Endosonografische Differenzialdiagnose von Pankreastumoren

Zusammenfassung

Der häufigste diagnostizierte Pankreastumor ist unbestritten das duktale Adenokarzinom. Eine Vielzahl weiterer benigner und maligner solider und zystischer Neoplasien muss beachtet werden und macht in unserem Patientengut mittlerweile mehr als die Hälfte der beobachteten Pankreastumoren aus. Eine optimierte Differenzialdiagnose ist somit notwendig und wird in der vorliegenden Arbeit skizziert.

Abstract

The most common pancreatic tumour is the ductal adenocarcinoma. Many other benign and malignant pancreatic neoplasms have to be recognised and now account for more than 50 % of the pancreatic lesions seen in our daily routine. An improved differential diagnosis is, therefore, mandatory and will be discussed in this review.

Schlüsselwörter

MEN - Insulinom - gastro-entero-pankreatische Tumoren

Key words

MEN - Insulinoma - gastro-entero-pancreatic tumours

Literatur

• 1 Paquin S C, Gariepy G, Lepanto L. et al . A first report of tumor seeding because of EUS-guided FNA of a pancreatic adenocarcinoma.  Gastrointest Endosc. 2005;  61 (4) 610-611
• 2 Hirooka Y, Goto H, Itoh A. et al . Case of intraductal papillary mucinous tumor in which endosonography-guided fine-needle aspiration biopsy caused dissemination.  J Gastroenterol Hepatol. 2003;  18 (11) 1323-1324
• 3 Dietrich C F. Endosonographie, Lehrbuch und Atlas des endoskopischen Ultraschalls. Stuttgart New York; Georg Thieme Verlag 2008
• 4 Dietrich C F. Evidenzbasierter Einsatz der Endosonografie in der gastroenterologischen Diagnostik.  Gastroenterologie up2date. 2007;  3 257-278
• 5 Klapman J B, Chang K J, Lee J G. et al . Negative predictive value of endoscopic ultrasound in a large series of patients with a clinical suspicion of pancreatic cancer.  Am J Gastroenterol. 2005;  100 (12) 2658-2661
• 6 Catanzaro A, Richardson S, Veloso H. et al . Long-term follow-up of patients with clinically indeterminate suspicion of pancreatic cancer and normal EUS.  Gastrointest Endosc. 2003;  58 (6) 836-840
• 7 Rosch T, Braig C, Gain T. et al . Staging of pancreatic and ampullary carcinoma by endoscopic ultrasonography. Comparison with conventional sonography, computed tomography, and angiography.  Gastroenterology. 1992;  102 (1) 188-199
• 8 Agarwal B, Correa A M, Ho L. Survival in pancreatic carcinoma based on tumor size.  Pancreas. 2008;  36 (1) e15-e20
• 9 Agarwal B, Abu-Hamda E, Molke K L. et al . Endoscopic ultrasound-guided fine needle aspiration and multidetector spiral CT in the diagnosis of pancreatic cancer.  Am J Gastroenterol. 2004;  99 (5) 844-850
• 10 Kloppel G. Pseudocysts and other non-neoplastic cysts of the pancreas.  Semin Diagn Pathol. 2000;  17 (1) 7-15
• 11 Kosmahl M, Egawa N, Schroder S. et al . Mucinous nonneoplastic cyst of the pancreas: a novel nonneoplastic cystic change?.  Mod Pathol. 2002;  15 (2) 154-158
• 12 Kosmahl M, Pauser U, Peters K. et al . Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal.  Virchows Arch. 2004;  445 (2) 168-178
• 13 Adsay N V. Cystic Neoplasia of the Pancreas: Pathology and Biology.  J Gastrointest Surg. 2008;  12 (3) 401-404
• 14 Oh H C, Kim M H, Hwang C Y. et al . Cystic lesions of the pancreas: challenging issues in clinical practice.  Am J Gastroenterol. 2008;  103 (1) 229-239
• 15 Ikeda M, Sato T, Morozumi A. et al . Morphologic changes in the pancreas detected by screening ultrasonography in a mass survey, with special reference to main duct dilatation, cyst formation, and calcification.  Pancreas. 1994;  9 (4) 508-512
• 16 Spinelli K S, Fromwiller T E, Daniel R A. et al . Cystic pancreatic neoplasms: observe or operate.  Ann Surg. 2004;  239 (5) 651-657
• 17 Kimura W, Nagai H, Kuroda A. et al . Analysis of small cystic lesions of the pancreas.  Int J Pancreatol. 1995;  18 (3) 197-206
• 18 Baert A. Radiology of the Pancreas: cystic tumors of the pancreas. Springer-Verlag 1999
• 19 Segal A J, Spataro R F. Computed tomography of adult polycystic disease.  J Comput Assist Tomogr. 1982;  6 (4) 777-780
• 20 Dietrich C F, Chichakli M, Bargon J. et al . Mediastinal lymph nodes demonstrated by mediastinal sonography: activity marker in patients with cystic fibrosis.  J Clin Ultrasound. 1999;  27 (1) 9-14
• 21 Horton W A, Wong V, Eldridge R. Von Hippel-Lindau disease: clinical and pathological manifestations in nine families with 50 affected members.  Arch Intern Med. 1976;  136 (7) 769-777
• 22 Dietrich C F, Chichakli M, Hirche T O. et al . Sonographic findings of the hepatobiliary-pancreatic system in adult patients with cystic fibrosis.  J Ultrasound Med. 2002;  21 (4) 409-416
• 23 Warshaw A L, Compton C C, Lewandrowski K. et al . Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients.  Ann Surg. 1990;  212 (4) 432-443
