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Small invasive ductal carcinoma of the pancreas distinct from branch duct intraductal papillary mucinous neoplasm

查看全文 作　　者：Hiroki [1]Sakamoto;Masayuki [1]Kitano;Takamitsu [1]Komaki;Hajime [1]Imai;Ken [1]Kamata;Masatomo [2]Kimura;Yoshifumi [3]Takeyama;Masatoshi [1]Kudo 高影响力作者 机构地区：[1]Division of Gastroenterology and Hepatology,Department of Internal Medicine,Kinki University School of Medicine,377-2,Ohno-Higashi,Osaka-Sayama 589-8511,Japan;[2]Department of Pathology,Kinki University School of Medicine,377-2,Ohno-Higashi,Osaka-Sayama 589- 8511,Japan;[3]Department of Surgery,Kinki University School of Medicine,377-2,Ohno-Higashi,Osaka-Sayama 589-8511,Japan高影响力机构 出　　处：《World Journal of Gastroenterology》索引2009年第15卷第43期,共4页高影响力期刊 基　　金：Supported by The Japan Society for Promotion of Science;The Research and Development Committee Program of The Japan Society of Ultrasonics in Medicine;Japan Research Foundation for Clinical Pharmacology;Japanese Foundation forResearch and Promotion of Endoscopy 摘　　要：Endoscopic ultrasonography(EUS)is a highly sensitive diagnostic method for the detection of small pancreatic carcinomas.Recently,there have been some reports describing the utility of contrast-enhanced harmonic EUS(CEH-EUS)which uses sonographic contrast agent for differentiation of a pancreatic mass.This report describes a case of small adenocarcinoma of the pancreas distinct from branch duct intraductal papillary mucinous neoplasm(IPMN)in which investigation by EUS took place every 6 mo and diagnosis was made accurately by additional CEH-EUS during the follow- up of the branch duct IPMN.A 68-year-old female was admitted to our hospital because of a branch duct IPMN in the pancreatic body.She had been followedup by EUS every 6 mo.However,after 2 years EUSdemonstrated a low echoic area distinct from the branch duct IPMN which was vaguely discernible by EUS,and accurate sizing and differential diagnosis were considered difficult on the EUS imaging.CHEUS with Sonazoid revealed a hypovascular tumor and we suspected small pancreatic carcinoma.The histopathological diagnosis was adenocarcinoma (10 mm)in the pancreatic tail,distinct from the branch duct IPMN of the pancreatic body.EUS and CEH-EUS may play an important role in the correct diagnosis of small pancreatic tumors,including synchronous and metachronous occurrence of IPMN and ductal adenocarcinoma of the pancreas. 关 键 词：分支管道 胰腺癌 肿瘤 黏液 乳头 管内 导管 浸润性
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