Endosonography in the diagnosis of metastatic lesion of the pancreas

Aim. To study the possibilities of endoscopic ultrasonography with contrast enhancement and fine-needle biopsy in the diagnosis of metastatic lesions of the pancreas. Materials and methods. 299 patients with solid pancreatic neoplasms were examined in the period from 2016 to 2018. Among them, adenocarcinoma of pancreas was diagnosed in 96.3% (n= 288), in 3.7% of cases (n= 11) a secondary lesion of the pancreas was suspected due to the presence of a tumor of another localization. Endosonography with contrast enhancement and fine-needle biopsy was performed for all these patients. Results. In 7 of 11 patients, there was a primary lesion of the pancreas (ductal adenocarcinoma), confirmed by morphological research data from a fine-needle biopsy. Of the 11 cases, the metastatic lesion of the gland was morphologically verified in 4 (36.4%) cases. In 2 cases, metastases of renal cell carcinoma were diagnosed, 1 was metastasis of small cell lung cancer, and 1 was metastases of colorectal cancer. Patients with secondary lesions of the pancreas accounted for 1.3% of the total number of patients. Conclusion. In the presented clinical observations, the possibilities of endo-ultrasound with contrast enhancement were analyzed, as well as the prospect of cytological and immunocytochemical studies in situations where the material obtained during fine-needle puncture is insufficient for histological examination. Such an approach is fully justified and helps to clarify the nature of the neoplasm in difficult situations.