• 24 Jenssen C, Dietrich C F. Endoscopic ultrasound in chronic pancreatitis.  Z Gastroenterol. 2005;  43 (8) 737-749
• 25 Fernandez-del Castillo C, Targarona J, Thayer S P. et al . Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients.  Arch Surg. 2003;  138 (4) 427-433
• 26 Kosmahl M, Pauser U, Peters K. et al . Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal.  Virchows Arch. 2004;  445 (2) 168-178
• 27 Balzano G, Zerbi A, Di C V. et al . Intraductal papillary mucinous tumors of the pancreas: incidence, clinical findings and natural history.  JOP. 2005;  6 (1 Suppl) 108-111
• 28 Kosmahl M, Pauser U, Anlauf M. et al . Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform.  Mod Pathol. 2005;  18 (9) 1157-1164
• 29 Tada M, Kawabe T, Arizumi M. et al . Pancreatic cancer in patients with pancreatic cystic lesions: a prospective study in 197 patients.  Clin Gastroenterol Hepatol. 2006;  4 (10) 1265-1270
• 30 Adsay N V, Klimstra D S. Cystic forms of typically solid pancreatic tumors.  Semin Diagn Pathol. 2000;  17 (1) 81-88
• 31 Frossard J L, Amouyal P, Amouyal G. et al . Performance of endosonography-guided fine needle aspiration and biopsy in the diagnosis of pancreatic cystic lesions.  Am J Gastroenterol. 2003;  98 (7) 1516-1524
• 32 Le Borgne J, Calan de L, Partensky C. Cystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases. French Surgical Association.  Ann Surg. 1999;  230 (2) 152-161
• 33 Spinelli K S, Fromwiller T E, Daniel R A. et al . Cystic pancreatic neoplasms: observe or operate.  Ann Surg. 2004;  239 (5) 651-657
• 34 Lee C J, Scheiman J, Anderson M A. et al . Risk of Malignancy in Resected Cystic Tumors of the Pancreas <3 cm in Size: Is it Safe to Observe Asymptomatic Patients? A Multi-institutional Report.  J Gastrointest Surg. 2007;  12 (2) 234-242
• 35 Andrejevic-Blant S, Kosmahl M, Sipos B. et al . Pancreatic intraductal papillary-mucinous neoplasms: a new and evolving entity.  Virchows Arch. 2007;  451 (5) 863-869
• 36 Brugge W R, Lewandrowski K, Lee-Lewandrowski E. et al . Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study.  Gastroenterology. 2004;  126 (5) 1330-1336
• 37 Linder J D, Geenen J E, Catalano M F. Cyst fluid analysis obtained by EUS-guided FNA in the evaluation of discrete cystic neoplasms of the pancreas: a prospective single-center experience.  Gastrointest Endosc. 2006;  64 (5) 697-702
• 38 Moparty B, Sluss M, Melanson S. et al . Pancreatic cyst fluid CEA: caution!, diagnostic cutoff values are assay system dependent (abstract).  Gastrointest Endosc. 2007;  65 (5) AB300
• 39 Moparty B, Logrono R, Nealon W H. et al . The role of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in distinguishing pancreatic cystic lesions.  Diagn Cytopathol. 2007;  35 (1) 18-25
• 40 Aljebreen A M, Romagnuolo J, Perini R. et al . Utility of endoscopic ultrasound, cytology and fluid carcinoembryonic antigen and CA 19 - 9 levels in pancreatic cystic lesions.  World J Gastroenterol. 2007;  13 (29) 3962-3966
• 41 Recine M, Kaw M, Evans D B. et al . Fine-needle aspiration cytology of mucinous tumors of the pancreas.  Cancer. 2004;  102 (2) 92-99
• 42 Waaij L A, Dullemen van H M, Porte R J. Cyst fluid analysis in the differential diagnosis of pancreatic cystic lesions: a pooled analysis.  Gastrointest Endosc. 2005;  62 (3) 383-389
• 43 Alhayaf van der N, Bigam D, Kneteman N. et al . Mucin stain of endoscopic ultrasound-guided pancreatic cyst fluid is indepently predictive of mucinous cystic neoplasms (abstract).  Gastrointest Endosc. 2007;  65 (5) AB303
• 44 Shami V M, Sundaram V, Stelow E B. et al . The level of carcinoembryonic antigen and the presence of mucin as predictors of cystic pancreatic mucinous neoplasia.  Pancreas. 2007;  34 (4) 466-469
• 45 Wang Y, Gao J, Li Z. et al . Diagnostic value of mucins (MUC1, MUC2 and MUC5AC) expression profile in endoscopic ultrasound-guided fine-needle aspiration specimens of the pancreas.  Int J Cancer. 2007;  121 (12) 2716-2722
• 46 Fukushima N, Fukayama M. Mucinous cystic neoplasms of the pancreas: pathology and molecular genetics.  J Hepatobiliary Pancreat Surg. 2007;  14 (3) 238-242
• 47 Singh M, Maitra A. Precursor lesions of pancreatic cancer: molecular pathology and clinical implications.  Pancreatology. 2007;  7 (1) 9-19
• 48 Ohashi K, Murakami Y, Maruyama M. Four cases of mucin producing cancer of the pancreas on specific findings on the papilla of Vater.  Prog Dig Endosc. 1982;  20 348-351
• 49 Farrell J J, Brugge W R. Intraductal papillary mucinous tumor of the pancreas.  Gastrointest Endosc. 2002;  55 (6) 701-714
• 50 Furukawa T, Kloppel G, Volkan A N. et al . Classification of types of intraductal papillary-mucinous neoplasm of the pancreas: a consensus study.  Virchows Arch. 2005;  447 (5) 794-799
