Endoscopic Ultrasound Fine-Needle Aspiration Detection of Extravascular Migratory Metastasis From a Remotely Located Pancreatic Cancer Michael J. Levy,

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Presentation transcript:

Endoscopic Ultrasound Fine-Needle Aspiration Detection of Extravascular Migratory Metastasis From a Remotely Located Pancreatic Cancer Michael J. Levy, Ferga C. Gleeson, Lizhi Zhang Clinical Gastroenterology and Hepatology Volume 7, Issue 2, Pages 246-248 (February 2009) DOI: 10.1016/j.cgh.2008.09.010 Copyright © 2009 AGA Institute Terms and Conditions

Figure 1 Pancreas protocol CT of the abdomen reveals a very subtle, hypoenhancing pancreatic body mass resulting in postobstructive ductal and parenchymal changes. Clinical Gastroenterology and Hepatology 2009 7, 246-248DOI: (10.1016/j.cgh.2008.09.010) Copyright © 2009 AGA Institute Terms and Conditions

Figure 2 Linear EUS examination identifies a 1.4 × 1.1 cm pancreatic body mass that appears confined to the pancreas (stage T1). Clinical Gastroenterology and Hepatology 2009 7, 246-248DOI: (10.1016/j.cgh.2008.09.010) Copyright © 2009 AGA Institute Terms and Conditions

Figure 3 Linear EUS and Power Doppler demonstrate a thin hypoechoic band (cuffing) surrounding the celiac trunk, with extension along the left gastric artery. Clinical Gastroenterology and Hepatology 2009 7, 246-248DOI: (10.1016/j.cgh.2008.09.010) Copyright © 2009 AGA Institute Terms and Conditions

Figure 4 EUS FNA of the celiac trunk hypoechoic cuffing. Clinical Gastroenterology and Hepatology 2009 7, 246-248DOI: (10.1016/j.cgh.2008.09.010) Copyright © 2009 AGA Institute Terms and Conditions

Figure 5 Cytologic analysis of the EUS FNA specimen reveals a metastasis from a well-differentiated pancreatic adenocarcinoma (Papanicolaou stain; original magnification, 400×). Clinical Gastroenterology and Hepatology 2009 7, 246-248DOI: (10.1016/j.cgh.2008.09.010) Copyright © 2009 AGA Institute Terms and Conditions