Diagnosis of metastatic pancreatic mesenchymal tumors by endoscopic ultrasound‐guided fine‐needle aspiration

Varghese, Linda; Ngae, Min Yi; Wilson, Andrew; Crowder, Clinton D.; Gulbahce, H. Evin; Pambuccian, Stefan E.

doi:10.1002/dc.21104

Cited by 17 publications

(18 citation statements)

References 45 publications

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“…In the current study cohort, all the patients with carcinoma, melanoma, and sarcoma had previously documented disease and underwent EUS‐FNA for either staging purposes or to document metastatic/recurrent disease. The use of EUS‐FNA for documenting metastatic sarcoma is especially rare, but 1 study recently reported the successful use of EUS‐FNA for the diagnosis of leiomyosarcoma, liposarcoma, alveolar rhabdomyosarcoma, and solitary fibrous tumor that were all metastatic to the pancreas 58. For patients with spindle cell lesions who are undergoing EUS‐FNA for initial tissue diagnosis such as the patient with SFT, the acquisition of sufficient materials for an adequate cell block is crucial.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound‐guided fine‐needle aspiration of intrathoracic and intra‐abdominal spindle cell and mesenchymal lesions

Bean

Baker²,

Eloubeidi

et al. 2010

Cancer Cytopathology

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BACKGROUND.The role of endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) in the evaluation of spindle cell and mesenchymal lesions is unclear. This study reviews the use of EUS‐FNA in diagnosing intrathoracic and intra‐abdominal spindle and mesenchymal cell lesions at an academic institution.METHODS.All EUS‐FNA specimens with a significant spindle or mesenchymal cell component were retrieved. Follow‐up was comprised of clinical correlation, chart review, or evaluation of subsequent tissue specimens, including FNAs, biopsies, and/or surgical resections. Lesions were categorized as either inflammatory/reactive or neoplastic.RESULTS.Forty‐four EUS‐FNA specimens were retrieved from 39 patients (21 men and 18 women with a median age of 61 years [range, 20‐88 years]). Anatomic sites included 19 lymph node specimens, 15 gastrointestinal tract specimens, 7 pancreatic specimens, and 4 other anatomic site specimens. Twenty‐two cases were inflammatory/reactive lesions, including 17 granulomatous lesions and 5 cases of chronic pancreatitis. Twenty‐two cases were neoplastic, including 14 gastrointestinal stromal tumors, 2 smooth muscle tumors, 2 sarcomatoid carcinomas, 2 melanomas, 1 sarcoma, and 1 solitary fibrous tumor. A specific cytologic diagnosis was rendered in 30 cases (81%). Immunocytochemistry was performed on 21 neoplastic cases and contributed to the differential diagnosis in 18 cases. No false‐positive findings were encountered. Three false‐negative results were identified and were attributed to sampling error.CONCLUSIONS.Spindle cell neoplasms are rarely encountered on EUS‐FNA. The differential diagnosis encompasses a wide variety of benign and neoplastic entities. Correlation of cytomorphology and ancillary studies yields a high diagnostic accuracy of spindle cell and mesenchymal lesions on EUS‐FNA. Cancer (Cancer Cytopathol) 2010. © 2010 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound‐guided fine‐needle aspiration of intrathoracic and intra‐abdominal spindle cell and mesenchymal lesions

Bean

Baker²,

Eloubeidi

et al. 2010

Cancer Cytopathology

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“…In the literature, metastases comprise at least 2% of pancreatic tumors. [5] These metastases arise from a diverse spectrum of malignancies, including sarcomas,[6] Merkel cell carcinoma,[7] squamous cell carcinoma,[8] cardiac rhabdomyosarcoma,[9] ovarian mixed müllerian tumor,[10] melanoma,[11] and phyllodes tumor. [12] In such cases, accurate diagnosis is extremely important because treatment frequently differs.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided fine-needle aspiration of metastases to the pancreas: A study of 25 cases

2011

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Background:Metastases to the pancreas are an uncommon cause of pancreatic masses seen on endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The purpose of this study is to retrospectively review the cytomorphology, clinical findings, and results of ancillary studies in a large series of these unusual cases.Materials and Methods:We searched our institution's pathology database for EUS-guided FNAs of the pancreas that were diagnostic of metastatic tumor over a 5-year period. The final cytologic diagnosis, results of ancillary studies, corresponding histological material, and clinical follow-up data were reviewed in these cases.Results:A total of 1172 pancreatic EUS-guided FNAs were identified, of which 25 cases (2.1%) had a confirmed diagnosis of a pancreatic metastasis. This included 12 (48%) cases of renal cell carcinoma, 3 (12%) melanomas, 3 (12%) small cell carcinomas, and 7 (28%) other malignancies. In these metastatic tumors involving the pancreas, 20 (80%) of the lesions were solitary. Four (16%) cases had no prior history of malignancy. The average time to diagnosis of pancreatic metastasis was 5.3 years. Immunohistochemistry and special stains were performed in 22 (88%) and 9 (36%) cases, respectively.Conclusions:Our data shows that although metastases to the pancreas are rare, they can present as a solitary mass many years after the primary malignancy is diagnosed and can even be the first manifestation of an extrapancreatic primary in a small number of cases. It is important to consider the possibility of a metastatic lesion in the pancreas because this may require a different management than a primary pancreatic tumor.

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“…5Y7 Pancreatic metastases (PM) may arise most frequently from the lung, kidney, breast, and colon. 8,9 Rare origins of PM include sarcomas, 10 Merkel cell carcinoma, 11 squamous cell carcinoma, 12 cardiac rhabdomyosarcoma, 13 ovarian mixed Mullerian tumor, 14 melanoma, 15 phylloides tumor, 16 adenoid cystic carcinoma, 17 as well as small bowel, stomach, liver, and urinary bladder tumors.…”

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confidence: 99%

Contrast Harmonic Endoscopic Ultrasonography in the Characterization of Pancreatic Metastases (With Video)

Fusaroli¹,

D'Ercole²,

Giorgio³

et al. 2014

Pancreas

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In our population, standard EUS features of PM were unremarkable. At CH-EUS, most of the PM appeared hypoenhancing suggesting a possible malignant origin. However, a subset of PM showed hyperenhancing pattern. In the appropriate context, particularly when cancer history is present, CH-EUS may add to the differential diagnosis and potentially spare endoscopic ultrasonography with fine-needle aspiration.

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Diagnosis of metastatic pancreatic mesenchymal tumors by endoscopic ultrasound‐guided fine‐needle aspiration

Cited by 17 publications

References 45 publications

Endoscopic ultrasound‐guided fine‐needle aspiration of intrathoracic and intra‐abdominal spindle cell and mesenchymal lesions

Endoscopic ultrasound‐guided fine‐needle aspiration of intrathoracic and intra‐abdominal spindle cell and mesenchymal lesions

Endoscopic ultrasound-guided fine-needle aspiration of metastases to the pancreas: A study of 25 cases

Contrast Harmonic Endoscopic Ultrasonography in the Characterization of Pancreatic Metastases (With Video)

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