Pancreatic involvement by metastasizing neoplasms as determined by endoscopic ultrasound‐guided fine needle aspiration: A clinicopathologic characterization

Sekulic, Miroslav; Amin, Khalid; Mettler, Tetyana; Miller, Lizette K.; Mallery, Shawn; Stewart, Jimmie

doi:10.1002/dc.23688

Cited by 15 publications

(17 citation statements)

References 32 publications

(123 reference statements)

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“…[3][4][5] In contrast to primary lesions, metastases to the pancreas are rarely aspirated and only 0.73%-4.2% of the total pancreatic FNAs are performed on the grounds of a metastasis. 1,[6][7][8][9] Aspirated metastases most often present as solitary lesions located in the pancreatic head and surrounded by well-defined borders. 1,8,[10][11][12][13] Most patients diagnosed with such lesions have a prior history of malignancy; however, metastases to the pancreas might appear long after the initial diagnosis, especially in the case of renal cell carcinoma (RCC).…”

Section: Introductionmentioning

confidence: 99%

“…14 RCC has been reported to be the most common origin of pancreatic metastases diagnosed with FNA; lung, colon, breast carcinomas and melanoma are also enlisted as relatively prevalent primaries. 1,6,[8][9][10][11]14,15 An accurate distinction between a metastatic and a primary neoplasm in the pancreas is imperative due to the difference in their therapeutic strategy and prognosis. 13,15 Metastases might mimic primary neoplasms in clinical, radiological and cytomorphological settings thus their differential diagnosis can be a challenging task for the cytopathologist, especially in the absence of clinical history.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to primary lesions, metastases to the pancreas are rarely aspirated and only 0.73%‐4.2% of the total pancreatic FNAs are performed on the grounds of a metastasis . Aspirated metastases most often present as solitary lesions located in the pancreatic head and surrounded by well‐defined borders .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of metastases to the pancreas with fine needle aspiration: A case series from a single centre with review of the literature

et al. 2020

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Objective Fine needle aspiration (FNA) is a minimally invasive albeit highly effective modality used to detect solid and cystic pancreatic lesions. This manuscript aims to present our experience in diagnosing metastases to the pancreas and highlight the importance of immunocytochemistry in the diagnostic process. It also aims to provide a brief review of the literature on this topic. Methods We retrospectively searched our archives for cases of metastatic deposits to the pancreas diagnosed with FNA over a 5‐year period. We also reviewed the literature for such cases. Results We describe seven cases from our archives that metastasised to the pancreas. Three of them (43%) represented metastatic renal cell carcinoma while the rest four comprised deposits from a lung adenocarcinoma, a colon adenocarcinoma, an adrenal leiomyosarcoma, and a small cell carcinoma of the urinary bladder, respectively. History of primary malignancy was available for all seven patients. All diagnoses were confirmed with the use of immunostains. In our literature review, similar to our case series, renal cell carcinoma was the most common metastasis to the pancreas managed with FNA (around one out of three patients; 35%). Of interest, our endoscopic ultrasound‐FNA case of pancreatic metastasis from urinary bladder small cell carcinoma is the first reported. Conclusions As metastases to the pancreas are commonly accompanied by diverse prognostic signatures and management strategies compared to primary pancreatic malignancies, their accurate identification is imperative. Pancreatic FNA is a diagnostic modality that can confirm or exclude metastasis to the organ, especially when immunocytochemistry is applied.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of metastases to the pancreas with fine needle aspiration: A case series from a single centre with review of the literature

et al. 2020

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“…En nuestro caso, el diagnóstico preoperatorio fue realizado con PAF-USE, similar a lo descrito en 8/24 casos reportados, resultando ser una técnica precisa para el diagnóstico, que permite evitar la biopsia abierta 5,7 . USE se reconoce como el examen más sensible (94-100%) para detectar lesiones tumorales pancreáticas, junto con su capacidad de distinguir lesiones primarias de metastásicas y la realización de punción por aguja fina 8,9 . Entre las características endosonográficas de las metástasis pancreáticas se incluye la hipoecogenicidad, heterogeneidad y bordes variablemente definidos 10 .…”