• 51 Loftus E V, Olivares-Pakzad B A, Batts K P. et al . Intraductal papillary-mucinous tumors of the pancreas: clinicopathologic features, outcome, and nomenclature. Members of the Pancreas Clinic, and Pancreatic Surgeons of Mayo Clinic.  Gastroenterology. 1996;  110 (6) 1909-1918
• 52 Ban Jr S, Naitoh Y, Mino-Kenudson M. et al . Intraductal papillary mucinous neoplasm (IPMN) of the pancreas: its histopathologic difference between 2 major types.  Am J Surg Pathol. 2006;  30 (12) 1561-1569
• 53 Uehara H, Nakaizumi A, Iishi H. et al . Cytologic examination of pancreatic juice for differential diagnosis of benign and malignant mucin-producing tumors of the pancreas.  Cancer. 1994;  74 (3) 826-833
• 54 Jang J Y, Kim S W, Ahn Y J. et al . Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery?.  Ann Surg Oncol. 2005;  12 (2) 124-132
• 55 Jang J Y, Kim S W, Lee S E. et al . Treatment guidelines for branch duct type intraductal papillary mucinous neoplasms of the pancreas: when can we operate or observe?.  Ann Surg Oncol. 2008;  15 (1) 199-205
• 56 Pelaez-Luna M, Chari S T, Smyrk T C. et al . Do consensus indications for resection in branch duct intraductal papillary mucinous neoplasm predict malignancy? A study of 147 patients.  Am J Gastroenterol. 2007;  102 (8) 1759-1764
• 57 Schmidt C M, White P B, Waters J A. et al . Intraductal papillary mucinous neoplasms: predictors of malignant and invasive pathology.  Ann Surg. 2007;  246 (4) 644-651
• 58 Maire F, Couvelard A, Hammel P. et al . Intraductal papillary mucinous tumors of the pancreas: the preoperative value of cytologic and histopathologic diagnosis.  Gastrointest Endosc. 2003;  58 (5) 701-706
• 59 Stelow E B, Stanley M W, Bardales R H. et al . Intraductal papillary-mucinous neoplasm of the pancreas. The findings and limitations of cytologic samples obtained by endoscopic ultrasound-guided fine-needle aspiration.  Am J Clin Pathol. 2003;  120 (3) 398-404
• 60 Michaels P J, Brachtel E F, Bounds B C. et al . Intraductal papillary mucinous neoplasm of the pancreas: cytologic features predict histologic grade.  Cancer. 2006;  108 (3) 163-173
• 61 Emerson R E, Randolph M L, Cramer H M. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of intraductal papillary mucinous neoplasm of the pancreas is highly predictive of pancreatic neoplasia.  Diagn Cytopathol. 2006;  34 (7) 457-462
• 62 Sole M, Iglesias C, Fernandez-Esparrach G. et al . Fine-needle aspiration cytology of intraductal papillary mucinous tumors of the pancreas.  Cancer. 2005;  105 (5) 298-303
• 63 Fernandez-Esparrach G, Pellise M, Sole M. et al . EUS FNA in intraductal papillary mucinous tumors of the pancreas.  Hepatogastroenterology. 2007;  54 (73) 260-264
• 64 Salla C, Chatzipantelis P, Konstantinou P. et al . Endoscopic ultrasound-guided fine-needle aspiration cytology in the diagnosis of intraductal papillary mucinous neoplasms of the pancreas. A study of 8 cases.  JOP. 2007;  8 (6) 715-724
• 65 Hibi Y, Fukushima N, Tsuchida A. et al . Pancreatic juice cytology and subclassification of intraductal papillary mucinous neoplasms of the pancreas.  Pancreas. 2007;  34 (2) 197-204
• 66 Obara T, Maguchi H, Saitoh Y. et al . Mucin-producing tumor of the pancreas: natural history and serial pancreatogram changes.  Am J Gastroenterol. 1993;  88 (4) 564-569
• 67 Woo S M, Ryu J K, Lee S H. et al . Survival and prognosis of invasive intraductal papillary mucinous neoplasms of the pancreas: comparison with pancreatic ductal adenocarcinoma.  Pancreas. 2008;  36 (1) 50-55
• 68 Cellier C, Cuillerier E, Palazzo L. et al . Intraductal papillary and mucinous tumors of the pancreas: accuracy of preoperative computed tomography, endoscopic retrograde pancreatography and endoscopic ultrasonography, and long-term outcome in a large surgical series.  Gastrointest Endosc. 1998;  47 (1) 42-49
• 69 Jang J Y, Kim S W, Ahn Y J. et al . Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery?.  Ann Surg Oncol. 2005;  12 (2) 124-132
• 70 Santini D, Poli F, Lega S. Solid-papillary tumors of the pancreas: histopathology.  JOP. 2006;  7 (1) 131-136
• 71 Adams A L, Siegal G P, Jhala N C. Solid pseudopapillary tumor of the pancreas: a review of salient clinical and pathologic features.  Adv Anat Pathol. 2008;  15 (1) 39-45
• 72 Papavramidis T, Papavramidis S. Solid pseudopapillary tumors of the pancreas: review of 718 patients reported in English literature.  J Am Coll Surg. 2005;  200 (6) 965-972
• 73 Casadei R, Santini D, Calculli L. et al . Pancreatic solid-cystic papillary tumor: clinical features, imaging findings and operative management.  JOP. 2006;  7 (1) 137-144
• 74 Mao C, Howard J M. Pancreatitis associated with neuroendocrine (islet cell) tumors of the pancreas.  Am J Surg. 1996;  171 (6) 562-564
