Limits...
The limitations of endoscopic ultrasound-guided fine needle aspiration cytology in the diagnosis of pancreatic serous cystadenoma: a brief case report.

Park HS, Yoon SO, Lim BJ, Kim JH, Hong SW - Korean J Pathol (2014)

View Article: PubMed Central - PubMed

Affiliation: Departments of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

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Endoscopic ultrasound (EUS) fine needle aspiration (FNA) biopsy is commonly used in the diagnosis of pancreatic tumors... Here, we report a case of pancreatic SCA that was suspected to be adenocarcinoma in preoperative test using EUS-guided FNA... The apical cytoplasm contained neutral mucin that was positive with periodic acid-Schiff (Fig. 2E) and negative with mucicarmine (Fig. 2F) stain... Singly occurring abnormal cells were not found... Pancreatic cystic neoplasms include SCA, mucinous cystic neoplasm (MCN), intraductal papillary mucinous neoplasm (IPMN), solid pseudopapillary tumor, cystic neuroendocrine tumor, and ductal adenocarcinoma with cystic change... The diagnostic value of FNA in SCA is controversial... Earlier studies only consider single case reports or discuss only a few cases, resulting in variable diagnostic accuracy (from 10% to 100%)... The low sensitivity of EUS-guided FNA in the diagnosis of SCA can be attributed to several reasons... Gastric mucosal sampling was also identified in ThinPrep and cell block preparations of this case... Some gastric foveolar cells showed atypical features such as nuclear overlapping and nuclear membrane irregularity, which resulted in the initial misdiagnosis of pancreatic adenocarcinoma... Unequivocal, preoperative diagnosis of SCA using EUS FNA is quite challenging... Neoplastic cells of SCA are usually aspirated in small numbers during the procedure and have benign cytomorphology... Possible gastrointestinal contamination in EUS-guided FNA samples from the pancreas should be considered to prevent the misinterpretation that normal gastric or intestinal epithelial cells are atypical cells, which may result in a misdiagnosis... Familiarity with the cytological features of both SCA and normal gastrointestinal epithelium may help improve the diagnostic accuracy of SCA using EUS-guided FNA samples.

No MeSH data available.


Abdominal computed tomography shows a solid and cystic mass (arrow) with focal enhancement in the body of the pancreas.
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f1-kjpathol-48-5-405: Abdominal computed tomography shows a solid and cystic mass (arrow) with focal enhancement in the body of the pancreas.

Mentions: A 74-year-old woman complaining of dyspepsia was referred to the hospital. An abdominal computed tomography scan revealed a 5-cm-sized mass in the body of the pancreas (Fig. 1) without upstream pancreatic duct dilatation or enlarged regional lymph nodes. The mass was mixed solid, macrocystic, and microcystic in nature. The large tumor size, macrocystic portion (suspicion for mucin pool), and solid components implied the possibility of pancreatic malignancy of an unusual cell type. Screening laboratory results for serum amylase, lipase, and tumor markers (carcinoembryonic antigen [CEA] and carbohydrate antigen 19-9) were normal. Upper gastrointestinal endoscopy revealed diffuse chronic gastritis. A microcystic pancreatic mass with solid components was found during an EUS examination. An EUS-guided FNA biopsy of the pancreatic lesion was performed using a 22-gauge needle. Papanicolaou-stained slides including conventional smears and a ThinPrep (Hologic Inc., Bedford, MA, USA) preparation were made.


The limitations of endoscopic ultrasound-guided fine needle aspiration cytology in the diagnosis of pancreatic serous cystadenoma: a brief case report.

Park HS, Yoon SO, Lim BJ, Kim JH, Hong SW - Korean J Pathol (2014)

Abdominal computed tomography shows a solid and cystic mass (arrow) with focal enhancement in the body of the pancreas.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215972&req=5

f1-kjpathol-48-5-405: Abdominal computed tomography shows a solid and cystic mass (arrow) with focal enhancement in the body of the pancreas.
Mentions: A 74-year-old woman complaining of dyspepsia was referred to the hospital. An abdominal computed tomography scan revealed a 5-cm-sized mass in the body of the pancreas (Fig. 1) without upstream pancreatic duct dilatation or enlarged regional lymph nodes. The mass was mixed solid, macrocystic, and microcystic in nature. The large tumor size, macrocystic portion (suspicion for mucin pool), and solid components implied the possibility of pancreatic malignancy of an unusual cell type. Screening laboratory results for serum amylase, lipase, and tumor markers (carcinoembryonic antigen [CEA] and carbohydrate antigen 19-9) were normal. Upper gastrointestinal endoscopy revealed diffuse chronic gastritis. A microcystic pancreatic mass with solid components was found during an EUS examination. An EUS-guided FNA biopsy of the pancreatic lesion was performed using a 22-gauge needle. Papanicolaou-stained slides including conventional smears and a ThinPrep (Hologic Inc., Bedford, MA, USA) preparation were made.

View Article: PubMed Central - PubMed

Affiliation: Departments of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Endoscopic ultrasound (EUS) fine needle aspiration (FNA) biopsy is commonly used in the diagnosis of pancreatic tumors... Here, we report a case of pancreatic SCA that was suspected to be adenocarcinoma in preoperative test using EUS-guided FNA... The apical cytoplasm contained neutral mucin that was positive with periodic acid-Schiff (Fig. 2E) and negative with mucicarmine (Fig. 2F) stain... Singly occurring abnormal cells were not found... Pancreatic cystic neoplasms include SCA, mucinous cystic neoplasm (MCN), intraductal papillary mucinous neoplasm (IPMN), solid pseudopapillary tumor, cystic neuroendocrine tumor, and ductal adenocarcinoma with cystic change... The diagnostic value of FNA in SCA is controversial... Earlier studies only consider single case reports or discuss only a few cases, resulting in variable diagnostic accuracy (from 10% to 100%)... The low sensitivity of EUS-guided FNA in the diagnosis of SCA can be attributed to several reasons... Gastric mucosal sampling was also identified in ThinPrep and cell block preparations of this case... Some gastric foveolar cells showed atypical features such as nuclear overlapping and nuclear membrane irregularity, which resulted in the initial misdiagnosis of pancreatic adenocarcinoma... Unequivocal, preoperative diagnosis of SCA using EUS FNA is quite challenging... Neoplastic cells of SCA are usually aspirated in small numbers during the procedure and have benign cytomorphology... Possible gastrointestinal contamination in EUS-guided FNA samples from the pancreas should be considered to prevent the misinterpretation that normal gastric or intestinal epithelial cells are atypical cells, which may result in a misdiagnosis... Familiarity with the cytological features of both SCA and normal gastrointestinal epithelium may help improve the diagnostic accuracy of SCA using EUS-guided FNA samples.

No MeSH data available.