Rare pancreatic neoplasms: the utility of endoscopic ultrasound-guided fine-needle aspiration—a large single center study

Imaoka, Hiroshi; Yamao, Kenji; Bhatia, Vikram; Shimizu, Yasuhiro; Yatabe, Yasushi; Koshikawa, Takashi; Kinoshita, Yoshikazu

doi:10.1007/s00535-008-2282-6

Cited by 25 publications

(14 citation statements)

References 35 publications

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“…A recent Japanese study (36) reviewed 455 pancreatic FNA procedures: 28 were rare pancreatic tumors (no ductal adenocarcinomas). EUS-FNA with cytology, cellblock, and immunocytochemistry correctly diagnosed tumor type in 19 patients 19 (68%).…”

Section: Discussionmentioning

confidence: 99%

Definitive diagnosis of neuroendocrine tumors using fine-needle aspiration-puncture guided by endoscopic ultrasonography

Gornals

Varas²,

Català

et al. 2011

Rev. esp. enferm. dig.

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Background: the detection and diagnosis of neuroendocrine tumors (NETs) is challenging. Endoscopic ultrasonography (EUS) has a significant role in the detection of NETs suspected from clinical manifestations or imaging techniques, as well as in their precise localization and cytological confirmation using EUS-Fineneedle aspiration-puncture (FNA).Objective: to assess the usefulness and precision of EUS-FNA in the differential diagnosis and confirmation of NETs, in a retrospective review of our experience.Patients and methods: in a total of 55 patients with suspected NETs who underwent radial or sectorial EUS, 42 tumors were detected in 40 cases. EUS-FNA using a 22G needle was performed for 16 cases with suspected functional (hormonal disorders: 6 cases) and non-functional NETs (10 cases). Ki 67 or immunocytochemistry (ICC) testing was performed for all.There was confirmation in 9 cases (5 female and 4 male) with a mean age of 51 years (range: 41-81 years).All tumors were located in the pancreas except for one in the mediastinum and one in the rectum, with a mean size of 19 mm (range: 10-40 mm).Results: there were no complications attributable to FNA. Sensitivity was 100% and both precision and PPV were 89%, as a false positive result suggested a diagnosis with NET during cytology that surgery finally revealed to be a pancreatic pseudopapillary solid tumor.Conclusions: EUS-FNA with a 22G needle for NETs has high sensitivity and PPV at cytological confirmation with few complications.

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Section: Discussionmentioning

confidence: 99%

Definitive diagnosis of neuroendocrine tumors using fine-needle aspiration-puncture guided by endoscopic ultrasonography

Gornals

Varas²,

Català

et al. 2011

Rev. esp. enferm. dig.

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“…The present authors and our colleagues previously reported that the cytology was more accurate than histopathology in EUS‐FNA for the differential diagnosis of pancreatic mass lesions 10 . However, the usefulness of histopathology combined with immunohistochemical analysis to determine specific etiology has been reported 9 . Thus, a system in which both cytology and histopathology are available, needs to be developed.…”

Section: Eus‐fnamentioning

confidence: 85%

“…Recently, the utility of EUS‐FNA making an etiological diagnoses has been reported. Examples include characterization of histological subtypes of rare forms of pancreatic cancer, 9 inflammatory pancreatic mass 10 or autoimmune pancreatitis, 11,12 gastrointestinal stromal tumor (GIST), 13,14 subtypes of malignant lymphoma, 15 sarcoidosis and so on. Such diagnoses are based on one or more of histological (H&E staining), immunohistochemical or genetic analysis.…”

Section: Eus‐fnamentioning

confidence: 99%

Interventional endoscopic ultrasonography

Yamao

Bhatia

Mizuno

et al. 2009

J of Gastro and Hepatol

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Endoscopic ultrasonography (EUS) is the combination of endoscopy and intraluminal ultrasonography. This allows use of a high frequency transducer, which, due to the short distance to the target lesion, enables ultrasonographic images of high resolution to be obtained. Endoscopic ultrasonography is now a widely accepted modality for the diagnosis of pancreatobiliary diseases. It can be used to determine the depth of invasion of gastrointestinal malignancies, and often for visualizing lesions more precisely than other imaging modalities. The most important early limitation of EUS was the lack of specificity in the differentiation between benign and malignant changes. In 1992, EUS-guided fine needle aspiration (EUS-FNA) of lesions in the pancreas head has been made possible using a curved linear array echoendoscope. Since then, many researchers have expanded the indication of EUS-FNA to various kinds of lesions and also for a variety of therapeutic purposes. In this review, we particularly focus on the present and future roles of interventional EUS, including EUS-FNA and therapeutic EUS.

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“…In their study on atypical lesions, Evan et al identified pancreatic lymphomas in 5% of their samples, benign lesions in 11% and pancreatic ductal carcinomas in 21% . Similar to the cytological diagnoses of tumours of the breast and thyroid gland and based on the Bethesda system, the cytological and histological diagnosis of pancreatic specimens should be performed while receiving constructive feedback with the possibility of re‐examination …”

Section: Discussionmentioning

confidence: 99%

Assessment of preoperative pancreatic biopsy, cytological/histological review of cell‐block‐specimens obtained by endoscopic ultrasound‐guided fine‐needle aspiration: Laboratory‐based study

Mizutani

Mochizuki

Toki

2019

Diagnostic Cytopathology

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Background Pancreatic cancer is among the most lethal cancers worldwide due to the limited availability of techniques for early detection of signs and symptoms. Reportedly, it is the fourth‐leading cause of cancer‐related mortality among Japanese adults. With the advent of endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) for diagnosing pancreatic cancer, the rate of the cytological and histological diagnoses of cell‐block‐specimens has significantly increased in Japan. Methods The cytological specimens of 165 patients with pancreatic lesions obtained using EUS‐FNA between January 2010 and July 2016 at the Kyorin University Hospital were investigated. The clinical course of 153 patients was assessed from their clinical records, which included information on their imaging diagnosis, laboratory data, final clinical diagnosis and treatment; moreover, the accuracy of the cytological/histological examination and clinical diagnosis at our hospital were analysed. Results The number of cells in cell‐block‐specimens was too small to estimate data. However, cytological specimens were sufficient to observe the findings of suspected malignancy such as necrosis. Biopsy was deemed necessary for diagnosis using both histological and cytological specimens. Conclusion EUS‐FNA can be used not only to diagnose benign or malignant types of pancreatic cancers but also to assess the sensitivity of molecular target drugs and chemotherapy methods. Therefore, both histological and cytological diagnoses are required to enhance diagnostic precision both in our hospital and at other institutions.

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Rare pancreatic neoplasms: the utility of endoscopic ultrasound-guided fine-needle aspiration—a large single center study

Abstract: Pancreatic neoplasms other than ductal adenocarcinomas have diverse imaging and histopathological features. EUS-FNA is accurate and safe for their identification.

Cited by 25 publications

References 35 publications

Definitive diagnosis of neuroendocrine tumors using fine-needle aspiration-puncture guided by endoscopic ultrasonography

Definitive diagnosis of neuroendocrine tumors using fine-needle aspiration-puncture guided by endoscopic ultrasonography

Interventional endoscopic ultrasonography

Assessment of preoperative pancreatic biopsy, cytological/histological review of cell‐block‐specimens obtained by endoscopic ultrasound‐guided fine‐needle aspiration: Laboratory‐based study

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