• 75 Bardales R H, Centeno B, Mallery J S. et al . Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid-pseudopapillary tumor of the pancreas: a rare neoplasm of elusive origin but characteristic cytomorphologic features.  Am J Clin Pathol. 2004;  121 (5) 654-662
• 76 Master S S, Savides T J. Diagnosis of solid-pseudopapillary neoplasm of the pancreas by EUS-guided FNA.  Gastrointest Endosc. 2003;  57 (7) 965-968
• 77 Jani N, Dewitt J, Eloubeidi M. et al . Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: a multicenter experience.  Endoscopy. 2008;  40 (3) 200-203
• 78 Salla C, Chatzipantelis P, Konstantinou P. et al . Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: a case report and literature review.  World J Gastroenterol. 2007;  13 (38) 5158-5163
• 79 Kosmahl M, Pauser U, Anlauf M. et al . Cystic pancreas tumors and their classification: features old and new.  Pathologe. 2005;  26 (1) 22-30
• 80 Kitagami H, Kondo S, Hirano S. et al . Acinar cell carcinoma of the pancreas: clinical analysis of 115 patients from Pancreatic Cancer Registry of Japan Pancreas Society.  Pancreas. 2007;  35 (1) 42-46
• 81 Hartman G G, Ni H, Pickleman J. Acinar cell carcinoma of the pancreas.  Arch Pathol Lab Med. 2001;  125 (8) 1127-1128
• 82 Stelow E B, Bardales R H, Shami V M. et al . Cytology of pancreatic acinar cell carcinoma.  Diagn Cytopathol. 2006;  34 (5) 367-372
• 83 Kitagami H, Kondo S, Hirano S. et al . Acinar cell carcinoma of the pancreas: clinical analysis of 115 patients from Pancreatic Cancer Registry of Japan Pancreas Society.  Pancreas. 2007;  35 (1) 42-46
• 84 ReMine S G, Frey D, Rossi R L. et al . Cystic neoplasms of the pancreas.  Arch Surg. 1987;  122 (4) 443-446
• 85 Lewandrowski K, Warshaw A, Compton C. Macrocystic serous cystadenoma of the pancreas: a morphologic variant differing from microcystic adenoma.  Hum Pathol. 1992;  23 (8) 871-875
• 86 Huh J R, Chi J G, Jung K C. et al . Macrocystic serous cystadenoma of pancreas - a case report.  J Korean Med Sci. 1994;  9 (1) 78-85
• 87 Egawa N, Maillet B, Schroder S. et al . Serous oligocystic and ill-demarcated adenoma of the pancreas: a variant of serous cystic adenoma.  Virchows Arch. 1994;  424 (1) 13-17
• 88 Mori K, Takeyama S, Hirosawa H. et al . A case of macrocystic serous cystadenoma of the pancreas.  Int J Pancreatol. 1995;  17 (1) 91-93
• 89 Inoue S, Yamaguchi K, Shimizu S. et al . Serous cystadenoma of the pancreas with atypical imaging features: a new variant of serous cystadenoma of the pancreas?.  Pancreas. 1998;  16 (1) 102-105
• 90 Gouhiri M, Soyer P, Barbagelatta M. et al . Macrocystic serous cystadenoma of the pancreas: CT and endosonographic features.  Abdom Imaging. 1999;  24 (1) 72-74
• 91 Fujiwara H, Ajiki T, Fukuoka K. et al . Macrocystic serous cystadenoma of the pancreas.  J Hepatobiliary Pancreat Surg. 2000;  7 (1) 92-96
• 92 Sperti C, Pasquali C, Ferronato A. et al . Median pancreatectomy for tumors of the neck and body of the pancreas.  J Am Coll Surg. 2000;  190 (6) 711-716
• 93 Matsumoto T, Hirano S, Yada K. et al . Malignant serous cystic neoplasm of the pancreas: report of a case and review of the literature.  J Clin Gastroenterol. 2005;  39 (3) 253-256
• 94 Blandamura S, Parenti A, Famengo B. et al . Three cases of pancreatic serous cystadenoma and endocrine tumour.  J Clin Pathol. 2007;  60 (3) 278-282
• 95 Ustun M O, Tugyan N, Tunakan M. Coexistence of an endocrine tumour in a serous cystadenoma (microcystic adenoma) of the pancreas, an unusual association.  J Clin Pathol. 2000;  53 (10) 800-802
• 96 Alasio T M, Vine A, Sanchez M A. et al . Pancreatic endocrine tumor coexistent with serous microcystic adenoma: report of a case and review of the literature.  Ann Diagn Pathol. 2005;  9 (4) 234-238
• 97 Slukvin I I, Hafez G R, Niederhuber J E. et al . Combined serous microcystic adenoma and well-differentiated endocrine pancreatic neoplasm: a case report and review of the literature.  Arch Pathol Lab Med. 2003;  127 (10) 1369-1372
• 98 Hammel P R, Vilgrain V, Terris B. et al . Pancreatic involvement in von Hippel-Lindau disease. The Groupe Francophone d’Etude de la Maladie de von Hippel-Lindau.  Gastroenterology. 2000;  119 (4) 1087-1095
• 99 Tseng J F, Warshaw A L, Sahani D V. et al . Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment.  Ann Surg. 2005;  242 (3) 413-419
• 100 Kimura W, Nagai H, Kuroda A. et al . Analysis of small cystic lesions of the pancreas.  Int J Pancreatol. 1995;  18 (3) 197-206
• 101 Koito K, Namieno T, Nagakawa T. et al . Solitary cystic tumor of the pancreas: EUS-pathologic correlation.  Gastrointest Endosc. 1997;  45 (3) 268-276
• 102 Sedlack R, Affi A, Vazquez-Sequeiros E. et al . Utility of EUS in the evaluation of cystic pancreatic lesions.  Gastrointest Endosc. 2002;  56 (4) 543-547
• 103 Gress F G, Barawi M, Kim D. et al . Preoperative localization of a neuroendocrine tumor of the pancreas with EUS-guided fine needle tattooing.  Gastrointest Endosc. 2002;  55 (4) 594-597
