| セッション情報 |
International Session8(消化器内視鏡学会・消化器病学会合同)
Recent advances in Interventional EUS 《Video》
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| タイトル |
内IS8-12指：EUS guided with needle-based confocal laser endomicroscopy (nCLE) for real-time histology in a solid pancreatic mass: Case series
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| 演者 |
R. Pittayanon（King Chulalongkorn Memorial Hospital） |
| 共同演者 |
P. Kongkam（King Chulalongkorn Memorial Hospital）, R. Rerknimitr（King Chulalongkorn Memorial Hospital） |
| 抄録 |
Background: Trans-abdominal ultrasound or EUS guided FNA is always required to diagnose a solid pancreatic mass (SPM). Needle-based confocal laser endomicroscopy (nCLE) through EUS guidance is a novel technique that can provide real-time histology at 1000X magnification. To date only a handful reports of EUS with nCLE in pancreatic cyst are available but the use of this technique in SPM has never been reported.Patients and Method: Three patients with a pancreatic mass were recruited. nCLE was inserted through a fine needle aspiration (FNA) needle (19G) under EUS guidance. Two and a half cc. of fluoresceine was administered intravenously to facilitate visualization of vascular structures in SPM during nCLE examination. The possible image criteria to diagnose pancreatic adenocarcinoma were adapted from our previous experience with probe based confocal laser endomicroscopy (pCLE) in gastric and bile duct cancers: 1) Epithelial visualization, 2) Dark clumping (size larger than 40 micrometer). FNA was performed at the end of nCLE examination for pathological confirmation.Result: There were two patients with adenocarcinoma confirmed by histology. nCLE showed epithelial with dark clumping in one and only dark clumping in another. Another patient had a fibrosis pattern read by nCLE and his histology revealed non-specific inflammation with fibrosis.Conclusion: EUS guided nCLE reading in SPM is a promising technique to have a real-time diagnosis of SPM. |
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