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9. Relapse rate and predictors of relapse after cessation of glucocorticoid maintenance therapy in type 1 autoimmune pancreatitis: a multicenter retrospective study

Author

Kiyoshita, Yusuke, Ishii, Yasutaka, Serikawa, Masahiro, Hanada, Keiji, Sasaki, Tamito, Fujimoto, Yoshifumi, Yamaguchi, Atsushi, Hirao, Ken, Noma, Bunjiro, Minami, Tomoyuki, Okazaki, Akihito, Yukutake, Masanobu, Mouri, Teruo, Tsuboi, Tomofumi, Tatsukawa, Yumiko, Nakamura, Shinya, Hirano, Tetsuro, Ikemoto, Juri, Saeki, Sho, Tamura, Yosuke, Miyamoto, Sayaka, Furukawa, Masaru, Nakmura, Kazuki, Yamashita, Yumiko, Iijima, Noriaki, and Oka, Shiro

Published
2023
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10. Optimal indication of endoscopic retrograde pancreatography-based cytology in the preoperative pathological diagnosis of pancreatic ductal adenocarcinoma

Author

Kawamura, Ryota, Ishii, Yasutaka, Serikawa, Masahiro, Tsuboi, Tomofumi, Tsushima, Ken, Nakamura, Shinya, Hirano, Tetsuro, Ikemoto, Juri, Kiyoshita, Yusuke, Saeki, Sho, Tamura, Yosuke, Miyamoto, Sayaka, Nakamura, Kazuki, Furukawa, Masaru, Ishida, Katsunari, Arihiro, Koji, Uemura, Kenichiro, and Aikata, Hiroshi

Published
2022
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11. Impact of endoscopic ultrasound‐guided fine needle aspiration on positive peritoneal lavage cytology in patients with resectable pancreatic body and tail cancer.

Author

Ishii, Yasutaka, Serikawa, Masahiro, Uemura, Kenichiro, Tatsukawa, Yumiko, Nakamura, Shinya, Ikemoto, Juri, Miyamoto, Sayaka, Arihiro, Koji, Takahashi, Shinya, and Oka, Shiro

Abstract

Background/Purpose: A recent study has demonstrated that the timing of endoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) significantly influences the peritoneal lavage cytology (CY) outcomes in pancreatic body‐tail cancer. The aim of this study was to clarify the impact of EUS‐FNA on CY positivity in patients with resectable pancreatic body‐tail cancer. Methods: Patients with anatomically resectable pancreatic body‐tail cancer surgically resected at Hiroshima University Hospital were enrolled, and elated clinicopathological factors, including EUS‐FNA variables and CY positivity rate, were analyzed. Results: Of the 129 eligible patients, 16 (12%) had positive CY. The EUS‐FNA rates of the CY‐positive and CY‐negative groups were not significantly different (63% vs. 52%, p =.440). Multivariate analysis revealed that lymph node metastasis was the only independent risk factor for CY positivity (odds ratio: 5.734, p =.031). A total of 10 (14%) of the 69 patients who underwent EUS‐FNA had positive CY; however, needle specifications and the interval between EUS‐FNA and CY examination did not differ between the CY‐positive and CY‐negative groups. CY positivity rates were comparable for intervals ≤14 days and ≥15 days (17% vs. 14%, p = 1.000). Conclusions: EUS‐FNA may not affect CY positivity in patients with resectable pancreatic body‐tail cancer, regardless of the timing. [ABSTRACT FROM AUTHOR]

Published
2024
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12. The role of apparent diffusion coefficient value in the diagnosis of localized type 1 autoimmune pancreatitis: differentiation from pancreatic ductal adenocarcinoma and evaluation of response to steroids

Author

Sekito, Tsuyoshi, Ishii, Yasutaka, Serikawa, Masahiro, Tsuboi, Tomofumi, Kawamura, Ryota, Tsushima, Ken, Nakamura, Shinya, Hirano, Tetsuro, Fukiage, Ayami, Mori, Takeshi, Ikemoto, Juri, Kiyoshita, Yusuke, Saeki, Sho, Tamura, Yosuke, Miyamoto, Sayaka, and Chayama, Kazuaki

Published
2021
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13. Endoscopic Retrograde Cholangiopancreatography-Related Procedures for the Differential Diagnosis of Isolated Immunoglobin G4-Related Sclerosing Cholangitis and Perihilar Cholangiocarcinoma.

