EUS Pathology with Digital Anatomy Correlation: Textbook and Atlas

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PMPH-USA, Dec 1, 2009 - Medical - 435 pages
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Atlas of Pathologic lesions by Endoscopic Ultrasonography(EUS) is a dedicated text to learn pathologic images seen during EUS. The digital anatomy correlation used in this work is the natural continuation of efforts to apply the University of Colorado Visible Human data set to gastroenterology.

The Visible Human data set was created by Dr. Vic Spitzer and colleagues at the University of Colorado and is currently housed at the university's Center for Human Simulation. The data set consists of high resolution transaxial digital images captured as cadavers were abraded away at 1 mm or less depths. These images are compiled into blocks of data and each structure is identified. This information can be used to pull out and manipulate 3-D structures as well as allowing one to review planar anatomy in any orientation. Using the Visible Human dataset, one should be able to find a normal anatomy correlate to any image found during a EUS examination.

However, as important as normal anatomy is, it is the abnormal features which are the crux of an EUS examination.

Endosonographers are asked to define lumps, bumps, cysts to find correlates for symptoms and abnormal laboratory findings. Accuracy requires a tremendous amount of skill and experience. To help in this task, we have assembled chapters from a world-wide group of expert endosonographers. These authors have shared their insight and images to help the readers of this work better see and understand some of the complexities uncovered during a EUS evaluation.

 

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Contents

Introduction and Overview
1
Upper GI tract Mediastinum
5
Early Esophageal Cancer
7
Introduction
8
Operator Expertise
9
Equipment
10
TumorRelated Factors
11
EUS Staging in Early Esophageal Cancer
12
Summary
221
Pancreas Divisum and Other Pancreaticobiliary Anomalies
225
Pancreas Divisum
226
Annular Pancreas
227
Santorinicele
231
Partial or Complete Pancreatic Agenesis
233
Duodenal Duplication Cysts
236
Miscellaneous Extrahepatic Biliary Anomalies
238

