Endoscopic ultrasound-guided, through-the-needle forceps biopsy in the assessment of an incidental large pancreatic cystic lesion with prior inconclusive fine-needle aspiration

A 68-year-old man underwent endoscopic ultrasound (EUS) and fine-needle aspiration of a large cystic lesion of the pancreatic neck seen incidentally on computed tomography (CT). CT demonstrated a nonenhancing, exophytic, multilocular cystic mass, measuring 82 × 72 mm ([Fig. 1], [Video 1]). A mural calcific focus was noted posteroinferiorly and a more solid component posteriorly. The CT density averaged 19 HU for the cystic component and 40 HU for the solid component.