Author

Furukawa, Masaru, Ishii, Yasutaka, Tatsukawa, Yumiko, Nakamura, Shinya, Ikemoto, Juri, Miyamoto, Sayaka, Nakamura, Kazuki, Yamashita, Yumiko, Iijima, Noriaki, Okuda, Yasuhiro, Nomura, Risa, Arihiro, Koji, Hanada, Keiji, and Oka, Shiro

Subjects
ENDOSCOPIC retrograde cholangiopancreatography, BILE ducts, DIFFERENTIAL diagnosis, CHOLANGITIS, CHOLANGIOCARCINOMA
Abstract

Background/Purpose: Differential diagnosis of isolated immunoglobin (Ig)G4-related sclerosing cholangitis (IgG4-SC) and cholangiocarcinoma is challenging. We aimed to clarify the role of endoscopic retrograde cholangiography (ERCP)-related procedures in the differential diagnosis of isolated IgG4-SC and perihilar cholangiocarcinoma (PHCC). Methods: Seven patients with hilar-type isolated IgG4-SC diagnosed at Hiroshima University Hospital and sixty-five patients with surgically resected invasive PHCC were enrolled, and the diagnostic yields of intraductal ultrasonography (IDUS), peroral cholangioscopy (POCS), and pathological examinations were determined. Results: In six of seven (86%) patients with isolated IgG4-SC, the stricture was in the perihilar bile duct. IDUS showed that symmetrical wall thickening (40% vs. 5%, p = 0.04), homogeneous internal echo (80% vs. 5%, p < 0.001), and smooth outer margins (80% vs. 6%, p < 0.001) were more frequent in isolated IgG4-SC than in PHCC. POCS showed a smooth mucosal surface more frequent in isolated IgG4-SC (75% vs. 7%, p = 0.006). Only one patient had two pathological findings characteristic of IgG4-SC. The sensitivity for diagnosing PHCC was 81% using two or more combined sampling methods. Conclusions: Pathological examinations have limitations in the differential diagnosis of isolated-IgG4-SC and PHCC, and a diagnostic strategy that combines multiple ERCP-related procedures, including IDUS and POCS, is recommended. [ABSTRACT FROM AUTHOR]

Published
2024
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14. The Significance of Histopathological Findings on Clinical Outcomes in Endoscopic Papillectomy with Endocut

Author

Miyamoto, Sayaka, primary, Serikawa, Masahiro, additional, Ishii, Yasutaka, additional, Tatsukawa, Yumiko, additional, Nakamura, Shinya, additional, Ikemoto, Juri, additional, Tamura, Yosuke, additional, Nakamura, Kazuki, additional, Furukawa, Masaru, additional, Yamashita, Yumiko, additional, Iijima, Noriaki, additional, Arihiro, Koji, additional, and Oka, Shiro, additional

Published
2023
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17. Utility of Covered Self-Expanding Metal Stents for Biliary Drainage during Neoadjuvant Chemotherapy in Patients with Borderline Resectable Pancreatic Cancer

Author

Furukawa, Masaru, primary, Ishii, Yasutaka, additional, Serikawa, Masahiro, additional, Tsuboi, Tomofumi, additional, Tatsukawa, Yumiko, additional, Hirano, Tetsuro, additional, Nakamura, Shinya, additional, Ikemoto, Juri, additional, Kiyoshita, Yusuke, additional, Saeki, Sho, additional, Tamura, Yosuke, additional, Miyamoto, Sayaka, additional, Nakamura, Kazuki, additional, Yamashita, Yumiko, additional, Iijima, Noriaki, additional, Uemura, Kenichiro, additional, and Oka, Shiro, additional

Published
2023
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18. Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study

Author

Nakamura, Shinya, primary, Ishii, Yasutaka, additional, Serikawa, Masahiro, additional, Hanada, Keiji, additional, Eguchi, Noriaki, additional, Sasaki, Tamito, additional, Fujimoto, Yoshifumi, additional, Yamaguchi, Atsushi, additional, Sugiyama, Shinichiro, additional, Noma, Bunjiro, additional, Kamigaki, Michihiro, additional, Minami, Tomoyuki, additional, Okazaki, Akihito, additional, Yukutake, Masanobu, additional, Mouri, Teruo, additional, Tatsukawa, Yumiko, additional, Ikemoto, Juri, additional, Arihiro, Koji, additional, and Oka, Shiro, additional

