Pancreatic Cancer Staging - Edubirdie

University:
The University Of Western Ontario
Course:
Pathology 3500B | Human Pathology
Academic year:

2023
Views:

177

Pages:

3
Author:

Kyuwon J.

EUS and Pancreatic cancer staging ● Hypoechoic Pancreatic Mass ○ Pancreatic cancer seems to be dark with irregular mass on pancreas in EUS ○ Poorly defined margin ○ Distort normal pancreatic architectures ● Cx ○ Malignant pancreatic tumor ○ Using EUS it is able to detect tumors which are smaller than 2cm ■ CT misses this tumors ● Invasion ○ Invades on near organs ■ Duodenum ■ Bile duct ■ Stomach ■ Portal vein ● Cx significance ○ T stage determination ■ Depth of tumor and its spread ○ Determination on tumor if it is resectable or unresectable ● Vascular invasion ○ Detect tumor involvement in major vessels ■ Superior mesenteric artery ● SMA ■ Superior mesenteric vein ● SMV ■ Portal vein ■ Celiac artery ○ S ■ Tumor surrounding vessel ■ Loss of vessel wall interface ■ Narrowing of vessel/obstruction ○ Cx ■ Invasion on vascular = surgery is not possible ● Lymph node involvement ○ EUS is able to detect regional lymph node (containing metastases) ■ Round shape ■ Hypoechoic appearance ■ Sharp borders ■ Size larger than 1cm ○ Cx significance ■ Indication of nodal metastasis ● Stage N ● EUS-FNA ○ Passes through endoscope ○ Obtain tissue sample ■ Confirm cancer diagnosis ■ Differentiating tumor from Chronic Pancreatitis ■ Treatment planning ○ Cx significance ■ Definitive pathological diagnosis EUS significance on Pancreatic Cancer Method Strength CT Scan Good for overall staging MRI Soft tissue detail EUS Best for small tumors and biopsy EU is seemed to be most sensitive methods on detecting early pancreatic tumors

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