Background : To evaluate malignancy and the lateral spread of intraductual papillary mucinous neoplasms (IPMNs) , pancreatoscopy is useful. SpyGlass DS (SpyDS) is a recently developed pancreatoscopy with high image quality and separate channels for irrigation and aspiration. We are reporting a rare case of intraductual papillary mucinous carcinoma (IPMC) using SpyDS.
Case : A 71-year-old man had been diagnosed with a main duct IPMNs using CT, MRI and EUS. ERCP showed a dilated main pancreatic duct (MPD) and multiple nodules in head MPD. After irrigating and aspirating pancreatic mucinous juice, SpyDS clearly showed fish-egg-like protrusions and vegetative protrusions localized in the pancreatic head MPD. The histological diagnosis of tissue fragments in pancreatic juice was gastric and pancreatobiliary type IPMC, which was confirmed after pancreaticoduodenectomy.
Conclusion : SpyDS may be useful for the evaluation of IPMNs in histological and morphological examinations, especially in tissue sampling from pancreatic juice.
