Endoscopic Ultrasound–Guided Fine-Needle Aspiration

Jhala, Nirag; Jhala, Darshana; Chhieng, David C.; Eloubeidi, Mohamad A.; Eltoum, Isam A.

doi:10.1309/mfrfj0xyjln8nvdp

Cited by 208 publications

(161 citation statements)

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“…Afterwards, an endoscopic fine needle aspiration biopsy was performed. This approach is consistent with literature which has shown that not only endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has dramatically improved our ability to sample pancreatic solid lesions (6), but also that EUS-FNA is a safe and accurate method in evaluating pancreatic masses, especially in the presence of an on-site cytopathologist who can provide a real-time determination of whether a specimen is adequate or additional samples are necessary (7)(8)(9). Other studies however, have shown that CT guided biopsy may also be an option (10).…”

Section: Discussionsupporting

confidence: 87%

Secondary malignancies mimicking primary pancreatic lymphoma

Petekkaya¹,

Roach²,

Gezgen³

et al. 2014

Gaziantep Med J

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Malignancies localized to the pancreas at times can mimic many other types of cancer. In imaging studies, tumors localized to the pancreas can resemble lymphoma. Especially in elderly patients, these tumors which appear like pancreatic cancer are sometimes left untreated by physicians, without confirming with biopsy, because the expected survival is extremely short. In this case report we examine how these discrepancies could be resolved. Keywords: Lymphoma; pancreas Özet Pankreas yerleşimli malignensiler birçok kanser alt tipi ile karışabilmektedir. Pankreas bölgesi tümörleri görüntülemede lenfoma ile karışabilir. Özellikle yaşlı hastalarda pankreas kanseri görünümü veren bu tümörler doktorlar tarafından ilginç olarak biyopsi yapılmadan yaşam süresi kısa olduğu belirtilip tedavisiz bırakılmaktadırlar. Vaka çalışmamızda bu tür karışıklıkların nasıl giderileceğini inceleyeceğiz.

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Section: Discussionsupporting

confidence: 87%

Secondary malignancies mimicking primary pancreatic lymphoma

Petekkaya¹,

Roach²,

Gezgen³

et al. 2014

Gaziantep Med J

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“…Conventional EUS-FNA has certain limitations. Sensitivity significantly decreases by 10-15 % without an on-site pathologist to evaluate the sample obtained during the procedure (40)(41)(42). Without on-site evaluation, the recommended number of passes is 5-7 for solid pancreatic lesions and 2-3 for lymph nodes (34,40,41).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Iglesias‐García

Abdulkader

Lariño‐Noia

et al. 2014

Rev. esp. enferm. dig.

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Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is an accurate technique for sampling intraintestinal and extraintestinal lesions. However, cytology possesses certain limitations, which may be overcome if histological specimens are provided to the pathologist.Aim: The aim of the study was to evaluate the accuracy of a newly developed 19G histology needle.Methods: Retrospective analysis of a prospectively collected data base including patients who underwent EUS-guided biopsy with the 19G ProCore TM histology needle for the evaluation of intraintestinal or extraintestinal lesions. Samples were obtained after one needle pass, recovered into ThinPrep ® and processed for histological analysis. Results were compared to the gold standard of surgical histopathology, or global pathological, clinical and radiological assessment, and follow-up in non-operated cases. Results are shown as mean ± SD. Percentage of optimal samples for histological evaluation and the overall diagnostic accuracy were evaluated.Results: 87 patients (mean age 62.9 years, range 25-88 years, 36 woman) were included. Lesions mean size was 41.6 ± 21.3 mm. 66 lesions (75.9 %) were considered as malignant and 21 (24.1 %) as benign. EUS-guided biopsy was feasible in all cases (100 %). Sample quality was adequate for histological assessment in 82 lesions (94.2 %). In the remaining cases the sample was adequate for cell-block evaluation. Sensitivity, specificity, PPV, NPV, and overall accuracy for malignancy were 93.4 %, 100 %, 100 %, 84 %, and 95.4 %, respectively. There were no complications related to the procedure. Conclusion:The EUS-guided biopsy with the 19G histology needle provides with an optimal core sample for histological evaluation allowing a high histopathologic diagnostic accuracy.

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“…In previous studies showing high diagnostic yields of cytology, 3 to 6 needle passes through the lesion [16][17][18][19][20][21][22][23]26] and on-site evaluation of the FNA sample adequacy by a cytopathologist [10,[27][28][29] was considered essential. We were able to obtain an adequate sample in 90% of cases by performing three passes, two for cytological evaluation and one for histological evaluation.…”

Section: Discussionmentioning

confidence: 99%

Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

Iglesias‐García

Domínguez‐Muñoz²,

Lozano-León³

et al. 2007

WJG

110

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INTRODUCTIONDifferential diagnosis of pancreatic masses is a frequent clinical challenge. Therapeutic decision in this context is mainly based on the ability to establish or exclude malignancy [1] . Although ductal adenocarcinoma is the most frequent cause of pancreatic masses, other neoplasms (e.g. lymphoma, cystic tumours) and benign conditions (e.g. chronic pancreatitis) with different prognoses and treatment options can arise within the pancreas. A histological diagnosis becomes therefore highly relevant for an optimal therapeutic decision [2] . Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has been proved to be a safe and useful method for tissue sampling of intramural and extramural gastrointestinal lesions including the pancreas [3,4] . Cytological study of the materials obtained by FNA allows the evaluation of cellular findings suggestive of malignancy, such as anisonucleosis, nuclear membrane irregularity and nuclear enlargement. Unfortunately, inflammation causes a reactive and regenerative process leading to cellular changes that can be difficult to distinguish from well-differentiated neoplasias. Histological study of tissue samples allows the assessment of tissue architecture and cell morphology, as well as the performance of immunohistochemical analysis [5,6] , thus usually providing with a higher diagnostic accuracy than cytology.Retrieving Abstract AIM: To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) material in the differential diagnosis of pancreatic solid masses. METHODS:Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs (22G needle) were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Materials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study. RESULTS:Length of the core specimen obtained for histological analysis was 6.5 ± 5.3 mm (range 1-22 mm). Cytological and histological samples were considered as adequate in 51 (82.3%) and 52 cases (83.9%), respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Contrary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases (90.3%), with a global sensitivity of 84.21%, specificity of 100% and an overall accuracy of 90.32%. The complication rate was 1.6%. CONCLUSION:Adequate pancreatic core specimens for

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Endoscopic Ultrasound–Guided Fine-Needle Aspiration

Cited by 208 publications

References 0 publications

Secondary malignancies mimicking primary pancreatic lymphoma

Secondary malignancies mimicking primary pancreatic lymphoma

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

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