Pancreas biopsies

Pancreas. Typically, the pancreas is surrounded by various organs like the stomach, liver, transverse colon, kidney, or major vessels. In particular, needle biopsy of small suspect masses in the pancreatic head is therefore usually regarded as technically sophisticated, and CT guidance preferred instead of ultrasound (Fig. 37.5). For differentiation of the tumor from surrounding normal parenchyma or inflammation, a contrast-enhanced CT scan obtained in an arterial phase should generally be performed prior to the intervention. The most common access route is from an anterior approach and often... 

For CT-guided core biopsies conducted in intraabdominal organs (fiver, pancreas) the study by Wutke et al. (2001) showed sensitivity, specificity, and accuracy values of 88.4,100, and 90.4%, respectively. 

Daly B, Templeton PA (1999) Real-time CT fluoroscopy evolution of an interventional tool. Radiology 211 309-3015 Elvin A et al. (1990) Biopsy of the pancreas with a biopsy gun. Radiology 176 677 79... 

Luning M etal. (1985) CT guided percutaneous fine-needle biopsy of the pancreas. Eur J Radiol 5 104-108 Memel DS et al. (1996) Efficacy of sonography as a guidance technique for biopsy of abdominal, pelvic, and retroperitoneal lymph nodes. AJR Am J Roentgenol 167 957-962 Mueller PR (1993) Pancreatic biopsy striving for excellence. Radiology 187 15-16... 

One investigator failed to observe any change in the blood, liver, kidney, pancreas, and muscle GSH level in the dog following adrenaline (0.3 mg./kg. intramuscularly) (140). A second investigator who compared the GSH content of muscle obtained at biopsy a number of days before and shortly after the injection of adrenaline reported a consistent increase in demedullated cats (25 %), whereas the change was less consistent in animals with intact adrenals (141). A third investigator has reported a consistent increase (62 %) in heart GSH level in rabbits 4 hr. after the subcutaneous injection of adrenaline (0.5 mg./kg.) (142). It is probable that the reported discrepancies in the literature are due to differences in species, dose of adrenaline, and time of observation. 

Fig. 2.22a,b. Ectopic Pancreas in the stomach. Double Contrast barium study (a) shows a small nodule in the antrum of the stomach (bottom left of image). Endoscopy (b) demonstrates the characteristic round umhilicated lesion situated a few centimeters proximal to the pylorus. Biopsy confirmed ectopic pancreas (pancreatic rest)... 

Fig. 8.6. An intramural gastric lesion ( ) with indeterminate EUS imaging features. The precise layer of origin deep to the muscularis mucosa (arrow) is unclear. Diagnostic uncertainty and noncontrihutory biopsies necessitated surgical resection. Aberrant pancreas proven histologically...

Fig. 7.17. Image from a 33-year-old man obtained 20 months after simultaneous pancreas-kidney transplantation with pancreatic graft dysfunction and acute rejection verified by histopathological examination. Helical CT is used for image-guided percutaneous biopsy arrows) of pancreatic graft arrow) adjacent to contrast-medium-filled small bowel arrowhead) and renal graft asterisk)...

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