Featured

Affiliation

Christoph F Dietrich. Medizinische Klinik 2, Caritas-Krankenhaus Bad Mergentheim, Germany.

Video and take home messages

The normal appendix is a wall layered blind-ending, tubular structure that arises from the variably located caecum. The normal appendix visualized without compression can be best seen within free fluid. The arrow indicates the orifice of the appendix.

Featured references

• Atkinson NS, Bryant RV, Dong Y, Maaser C, Kucharzik T, Maconi G, Asthana AK, Dietrich CF. WFUMB Position Paper. Learning Gastrointestinal Ultrasound: Theory and Practice. Ultrasound Med Biol 2016;42:2732-2742.
• Atkinson NSS, Bryant RV, Dong Y, Maaser C, Kucharzik T, Maconi G, Dietrich CF. How to perform gastrointestinal ultrasound: Anatomy and normal findings. World J Gastroenterol. 2017;23(38):6931-41.

Author and Affiliation

Alina Constantin¹,  Cătălin Copăescu²,  Victor Tomulescu²,  Adrian Săftoiu³

¹Gastroenterology Department, Ponderas Academic Hospital Bucharest
²Surgical Department, Ponderas Academic Hospital Bucharest
³Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania

Video and Figure 1

SPN which occurs in young women in the third decade of life has well-defined borders and variable central areas with cystic degeneration, necrosis, or hemorrhage (Figure 1a). Contrast enhanced EUS reveals  in SPN  hypoenhancement in the the arterial and venous phase (Video 1). In contrast, NETs are hyperenhancing lesions. Elastography shows stiffer tissue compared to the surrounding (Figure 1b). Biopsy and immunohistochemical staining were performed for final diagnosis.

Take Home Message

Neuroendocrine tumor (NET) and solid-pseudopapillary neoplasm (SPN) are two types of pancreatic tumor that were sometimes difficult to differentiate. Biopsy and immunohistochemical analysis obtained  by a histological needle biopsy plays a crucial role in differentiating these two tumor types, E-cadherin, chromogranin A, and β-catenin representing the most useful markers which should be employed for differentiating between NET and SPN.

Featured reference

Yusuke Ohara, Tatsuya Oda, Shinji Hashimoto. Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: Key immunohistochemical profiles for differential diagnosis, World J Gastroenterol 2016;22(38):8596-8604.