  radiography
Biopsy, Needle / methods*
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis / etiology,  radiography
Constriction, Pathologic / etiology,  radiography
Pancreatic Ducts / radiography
Pancreatic Neoplasms / pathology*,  radiography
Tomography, X-Ray Computed
Comment In:
Abdom Imaging. 1997 May-Jun;22(3):311-2   [PMID:  9107657 ]

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