Endoscopic Diagnosis of Pancreatic Cystic Tumors

Pancreatic cystic neoplasms are frequently recognized on routine screening cross-sectional imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI), which can be used in their diagnosis and management when characteristic features are present. However, not all such neoplasms can be evaluated completely with CT or MRI and the diagnosis and risk of malignancy are often unclear. Despite recent advances in these diagnostic modalities, the preoperative diagnosis of pancreatic cystic tumors remains difficult. Endoscopic ultrasonography (EUS) has been used increasingly for the diagnosis of pancreatic cystic tumors, as it provide high-resolution images of pancreatic cystic tumors and EUS-guided fine needle aspiration (EUS-FNA) can enable the analysis of cystic fluid for cytology and tumor markers. EUS-FNA provides useful information for the differential diagnosis of mucinous cystic lesions, although it has limited diagnostic accuracy. Other techniques and markers are needed to improve the diagnostic accuracy of mucinous cystic lesions. (Korean J Med 2014;87:251-260