Percutaneous Pancreatic Biopsies-Still an Effective Method for Histologic Confirmation of Malignancy.

PURPOSE: To determine the accuracy and safety of the percutaneous biopsy of pancreatic mass lesions. MATERIALS AND METHODS: Over a 12-year period clinical parameters, imaging, pathologic results, and complications were assessed in patients undergoing percutaneous biopsies pancreatic lesions. RESULTS: One hundred fifty-three patients underwent pancreatic biopsy. The preferred modality for performing the biopsy was ultrasound (93%, n=143) followed by computerized tomography (7%, n=10). Histologic diagnosis was achieved in 147 patients, of which 3 (2%) were benign and 144 (94%) were malignant. Complications included a single death from overwhelming hemorrhage and 2 patients with morbidity (hematoma and cerebrovascular accident). The sensitivity and specificity of percutaneous biopsies was 90% and 95%, respectively. CONCLUSIONS: Ultrasound-guided and computerized tomographic-guided percutaneous biopsy of pancreatic lesions is an effective and safe method to confirm or refute malignancy in suspicious pancreatic lesions. Endoscopic ultrasound-guided Tru-Cut may have the added advantage of avoiding the risk of peritoneal soiling.

Imaging findings post colorectal endoscopic mucosal resection.

Endoscopic mucosal resection is commonly the treatment regime of choice for large sessile colonic polyps. We describe the computed tomography findings of a 51 year old female who presented with transient severe abdominal pain without systemic upset post endoscopic mucosal polyp resection, which resolved with conservative management. This is the second case in the literature that demonstrates 'normal' appearances post endoscopic mucosal resection. The clinical team and radiologist need to be aware of these findings when making management decisions in patients who present with acute pain post endoscopic mucosal resection.

Dilated SMV in colon cancer--is there any significance.

OBJECTIVE: Changes in splanchnic circulation have been seen in patients with colorectal cancer. We have previously reported that the inferior mesenteric vein is dilated in rectal cancer. We wanted to assess whether the superior mesenteric vein (SMV) is dilated in right-sided colon cancer. MATERIALS AND METHODS: From a colorectal database, three cohorts were formed: right colon cancer, rectal cancer, and normal. The SMV (2 cm proximal to the confluence of the SMV and portal vein) and the gastrocolic trunk (GCT) were saved and anonymized. The short-axis diameter of the vein was measured independently by three radiologists. RESULTS: The diameter of the SMV and GCT was higher in the right colon group than the other two groups. There was no correlation with the stage of tumor (locoregional or metastatic). CONCLUSION: Patients with right colon cancer showed a significantly increased mean SMV diameter at presentation, which may be due to increased venous return secondary to neovascularization. Further studies are required to evaluate this further.

Rapid microwave ablation of large hepatocellular carcinoma in a high-risk patient.

A 74-year-old male with an inoperable, large (6 cm in diameter) primary hepatocellular carcinoma of the liver was successfully treated using a novel microwave ablating system. Using a single applicator, the tumour was treated at 150 W for 4 minutes. An ablation zone 8 cm in diameter was achieved, which gradually shrunk to form scar tissue that remained unchanged without tumour recurrence for 2 years.