New this month in Scientific American Gastroenterology, Hepatology & Endoscopy:
- Malignant Lesions of the Pancreas
- Familial Polyposis Syndromes
A peripancreatic lymph node in a patient with a pancreatic mass.
OMER BASAR, MD
ABDURRAHMAN KADAYIFCI, MD
WILLIAM R. BRUGGE, MD
Screening Modalities for Pancreatic Ductal Adenocarcinoma
In spite of many risk factors for pancreatic ductal adenocarcinoma, no definite screening program has been identified to date. There is no doubt that endoscopic ultrasound is the best modality for screening, but it is invasive and high cost, and its use is difficult in high-risk populations. Screening by magnetic resonance imaging and/or magnetic resonance cholangiopancreatography biannually for 3 to 5 years has been suggested, but just at the time of what is believed to be the high-risk time interval (i.e., age > 50 years with new-onset diabetes mellitus).
Spectrum of histologic types and genetic etiologies of hereditary polyposis syndromes.
SAHAR NISSIM, MD, PhD
RAMONA M. LIM, MD
Imaging in Polyposis Syndromes
Serrated polyposis is characterized by an increased appearance of serrated polyps and an associated elevated risk of colorectal cancer. Although imaging is not routinely used to diagnosis polyposis syndromes, serrated lesions can be distinguished from adenomas by narrow-band imaging. Narrow-band imaging shows serrated lesions to be a lighter color compared with surrounding mucosa, with scarce or no blood vessels across the surface.