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Abstract：
BACKGROUND: Metastatic pancreatic lesions (MPLs) are relatively uncommon, constituting 2 to 5% of all pancreatic tumors. They often manifest as solitary lesions without distinct clinical symptoms, usually identified incidentally during radiologic imaging for the surveillance of prior malignancies. Differentiating these lesions from primary pancreatic tumors presents a significant challenge due to their nonspecific presentation.
METHODS: We aimed to prospectively assess the effectiveness of endoscopic ultrasound (EUS) and EUS-guided fine needle aspiration/biopsy (EUS-FNA/B) in diagnosing MPLs in a carefully selected cohort of patients presenting with pancreatic masses. Additionally, we sought to examine the relevance of specific EUS findings in supporting the initial diagnosis of MPLs and their agreement with the definitive cytological diagnosis. This study retrospectively analyzed data from 41 patients diagnosed with MPLs between 2013 and 2023, focusing on their clinical and pathological characteristics, the echogenic features of the pancreatic lesions, and the techniques used for tissue acquisition.
RESULTS: The incidence of MPLs in our cohort was 3.53%, with the most frequent primary tumors originating in the kidney (43.90%), colorectum (9.76%), lung (9.76%), lymphoma (9.76%), and breast (4.88%). MPLs typically presented as hypoechoic, oval-shaped lesions with well-defined borders and were predominantly hypervascular. Interestingly, 68.29% of the cases were discovered incidentally during follow-up of the primary tumors, while the involvement of the common bile duct was uncommon (19.51%).
CONCLUSIONS: EUS and EUS-FNA/B have been validated as valuable diagnostic tools for identifying MPLs. While our findings are promising, further multicenter studies are necessary to corroborate these results and elucidate the predictive value of specific EUS characteristics in determining the metastatic origin of pancreatic lesions.
METHODS: We aimed to prospectively assess the effectiveness of endoscopic ultrasound (EUS) and EUS-guided fine needle aspiration/biopsy (EUS-FNA/B) in diagnosing MPLs in a carefully selected cohort of patients presenting with pancreatic masses. Additionally, we sought to examine the relevance of specific EUS findings in supporting the initial diagnosis of MPLs and their agreement with the definitive cytological diagnosis. This study retrospectively analyzed data from 41 patients diagnosed with MPLs between 2013 and 2023, focusing on their clinical and pathological characteristics, the echogenic features of the pancreatic lesions, and the techniques used for tissue acquisition.
RESULTS: The incidence of MPLs in our cohort was 3.53%, with the most frequent primary tumors originating in the kidney (43.90%), colorectum (9.76%), lung (9.76%), lymphoma (9.76%), and breast (4.88%). MPLs typically presented as hypoechoic, oval-shaped lesions with well-defined borders and were predominantly hypervascular. Interestingly, 68.29% of the cases were discovered incidentally during follow-up of the primary tumors, while the involvement of the common bile duct was uncommon (19.51%).
CONCLUSIONS: EUS and EUS-FNA/B have been validated as valuable diagnostic tools for identifying MPLs. While our findings are promising, further multicenter studies are necessary to corroborate these results and elucidate the predictive value of specific EUS characteristics in determining the metastatic origin of pancreatic lesions.
摘要：
背景：转移性胰腺病变（MPL）相对少见，占所有胰腺肿瘤的2-5%。它们通常表现为孤立性病变，没有明显的临床症状，通常在放射成像期间偶然发现，用于监测先前的恶性肿瘤。由于这些病变的非特异性表现，将其与原发性胰腺肿瘤区分开来存在重大挑战。
方法：我们旨在前瞻性评估内镜超声（EUS）和EUS引导的细针穿刺活检（EUS-FNA/B）在精心选择的胰腺肿块患者队列中诊断MPL的有效性。此外,我们试图研究特定EUS结果在支持MPL的初始诊断方面的相关性,以及它们与最终细胞学诊断的一致性.这项研究回顾性分析了2013年至2023年间41例确诊为MPL的患者的临床和病理特征，胰腺病变的回声特征，以及用于组织采集的技术。
结果：我们队列中MPL的发生率为3.53％，最常见的原发性肿瘤起源于肾脏（43.90%），结肠直肠（9.76%），肺（9.76%），淋巴瘤（9.76%），和乳房(4.88%)。MPL通常表现为低回声，椭圆形病变边界清晰，主要是血管过度。有趣的是,68.29%的病例是在原发肿瘤的随访中偶然发现的,而胆总管受累并不常见（19.51％）。
结论：EUS和EUS-FNA/B已被验证为识别MPL的有价值的诊断工具。虽然我们的发现很有希望，需要进一步的多中心研究来证实这些结果,并阐明特定EUS特征在确定胰腺病变转移来源方面的预测价值.
方法：我们旨在前瞻性评估内镜超声（EUS）和EUS引导的细针穿刺活检（EUS-FNA/B）在精心选择的胰腺肿块患者队列中诊断MPL的有效性。此外,我们试图研究特定EUS结果在支持MPL的初始诊断方面的相关性,以及它们与最终细胞学诊断的一致性.这项研究回顾性分析了2013年至2023年间41例确诊为MPL的患者的临床和病理特征，胰腺病变的回声特征，以及用于组织采集的技术。
结果：我们队列中MPL的发生率为3.53％，最常见的原发性肿瘤起源于肾脏（43.90%），结肠直肠（9.76%），肺（9.76%），淋巴瘤（9.76%），和乳房(4.88%)。MPL通常表现为低回声，椭圆形病变边界清晰，主要是血管过度。有趣的是,68.29%的病例是在原发肿瘤的随访中偶然发现的,而胆总管受累并不常见（19.51％）。
结论：EUS和EUS-FNA/B已被验证为识别MPL的有价值的诊断工具。虽然我们的发现很有希望，需要进一步的多中心研究来证实这些结果,并阐明特定EUS特征在确定胰腺病变转移来源方面的预测价值.
