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Endosonograph shows irregular mass in pancreatic head and parenchymal abnormalities. More worrisome than mass?

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Had an endosonograph and it states: An irregular mass was identified in the pancreatic head, the mas was hypoechoic........... which they stated there was a mass that was cancerous and it would be determined to remove it or do chemo. But the results also state: Pancreatic parenchymal abnormalities were noted in the pancratic body and in the pancratic tail, these consisted of atrophy, hyperechoic foci and lobularity. The Upstream pancreatic duct had a dilated endosonographic appearance and had an irregularly contoured endosonographic appearance in the pancratic head, in the genu of the pancreas, in the body of the pancreas, in the tail of the pancreas and in the main pancreatic duct. Does this indicate more concern then just the mass? not jumping to conclusions, just trying to digest the results.
Posted Wed, 12 Sep 2012 in Cancer
Answered by Dr. Om Lakhani 2 hours later

Thanks for writing in.

The changes on endosono that you have mentioned suggest chronic pancreatitis. Chronic pancreatitis increases the risk of a pancreatic cancer by many folds. Presence of a mass on Endosono definitely requires evaluation. The mass could be a tumor or an inflammatory mass. The best way to diagnose this is by a FNAC from the mass (which I am sure your doctors would have taken). If the FNAC is inconclusive a core biopsy is also often taken through endosono.

I would also advise you to undergo a CT abdomen (with pancreatic protocol). CT also helps to know if there are any metastasis (which would make the cancer if present inoperable). A blood test CA 19-9 would also help collaborate the result.

There are two issues here:

1. IF the FNAC/biopsy shows malignancy
2. If the FNAC/Biopsy is inconclusive / negative for malignancy.

The further plan of action can be discussed once we have the final tissue diagnosis. In conclusion it is impossible to label a malignancy without a tissue diagonsis (FNAC/Biopsy). Once we have that further management would be discussed.

Hope I have answered your query. If you have any further questions I will be happy to help

Dr. Om Lakhani
Above answer was peer-reviewed by
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