Fine‐needle aspiration of intrapancreatic accessory spleen: Cytomorphologic features and differential diagnosis

Tatsas, Armanda; Owens, Christopher L.; Siddiqui, Momin T.; Hruban, Ralph H.; Ali, Syed Z.

doi:10.1002/cncy.21185

Cited by 39 publications

(36 citation statements)

References 18 publications

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“…Tatsas et al reported 6 cases with a suspected intrapancreatic accessory spleen (IPAS) who underwent EUS-FNA (40). Of these 6 cases, IPAS was histologically confirmed for 3 cases.…”

Section: Discussionmentioning

confidence: 99%

Epidermoid Cyst in an Intrapancreatic Accessory Spleen: Case Report and Literature Review of the Preoperative Imaging Findings

et al. 2016

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An epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS) is rare, and also difficult to correctly diagnose before surgery. It is mostly misdiagnosed as a cystic tumor, such as a mucinous cystic neoplasm or as a solid tumor with cystic degeneration, such as a neuro endocrine tumor. We herein report a case of ECIAS and also perform a literature review of 35 reports of ECIAS. Although the preoperative diagnosis of ECIAS using conventional imaging is relatively difficult to make, careful preoperative examinations of the features on computed tomography and magnetic resonance imaging could lead to a correct preoperative diagnosis of ECIAS which might thereby reduce the number of unnecessary resections.

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“…Tatsas et al reported 6 cases with a suspected intrapancreatic accessory spleen (IPAS) who underwent EUS-FNA (40). Of these 6 cases, IPAS was histologically confirmed for 3 cases.…”

Section: Discussionmentioning

confidence: 99%

Epidermoid Cyst in an Intrapancreatic Accessory Spleen: Case Report and Literature Review of the Preoperative Imaging Findings

et al. 2016

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“…[1] IPAS is a benign congenital lesion of the pancreas that results from entrapment of portion of the spleen in the dorsal pancreatic bud during embryologic development. [23] IPAS affects approximately 10% of the population with 15%–20% of the cases present in the tail of the pancreas. [23] IPASs are usually incidentally discovered due to increased use of sophisticated imaging studies.…”

Section: Brief Review Of the Topicmentioning

confidence: 99%

“…[23] IPAS affects approximately 10% of the population with 15%–20% of the cases present in the tail of the pancreas. [23] IPASs are usually incidentally discovered due to increased use of sophisticated imaging studies. IPAS does not require surgical intervention unless it is involved by a secondary process, such as benign disease or malignancy.…”

Section: Brief Review Of the Topicmentioning

confidence: 99%

“…IPAS does not require surgical intervention unless it is involved by a secondary process, such as benign disease or malignancy. [23] Radiologically, the IPAS mimics PanNET. [13] To clarify the nature of an incidentally discovered pancreatic mass, EUS-FNA is the method of choice due to its high sensitivity.…”

Section: Brief Review Of the Topicmentioning

confidence: 99%

“…[13] To clarify the nature of an incidentally discovered pancreatic mass, EUS-FNA is the method of choice due to its high sensitivity. [23]…”

Section: Brief Review Of the Topicmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound-guided fine-needle aspiration of hyperenhancing lesion suspicious for pancreatic neuroendocrine tumor in the tail of pancreas-potential pitfalls

2017

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Endoscopic ultrasound‐guided pancreatic fine‐needle aspiration: Potential pitfalls in one institution's experience of 1212 procedures

Bergeron

Perry

Houser

et al. 2014

Cancer Cytopathology

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BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has emerged as the diagnostic modality of choice for mass lesions in the pancreas. The objective of the current study was to determine the accuracy and pitfalls of EUS-FNA in the diagnosis of pancreatic lesions in cases that involved follow-up surgical resection. METHODS: Cases of EUS-FNA of pancreatic lesions performed from 2007 to mid-2012 for which subsequent surgical resection was performed were retrieved from the department's database. The accuracy of the cytologic diagnosis was assessed using the histological diagnosis as the gold standard. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. "Neoplastic," "suspicious," and "malignant" were classified as a positive cytologic diagnosis. In one calculation method, "atypical" was also included as a positive cytologic diagnosis whereas in another it was not considered to be a positive cytological result. The cases with a cytologic-histological discrepancy were reviewed to identify sources of errors.RESULTS: A total of 1212 cases from 1104 patients (518 women and 586 men; age range, 18-94 years [average age, 63.5 years]) were identified. Cytologic diagnoses included 52 unsatisfactory, 224 benign, 129 atypical, 140 neoplasm, 35 suspicious, and 632 malignant diagnoses. Of these cases, 397 patients had histological follow-up information available. The sensitivity, specificity, positive predictive value, and negative predictive value were 83.2%, 85.9%, 95.9%, and 56.1%, respectively, with atypical cases excluded from the analysis. When atypical cases were included as a positive cytologic diagnosis, the sensitivity, specificity, positive predictive value, and negative predictive value were 86.7%, 67.9%, 90.7%, and 58.5%, respectively, and were 73.7%, 87.7%, 95.6%, and 48.0%, respectively, when atypical cases were included as a negative cytologic diagnosis. The major difficulty in EUS-FNA cytology was to differentiate pancreatic mucinous neoplasms from contaminants of gastric mucosa. Other pitfalls included differentiating mucinous neoplasm from extensive pancreatic intraepithelial neoplasia, and endocrine tumor from nesidioblastosis versus acinar cell carcinoma or intrapancreatic spleen.CONCLUSIONS: EUS-FNA is a valuable tool for the diagnosis of pancreatic lesions, especially solid malignant tumors.Cytologic-radiological correlation is essential in differentiating pancreatic mucinous neoplasms from gastric mucosa, because the former usually are found to have characteristic features on imaging. Pathologists should be aware of the pitfalls in the cytologic diagnosis of pancreatic lesions that may significantly change the clinical management of the patients.Cancer (Cancer Cytopathol) 2015;123:98-107.

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Fine‐needle aspiration of intrapancreatic accessory spleen: Cytomorphologic features and differential diagnosis

Cited by 39 publications

References 18 publications

Epidermoid Cyst in an Intrapancreatic Accessory Spleen: Case Report and Literature Review of the Preoperative Imaging Findings

Epidermoid Cyst in an Intrapancreatic Accessory Spleen: Case Report and Literature Review of the Preoperative Imaging Findings

Ultrasound-guided fine-needle aspiration of hyperenhancing lesion suspicious for pancreatic neuroendocrine tumor in the tail of pancreas-potential pitfalls

Endoscopic ultrasound‐guided pancreatic fine‐needle aspiration: Potential pitfalls in one institution's experience of 1212 procedures

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