Endoscopic ultrasound-guided fine needle aspiration improves the pre-operative diagnostic yield of solid-pseudopapillary neoplasm of the pancreas: an international multicenter case series (with video)

Law, Joanna K.; Stoita, Alina; Wever, W. F. M. De; Gleeson, Ferga C.; Dries, Andrew; Blackford, Amanda L.; Kiswani, Vandhana; Shin, Eun Ji; Khashab, Mouen A.; Canto, Marcia Irene; Singh, Vikesh K.; Lennon, Anne Marie

doi:10.1007/s00464-014-3508-8

Cited by 59 publications

(65 citation statements)

References 18 publications

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“…16 The use of fine-needle aspiration cytology (FNAC) either percutaneously or EUS guided can help distinguish SPNs from other pancreatic tumors. 17 However, seeding of the needle tract by neoplastic cells and complications, such as bleeding, pancreatic fistula, and biliary fistula during the procedure, also had been reported. 18 PET may not add additional information for diagnosis.…”

Section: Discussionmentioning

confidence: 98%

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

Cheng

et al. 2015

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 98%

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

Cheng

et al. 2015

Journal of Gastrointestinal Surgery

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“…The diagnostic accuracy of EUS-FNA for SPT was found to be 75% in a multicentric experience of Jani et al [12] in 2008. More recently, Law et al [13] reported that the addition of EUS-FNA to a preoperative work-up of SPT significantly increased the diagnostic yield to 82.4%. In our experience, 5 patients underwent preoperative EUS-FNA: only 2 patients had a correct diagnosis of SPT.…”

Section: Discussionmentioning

confidence: 99%

Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Beltrame

Pozza

Bona

et al. 2016

Gastroenterology Research and Practice

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Aim of this study was to review the institutional experience of solid-pseudopapillary tumors of the pancreas with particular attention to the problems of preoperative diagnosis and treatment. From 1997 to 2013, SPT was diagnosed in 18 patients among 451 pancreatic cystic neoplasms (3.7%). All patients underwent preoperative abdominal ultrasound, computed assisted tomography, and tumor markers (CEA and CA 19-9) determinations. In some instances, magnetic resonance, positron emission tomography, and endoscopic ultrasound with aspiration cytology were performed. There were two males and 16 females. Serum CA 19-9 was slightly elevated in one case. Preoperative diagnosis was neuroendocrine tumor (n = 2), mucinous tumor (n = 2), and SPT (n = 14). Two patients underwent previous operation before referral to our department: one explorative laparotomy and one enucleation of SPT resulting in surgical margins involvement. All patients underwent pancreatic resection associated with portal vein resection (n = 1) or liver metastases (n = 1). One patient died of metastatic disease, 77 months after operation, and 17 are alive and free with a median survival time of 81.5 months (range 36–228 months). Most of SPT can be diagnosed by CT or MRI, and the role of other diagnostic tools is very limited. We lack sufficient information regarding clinicopathologic features predicting prognosis. Caution is needed when performing limited resection, and long and careful follow-up is required for all patients after surgery.

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“…Hyaline globules, papillary or pseudopapillary fragments and deposits of basement membrane material can be recognized by careful morphologic evaluation of the cytological smears in both YST and SPNP . Moreover, a new subtype of primary ovarian neoplasm with identical histological and immunohistochemical features of SPNP has recently been described; therefore the differential diagnosis of cytologic/histologic findings in some particular clinical setting is a challenge .…”

mentioning

confidence: 98%

“…YST may exhibit numerous histological patterns, including microcystic/reticular, glandular, endodermal sinus, papillary, alveolar‐glandular, macrocystic, hepatoid, polyvesicular vitelline, myxoid and uncommonly a solid configuration . Solid pseudopapillary neoplasm of the pancreas (SPNP) is an infrequent tumor reported to account for <3% of all non‐endocrine pancreatic tumors . It frequently appears in young women, and due to its rare aggressive behavior it should be differentiated from other highly metastatic pancreatic neoplasms …”

mentioning

confidence: 99%

Hyaline globules and papillary fragments in cytologic smears from two intra‐abdominal tumors (ovarian and hepatic) in female patients: A diagnostic pitfall with histologic correlation

Machado

López-Soto²,

Pérez-López³

et al. 2016

Diagnostic Cytopathology

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Hyaline globules and papillary fragments in cytologic samples from two intra-abdominal tumors in young females are presented including the cytological features and the correlation with the histopathologic and immunohistochemical findings. In the first case a cytologic study from an ovarian mass showed papillary structures and isolated tumor cells with epithelioid morphology, irregular reniform-like nuclear contour, pale or vacuolated cytoplasm, abundant hyaline globules and occasional glomeruloid structures resembling Schiller-Duval bodies. Yolk sac tumor (YST) was the diagnosis on the histological slides. Tumor cells showed positivity for cytokeratin (AE1/AE3), epithelial membrane antigen (EMA), alpha-fetoprotein (AFP) and Sal-like protein 4 (SALL4). In case number two the cytologic study from a liver metastasis displayed papillary and rosette-like clusters composed of uniform and bland cells showing occasional long cytoplasmic tails, hyaline globules and nuclear grooves. A diagnosis of hepatic metastasis from solid pseudopapillary neoplasm of the pancreas (SPNP) was rendered from the histology. Tumor cells revealed immunoreactivity for cytokeratin (AE1/AE3), Vimentin, Galectin-1 (GAL-1), Neuron specific-enolase, CD10, progesterone and β-catenin (nuclear stain). Regarding differential diagnosis, in the patient with the ovarian mass an ovarian clear cell carcinoma was considered, as well as other germ cell tumors or metastatic carcinoma, while in the patient with a liver metastasis a neuroendocrine carcinoma was taken into account. YST and SPNP share some cytological findings, including hyaline globules, papillary structures, clear cells and intercellular eosinophilic basement membrane deposits. Thus, a detailed study and careful interpretation of the cytological, histological and immunohistochemical findings may be worthwhile to avoid a potential misdiagnosis, particularly in the cytologic specimens of the ovarian and/or intra-abdominal mass, when involving young females. Diagn. Cytopathol. 2016;44:935-943. © 2016 Wiley Periodicals, Inc.

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Endoscopic ultrasound-guided fine needle aspiration improves the pre-operative diagnostic yield of solid-pseudopapillary neoplasm of the pancreas: an international multicenter case series (with video)

Abstract: SPNs are rare pancreatic tumors primarily affecting young women. The addition of EUS-FNA significantly increased the pre-operative diagnostic yield of SPN to 82.4 %.

Cited by 59 publications

References 18 publications

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

Solid-Pseudopapillary Tumor of the Pancreas: A Single Center Experience

Hyaline globules and papillary fragments in cytologic smears from two intra‐abdominal tumors (ovarian and hepatic) in female patients: A diagnostic pitfall with histologic correlation

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