期刊
WORLD JOURNAL OF GASTROENTEROLOGY
卷 29, 期 7, 页码 1235-1242出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v29.i7.1235
关键词
Percutaneous transhepatic intravascular biopsy; Portal vein tumor thrombosis; Gastroscope biopsy forceps; Pancreatic neuroendocrine neoplasms; Case report
In this case, a histopathological diagnosis of pancreatic neuroendocrine neoplasm (G2) was obtained by performing a percutaneous transportal biopsy using a gastroscope biopsy forceps. This method appears to be a safe and effective way to obtain a pathological diagnosis.
BACKGROUND Pancreatic neuroendocrine neoplasms (PNENs) are a rare group of neoplasms originating from the islets of the Langerhans. Portal vein tumor thrombosis has been reported in 33% of patients with PNENs. While the histopathological diagnosis of PNENs is usually based on percutaneous biopsy or endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), these approaches may be impeded by gastric varices, poor access windows, or anatomically contiguous critical structures. Obtaining a pathological diagnosis using a gastroscope biopsy forceps via percutaneous transhepatic intravascular pathway is an innovative method that has rarely been reported.CASE SUMMARY A 72-year-old man was referred to our hospital for abdominal pain and melena. Abdominal contrast-enhanced magnetic resonance imaging revealed a well-enhanced tumor (size: 2.4 cm x 1.2 cm x 1.2 cm) in the pancreatic tail with portal vein invasion. Traditional pathological diagnosis via EUS-FNA was not possible because of diffuse gastric varices. We performed a percutaneous transportal biopsy of the portal vein tumor thrombus using a gastroscope biopsy forceps. Histopathologic examination revealed a pancreatic neuroendocrine neoplasm (G2) with somatostatin receptors 2 (+), allowing systemic treatment.CONCLUSION Intravascular biopsy using gastroscope biopsy forceps appears to be a safe and effective method for obtaining a histopathological diagnosis. Although well-designed clinic trials are required to obtain more definitive evidence, this procedure may help improve the diagnosis of portal vein thrombosis and related diseases.
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