Published
2023
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20. Relapse rate and predictors of relapse after cessation of glucocorticoid maintenance therapy in type 1 autoimmune pancreatitis: a multicenter retrospective study

Author

Kiyoshita, Yusuke, primary, Ishii, Yasutaka, additional, Serikawa, Masahiro, additional, Hanada, Keiji, additional, Sasaki, Tamito, additional, Fujimoto, Yoshifumi, additional, Yamaguchi, Atsushi, additional, Hirao, Ken, additional, Noma, Bunjiro, additional, Minami, Tomoyuki, additional, Okazaki, Akihito, additional, Yukutake, Masanobu, additional, Mouri, Teruo, additional, Tsuboi, Tomofumi, additional, Tatsukawa, Yumiko, additional, Nakamura, Shinya, additional, Hirano, Tetsuro, additional, Ikemoto, Juri, additional, Saeki, Sho, additional, Tamura, Yosuke, additional, Miyamoto, Sayaka, additional, Furukawa, Masaru, additional, Nakmura, Kazuki, additional, Yamashita, Yumiko, additional, Iijima, Noriaki, additional, and Oka, Shiro, additional

Published
2023
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22. Comparative study of therapeutic outcomes in patients who developed hepatolithiasis after hepaticojejunostomy: balloon-assisted enteroscopic approach versus percutaneous transhepatic approach

Author

Nakamura, Kazuki, Ishii, Yasutaka, Tatsukawa, Yumiko, Nakamura, Shinya, Ikemoto, Juri, Miyamoto, Sayaka, Furukawa, Masaru, Iijima, Noriaki, Hanada, Keiji, and Oka, Shiro

Abstract

Background: The treatment of hepatolithiasis in patients who underwent hepaticojejunostomy (HJS) is challenging. In this study, we aimed to clarify the therapeutic outcomes of double balloon enteroscopy (DBE) and percutaneous transhepatic biliary drainage (PTBD) for hepatolithiasis after HJS. Methods: Patients who underwent DBE or PTBD for hepatolithiasis after HJS at Hiroshima University Hospital were enrolled, and treatment outcomes and recurrence were compared. Results: Forty-eight of the 84 eligible patients underwent DBE, with the HJS site reached in 42 patients (87.5%; DBE group). Forty-one patients underwent PTBD (PTBD group). There were no differences in the clinical characteristics and stone-related factors, including localization, maximum diameter, and quantity, between both groups. The complete stone removal rates in the DBE and PTBD groups were 85.7% and 90.2%, respectively. The DBE group had a significantly shorter median length of hospital stay than the PTBD group (6 vs. 21 days, P&lt; 0.001). During a median follow-up of 45 months, stone recurrence was observed in 22 (32.8%) patients. The cumulative recurrence rates at 1, 3, 5, and 10 years were 13.1%, 31.8%, 34.9%, and 52.7%, respectively. The stone recurrence rates of the DBE and PTBD groups were not significantly different (28.6% vs. 37.5%). Multivariate analysis revealed a stone diameter > 8 mm (hazard ratio, 2.602; P= 0.026) and age ≥ 70 years (hazard ratio, 3.077; P= 0.017) as independent risk factors for stone recurrence. Conclusions: DBE showed outcomes comparable to those of PTBD in the treatment of hepatolithiasis in patients who underwent HJS. Although reaching the HJS site is difficult in some cases, treatment can be completed within a short period with DBE; therefore, it could be the first choice of treatment for hepatolithiasis after HJS.

Published
2024
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23. Pembrolizumab-induced Focal Pancreatitis Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration

Author

Ikemoto, Juri, primary, Ishii, Yasutaka, additional, Serikawa, Masahiro, additional, Tsuboi, Tomofumi, additional, Tsushima, Ken, additional, Nakamura, Shinya, additional, Hirano, Tetsuro, additional, Kiyoshita, Yusuke, additional, Saeki, Sho, additional, Tamura, Yosuke, additional, Miyamoto, Sayaka, additional, Nakamura, Kazuki, additional, Furukawa, Masaru, additional, Arihiro, Koji, additional, and Aikata, Hiroshi, additional

Published
2022
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25. Transabdominal Ultrasound Real-time Tissue Elastography as a Screening Method for Early Chronic Pancreatitis

