Endoscopic ultrasound-guided fine-needle aspiration biopsy: A powerful tool to obtain samples from small lesions

Jhala, Nirag; Jhala, Darshana; Eltoum, M.B.A. Isam A.; Vickers, Selwyn M.; Wilcox, C. Mel; Chhieng, David C.; Eloubeidi, Mohamad

doi:10.1002/cncr.20451

Cited by 141 publications

(119 citation statements)

References 35 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Contrary to what might be expected, the size of the lesions, whether small ( 25 mm) or large (>25 mm) does not influence the overall diagnostic yield, sensitivity, specificity, or accuracy of the method. 120 Several studies have assessed EUS-FNA receiver operating characteristics by including only pancreatic cancer patients. [121][122][123][124][125][126][127][128][129][130][131][132] The initial reports showed a sensitivity of 85-95%, with a specificity close to 100%.…”

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

View full text Add to dashboard Cite

Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

show abstract

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

View full text Add to dashboard Cite

show abstract

“…6,7 The pancreas remains 1 of the most commonly aspirated sites using this modality. This high degree of accuracy is achieved through understanding the key cytologic features of the various pancreatic lesions, which have been previously documented in the literature.…”

mentioning

confidence: 99%

Large, clear cytoplasmic vacuolation

Jhala

Siegal

Jhala

2008

Cancer

Self Cite

View full text Add to dashboard Cite

BACKGROUND. Solid pseudopapillary neoplasm (SPN) and pancreatic endocrine neoplasm (PEN) are uncommon neoplasms that demonstrate characteristic cytologic features. It is also known that both these tumors may share similar morphologic changes. These features not uncommonly pose significant diagnostic challenge for unsuspecting cytopathologists. In the current study, the authors report that recognition of clear cytoplasmic vacuoles in endoscopic ultrasound–guided fine–needle aspiration (EUS‐FNA) samples from SPN serves as a useful clue that can distinguish this tumor from PEN. METHODS. The cytologic features from 5 SPN and 20 PEN cases were evaluated. Both Diff‐Quik and Papanicolaou stains from these cases were examined. A Fisher exact test of probability was performed to determine differences in the individual cytologic features noted in these 2 tumor types. RESULTS. The results demonstrated that pseudopapillary groups (P = .004); metachromatic matrix material (P = .004); nuclear membrane irregularity (P = .004); and large, clear cytoplasmic vacuoles (P = .001) are noted significantly more frequently in SPN. The authors also demonstrated that large, clear cytoplasmic vacuoles can serve as a powerful cytologic clue for the suspicion of SPN over PEN when there is a paucity of papillary groups within the smears. Large, clear cytoplasmic vacuoles, however, were noted only in Diff‐Quik–stained smears, but not in Papanicolaou‐;stained smears. CONCLUSIONS. The results of the current study highlight that large, clear cytoplasmic vacuoles can serve as a critical clue with which to distinguish SPN from PEN in diagnostically challenging cases. Cancer (Cancer Cytopathol) 2008. © 2008 American Cancer Society.

show abstract

“…It has proven to be a valuable tool in the preoperative diagnosis and management of patients with pancreatic lesions. [1][2][3][4][5][6] Whereas most aspirations yield diagnostic material, the differential diagnosis of the reactive/reparative and neoplastic processes as well as their precise classification in the pancreatic EUS-FNAs specimens can be challenging. This can be explained by the considerable overlap in the cytomorphologic features of these processes in the pancreas.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Ductal adenocarcinoma is the most common malignancy of the pancreas. 7 Recently, it has been shown that the malignant transformation of pancreatic ductal epithelium changes the epithelial expression of apomucins.…”

mentioning

confidence: 99%