• 104 Song M H, Lee S K, Kim M H. et al . EUS in the evaluation of pancreatic cystic lesions.  Gastrointest Endosc. 2003;  57 (7) 891-896
• 105 Brandwein S L, Farrell J J, Centeno B A. et al . Detection and tumor staging of malignancy in cystic, intraductal, and solid tumors of the pancreas by EUS.  Gastrointest Endosc. 2001;  53 (7) 722-727
• 106 Ahmad N A, Kochman M L, Lewis J D. et al . Can EUS alone differentiate between malignant and benign cystic lesions of the pancreas?.  Am J Gastroenterol. 2001;  96 (12) 3295-3300
• 107 Ahmad N A, Kochman M L, Brensinger C. et al . Interobserver agreement among endosonographers for the diagnosis of neoplastic versus non-neoplastic pancreatic cystic lesions.  Gastrointest Endosc. 2003;  58 (1) 59-64
• 108 Khalid A, Brugge W. ACG practice guidelines for the diagnosis and management of neoplastic pancreatic cysts.  Am J Gastroenterol. 2007;  102 (10) 2339-2349
• 109 Gan S I, Thompson C C, Lauwers G Y. et al . Ethanol lavage of pancreatic cystic lesions: initial pilot study.  Gastrointest Endosc. 2005;  61 (6) 746-752
• 110 Modlin I M, Sandor A. An analysis of 8305 cases of carcinoid tumors.  Cancer. 1997;  79 (4) 813-829
• 111 Oberg K. Neuroendocrine gastrointestinal tumours.  Ann Oncol. 1996;  7 (5) 453-463
• 112 Jensen R T. Natural history of digestiv endocrine tumors. Mignon M, Colombel JF Recent advances in the pathophysiology and management of inflammatory bowel diseases and digestiv endocrine tumors John Libbey Eurotext 1999: 192-219
• 113 Lehnert T, Knaebel H P. Diagnosis and therapy of liver metastases of neuroendocrine tumors.  Chirurg. 1997;  68 (2) 122-131
• 114 Lubensky I A, Pack S, Ault D. et al . Multiple neuroendocrine tumors of the pancreas in von Hippel-Lindau disease patients: histopathological and molecular genetic analysis.  Am J Pathol. 1998;  153 (1) 223-231
• 115 Williams E D, Sandler M. The classification of carcinoid tum ours.  Lancet. 1963;  1 238-239
• 116 Kulke M H, Mayer R J. Carcinoid tumors.  N Engl J Med. 1999;  340 (11) 858-868
• 117 Pape U F, Hocker M, Seuss U. et al . New molecular aspects in the diagnosis and therapy of neuroendocrine tumors of the gastroenteropancreatic system.  Recent Results Cancer Res. 2000;  153 45-60
• 118 Capella C, Heitz P U, Hofler H. et al . Revised classification of neuroendocrine tumours of the lung, pancreas and gut.  Virchows Arch. 1995;  425 (6) 547-560
• 119 Kloeppel G. WHO International histological classification of tumors of the exocrine pancreas. Springer 1996
• 120 McEntee G P, Nagorney D M, Kvols L K. et al . Cytoreductive hepatic surgery for neuroendocrine tumors.  Surgery. 1990;  108 (6) 1091-1096
• 121 Moertel C G. Karnofsky memorial lecture. An odyssey in the land of small tumors.  J Clin Oncol. 1987;  5 (10) 1502-1522
• 122 Norheim I, Oberg K, Theodorsson-Norheim E. et al . Malignant carcinoid tumors. An analysis of 103 patients with regard to tumor localization, hormone production, and survival.  Ann Surg. 1987;  206 (2) 115-125
• 123 Solcia E, Kloeppel G, Sobin L H. Organisation Pathology Panel: World Health Organisation. Berlin, Heidelberg, New York, Tokyo; Springer 2001
• 124 Chung D C, Smith A P, Louis D N. et al . A novel pancreatic endocrine tumor suppressor gene locus on chromosome 3 p with clinical prognostic implications.  J Clin Invest. 1997;  100 (2) 404-410
• 125 Chandrasekharappa S C, Guru S C, Manickam P. et al . Positional cloning of the gene for multiple endocrine neoplasia-type 1.  Science. 1997;  276 (5311) 404-407
• 126 Berndt I, Reuter M, Saller B. et al . A new hot spot for mutations in the ret protooncogene causing familial medullary thyroid carcinoma and multiple endocrine neoplasia type 2A.  J Clin Endocrinol Metab. 1998;  83 (3) 770-774
• 127 Donis-Keller H, Dou S, Chi D. et al . Mutations in the RET proto-oncogene are associated with MEN 2A and FMTC.  Hum Mol Genet. 1993;  2 (7) 851-856
• 128 Mulligan L M, Kwok J B, Healey C S. et al . Germ-line mutations of the RET proto-oncogene in multiple endocrine neoplasia type 2A.  Nature. 1993;  363 (6428) 458-460
• 129 Mullan M H, Gauger P G, Thompson N W. Endocrine tumours of the pancreas: review and recent advances.  ANZ J Surg. 2001;  71 (8) 475-482
• 130 Snow N D, Liddle R A. Gastrointestinal Cancers: Biology, Diagnosis and Therapy,. Philadelphia; Lippincott-Raven 1995
• 131 King C M, Reznek R H, Dacie J E. et al . Imaging islet cell tumours.  Clin Radiol. 1994;  49 (5) 295-303
• 132 Sternberg S. Diagnostic surgical pathology. Philadephia/Baltimore/New York; Williams&Wilkins 2000
• 133 Wiedenmann B, Jensen R T, Mignon M. et al . Preoperative diagnosis and surgical management of neuroendocrine gastroenteropancreatic tumors: general recommendations by a consensus workshop.  World J Surg. 1998;  22 (3) 309-318