Section: Discussionunclassified

Metástasis pancreática como debut de carcinoma papilar de tiroides. Caso clínico y revisión del perfil clínico patológico y molecular

et al. 2020

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Papillary thyroid carcinoma presenting with pancreatic metastases. Report of one case Pancreatic metastases of papillary thyroid carcinoma (PTC) are exceptional. We report a 80-year-old man consulting for obstructive jaundice and dysphonia. Abdominal ultrasonography showed biliary dilation and abdominal magnetic resonance imaging (MRI) showed a pancreatic head mass of 36 mm. A left vocal cord paralysis was confirmed and cervical computed tomography (CT) showed multiple thyroid nodules of up to 35 mm associated with bilateral cervical lymph nodes (LN). Positron emission tomography (18 F-FDG PET/CT) evidenced hypermetabolic activity in bilateral cervical LN, lungs, pancreas and left intercostal soft tissue, as well as left gluteus. Thyroid biopsy reported a tall-cell variant of PTC, and endoscopic ultrasound guided fine needle aspiration (EUS-FNA) of pancreatic mass confirmed PTC metastasis. The molecular study was positive for BRAFV600E. Pancreatic metastasis from PTC can be accurately diagnosed with 18 F-FDG PET/CT and EUS-FNA, which is consistent with a predominant expression of BRAFV600E mutation and, thus, an aggressive presentation with poor short-term survival.

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“…1 Over the past few years, several studies have confirmed the diagnostic utility of FNAB in cancer, and therefore, it is now widely used in clinical practice. [2][3][4][5][6][7][8][9][10][11] Owing to innovative developments in FNA technology, we can now collect more cells to prepare cell blocks (CB) that can be used for cell smears and immunohistochemistry (IHC) staining analysis, which compensates for some of the shortcomings of simple smears in organisational structure and cell morphology. IHC analysis represents an important technique to improve the accuracy of FNAB diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of immunohistochemical analysis and Epstein–Barr virus‐encoded small RNAs in situ hybridisation of cell block sections obtained using fine‐needle aspiration in nasopharyngeal carcinoma with lymph node metastasis

Zhang

Xing

Yang

et al. 2018

Diagnostic Cytopathology

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Objective This study aimed to investigate the diagnostic utility of immunohistochemistry (IHC) analysis (FNA) and Epstein–Barr virus‐ (EBV) encoded small RNAs (EBERs) in situ hybridisation analyses of cell block (CB) sections obtained using fine needle aspiration in nasopharyngeal carcinoma (NPC) with lymph node metastasis. Methods A total of 38 FNA biopsies were collected using a Youyi aspirator. The cytomorphology, CB‐based histomorphology, IHC, and EBERs in situ hybridisation were observed and the sensitivity/final diagnostic rates were compared with those of simple smears and a combination of smears and CBs. Results The 38 cases of metastatic lymph nodes from NPC displayed the morphological characteristics of non‐keratinising carcinoma in cell smears and CB sections. The tumour cells showed high expression of CK5/6, P63, Ki‐67, and EBERs (94.7%, 36/38 cases) in the CB sections. The sensitivity and the final diagnostic rates were lowest with the simple cell smears (86.8%, 33/38 and 71.1%, 27/38 cases), moderate with the smears combined with CB sections (92.1%, 35/38 cases and 81.6%, 31/38 cases), and the highest with IHC and EBERs in situ hybridisation (94.7%, 36/38 and 94.7%, 36/38 cases). Conclusions FNA has great value in the diagnosis of NPC with lymph node metastases, and using cell smears combined with IHC and EBERs in situ hybridisation of CB sections could help clinical doctors promptly identify the primary lesions.

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Pancreatic involvement by metastasizing neoplasms as determined by endoscopic ultrasound‐guided fine needle aspiration: A clinicopathologic characterization

Cited by 15 publications

References 32 publications

Evaluation of metastases to the pancreas with fine needle aspiration: A case series from a single centre with review of the literature

Evaluation of metastases to the pancreas with fine needle aspiration: A case series from a single centre with review of the literature

Metástasis pancreática como debut de carcinoma papilar de tiroides. Caso clínico y revisión del perfil clínico patológico y molecular

Diagnostic utility of immunohistochemical analysis and Epstein–Barr virus‐encoded small RNAs in situ hybridisation of cell block sections obtained using fine‐needle aspiration in nasopharyngeal carcinoma with lymph node metastasis

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