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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

Acinar cell carcinoma: (a) one cohesive group and scattered bare nuclei, Diff-Quik stain at 400x; (b) abundant cytoplasm and prominent nucleoli, Diff-Quik stain at 600x, (c) prominent nucleoli, Papanicolaou stain at 400x; (d) discohesive cells in cell block H&E at 400x.
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fig15: Acinar cell carcinoma: (a) one cohesive group and scattered bare nuclei, Diff-Quik stain at 400x; (b) abundant cytoplasm and prominent nucleoli, Diff-Quik stain at 600x, (c) prominent nucleoli, Papanicolaou stain at 400x; (d) discohesive cells in cell block H&E at 400x.

Mentions: These tumors tend to be extremely cellular and dyscohesive on aspirate smears (Figure 15). Typically they have abundant cytoplasm and a prominent nucleolus, evident even on Diff-Quik-stained aspirate smears. Arriving at the correct final diagnosis is only possible after establishing the presence of zymogen granules by immunohistochemical stains for trypsin. Acinar cell carcinoma may mimic pancreatic neuroendocrine tumors on cytomorphology and immunohistochemistry because they may occasionally stain with neuroendocrine markers [47]. In a small sample such as a cell block preparation, it is often difficult to prove its true lineage and may be erroneously diagnosed as a neuroendocrine tumor.


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)

Acinar cell carcinoma: (a) one cohesive group and scattered bare nuclei, Diff-Quik stain at 400x; (b) abundant cytoplasm and prominent nucleoli, Diff-Quik stain at 600x, (c) prominent nucleoli, Papanicolaou stain at 400x; (d) discohesive cells in cell block H&E at 400x.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig15: Acinar cell carcinoma: (a) one cohesive group and scattered bare nuclei, Diff-Quik stain at 400x; (b) abundant cytoplasm and prominent nucleoli, Diff-Quik stain at 600x, (c) prominent nucleoli, Papanicolaou stain at 400x; (d) discohesive cells in cell block H&E at 400x.
Mentions: These tumors tend to be extremely cellular and dyscohesive on aspirate smears (Figure 15). Typically they have abundant cytoplasm and a prominent nucleolus, evident even on Diff-Quik-stained aspirate smears. Arriving at the correct final diagnosis is only possible after establishing the presence of zymogen granules by immunohistochemical stains for trypsin. Acinar cell carcinoma may mimic pancreatic neuroendocrine tumors on cytomorphology and immunohistochemistry because they may occasionally stain with neuroendocrine markers [47]. In a small sample such as a cell block preparation, it is often difficult to prove its true lineage and may be erroneously diagnosed as a neuroendocrine tumor.

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