Management of Pancreatic Cystic Lesions

Evaluation and Management of Pancreatic Cystic Lesions with Endoscopic Ultrasound and Fine Needle Aspiration.
Presentation by:Praveen Sateesh, M.D., M.H.S.A.
Georgetown Internal Medicine,

Differential Diagnosis of Pancreatic Cystic Lesion.
* Congenital cysts
* Acquired cysts
* Extrapancreatic cysts
* Cystic Pancreatic Tumors
* Serous Cystadenoma
* Mucinous Cystic Neoplasm
* Intraductal Papillary Mucinous Neoplasm

Role of EUS
* Identify architecture of cystic lesion
* Ease of FNA
* Determine type of CPT and malignant potential
* Examination of pancreatic ducts and parenchyma
* Guide surgery

Cystic Fluid Analysis
* Cytology
* Tumor markers
* Amylase

EUS FNA characteristics of certain pancreatic cystic lesions
Retrospective Study
* Preoperative diagnosis of pancreatic cystic lesions remains difficult and no established guidelines for evaluation and management of these lesions.
* Identify cases of cystic pancreatic lesions identified by CT or MR undergone EUS FNA with fluid sent for amylase, CEA, and cytology
* Evaluate performance of EUS findings and FNA findings (cytology, amylase, CEA) as compared to surgical pathology and/or clinical follow up (final diagnosis)
* Number of cases
* Differentiating cysts based on size, location, and EUS characteristics
* Obtaining data including amylase, CEA, cytology, surgical pathology, and 6 month clinical follow up after EUS FNA.

Management of Pancreatic Cystic Lesions.ppt