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Endoscopy 1997; 29(9): 854-858
DOI: 10.1055/s-2007-1004321
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Ultrasound Guided Fine Needle Aspiration of Malignant Pancreatic Lesions

M. S. Bhutani1 , R. H. Hawes2 , P. L. Baron2 , A. Sanders-Cliette2 , A. van Velse2 , J. F. Osborne2 , B. J. Hoffman2
  • 1VA Medical Center, Dayton, Ohio, USA
  • 2Medical University of South Carolina, Digestive Disease Center, Charleston, South Carolina, USA
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Publication History

Publication Date:
17 March 2008 (online)

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Abstract

Purpose: To evaluate the accuracy, safety, and clinical utility of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) of pancreatic masses.

Methods: Forty-seven patients were referred for EUS with a pancreatic mass and suspicion of pancreatic cancer based upon painless obstructive jaundice, epigastric abdominal pain plus weight loss/anorexia, or idiopathic pancreatitis. All patients underwent EUS with both radial (Olympus UM20) and linear array (Pentax FG32-UA) systems. After TNM staging by EUS, ultrasound directed FNA of the pancreatic mass was performed using a 23 gauge, 4 cm long needle.

Results: EUS-guided FNA was performed in all 47 patients. Results: successful targeting = 100 %, adequate cellularity = 100 %, Findings: adeno Ca = 25, squamous cell Ca = 1, lymphoma = 1, poorly differentiated Ca = 1, atypical cytology or suspicious for carcinoma = 9, no malignant cells = 10. The sensitivity, specificity, positive predictive value and negative predictive value of EUS-guided pancreatic FNA for the diagnosis of malignancy was 64 %, 100 %, 100 % and 16 % respectively.

Conclusions: EUS with FNA is useful for detection of malignancy in a pancreatic mass. The procedure appears to have a complication rate of 2 %. Impact of this technique on clinical management of patients needs further evaluation.