{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:50:52Z","timestamp":1778734252022,"version":"3.51.4"},"reference-count":55,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Due to their aspecific macroscopic appearance, uncommon pancreatic cystic lesions (PCLs) are often misdiagnosed as mucinous lesions and improperly resected. We aimed to evaluate the endoscopic ultrasound (EUS)-guided through-the-needle biopsy (TTNB) capacity of the preoperative diagnosis of uncommon PCLs. Overall, 136 patients with PCLs who underwent EUS-TTNB between 2016 and 2022 were retrospectively identified. Common histotypes (e.g., IPMN, serous cystadenoma, and mucinous cystadenoma) were excluded and 26 (19.1%) patients (15 female, mean age 52.9 \u00b1 10.4) were analyzed. The EUS findings, adverse events (AEs), and TTNB outcomes in uncommon PCLs were evaluated. The cysts histotype was accurately diagnosed by TTNB in 24\/26 (92.3%) cases (seven cystic neuroendocrine tumors, four squamoid cysts, three acinar cells cystadenomas, two lymphoepithelial cysts, two mucinous non-neoplastic cysts, two bronchogenic cysts, two cystic lymphangiomas, one solid-pseudopapillary neoplasm, and one schwannoma). In the remaining two cases, lymphangioma was eventually diagnosed after resection. Surgery was performed in 15\/26 (57.7%) patients. The mean follow-up of non-surgical patients was 32.5 months. One severe acute case of pancreatitis (3.8%) that required surgery occurred after EUS-TTNB. Uncommon pancreatic\/peripancreatic lesions represent the 19.1% of PCLs in our series, with mainly benign histotypes. TTNB demonstrated a high diagnostic performance with a low rate of AEs in this setting, representing a reliable tool with which to avoid useless surgery.<\/jats:p>","DOI":"10.3390\/diagnostics13243663","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T03:58:02Z","timestamp":1702526282000},"page":"3663","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Rare Pancreatic\/Peripancreatic Cystic Lesions Can Be Accurately Characterized by EUS with Through-the-Needle Biopsy\u2014A Unique Pictorial Essay with Clinical and Histopathological Correlations"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-1583","authenticated-orcid":false,"given":"Maria Cristina","family":"Conti Bellocchi","sequence":"first","affiliation":[{"name":"Diagnostic and Interventional Endoscopy of Pancreas, Pancreas Institute, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erminia","family":"Manfrin","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Brillo","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Endoscopy of Pancreas, Pancreas Institute, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bernardoni","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Endoscopy of Pancreas, Pancreas Institute, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7724-7402","authenticated-orcid":false,"given":"Andrea","family":"Lisotti","sequence":"additional","affiliation":[{"name":"Gastrointestinal Unit, Department of Medical and Surgical Sciences, Hospital of Imola, University of Bologna, 40026 Imola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Fusaroli","sequence":"additional","affiliation":[{"name":"Gastrointestinal Unit, Department of Medical and Surgical Sciences, Hospital of Imola, University of Bologna, 40026 Imola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Parisi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Diagnostics, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sokol","family":"Sina","sequence":"additional","affiliation":[{"name":"Department of Pathology and Diagnostics, University Hospital of Verona, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2107-2156","authenticated-orcid":false,"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Sciences, University of Foggia, 00161 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Gabbrielli","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Endoscopy of Pancreas, Pancreas Institute, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4560-8741","authenticated-orcid":false,"given":"Stefano Francesco","family":"Crin\u00f2","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Endoscopy of Pancreas, Pancreas Institute, University of Verona, 37134 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/MPA.0000000000000833","article-title":"Prevalence of pancreatic cystic lesions is associated with diabetes mellitus and obesity: An analysis of 5296 individuals who underwent a preventive medical examination","volume":"46","author":"Mizuno","year":"2017","journal-title":"Pancreas"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.pan.2017.07.007","article-title":"Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas","volume":"17","author":"Tanaka","year":"2017","journal-title":"Pancreatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1016\/j.surg.2012.05.019","article-title":"Pancreatic resections for cystic neoplasms: From the surgeon\u2019s presumption 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