Endoscopic ultrasound-guided fine needle aspiration cytology of metastatic renal cell carcinoma to the pancreas: A multi-center experience

Abstract

Introduction:The increasing use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology to examine pancreatic neoplasms has led to an increase in the diagnosis of metastases to the pancreas. Renal cell carcinoma (RCC) is the most common metastasis to the pancreas. Our study examines 33 cases of metastatic RCC to the pancreas sampled by EUS-FNA from four large tertiary care hospitals.Materials and Methods:We searched the cytopathology database for RCC metastatic to the pancreas diagnosed by EUS-FNA from January 2005 to January 2015. Patient age, history of RCC, nephrectomy history, follow-up postnephrectomy, radiological impression, and EUS-FNA cytologic diagnosis were reviewed.Results:Thirty-three patients were identified. The average age was 67.5 years (range, 49–84 years). Thirty-two patients had a previous documented history of RCC. One patient had the diagnosis of pancreatic metastasis at the same time of the kidney biopsy. Thirty-one patients had been treated with nephrectomy. Twenty-seven patients were being monitored annually by computed tomography or magnetic resonance imaging. Twenty-five patients had multiple masses by imaging, but 8 patients had a single mass in the pancreas at the time of EUS-FNA. EUS-FNA of 20 cases showed classic morphology of RCC. Thirteen cases had either “atypical” clinical-radiologic features or morphologic overlaps with primary pancreatic neoplasms or other neoplasms. Cell blocks were made on all 13 cases and immunochemical stains confirmed the diagnosis.Conclusions:EUS-FNA cytology is useful for the diagnosis of metastatic RCC to the pancreas. Cytomorphology can be aided with patient history, imaging analyses, cell blocks, and immunochemical stains.

Comparison of EUS-guided conventional smear and liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

“…Our study included only those studies in which a comparative analysis between CS and LBC was performed in pancreatic lesions. We excluded studies in which either only one technique was evaluated 57 58 or non-pancreatic lesions were evaluated 59 60 There are limitations to this study as well, most of which are inherent in any meta-analysis. We were unable to evaluate the effect of lesion location, size, number of passes, needle size, or operator experience on our results.…”

Metastatic squamous cell carcinoma to the pancreas: Report of an extremely rare case

“…As a result, imaging studies can only precisely evaluate the stage of disease, whereas histopathological examination can more accurately distinguish primary from metastatic pancreatic lesions (12). Percutaneous fine-needle biopsy of the pancreatic tumor, guided by either CT or EUS, can help establish a solid diagnosis (13,14). Following meticulous evaluation of preoperative imaging studies and assessment of the patient's clinical condition, surgical teams can determine whether the patient is eligible to undergo resection with curative intent (10).…”

An Unusual Case of Pancreatic Metastasis from Squamous Cell Carcinoma of the Lung Diagnosed by EUS-Guided Fine Needle Biopsy

“…The usefulness of EUS-guided tissue sampling in the diagnosis of pancreatic metastases has previously been reported [1, 5–7]. However, some of the metastatic tumors to the pancreas (e.g., esophageal and non-SCLC metastases) cannot be definitively confirmed by cytomorphology alone [5], and obtaining optimal histological samples is highly desirable to improve diagnostic accuracy and certainty.…”