A percutaneous biopsy technique for patients with suspected biliary or pancreatic cancer without a radiographic mass

R E Pelsang; F C Johlin

doi:10.1007/s002619900195

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Journal article

A percutaneous biopsy technique for patients with suspected biliary or pancreatic cancer without a radiographic mass

R E Pelsang and F C Johlin

Abdominal imaging, Vol.22(3), pp.307-310

05/1997

DOI: 10.1007/s002619900195

PMID: 9107656

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Abstract

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. 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. Two patients had adenocarcinoma of the pancreas. One patient had malignant lymphoma and another had cholangiocarcinoma. One patient had inflammatory cells and was followed. 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.

Constriction, Pathologic - etiology

Pancreatic Ducts - diagnostic imaging

Humans

Pancreatic Neoplasms - pathology

Cholangiopancreatography, Endoscopic Retrograde

Cholestasis - diagnostic imaging

Male

Tomography, X-Ray Computed

Biopsy, Needle - methods

Cholestasis - etiology

Biliary Tract Neoplasms - diagnostic imaging

Female

Aged

Constriction, Pathologic - diagnostic imaging

Pancreatic Neoplasms - diagnostic imaging

Biliary Tract Neoplasms - pathology

Details

Title: Subtitle: A percutaneous biopsy technique for patients with suspected biliary or pancreatic cancer without a radiographic mass
Creators: R E Pelsang - Department of Radiology, University of Iowa College of Medicine, Iowa City 52242, USA
F C Johlin
Resource Type: Journal article
Publication Details: Abdominal imaging, Vol.22(3), pp.307-310
DOI: 10.1007/s002619900195
PMID: 9107656
ISSN: 0942-8925
eISSN: 1432-0509
Language: English
Date published: 05/1997
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094715802771

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