A 52 yrs old male patient was referred to us forĀ  the favour of EUS to evaluate the exact status of pancreas in view of recent episodes of acute pancreatitis. Patient has lost 5 kgs in the last few weeks and is complaining of recurrent pain off and on. All other imaging studies have been inconclusive so far.

  • EUS revealed a large hypoechoic mass lesion in the pancreatic head region ( 3.5 cms x 3.0 cms) with multiple large nodes.
  • The mass appeared hard on Elastography. Contrast enhanced EUS was then performed which revealed hypoenhancement in the lesion suggestive of neoplastic process.
  • A lesion was also noted in the left lobe of liver which measured around 11 mm x 14 mm.
  • In view of these findings EUS guided FNA was then performed first from the left lobe liver lesion under color doppler control with a 22 g needle.
  • This was followed by one pass into the primary mass in the pancreatic head region. Aspirated material was sent for cytological examination and cell block preparation.

A large hypoechoic mass lesion in the pancreatic head region

The mass appeared hard on Elastography

 

 

 

 

 

 

 

 

Contrast enhanced EUS was then performed

A lesion was also noted in the left lobe of liver

 

 

 

 

 

 

 

 

EUS guided FNA was then performed first from the left lobe liver lesion

EUS guided FNA was then performed from the pancreatic head region.

 

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