Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Bardales, Ricardo H.; Stelow, Edward B.; Mallery, Shawn; Lai, Rebecca; Stanley, Michael W.

doi:10.1002/dc.20300

Cited by 77 publications

(50 citation statements)

References 292 publications

(323 reference statements)

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“…In particular, image-guided fine-needle aspiration biopsy has been used as an accurate and safe modality for diagnosis of neuroendocrine tumors and their metastases. [3][4][5][6][7] Islet-1 and NESP-55 have been identified as potential markers to distinguish primary pancreatic neuroendocrine tumors from neuroendocrine tumors of other sites, but both markers suffer from relatively low sensitivity and specificity. 8,9 Other studies have evaluated TTF-1 and CDX-2 immunohistochemistry, although both antibodies are not entirely specific (CDX-2) or sensitive (TTF-1).…”

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confidence: 99%

PAX8 is expressed in pancreatic well‐differentiated neuroendocrine tumors and in extrapancreatic poorly differentiated neuroendocrine carcinomas in fine‐needle aspiration biopsy specimens

Haynes

Sangoi

Pai

2011

Cancer Cytopathology

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BACKGROUND:PAX (paired box) genes encode a family of transcription factors important for organogenesis. Recently, PAX8 has been recognized as a potential immunohistochemical marker of pancreatic neuroendocrine tumors. The authors evaluated PAX8 expression in fine‐needle aspiration biopsies of neuroendocrine tumors to establish whether PAX8 immunohistochemistry can be used as an ancillary marker of pancreatic origin for neuroendocrine tumors.METHODS:Fine‐needle aspiration biopsies from 72 neuroendocrine tumors were evaluated for PAX8 expression: 32 primary and 23 metastatic well‐differentiated neuroendocrine tumors (25 pancreatic, 13 pulmonary, 3 ileal, 2 duodenal, 1 rectal, 1 ovarian, and 10 primary site unknown) and 17 poorly differentiated neuroendocrine carcinomas (11 pulmonary, 1 pancreas, 1 breast, 1 thymus, and 3 primary site unknown).RESULTS:Among well‐differentiated neuroendocrine tumors, only tumors from the pancreas were PAX8 positive (14 of 25, 56%) whereas no cases of pulmonary (0 of 13), ileal (0 of 3), duodenal (0 of 2), rectal (0 of 1), or ovarian (0 of 1) well‐differentiated neuroendocrine tumors were positive for PAX8. One of 10 (10%) well‐differentiated neuroendocrine tumors of unknown primary origin was PAX8 positive. Among poorly differentiated neuroendocrine carcinomas, PAX8 expression was identified in 1 of 1 (100%) pancreatic, 1 of 1 (100%) thymic, 4 of 11 (36%) pulmonary, and 0 of 1 (0%) breast carcinomas. One of 3 (33%) poorly differentiated neuroendocrine carcinomas of unknown primary origin was PAX8 positive.CONCLUSIONS:Pancreatic well‐differentiated neuroendocrine tumors frequently express PAX8, which can help distinguish pancreatic primary tumors from tumors of other anatomic sites. In contrast, PAX8 expression in poorly differentiated neuroendocrine carcinomas is not specific for pancreatic origin and can be seen in extrapancreatic poorly differentiated neuroendocrine carcinomas. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society

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confidence: 99%

PAX8 is expressed in pancreatic well‐differentiated neuroendocrine tumors and in extrapancreatic poorly differentiated neuroendocrine carcinomas in fine‐needle aspiration biopsy specimens

Haynes

Sangoi

Pai

2011

Cancer Cytopathology

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“…An enhancing renal neoplasm on CT or MRI has been considered by most urologists to be a sufficient indication for surgery because about 80% of such lesions prove to be RCC (9) . Currently, if local experience is sufficient and the biopsy result has the potential to impact treatment decisions, urologists should consider increasing the use of core biopsy and FNA to better characterize suspicious renal masses preoperatively (2,12,14) . The advantages of a biopsy in these cases are the potential to decrease unnecessary treatment of small renal masses and better selection of tumors for active surveillance and minimally invasive ablative therapies (7,14) .…”

Section: Discussionmentioning

confidence: 99%

INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

Moura

Lopes

Srougi

et al. 2014

Arq. Gastroenterol.

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-Context -Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly.The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives -To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Method -Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results -Ten procedures were performed in nine male patients (median age 54.7 years) on the right (n = 4) and left kidney (n = 4) and bilaterally (n = 1). Kidney masses (median diameter 55 mm ; range 13-160 mm) were located in the upper pole (n = 3), the lower pole (n = 2) and the mesorenal region (n = 3). In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions -Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity. HEADINGS -Kidney neoplasms, diagnosis. Ultrasonography. Endoscopic ultrasound-guided fine needle aspiration.

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“…12,21,[74][75][76][77][78][79][80][81] Cytology may underestimate the final histologic grade of neoplastic mucinous cyst, given that the cyst lining is quite heterogeneous, and the degree of epithelial atypia may not be representative of the highest degree of atypia of the cyst on histology. 12,79,82 Aside from the clinical suspicion of a neoplastic mucinous cyst, the presence of a mucinous cyst is often confirmed at the time of aspiration when thick, viscous mucus is grossly appreciated by the aspirator.…”

Section: Pseudocystmentioning

confidence: 99%

Pancreatic cysts

Pitman

Lewandrowski

Shen

et al. 2010

Cancer Cytopathology

125

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Preoperative diagnosis of pancreatic cysts benefits from integrating the clinical, radiological, and cytological features. As patient management algorithms evolve to increasingly nonsurgical options, accuracy in distinguishing mucinous from nonmucinous and benign from malignant mucinous cysts is important. This review focuses on pseudocysts, serous cystadenomas, intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms. Patients with pseudocysts almost always present with pancreatitis and are usually medically managed. Radiological studies reveal a unilocular cyst mostly in the pancreatic tail. Cyst fluid is thin, with high amylase but low carcinoembryonic antigen (CEA) levels. DNA mutations are absent. Serous cystadenomas are benign and do not require resection. Patients are usually asymptomatic and have microcystic or macrocystic masses anywhere in the pancreas. Cytology is frequently nondiagnostic. CEA and amylase levels are low. DNA analysis may reveal loss of heterozygosity (LOH) at 3p if associated with Von Hippel-Lindau disease. Neoplastic mucinous cysts are highly variable in their presentation. Most are resected. Mucinous cystic neoplasms typically arise in the body or tail of the pancreas of middle-aged women and demonstrate a septated cyst without dilatation of the main pancreatic duct. Branch duct IPMNs are more common in the pancreatic head of elderly men. Main duct dilatation correlates with main duct or combined type IPMN. Both types of mucinous cysts produce variable amounts of mucin. Cytologically nonmalignant but atypical epithelial cells, even when scant, are an indication of a high risk for malignancy. High CEA level supports a mucinous cyst, as do KRAS mutation and good quality DNA levels. KRAS mutation and multiple LOH support malignancy.

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Review of endoscopic ultrasound‐guided fine‐needle aspiration cytology

Cited by 77 publications

References 292 publications

PAX8 is expressed in pancreatic well‐differentiated neuroendocrine tumors and in extrapancreatic poorly differentiated neuroendocrine carcinomas in fine‐needle aspiration biopsy specimens

PAX8 is expressed in pancreatic well‐differentiated neuroendocrine tumors and in extrapancreatic poorly differentiated neuroendocrine carcinomas in fine‐needle aspiration biopsy specimens

INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

Pancreatic cysts

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