Pancreatic cystosis in cystic fibrosis: Sometimes a bike ride can help you decide

Marcello Di Paolo; Alessandro Di Gaeta; Elena Lucia Indino; Michela Mordenti; Paolo Palange

doi:10.1016/j.rmcr.2020.101018

Pancreatic cystosis in cystic fibrosis: Sometimes a bike ride can help you decide

Respir Med Case Rep. 2020 Feb 5:29:101018. doi: 10.1016/j.rmcr.2020.101018. eCollection 2020.

Authors

Marcello Di Paolo¹, Alessandro Di Gaeta², Elena Lucia Indino², Michela Mordenti¹, Paolo Palange¹

Affiliations

¹ Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
² Department of Radiology, Oncology and Pathology, "Sapienza" University of Rome, Rome, Italy.

Abstract

Pancreatic cystosis (PC) is an uncommon manifestation of pancreas involvement in cystic fibrosis (CF), characterized by the presence of multiple macrocysts partially or completely replacing pancreas. Only few reports are available from literature and management (surgery vs follow up) is commonly based on the presence of symptoms or complications due to local mass effect, although evidence-based recommendations are still not available. We here report the case of a young adult CF patient with PC, in which cardiopulmonary exercise testing (CPET) provided important information to be integrated to the radiological finding of inferior vena cava compression by the multicystic pancreas complex. Through the analysis of oxygen kinetic cardiodynamic phase pattern, CPET may be helpful to safely exclude significant mass effects on blood venous return and to improve the decision-making process on whether to consider surgery or not in patients with PC.

Keywords: Cardiodynamic component; Cardiopulmonary exercise testing; Cystic fibrosis; Oxygen kinetics; Pancreatic cystosis.

Publication types

Case Reports