Intermittent endoscopic ultrasound guided fine-needle aspiration for the diagnosis of solid pancreatic lesions. Pilot study

Abstract

Background and purpose of the study: endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) is the method of choice for sampling pancreatic solid lesions.However, there is significant heterogeneity in terms of the technique used. Intermittent aspiration has not been evaluated in pancreatic solid lesions and could improve the diagnostic performance. Methods: Single-blind, non-inferiority pilot study. Patients with solid pancreatic lesions and indication for EUS-FNA were prospectively included. Patients were randomly assigned to intermittent (IS) or continuous (CS) suction techniques. Diagnostic performance, cellularity, blood contamination and number of passes required to reach diagnosis were evaluated.Main results: 33 patients were assigned to CS (16 patients) or IS (17 patients).Diagnostic performance was 87.5% for CS and 94.1% for IS (OR 2.29, p = 0.51). In the IS group samples had higher cellularity (OR 1.83, 95%CI 0.48-6.91, p = 0.37) and lower blood contamination (OR 0.38, 95%CI 0.09-1.54, p = 0.18). The number of passes required to reach diagnosis was 2.12 for CS and 1.94 for IS (p = 0.64). Liquid cytology was obtained in 73.3% of IS and 61.5% of CS (OR 1.72,. Conclusions:The IS technique was not inferior to CS in terms of diagnostic accuracy in the evaluation of pancreatic solid lesions, with a tendency to obtain higher cellularity, lower blood contamination and frequent presence of cell block.

Acute pancreatitis secondary to osteosarcoma metastasis

“…Radiologically, they show circumscribed calcified lesions with homogeneous enhancement and locoregional infiltration. 4 Endoscopic ultrasound-guided puncture-aspiration is essential to take samples for histological study. Intermittent aspiration has greater diagnostic yield than continuous aspiration with a lower risk of cellular contamination 4 .…”

“…4 Endoscopic ultrasound-guided puncture-aspiration is essential to take samples for histological study. Intermittent aspiration has greater diagnostic yield than continuous aspiration with a lower risk of cellular contamination 4 . Surgical intervention is possible in some cases with variable results 5 .…”