Onsite cytopathology evaluation and ancillary studies beneficial in EUS‐FNA of pancreatic, mediastinal, intra‐abdominal, and submucosal lesions

Mehmood, Shafqat; Jahan, Amna; Loya, Asif; Yusuf, Muhammed Aasim

doi:10.1002/dc.23207

Cited by 33 publications

(23 citation statements)

References 39 publications

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“…On‐site cytopathology after three or more needle passes of EUS‐FNA can provide a higher diagnostic yield in upper GI subepithelial or extraluminal lesions, but needle size has no significant association with the improvement in diagnostic yield . However, data on the effect of on‐site cytological evaluation for EUS‐FNB in gastric SETs are lacking.…”

Section: Discussionmentioning

confidence: 99%

EUS‐guided FNA and FNB after on‐site cytological evaluation in gastric subepithelial tumors

Han

Lee

Hong

et al. 2016

J of Digest Diseases

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Section: Discussionmentioning

confidence: 99%

EUS‐guided FNA and FNB after on‐site cytological evaluation in gastric subepithelial tumors

Han

Lee

Hong

et al. 2016

J of Digest Diseases

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“…[2] Despite using a thin (25-gauge) needle, sufficient diagnostic material was obtained in both cases at our institution by making dedicated passes for cell block (one pass with suction in the first case and two without suction in the second) which improved cellular yield and by utilizing rapid on-site evaluation (ROSE). ROSE has been shown to have concordance rate >98% with final cytopathology while considerably decreasing the number of repeat procedures performed,[34] further improving the utility of EUS-FNA for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Falling under the umbrella cells: A single institutional experience and literature review of urothelial carcinoma presenting as a primary pancreatic mass on endoscopic ultrasound-guided fine-needle aspiration

2017

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Metastases to the pancreas are much less common than primary pancreatic lesions, and there are few reports in the literature of metastatic urothelial carcinoma (UC) found in the pancreas. We report two cases of metastatic UC mimicking a primary pancreatic lesion. Two female patients, aged 48 and 83 years, presented with isolated pancreatic lesions causing obstructive jaundice suspicious for pancreatic adenocarcinoma and underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with rapid on-site evaluation (ROSE). On cytopathology, the lesions were found to be UC, confirmed with immunohistochemical (IHC) staining. UC rarely metastasizes to the pancreas, and diagnosis through EUS-FNA can be challenging. However, the utilization of ROSE, dedicated cell block passes, and IHC have proved to be effective in obtaining this unusual pancreatic diagnosis by EUS-FNA.

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“…The role of rapid microscopic evaluation (either physically on site or in a nearby laboratory) of FNA smears from any anatomic location while the patient is physically present in a treatment room has been well established for a whole host of pathologic conditions. This is especially critical for deep‐seated lymphoproliferative lesions . Rapid evaluation not only increases the diagnostic yield but also effectively helps to triage the specimen for these essential ancillary studies.…”

Section: Rapid Evaluation Specimen Triage and Diagnostic Approachmentioning

confidence: 99%

Lymph node cytopathology: Essential ancillary studies as applied to lymphoproliferative neoplasms

Jin

Wakely

2018

Cancer Cytopathology

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Ancillary testing is absolutely integral to the correct recognition and classification of lymphoid neoplasms as procured with the fine-needle aspiration (FNA) biopsy technique. In patients with a newly diagnosed lymphoid neoplasm, immunophenotyping with flow cytometry, immunohistochemistry, or both is a standard that is currently expected by oncologists before any form of therapy is initiated. This is often the case also for patients with recurrent/relapsed disease. The cellular material obtained with FNA is perfectly suited to meet this demand. That said, the exceptional complexity of modern-day lymphoma classification often precludes definitive subclassification in a subset of lymphomas for a variety of reasons with the FNA biopsy technique, even with the application of ancillary tests. These include a requirement for definitive knowledge of the nodal architecture (eg, Hodgkin lymphoma), of the histologic grade via the counting of cells per microscopic field (follicular lymphoma), and of molecular findings (often unobtainable because of limitations of cellularity). The application of molecular tests to lymph node aspirates continues to evolve but is still largely confined to specialized medical centers. The intent of this article is to briefly review the diagnostic approach and algorithm for handling lymph node aspirates at the authors' own laboratory. This article highlights what the authors and others consider to be essential ancillary tests and discusses their respective advantages and shortcomings. It lists limited and extended antibody panels and molecular tests that the authors have found helpful not only for correctly recognizing lymphoma with FNA cytopathology but also for subtyping lymphomas whenever possible.

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Onsite cytopathology evaluation and ancillary studies beneficial in EUS‐FNA of pancreatic, mediastinal, intra‐abdominal, and submucosal lesions

Abstract: EUS-FNA, combined with ROSE, is a safe and highly effective technique in experienced hands with excellent diagnostic accuracy and low complication rates.

Cited by 33 publications

References 39 publications

EUS‐guided FNA and FNB after on‐site cytological evaluation in gastric subepithelial tumors

EUS‐guided FNA and FNB after on‐site cytological evaluation in gastric subepithelial tumors

Falling under the umbrella cells: A single institutional experience and literature review of urothelial carcinoma presenting as a primary pancreatic mass on endoscopic ultrasound-guided fine-needle aspiration

Lymph node cytopathology: Essential ancillary studies as applied to lymphoproliferative neoplasms

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