My approach to endoscopic ultrasound-guided fine-needle aspiration biopsy specimens of the pancreas

Abstract

<jats:p>Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is the optimal method for sampling lesions of the pancreas. This procedure is being performed at increasing numbers of hospitals and therefore, more and more cellular pathology departments are having to process and report EUS-FNAB specimens. This article outlines the advantages of using tissue/cell block preparation to process these specimens. In particular, such preparation concentrates, conserves and preserves sampled material which is then available for a full array of further analyses. Tissue/cell block preparation also enables EUS-FNAB specimens to be assessed by a wider range of cellular pathologists. This article demonstrates how a tissue/cell block protocol permits the diagnosis of the full range of pancreatic pathologies sampled by EUS-FNAB. The protocol is identical for all these pathologies (including both solid and cystic lesions) and is simple at all stages of the specimen pathway, from collection to processing to assessment.</jats:p>

Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial

“…In contrast with the traditional smears used for cytological examination, all samples in this study were processed for histological examination with cell block. This processing technique may overcome the negative impact of blood contamination usually seen in cytological smears [28]. Our results showed that despite an increase in the blood content in S+samples, the processing technique may overcome the impact in pathology interpretation in such samples.…”

“…The use of FNB associated with cell block sample processing instead of smearing, allows for not only histological observation but also conduct of immunohistochemistry studies with appropriate controls. It potentially eliminates the need for rapid onsite evaluation (ROSE), resulting in cost savings [3][4][5].…”

“…The role of the different aspiration techniques when performing FNB was assumed from previous studies on FNA needles, despite the differences in the sample processing techniques (smear/liquid-based techniques for cytology generally used in FNA vs. tissue/cell block for histology in FNB) [3]. A recent randomized trial compared two sampling methods (standard suction or stylet slow-pull) during endoscopic ultrasoundguided FNB with a reverse-bevel needle in patients with pancreatic solid lesions.…”

Calponin and MUC6 complement inhibin as diagnostic immunomarkers of serous cystadenoma in endoscopic ultrasound‐guided aspiration/biopsy specimens

“…1 There are microscopic features in an EUS-FNAB specimen which are usually sufficient to morphologically distinguish SCA from MCN and SPPN. 5 However, this histological distinction can be more difficult for other differential diagnoses, including NET in particular, [4][5][6] and if the specimen is less cellular. Histochemistry can be performed on EUS-FNAB material to demonstrate the characteristic cytoplasmic glycogen of SCA cells.…”

“…However, assessment of such stained sections is not always straightforward, and we have not always been able to demonstrate cytoplasmic glycogen among SCA cells in EUS-FNAB specimens. 5 An ideal alternative marker would be an immunohistochemical one, which works reliably on EUS-FNAB material and is specific to SCA, but is also sensitive so it can be used to pick out the typically sparse neoplastic cells in EUS-FNAB samples of SCA. [4][5][6] (Alpha) inhibin is currently the best recognised and most widely used immunomarker for this purpose.…”