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Endoscopic-ultrasound-guided fine-needle aspiration and the role of the cytopathologist in solid pancreatic lesion diagnosis.

Iqbal S, Friedel D, Gupta M, Ogden L, Stavropoulos SN - Patholog Res Int (2012)

Bottom Line: The final diagnosis is based upon the correlation of clinical, EUS, and cytologic features.A close interaction with the cytopathologist is required in improving the diagnostic yield.Day to day examples of different solid pancreatic lesions have been presented at the end.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Winthrop-University Hospital, Mineola, NY 1150, USA.

ABSTRACT
Endoscopic ultrasound (EUS) is the most sensitive imaging modality for solid pancreatic lesions. The specificity, however, is low (about 75%). It can be increased to 100% with an accuracy of 95% by the addition of fine-needle aspiration (FNA). Cytopathology plays an important role. The final diagnosis is based upon the correlation of clinical, EUS, and cytologic features. A close interaction with the cytopathologist is required in improving the diagnostic yield. In this paper, we present an overview of the role of EUS-guided FNA and importance of close interaction with the cytopathologist. Day to day examples of different solid pancreatic lesions have been presented at the end.

No MeSH data available.


Related in: MedlinePlus

Pancreatic ductal adenocarcinoma. (a) EUS showed a 17 mm by 15 mm hypoechoic and homogenous solid mass in the pancreatic head area obstructing the distal common bile duct (CBD) and main pancreatic duct (PD) near ampulla. (b) A single FNA was done using 25-gauge needle via transduodenal approach.
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Related In: Results  -  Collection


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fig5: Pancreatic ductal adenocarcinoma. (a) EUS showed a 17 mm by 15 mm hypoechoic and homogenous solid mass in the pancreatic head area obstructing the distal common bile duct (CBD) and main pancreatic duct (PD) near ampulla. (b) A single FNA was done using 25-gauge needle via transduodenal approach.

Mentions: (1) Pancreatic ductal adenocarcinoma: a 67-year-old gentleman presented with painless jaundice. MRI abdomen showed dilated bile and pancreatic ducts, but no obvious pancreatic mass was noted. EUS showed a 17 mm by 15 mm hypoechoic and homogenous mass in the pancreatic head area obstructing the distal common bile duct (CBD) and main pancreatic duct (PD) near ampulla (Figure 5). One FNA was done using 25-gauge needle via transduodenal approach. The specimen was analyzed by an onsite cytopathologist for adequate cellularity.


Endoscopic-ultrasound-guided fine-needle aspiration and the role of the cytopathologist in solid pancreatic lesion diagnosis.

Iqbal S, Friedel D, Gupta M, Ogden L, Stavropoulos SN - Patholog Res Int (2012)

Pancreatic ductal adenocarcinoma. (a) EUS showed a 17 mm by 15 mm hypoechoic and homogenous solid mass in the pancreatic head area obstructing the distal common bile duct (CBD) and main pancreatic duct (PD) near ampulla. (b) A single FNA was done using 25-gauge needle via transduodenal approach.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3362237&req=5

fig5: Pancreatic ductal adenocarcinoma. (a) EUS showed a 17 mm by 15 mm hypoechoic and homogenous solid mass in the pancreatic head area obstructing the distal common bile duct (CBD) and main pancreatic duct (PD) near ampulla. (b) A single FNA was done using 25-gauge needle via transduodenal approach.
Mentions: (1) Pancreatic ductal adenocarcinoma: a 67-year-old gentleman presented with painless jaundice. MRI abdomen showed dilated bile and pancreatic ducts, but no obvious pancreatic mass was noted. EUS showed a 17 mm by 15 mm hypoechoic and homogenous mass in the pancreatic head area obstructing the distal common bile duct (CBD) and main pancreatic duct (PD) near ampulla (Figure 5). One FNA was done using 25-gauge needle via transduodenal approach. The specimen was analyzed by an onsite cytopathologist for adequate cellularity.

Bottom Line: The final diagnosis is based upon the correlation of clinical, EUS, and cytologic features.A close interaction with the cytopathologist is required in improving the diagnostic yield.Day to day examples of different solid pancreatic lesions have been presented at the end.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Winthrop-University Hospital, Mineola, NY 1150, USA.

ABSTRACT
Endoscopic ultrasound (EUS) is the most sensitive imaging modality for solid pancreatic lesions. The specificity, however, is low (about 75%). It can be increased to 100% with an accuracy of 95% by the addition of fine-needle aspiration (FNA). Cytopathology plays an important role. The final diagnosis is based upon the correlation of clinical, EUS, and cytologic features. A close interaction with the cytopathologist is required in improving the diagnostic yield. In this paper, we present an overview of the role of EUS-guided FNA and importance of close interaction with the cytopathologist. Day to day examples of different solid pancreatic lesions have been presented at the end.

No MeSH data available.


Related in: MedlinePlus