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Indications de la ponction-biopsie à l’aiguille fine sous écho-endoscopie (EUS-FNA) dans Les kystes pancréatiques

Indications of EUS-FNA in pancreatic cysts

  • Published:
Acta Endoscopica

Résumé

Les kystes pancréatiques regroupent une grande variété de lésions, incluant les processus inflammatoires (pseudokystes) dont l’histologie peut être bénigne (kyste simple, cystadénome séreux), précancéreuse et maligne (tumeur papillaire mucineuse intracanalaire, cystadénome mucineux et cystadénocarcinome). L’EE est un bon outil pour la caractérisation des kystes pancréatiques afin d’orienter les indications vers une résection chirurgicale ou vers un simple suivi clinique. Les caractéristiques EE de chaque type de lésion kystique du pancréas seront décrites en détail. Toutefois, la séméiologie EE n’est pas suffisamment précise pour pouvoir différencier un kyste pancréatique malin d’un kyste bénin et la concordance interobservateur est décevante. Pour ces raisons, l’emploi de la PAF-EE a été proposée afin d’accroître la précision diagnostique. De ce point de vue, l’association de la cytologie aux marqueurs tumoraux du liquide kystique semble fournir le meilleur rendement diagnostique.

Summary

Pancreatic cysts encompass a wide spectrum of histology, including inflammatory (pseudocyst), benign (simple cyst, serous cystadenoma), premalignant and malignant lesions (intraductal papillary mutinous tumor, mutinous cystadenoma and cystadenocarcinoma).

EUS is a valuable tool for characterizing pancreatic cysts in order to establish indications for surgical operation or, on the other hand, follow up. EUS features of each kind of pancreatic cystic lesion are described in detail. However, EUS features are not very accurate in differentiating between malignant and nonmalignant pancreatic cysts and interobserver agreement is dismal. For this reason, the use of EUS-FNA has been advocated to increase diagnostic accuracy. In this respect, a combination of cytologic examination and assay of tumoral biomarkers in the cystic fluid seems to provide the best diagnostic yield.

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Authors and Affiliations

  1. Gastroenterology Unit, University of Bologna, AUSL di Imola, Ospedale di Castel S. Pietro Terme, Viale Oriani 1, 40024, Castel S. Pietro Terme, BO, Italy

    P. Fusaroli, Stefania Maltoni & G. Caletti

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  1. P. Fusaroli
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  2. Stefania Maltoni
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  3. G. Caletti
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Fusaroli, P., Maltoni, S. & Caletti, G. Indications de la ponction-biopsie à l’aiguille fine sous écho-endoscopie (EUS-FNA) dans Les kystes pancréatiques. Acta Endosc 35, 11–16 (2005). https://doi.org/10.1007/BF03002642

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  • DOI: https://doi.org/10.1007/BF03002642

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