Author

Shimizu, Akinori, Ishii, Yasutaka, Serikawa, Masahiro, Tsuboi, Tomofumi, Kurihara, Keisuke, Tatsukawa, Yumiko, Kawamura, Ryota, Tsushima, Ken, Saito, Yuhei, Sekito, Tsuyoshi, Nakamura, Shinya, Hirano, Tetsuro, Fukiage, Ayami, Mori, Takeshi, Ikemoto, Juri, and Chayama, Kazuaki

Subjects
Chronic Pancreatitis, Early Medical Intervention, Elasticity Imaging Techniques, Pancreatic Diseases, Ultrasonography, Endosonography
Abstract

Background and Purpose: The concept of early chronic pancreatitis was proposed in Japan with the aim to improve the prognosis of patients with chronic pancreatitis. Endoscopic ultrasonography plays an important role in early diagnoses, but is limited by its invasiveness and poor objectivity. Hence, this study aimed to determine the usefulness of transabdominal ultrasound real-time tissue elastography as a screening method for early chronic pancreatitis. Methods: We retrospectively examined 73 patients who underwent simultaneous ultrasound real-time tissue elastography and endoscopic ultrasonography from 2011 to 2014. The correlation between feature values (MEAN, %AREA, COMP) calculated by real-time tissue elastography and the Rosemont classification of endoscopic ultrasonography diagnostic criteria for chronic pancreatitis, and the diagnostic ability of ultrasound real-time tissue elastography to recognize “indeterminate for chronic pancreatitis” findings, which correspond to early chronic pancreatitis, were evaluated. Main Results: Based on the Rosemont classification, 26 patients were “normal”, 16 were “indeterminate for chronic pancreatitis”, 13 were “suggestive of chronic pancreatitis”, and 18 were “consistent with chronic ancreatitis”. There were significant correlations between the feature values (MEAN, %AREA, COMP) and the Rosemont classification (p < 0.001; ρ = –0.788, 0.779, and 0.489, respectively). The area under the curve for the ability of MEAN to diagnose “indeterminate for chronic pancreatitis” was 0.889 (sensitivity, 93.8%; specificity, 76.9%). Conclusions: The feature values calculated by ultrasound real-time tissue elastography were correlated with the Rosemont classification. Ultrasound real-time tissue elastography may be a useful screening method for early chronic pancreatitis.

Published
2019

27. Pathological Features and Imaging Findings in Pancreatic Carcinoma In Situ

Author

Hanada, Keiji, primary, Fukuhara, Motomitsu, additional, Minami, Tomoyuki, additional, Yano, Shigeki, additional, Ikemoto, Juri, additional, Shimizu, Akinori, additional, Kurihara, Keisuke, additional, Okuda, Yasuhiro, additional, Ikeda, Morito, additional, Yokode, Masataka, additional, Abe, Tomoyuki, additional, Yonehara, Shuji, additional, and Yanagisawa, Akio, additional

Published
2021
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28. Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study

Author

Ikemoto, Juri, primary, Serikawa, Masahiro, additional, Hanada, Keiji, additional, Eguchi, Noriaki, additional, Sasaki, Tamito, additional, Fujimoto, Yoshifumi, additional, Sugiyama, Shinichiro, additional, Yamaguchi, Atsushi, additional, Noma, Bunjiro, additional, Kamigaki, Michihiro, additional, Minami, Tomoyuki, additional, Okazaki, Akihito, additional, Yukutake, Masanobu, additional, Ishii, Yasutaka, additional, Mouri, Teruo, additional, Shimizu, Akinori, additional, Tsuboi, Tomofumi, additional, Arihiro, Koji, additional, and Chayama, Kazuaki, additional

Published
2021
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29. Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Cancer

Author

Ishii, Yasutaka, primary, Serikawa, Masahiro, additional, Tsuboi, Tomofumi, additional, Kawamura, Ryota, additional, Tsushima, Ken, additional, Nakamura, Shinya, additional, Hirano, Tetsuro, additional, Fukiage, Ayami, additional, Mori, Takeshi, additional, Ikemoto, Juri, additional, Kiyoshita, Yusuke, additional, Saeki, Sho, additional, Tamura, Yosuke, additional, Miyamoto, Sayaka, additional, and Chayama, Kazuaki, additional

Published
2021
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30. The relationship between the degree of histopathological differentiation and imaging findings in pancreatic neuroendocrine neoplasms