• 134 Schurmann G, Raeth U, Wiedenmann B. et al . Serum chromogranin A in the diagnosis and follow-up of neuroendocrine tumors of the gastroenteropancreatic tract.  World J Surg. 1992;  16 (4) 697-701
• 135 Bax N D, Woods H F, Batchelor A. et al . Clinical manifestations of carcinoid disease.  World J Surg. 1996;  20 (2) 142-146
• 136 Proye C. Natural history of liver metastasis of gastroenteropancreatic neuroendocrine tumors: place for chemoembolization.  World J Surg. 2001;  25 (6) 685-688
• 137 Dousset B, Saint-Marc O, Pitre J. et al . Metastatic endocrine tumors: medical treatment, surgical resection, or liver transplantation.  World J Surg. 1996;  20 (7) 908-914
• 138 Makridis C, Rastad J, Oberg K. et al . Progression of metastases and symptom improvement from laparotomy in midgut carcinoid tumors.  World J Surg. 1996;  20 (7) 900-906
• 139 Ahlman H, Westberg G, Wangberg B. et al . Treatment of liver metastases of carcinoid tumors.  World J Surg. 1996;  20 (2) 196-202
• 140 Ambacher T, Kasperk R, Schumpelick V. Rational preoperative diagnosis of insulinoma.  Chirurg. 1999;  70 (3) 298-301
• 141 Anderson M A, Carpenter S, Thompson N W. et al . Endoscopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas.  Am J Gastroenterol. 2000;  95 (9) 2271-2277
• 142 Kisker O, Weinel R J, Geks J. et al . Value of somatostatin receptor scintigraphy for preoperative localization of carcinoids.  World J Surg. 1996;  20 (2) 162-167
• 143 Zimmer T, Stolzel U, Bader M. et al . Endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localisation of insulinomas and gastrinomas.  Gut. 1996;  39 (4) 562-568
• 144 Zimmer T, Scherubl H, Faiss S. et al . Endoscopic ultrasonography of neuroendocrine tumours.  Digestion. 2000;  62 Suppl 1 45-50
• 145 Kann P H. Endoscopic ultrasound imaging in neuroendocrine pancreatic tumors. A critical analysis.  Med Klin. 2006;  101 (7) 546-551
• 146 Rosch T, Lightdale C J, Botet J F. et al . Localization of pancreatic endocrine tumors by endoscopic ultrasonography.  N Engl J Med. 1992;  326 (26) 1721-1726
• 147 Ardengh J C, Paulo G A, Ferrari A P. EUS-guided FNA in the diagnosis of pancreatic neuroendocrine tumors before surgery.  Gastrointest Endosc. 2004;  60 (3) 378-384
• 148 Wamsteker E J, Gauger P G, Thompson N W. et al . EUS detection of pancreatic endocrine tumors in asymptomatic patients with type 1 multiple endocrine neoplasia.  Gastrointest Endosc. 2003;  58 (4) 531-535
• 149 Gauger P G, Scheiman J M, Wamsteker E J. et al . Role of endoscopic ultrasonography in screening and treatment of pancreatic endocrine tumours in asymptomatic patients with multiple endocrine neoplasia type 1.  Br J Surg. 2003;  90 (6) 748-754
• 150 Hellman de P, Hennings J, Akerstrom G. et al . Endoscopic ultrasonography for evaluation of pancreatic tumours in multiple endocrine neoplasia type 1.  Br J Surg. 2005;  92 (12) 1508-1512
• 151 Thomas-Marques L, Murat A, Delemer B. et al . Prospective endoscopic ultrasonographic evaluation of the frequency of nonfunctioning pancreaticoduodenal endocrine tumors in patients with multiple endocrine neoplasia type 1.  Am J Gastroenterol. 2006;  101 (2) 266-273
• 152 Kann P H, Balakina E, Ivan D. et al . Natural course of small, asymptomatic neuroendocrine pancreatic tumours in multiple endocrine neoplasia type 1: an endoscopic ultrasound imaging study.  Endocr Relat Cancer. 2006;  13 (4) 1195-1202
• 153 Kann P H, Kann B, Fassbender W J. et al . Small neuroendocrine pancreatic tumors in multiple endocrine neoplasia type 1 (MEN1): least significant change of tumor diameter as determined by endoscopic ultrasound (EUS) imaging.  Exp Clin Endocrinol Diabetes. 2006;  114 (7) 361-365
• 154 Kann P H, Ivan D, Pfutzner A. et al . Preoperative diagnosis of insulinoma: low body mass index, young age, and female gender are associated with negative imaging by endoscopic ultrasound.  Eur J Endocrinol. 2007;  157 (2) 209-213
• 155 Langer P, Kann P H, Fendrich V. et al . Prospective evaluation of imaging procedures for the detection of pancreaticoduodenal endocrine tumors in patients with multiple endocrine neoplasia type 1.  World J Surg. 2004;  28 (12) 1317-1322
• 156 Jürgensen C, Neser F, Stölzel U. Neuroendokrine Tumoren des gastropankreatischen Systems - Bedeutung der Endosonografie.  Endo heute. 2007;  20 186-189
• 157 Kann P, Bittinger F, Engelbach M. et al . Endosonography of insulin-secreting and clinically non-functioning neuroendocrine tumors of the pancreas: criteria for benignancy and malignancy.  Eur J Med Res. 2001;  6 (9) 385-390
• 158 Gines A, Vazquez-Sequeiros E, Soria M T. et al . Usefulness of EUS-guided fine needle aspiration (EUS-FNA) in the diagnosis of functioning neuroendocrine tumors.  Gastrointest Endosc. 2002;  56 (2) 291-296
