Type:
Educational Exhibit
Keywords:
Cancer, Biopsy, Ultrasound, CT, Pancreas, Abdomen
Authors:
N. Colic1, D. Masulovic2, R. STEVIC2, M. Zakošek2, D. Bulatović2, F. Vitosevic2, D. Šaponjski2, I. S. Andjelkovic3; 1Beograd, Serbia/RS, 2Belgrade/RS, 3Beograd, Se/RS
DOI:
10.26044/ecr2019/C-0449
Findings and procedure details
Biopsy methods:
CT-guided biopsies
Ultrasound-guided biopsies
Also it can be done by:
Surgical biopsy
Endoscopic ultrasound biopsies
Biopsies during ERCP
Techniques:
Fine-needle aspiration (FNA)
Core-Needle Biopsy (CNB)
Fine-needle aspiration (FNA) is a useful technique for malignancy confirmation,
but requires a pathologist with cytology experts to obtain a reliable diagnosis.
Core-Needle Biopsy (CNB) has the advantage of providing a better tissue sample,
allowing further differentiation of the lesion
Biopsy pathways are divided into three categories:
- trans organic biopsy
- trans-mesenteric path
- posterior retroperitoneal approach
Ultrasound guided biopsy
is an ideal technique with advantages of being fast economical and giving real time vizualization with no radiation.
However,
this method is technically challenging,
and the pancreatic lesion is not always visualized due to its deep position and overlapping with intestinal angularity.
Ultrasound B-mode may not be suitable for large tumors with necrotic tissue,
severe fibrosis,
local pancreatic island,
or poorly visible small lesions.
Thus,
the injection of a contrast medium to identify a sustained portion of the pancreas tumor is considered useful for performing a diagnostic biopsy
Main complication of both techniques are:
Pain
Bleeding
Infections
Pancreatitis