What Does Endoscopic Ultrasound (EUS)-Guided Fine Needle Aspiration (FNA) Add to Multidetector CT in the Evaluation of Pancreatic Cysts?

Diagnostic evaluation of cystic pancreatic lesions

“…We generally reserve FNA for lesions with a low risk of cancer, a poor risk patient with an indeterminate cystic mass in the head of the pancreas that would require pancreatoduodenectomy, or a patient with a probable mucinous tumor who desires additional evidence prior to resection. There is some evidence that EUS with FNA increases diagnostic accuracy over cross-sectional imaging alone [39]. Although in this series (through 2003) just 12 patients had EUS, this technology is now used frequently.…”

“…Twelve patients in this series underwent EUS, which suggested the correct diagnosis in two cases because of morphologic characteristics and in four by FNA. Characterization of morphology has shown little promise for differentiating cystic pancreatic lesions due to the overlap in features [31] and to wide inter‐ and intra‐observer variability [39]. The sensitivity of cytology of pancreatic cyst aspirate is low 29, 32–34.…”