Author

MIYAKI, Eisuke, primary, SERIKAWA, Masahiro, additional, ISHII, Yasutaka, additional, TSUBOI, Tomofumi, additional, KURIHARA, Keisuke, additional, TATSUKAWA, Yumiko, additional, KAWAMURA, Ryota, additional, NAKAMURA, Shinya, additional, SEKITO, Tsuyoshi, additional, HIRANO, Tetsuro, additional, MORI, Takeshi, additional, IKEMOTO, Juri, additional, and CHAYAMA, Kazuaki, additional

Published
2019
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31. Endoscopic ultrasound findings and pathological features of pancreatic carcinoma in situ

Author

Izumi, Yoshihiro, additional, Hanada, Keiji, additional, Okazaki, Akihito, additional, Minami, Tomoyuki, additional, Hirano, Naomichi, additional, Ikemoto, Juri, additional, Kanemitsu, Kozue, additional, Nakadoi, Koichi, additional, Shishido, Takayoshi, additional, Katamura, Yoshio, additional, Onogawa, Seiji, additional, Amano, Hajime, additional, Hino, Fumiaki, additional, Amano, Hironobu, additional, and Yonehara, Shuji, additional

Published
2019
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33. Su1307 Outcomes of Biliary Drainage in Pancreatic Cancer Patients With an Indwelling Gastroduodenal Stent: A Multicenter Retrospective Study in West Japan

Author

Yamao, Kentaro, primary, Kitano, Masayuki, additional, Kayahara, Takahisa, additional, Ishida, Etsuji, additional, Yamamoto, Hiroshi, additional, Yoshikawa, Tomoe, additional, Minaga, Kosuke, additional, Yamashita, Yukitaka, additional, Asada, Masanori, additional, Okabe, Yoshihiro, additional, Osaki, Yukio, additional, Ikemoto, Juri, additional, Hanada, Keiji, additional, Takenaka, Mamoru, additional, and Kudo, Masatoshi, additional

Published
2017
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39. Sa1509 Clinical Values of Cytodiagnosis Using Pancreatic Juice Multiple Times via Endoscopic Nasopancreatic Drainage for Early Diagnosis of Pancreatic Cancer

Author

Minami, Tomoyuki, primary, Hanada, Keiji, additional, Hirano, Naomichi, additional, Okazaki, Akihito, additional, Izumi, Yoshihiro, additional, Kanemitsu, Kozue, additional, Ikemoto, Juri, additional, Amano, Hironobu, additional, Abe, Tomoyuki, additional, and Yonehara, Shuji, additional

Published
2016
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43. A Trial of the Use of Patency Capsules in Combination with Overnight Capsule Endoscopy

Author

Imagawa, Hiroki, primary, Ikemoto, Juri, additional, Kanemitu, Kozue, additional, Teraoka, Yuji, additional, Izumi, Yoshihiro, additional, Nakadoi, Koichi, additional, Okazaki, Akihiro, additional, Katamura, Yoshio, additional, Shinzato, Masato, additional, Onogawa, Seiji, additional, Hirano, Norimiti, additional, Hanada, Keiji, additional, Amano, Hajime, additional, and Hino, Fumiaki, additional

Published
2015
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44. Diagnostic strategies for early pancreatic cancer

Author

Hanada, Keiji, primary, Okazaki, Akihito, additional, Hirano, Naomichi, additional, Izumi, Yoshihiro, additional, Teraoka, Yuji, additional, Ikemoto, Juri, additional, Kanemitsu, Kozue, additional, Hino, Fumiaki, additional, Fukuda, Toshikatsu, additional, and Yonehara, Shuji, additional

Published
2014
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46. Impact of endoscopic ultrasound-guided fine needle aspiration on positive peritoneal lavage cytology in patients with resectable pancreatic body and tail cancer.

Author

Ishii Y, Serikawa M, Uemura K, Tatsukawa Y, Nakamura S, Ikemoto J, Miyamoto S, Arihiro K, Takahashi S, and Oka S

Subjects
Humans, Male, Female, Aged, Middle Aged, Retrospective Studies, Pancreatectomy methods, Aged, 80 and over, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Pancreatic Neoplasms pathology, Pancreatic Neoplasms surgery, Pancreatic Neoplasms diagnostic imaging, Peritoneal Lavage
Abstract

