EUS-FNA diagnosis of pancreatic tophaceous gout: Two rare cases

IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Brant G. Wang MD, PhD, Iris H. Lee MD
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引用次数: 0

Abstract

We report two patients with pancreatic tophaceous gout diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of presumed cystic mass lesions. The first case involved a patient who had a recent episode of acute pancreatitis 6 months prior, with subsequent imaging concerning for a pseudocyst or mass lesion. The second case involved a patient with epigastric pain associated with a pancreatic head cystic mass and an erroneous original diagnosis of a mucinous pancreatic neoplasm on EUS-FNA. Diff-Quik stained direct smears on fresh material obtained from EUS-FNA of the lesions showed chalky debris with needle shaped negatively birefringent crystals consistent with gout. For the first case, the chalky material was not present on the H&E stained paraffin embedded formalin fixed cellblock slides. The importance of inclusion of cytologic specimen preparations to examine monosodium urate crystals is emphasized.

Abstract Image

胰腺顶部痛风的 EUS-FNA 诊断:两例罕见病例
我们报告了两名通过内镜超声引导下细针穿刺(EUS-FNA)诊断出假定囊性肿块病变的胰腺痛风患者。第一例患者在 6 个月前曾患急性胰腺炎,随后的影像学检查显示其为假性囊肿或肿块病变。第二例患者上腹部疼痛,伴有胰头囊性肿块,EUS-FNA 原始诊断为粘液性胰腺肿瘤。从 EUS-FNA 病变部位获得的新鲜材料经 Diff-Quik 染色后直接涂片,显示出白垩状碎屑和针状负双折射结晶,与痛风一致。第一个病例的 H&E 染色石蜡包埋福尔马林固定细胞块切片上没有白垩状物质。强调了细胞学标本制备对检查单钠尿酸盐结晶的重要性。
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来源期刊
Diagnostic Cytopathology
Diagnostic Cytopathology 医学-病理学
CiteScore
2.60
自引率
7.70%
发文量
163
审稿时长
3-6 weeks
期刊介绍: Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.
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