Endoscopic ultrasound findings and pathological features of pancreatic carcinoma in situ

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

doi:10.1055/a-0839-4312

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(04): E585-E593
DOI: 10.1055/a-0839-4312

Original article

Endoscopic ultrasound findings and pathological features of pancreatic carcinoma in situ

Authors

Yoshihiro Izumi

¹Department of Gastroenterology, Kumamoto General Hospital, Japan Community Health Care Organization, Kumamoto, Japan
Keiji Hanada

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Akihito Okazaki

³Department of Gastroenterology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
Tomoyuki Minami

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Naomichi Hirano

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Juri Ikemoto

⁴Department of Gastroenterology and Metabolism of Hiroshima University, Hiroshima, Japan
Kozue Kanemitsu

⁵Department of Gastroenterology, Uwajima City Hospital, Uwajima, Japan
Koichi Nakadoi

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Takayoshi Shishido

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Yoshio Katamura

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Seiji Onogawa

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Hajime Amano

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Fumiaki Hino

²Department of Gastroenterology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Hironobu Amano

⁶Department of Surgery, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan
Shuji Yonehara

⁷Department of Pathology, Onomichi General Hospital, Hiroshima Kosei Federation of Agricultural Cooperatives, Hiroshima, Japan

Abstract

Background and study aims Few studies have evaluated detection of pancreatic carcinoma in situ (PCIS). We evaluated findings of endoscopic ultrasound (EUS) and pathological features of PCIS.

Patients and methods We histopathologically studied 16 patients with PCIS following EUS. Diagnostic features evaluated retrospectively included stricture of the main pancreatic duct (MPD) on EUS, presence or absence of hypoechoic areas surrounding the MPD stricture on EUS, the noncancerous part (pancreas of background) on EUS and histopathology, and histological findings adjacent to the area of PCIS.

Results On EUS, stricture of the MPD was found in 15 patients (93.8 %). Hypoechoic areas surrounding the MPD stricture were observed in 9 patients (56.3 %), including three (18.8 %) with a 10- to 11-mm hypoechoic mass. EUS findings of the noncancerous part indicated chronic pancreatitis in six patients (37.5 %), pancreatic fatty infiltration in seven (43.8 %), early chronic pancreatitis in two (12.5 %), and normal pancreas in one (6.3 %). Histological findings of the noncancerous part (proximal to the MPD stricture) indicated chronic pancreatitis in 13 patients (81.3 %) and pancreatic fatty infiltration in five patients (31.3 %). Histopathologically, subepithelial inflammatory cell infiltration and fibrosis were present in all 16 patients with PCIS.

Conclusions PCIS frequently causes localized changes in inflammation and fibrosis around the pancreatic duct. PCIS often accompanies chronic pancreatitis and pancreatic fatty infiltration in the background of the pancreas. EUS offers sufficient resolution to demonstrate pancreatic changes of PCIS.

Full Text

References

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