Background/purpose: A recent study has demonstrated that the timing of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) significantly influences the peritoneal lavage cytology (CY) outcomes in pancreatic body-tail cancer. The aim of this study was to clarify the impact of EUS-FNA on CY positivity in patients with resectable pancreatic body-tail cancer., Methods: Patients with anatomically resectable pancreatic body-tail cancer surgically resected at Hiroshima University Hospital were enrolled, and elated clinicopathological factors, including EUS-FNA variables and CY positivity rate, were analyzed., Results: Of the 129 eligible patients, 16 (12%) had positive CY. The EUS-FNA rates of the CY-positive and CY-negative groups were not significantly different (63% vs. 52%, p = .440). Multivariate analysis revealed that lymph node metastasis was the only independent risk factor for CY positivity (odds ratio: 5.734, p = .031). A total of 10 (14%) of the 69 patients who underwent EUS-FNA had positive CY; however, needle specifications and the interval between EUS-FNA and CY examination did not differ between the CY-positive and CY-negative groups. CY positivity rates were comparable for intervals ≤14 days and ≥15 days (17% vs. 14%, p = 1.000)., Conclusions: EUS-FNA may not affect CY positivity in patients with resectable pancreatic body-tail cancer, regardless of the timing., (© 2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.)

Published
2024
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47. A case of collagenous colitis associated with novel oral anticoagulants use.

Author

Ikemoto J, Nakadoi K, Onogawa S, Fukuhara M, Shishido T, Hanada K, and Yonehara S

Subjects
Administration, Oral, Aged, 80 and over, Anticoagulants administration & dosage, Colitis, Collagenous diagnosis, Colonoscopy, Humans, Male, Tomography, X-Ray Computed, Anticoagulants adverse effects, Colitis, Collagenous chemically induced
Abstract

An 84-year-old man was referred to our hospital because of watery diarrhea. Due to cerebral infarction, he had started treatment with a novel oral anticoagulants (NOAC) 1 month prior to admission. The patient underwent blood tests, enhanced computed tomography, and colonoscopy, which indicated infectious or medicinal colitis. The diarrhea persisted and he developed hypokalemia, so a second colonoscopy was performed, which showed edematous mucosa. Colonic mucosal biopsies showed a thick collagen band in the subepithelial region, and collagenous colitis was diagnosed. The watery diarrhea subsequently resolved 1 week after changing the NOAC to warfarin. Reports on collagenous colitis caused by NOAC are very rare, and we consider this case valuable.

Published
2017
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48. A case report on metastatic pancreatic tumor from pulmonary adenocarcinoma that difficult to differentiate from primary pancreatic ductal carcinoma.

Author

Takei D, Okazaki A, Minami T, Ikemoto J, Hirano N, Hanada K, Teraoka Y, Fukuda T, and Yonehara S

Subjects
Adenocarcinoma drug therapy, Adenocarcinoma secondary, Adenocarcinoma of Lung, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Pancreatic Ductal pathology, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Female, Humans, Lung Neoplasms drug therapy, Lung Neoplasms secondary, Neoplasm Invasiveness, Neoplasm Staging, Pancreatic Neoplasms pathology, Adenocarcinoma diagnostic imaging, Carcinoma, Pancreatic Ductal diagnostic imaging, Diagnosis, Differential, Lung Neoplasms diagnostic imaging, Pancreatic Neoplasms diagnostic imaging
Abstract

A woman was admitted to our department for lung adenocarcinoma and she was treated with left upper lobectomy. The carcinoembryonic antigen level had increased. Enhanced computed tomography showed a hypovascular tumor in the pancreatic tail and in the extension of the distal main pancreatic duct. Endoscopic ultrasonography (EUS) clearly showed a low echoic lesion, and histological examination revealed adenocarcinoma. On immunostaining, the lesion was diagnosed as metastatic adenocarcinoma of the lungs. The patient was treated with chemotherapy for lung cancer and survived for 4 years after diagnosis. Differentiating a metastatic lesion to the pancreas from pancreatic ductal adenocarcinoma is very important. Accurate diagnosis enables administration of appropriate treatment. In this case, EUS was especially useful for assessing the tumor in the pancreas. When patients with a history of extra-pancreatic cancer present with a pancreatic lesion, pancreatic metastases should be considered, regardless of the time elapsed since occurrence of the primary cancer. EUS-fine needle aspiration (FNA) with histological examination is the best method for definitive diagnosis of pancreatic disease in this group of patients. This approach has very high sensitivity and accuracy for the diagnosis of pancreatic metastases.

Published
2016
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