Volume 80 - 2017 - Fasc.2 - Case series
Radiological and endoscopic imaging methods in the management of cystic pancreatic neoplasms
The management of cystic pancreatic neoplasm (CPN) is a clinical dilemma because of its clinical presentations and malignant potential. Surgery is the best treatment choice ; however, pancreatic surgery still has high complication rates, even in experienced centers. Imaging methods have a definitive role in the management of CPN and computed tomography, magnetic resonance imaging, and endoscopic ultrasonography are the preferred methods since they can reveal the suspicious features for malignancy. Therefore, radiologists, gastroenterologists, endoscopists, and surgeons should be aware of the common features of CPN, its discrete presentations on imaging methods, and the limitations of these modalities in the management of the disease. This study aims to review the radiological and endoscopic imaging methods used for the management of CPN. (Acta gastroenterol. belg., 2017, 80, 283-291)
Benign, premalignant and malignant pancreatic cystic lesions: the pathology landscape
Pancreatic cystic lesions are being increasingly detected in last years. Pancreatic cysts can be classified grossly into pseudocysts and true cysts. In the true cysts group, it is important to distinguish mucinous from non-mucinous cysts because the former are considered being premalignant lesions. In this article the major types of pancreatic cysts are reviewed, with emphasis on the histopathological aspects. Molecular markers in the cyst fluid are being increasingly studied in recent years ; the clinical utility of such biomarkers should be addressed in future studies. (Acta gastroenterol. belg., 2017, 80, 293-298).
Dysplasia in inflammatory bowel disease
Ulcerative colitis and Crohn's diseases are relapsing longstanding inflammatory bowel diseases, associated with an increased risk of developing colorectal cancer. Continuous surveillance is necessary to detect the preneoplastic lesions in an early stage. New endoscopic techniques have improved the diagnostic accuracy and have resulted in a new and more simplified classification system of the dysplastic lesions in the bowel. Histopathologically these lesions are very heterogenous, consisting of adenomatous, villous and the more recently discovered serrated dysplasia. Its diagnosis may be hampered by the inflamed mucosa, resulting in a high interobserver variability in the categories of indefinite for dysplasia and low- grade dysplasia. Therefore the ECCO guidelines recommend to confirm the diagnosis of dysplasia by a pathologist with expertise in gastrointestinal pathology.
In this article we give an overview of colitis-associated dysplasia from the point of view of the endoscopist and the pathologist. (Acta gastroenterol. belg., 2017, 80, 299-308).