• 159 Ardengh J C, Paulo G A, Ferrari A P. EUS-guided FNA in the diagnosis of pancreatic neuroendocrine tumors before surgery.  Gastrointest Endosc. 2004;  60 (3) 378-384
• 160 Jani de N, Khalid A, Kaushik N. et al . EUS-guided FNA diagnosis of pancreatic endocrine tumors: new trends identified.  Gastrointest Endosc. 2008;  67 (1) 44-50
• 161 Dietrich C F, Barreiros A P, Jenssen C. Zystische, neuroendokrine und andere seltene Pankreastumoren. Dietrich CF Endosonographie. Lehrbuch und Atlas des endoskopischen Ultraschalls Stuttgart, New York; Thieme 2008: 287-331
• 162 Dralle H, Krohn S L, Karges W. et al . Surgery of resectable nonfunctioning neuroendocrine pancreatic tumors.  World J Surg. 2004;  28 (12) 1248-1260
• 163 Gress F G, Barawi M, Kim D. et al . Preoperative localization of a neuroendocrine tumor of the pancreas with EUS-guided fine needle tattooing.  Gastrointest Endosc. 2002;  55 (4) 594-597
• 164 Jurgensen C, Schuppan D, Neser F. et al . EUS-guided alcohol ablation of an insulinoma.  Gastrointest Endosc. 2006;  63 (7) 1059-1062
• 165 Minni F, Casadei R, Perenze B. et al . Pancreatic metastases: observations of three cases and review of the literature.  Pancreatology. 2004;  4 (6) 509-520
• 166 Baron T H. Endoscopic US for metastases to the pancreas: chasing the satellites.  Gastrointest Endosc. 2005;  61 (6) 697-699
• 167 Dewitt J, Jowell P, Leblanc J. et al . EUS-guided FNA of pancreatic metastases: a multicenter experience.  Gastrointest Endosc. 2005;  61 (6) 689-696
• 168 Baron T H. Endoscopic US for metastases to the pancreas: chasing the satellites.  Gastrointest Endosc. 2005;  61 (6) 697-699
• 169 Hiotis S P, Klimstra D S, Conlon K C. et al . Results after pancreatic resection for metastatic lesions.  Ann Surg Oncol. 2002;  9 (7) 675-679
• 170 Law C H, Wei A C, Hanna S S. et al . Pancreatic resection for metastatic renal cell carcinoma: presentation, treatment, and outcome.  Ann Surg Oncol. 2003;  10 (8) 922-926
• 171 Zerbi A, Ortolano E, Balzano G. et al . Pancreatic Metastasis From Renal Cell Carcinoma: Which Patients Benefit From Surgical Resection?.  Ann Surg Oncol. 2008;  15 (4) 1161-1168
• 172 Dewitt J, Jowell P, Leblanc J. et al . EUS-guided FNA of pancreatic metastases: a multicenter experience.  Gastrointest Endosc. 2005;  61 (6) 689-696
• 173 Baron T H. Endoscopic US for metastases to the pancreas: chasing the satellites.  Gastrointest Endosc. 2005;  61 (6) 697-699
• 174 Lin H, Li S D, Hu X G. et al . Primary pancreatic lymphoma: report of six cases.  World J Gastroenterol. 2006;  12 (31) 5064-5067
• 175 Koomalsingh K J, Fazylov R, Chorost M I. et al . Cystic teratoma of the pancreas: presentation, evaluation and management.  JOP. 2006;  7 (6) 643-646
• 176 Farrell J J, Garber J, Sahani D. et al . EUS findings in patients with autoimmune pancreatitis.  Gastrointest Endosc. 2004;  60 (6) 927-936
• 177 Okai T, Fujii T, Ida M. et al . EUS and ERCP features of nonalcoholic duct-destructive, mass-forming pancreatitis before and after treatment with prednisolone.  Abdom Imaging. 2002;  27 (1) 74-76
• 178 Finkelberg D L, Sahani D, Deshpande V. et al . Autoimmune pancreatitis.  N Engl J Med. 2006;  355 (25) 2670-2676
• 179 Weber S M, Cubukcu-Dimopulo O, Palesty J A. et al . Lymphoplasmacytic sclerosing pancreatitis: inflammatory mimic of pancreatic carcinoma.  J Gastrointest Surg. 2003;  7 (1) 129-137
• 180 Notohara K, Burgart L J, Yadav D. et al . Idiopathic chronic pancreatitis with periductal lymphoplasmacytic infiltration: clinicopathologic features of 35 cases.  Am J Surg Pathol. 2003;  27 (8) 1119-1127
• 181 Hyodo N, Hyodo T. Ultrasonographic evaluation in patients with autoimmune-related pancreatitis.  J Gastroenterol. 2003;  38 (12) 1155-1161
• 182 Abraham S C, Wilentz R E, Yeo C J. et al . Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: are they all ‘chronic pancreatitis’?.  Am J Surg Pathol. 2003;  27 (1) 110-120
• 183 Yadav D, Notahara K, Smyrk T C. et al . Idiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection.  Clin Gastroenterol Hepatol. 2003;  1 (2) 129-135
• 184 Sahani D V, Kalva S P, Farrell J. et al . Autoimmune pancreatitis: imaging features.  Radiology. 2004;  233 (2) 345-352
• 185 Deshpande V, Mino-Kenudson M, Brugge W R. et al . Endoscopic ultrasound guided fine needle aspiration biopsy of autoimmune pancreatitis: diagnostic criteria and pitfalls.  Am J Surg Pathol. 2005;  29 (11) 1464-1471
• 186 Levy M J, Wiersema M J, Chari S T. Chronic pancreatitis: focal pancreatitis or cancer? Is there a role for FNA/biopsy? Autoimmune pancreatitis.  Endoscopy. 2006;  38 (Suppl 1) S30-S35
• 187 Levy M J, Reddy R P, Wiersema M J. et al . EUS-guided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice.  Gastrointest Endosc. 2005;  61 (3) 467-472