Accuracy of EUS in Staging Early Esophageal Cancer
13
Overand Understaging
15
Conclusion
17
EUS in Barretts Esophagus and High Grade DysplasiaEarly Carcinoma
19
Introduction
20
EUS in HighGrade Dysplasia and Early Carcinoma
21
Advanced Esophageal Cancer
25
Radial Versus Linear Scanners
26
TStaging
27
NStaging
28
Dilation of Strictures
29
Dr Chan Sup Shim
33
Introduction
34
EUS Techniques
35
Future Perspectives of EUS
45
Conclusion
47
Advanced Gastric Cancer
49
Introduction
50
Summary
54
Large Gastric Folds
57
Introduction
58
EUS for Differential Diagnosis
59
EUS for Staging of Malignancies
60
Lymphoma
62
Linitis Plastica
66
Menetriers Disease
69
ZollingerEiiison Syndrome
70
Gastric Varices
71
Other Causes of LGF
72
Subepithelial Lesions of the Upper GI Tract
79
Introduction
80
Tissue Diagnosis
81
Stacked Forceps Biopsy
82
Extramural Lesions
83
Conclusions
91
Esophageal and Gastric Varices
95
Introduction
96
EUS Imaging
98
Stomach
103
Conclusion
105
Vascular Anomolies
107
AORTIC ARCH ANOMOLIES
108
ACQUIRED VASCULAR LESIONS
111
DIEULAFOY LESIONS
115
CONCLUSION
116
EUS for Mediastinal Lymph Nodes and Masses
117
EUS Technique
118
Benign Posterior Mediastinal Lymph Nodes and Masses
119
Mediastinal Cysts
121
Malignant Posterior Mediastinal Lesions
122
Risks of Mediastinal EUS FNA
126
Conclusion
127
EUS lmaging and FNA of Primary Lung Tumors
129
Introduction
130
Cytopathology of Lung Tumors
133
Tumor Types
134
Conclusion
135
Transbronchial Ultrasound
137
Background
138
Endobronchial Ultrasound Guided Fine Needle Aspiration EBUSTBNA
140
Diagnostic Yield and impact on Management
142
Combined Yield of EUS FNA With EBUS TBNA
143
Hepatopancreatobiliary Abdomen
147
Pancreatic Carcinoma Detection and Staging
149
Background
150
Diagnosis and Staging by CT MRI and EUS
151
MRI
156
EUS
158
Conclusion
161
Pancreatic Neuroendocrine Tumors
165
Localized Functional Pancreatic
167
Localized Nonfunctional Pancreatic Neuroendocrine Tumors
168
Metastatic Pancreatic Neuroendocrine Tumors
169
LUMINAL NEUROENDOCRINE TUMORS
170
Pancreatic Metastases
173
Introduction
174
Cystic Pancreatic Lesions
183
Pseudocysts
185
Other Cystic Neoplasms
186
Summary
188
Endoscopic Ultrasonography in intraductal Papillary Mucinous Tumors of the Pancreas
191
Introduction
192
Pathology
193
Diagnosis
194
Role of EUS with Fine Needle Aspiration
199
Role of Intraductal Ultrasound and 3Dimentional EUS
200
Outcome and Therapy
202
Chronic Pancreatitis
205
EUS Features of Chronic Pancreatitis
206
Ductal Features of Chronic Pancreatitis
211
Autoimmune Pancreatitis
213
Introduction
214
Pancreatic Imaging
215
Endoscopic Retrograde Cholangiopancreatography ERCP
216
Serology
219
Other Organ Involvement
220
Choledocholithiasis and Other Benign Bile Duct Lesions
243
Introduction
244
The Problem of Choledocholithiasis
245
EUS for CBD Stones
246
lntraductal US and ERCP
248
Malignant Bile Duct Lesions Cholangiocarcinoma
249
Introduction
250
Intraductal Ultrasound
251
EUSFNA Technique
252
Role of EUS and rous
253
Role of EUSFNA in Cholangiocarcinoma
254
Conclusion
256
Benign and Malignant Lesions of the Gallbladder
257
Gallbladder
258
Pathologic Findings CholesterolosisCholesterol Polyp
259
Cholecystitis
260
Inflammatory Polyp
264
Ampullary Lesions
273
Introduction
274
Benign Lesions
275
Malignant Lesions
277
Therapeutic Endoscopy
282
Interventional EUS
283
Conclusion
285
Liver Lesions
287
Benign Tumors and TumorLike Lesions
288
Cystic Lesions
291
Fibrolamellar Hepatocellular Carcinoma
292
Combined Hepatocellular and Cholangiocarcinoma
293
Epithelioid Hemangioendothelioma
294
Splenic Lesions
299
Methods
301
Pathology
302
Benign Splenic Lesions
303
Malignant Diseases
306
Accessory Spleen
310
Adrenal Lesions
313
Identification of the Left Adrenal Gland
314
Glandular Morphology
315
EUSGuided FNA
316
Summary
317
Portal Vein Thrombosis
319
Jj Portal Vein Thrombosis
320
Splenic vein Thrombosis
322
Peritoneal and Pleural Fluid
325
Introduction
326
EUSGuided FineNeedle Aspiration
327
Technique
329
Complications and Their Avoidance
330
Colorectal
333
Rectal Cancer
335
Introduction
336
Equipment and Technique
337
ERUS Staging of Rectal Cancer
338
EUS Lymph Node Staging
339
Restaging After Neoadjuvant Therapy
340
ThreeDimentional EUS
341
Conclusion
342
Perirectal Abscesses
345
Introduction
346
Endoanal Ultrasound in Perirectal Abscess
351
Anorectal Fistulae
355
Introduction
356
Endoanal Ultrasound in Specific Anorectal Fistula
359
Anal Sphincter Defects
361
Introduction
362
Endoanal Ultrasound in Fecal Incontinence
363
Ovarian and Gynecological Lesions
369
Pelvic Inflammatory Disorders
372
Conclusion
374
Subepithelial Colorectal LesionsColon PolypsAdenomas
375
Introduction
376
Endoscopic Ultrasound in Colonic and Rectal Adenomas
378
Applications of EUS
379
Subepithelial Colorectal Lesions
380
Schwannomas Paragangliomas and Fibrosarcomas
381
Lymphangiomas
383
Prostate Lesions
387
Urologic Echoendoscopy
388
Cysts
389
Histopathologic Aspects of Prostate Cancer
390
Discussion and Critical Analysis
394
Endoscopic ID U Ultrasound EUS in Inflammatory Bowel Disease IBD
397
Fistulae and Abscesses
398
Miscellaneous
401
EUS Elastography
403
Introduction
404
EUS Applications
406
Pancreatic Diseases
407
Focal Liver Lesions
408
Perspectives
409
EUS Contrast Agents
413
Contrast Agents
414
Esophageal and Gastric Cancer
415
Esophageal Varices and Portal Hypertension
417
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About the author (2009)

Manoop S. Bhutani, MD, FACG, FACPCo-Director, CERTAINDirector, Center for Endoscopic UltrasoundDepartment of Internal MedicineThe University of Texas Medical BranchHouston TX

John C. DeutschInternal Medicine, Gastroenterology, Hematology/OncologyDuluth Clinic, Duluth MN

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