• 188 Baron P L, Aabakken L E, Cole D J. et al . Differentiation of benign from malignant pancreatic masses by endoscopic ultrasound.  Ann Surg Oncol. 1997;  4 (8) 639-643
• 189 Barthet M, Hastier P, Buckley M J. et al . Eosinophilic pancreatitis mimicking pancreatic neoplasia: EUS and ERCP findings - is nonsurgical diagnosis possible?.  Pancreas. 1998;  17 (4) 419-422
• 190 Brand B, Pfaff T, Binmoeller K F. et al . Endoscopic ultrasound for differential diagnosis of focal pancreatic lesions, confirmed by surgery.  Scand J Gastroenterol. 2000;  35 (11) 1221-1228
• 191 Nattermann C, Goldschmidt A J, Dancygier H. Endosonography in the assessment of pancreatic tumors. A comparison of the endosonographic findings of carcinomas and segmental inflammatory changes.  Dtsch Med Wochenschr. 1995;  120 (46) 1571-1576
• 192 Rosch T, Lorenz R, Braig C. et al . Endoscopic ultrasound in pancreatic tumor diagnosis.  Gastrointest Endosc. 1991;  37 (3) 347-352
• 193 Hocke M, Schulze E, Gottschalk P. et al . Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer.  World J Gastroenterol. 2006;  12 (2) 246-250
• 194 Hocke M, Ignee A, Topalidis T. et al . Contrast-enhanced endosonographic Doppler spectrum analysis is helpful in discrimination between focal chronic pancreatitis and pancreatic cancer.  Pancreas. 2007;  35 (3) 286-288
• 195 Numata K, Ozawa Y, Kobayashi N. et al . Contrast-enhanced sonography of autoimmune pancreatitis: comparison with pathologic findings.  J Ultrasound Med. 2004;  23 (2) 199-206
• 196 Eloubeidi M A, Chen V K, Eltoum I A. et al . Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: diagnostic accuracy and acute and 30-day complications.  Am J Gastroenterol. 2003;  98 (12) 2663-2668
• 197 Harewood G C, Wiersema M J. Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses.  Am J Gastroenterol. 2002;  97 (6) 1386-1391
• 198 Raut C P, Grau A M, Staerkel G A. et al . Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration in patients with presumed pancreatic cancer.  J Gastrointest Surg. 2003;  7 (1) 118-126
• 199 Wiersema M J, Vilmann P, Giovannini M. et al . Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment.  Gastroenterology. 1997;  112 (4) 1087-1095
• 200 Fritscher-Ravens A, Brand L, Knofel W T. et al . Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis.  Am J Gastroenterol. 2002;  97 (11) 2768-2775
• 201 Takahashi K, Yamao K, Okubo K. et al . Differential diagnosis of pancreatic cancer and focal pancreatitis by using EUS-guided FNA.  Gastrointest Endosc. 2005;  61 (1) 76-79
• 202 Ardengh J C, Lopes C V, Campos A D. et al . Endoscopic ultrasound and fine needle aspiration in chronic pancreatitis: differential diagnosis between pseudotumoral masses and pancreatic cancer.  JOP. 2007;  8 (4) 413-421
• 203 Schwartz D A, Unni K K, Levy M J. et al . The rate of false-positive results with EUS-guided fine-needle aspiration.  Gastrointest Endosc. 2002;  56 (6) 868-872
• 204 Al Haddad M, Wallace M B. Molecules and markers for endosonographers: what do we need to know and measure?.  Endoscopy. 2006;  38 (Suppl 1) S50-S53
• 205 Mishra G. DNA analysis of cells obtained from endoscopic ultrasound-fine needle aspiration in pancreatic adenocarcinoma: Fool’s Gold, Pandora’s Box, or Holy Grail?.  Am J Gastroenterol. 2006;  101 (11) 2501-2503
• 206 Itoi T, Takei K, Sofuni A. et al . Immunohistochemical analysis of p53 and MIB-1 in tissue specimens obtained from endoscopic ultrasonography-guided fine needle aspiration biopsy for the diagnosis of solid pancreatic masses.  Oncol Rep. 2005;  13 (2) 229-234
• 207 Khalid A, Nodit L, Zahid M. et al . Endoscopic ultrasound fine needle aspirate DNA analysis to differentiate malignant and benign pancreatic masses.  Am J Gastroenterol. 2006;  101 (11) 2493-2500
• 208 Mishra G, Zhao Y, Sweeney J. et al . Determination of qualitative telomerase activity as an adjunct to the diagnosis of pancreatic adenocarcinoma by EUS-guided fine-needle aspiration.  Gastrointest Endosc. 2006;  63 (4) 648-654
• 209 Tada M, Komatsu Y, Kawabe T. et al . Quantitative analysis of K-ras gene mutation in pancreatic tissue obtained by endoscopic ultrasonography-guided fine needle aspiration: clinical utility for diagnosis of pancreatic tumor.  Am J Gastroenterol. 2002;  97 (9) 2263-2270
• 210 Dietrich C F, Ignee A, Braden B. et al . Improved differentiation of pancreatic tumors using contrast enhanced endoscopic ultrasound.  Clin Gastroenterol Hepatol. 2008;  6 (5) 590-597
• 211 Mork H, Ignee A, Schuessler G. et al . Analysis of neuroendocrine tumour metastases in the liver using contrast enhanced ultrasonography.  Scand J Gastroenterol. 2007;  42 (5) 652-662
• 212 Dietrich C F, Ignee A, Frey H. Contrast-enhanced endoscopic ultrasound with low mechanical index: a new technique.  Z Gastroenterol. 2005;  43 (11) 1219-1223