Mucicarmne staining of fine needle aspirates (FNA) of cyst fluid can differentiate mucinous cystic neoplasm from other cystic lesions of the pancreas

1998 ◽  
Vol 114 ◽  
pp. A494
Author(s):  
JK Ryu ◽  
Y-T Kim ◽  
IA Park ◽  
YB Yoon ◽  
CY Kim
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cyst Fluid ◽  
Cystic Neoplasm ◽  
Cystic Lesions ◽  
Fine Needle ◽  
Fine Needle Aspirates

scholarly journals Cytologic Assessment of Cystic/Intraductal Lesions of the Pancreatobiliary Tract

2021 ◽  
Author(s):  
Michelle D. Reid
Keyword(s):  
Fine Needle Aspiration ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Imaging Techniques ◽  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Cyst Fluid ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Fine Needle ◽  
Mucinous Neoplasm

Context.— Because of new and improved imaging techniques, cystic/intraductal pancreatobiliary tract lesions are increasingly being discovered, and brushings or endoscopic ultrasound/computed tomography/magnetic resonance imaging–guided fine-needle aspiration biopsies from these lesions have become an integral part of pathologists' daily practice. Because patient management has become increasingly conservative, accurate preoperative diagnosis is critical. Cytologic distinction of low-risk (pseudocysts, serous cystadenoma, lymphoepithelial cysts, and squamoid cysts of the pancreatic duct) from high-risk pancreatic cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) requires incorporation of clinical, radiologic, and cytologic findings, in conjunction with chemical and molecular analysis of cyst fluid. Cytopathologists must ensure appropriate specimen triage, along with cytologic interpretation, cyst classification, and even grading of some (mucinous) cysts. Epithelial atypia in mucinous cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) has transitioned from a 3-tiered to a 2-tiered classification system, and intraductal oncocytic papillary neoplasms and intraductal tubulopapillary neoplasms have been separately reclassified because of their distinctive clinicopathologic characteristics. Because these lesions may be sampled on brushing or fine-needle aspiration biopsy, knowledge of their cytomorphology is critical. Objective.— To use an integrated, multidisciplinary approach for the evaluation of cystic/intraductal pancreatobiliary tract lesions (incorporating clinical, radiologic, and cytologic findings with [chemical/molecular] cyst fluid analysis and ancillary stains) for definitive diagnosis and classification. Data Sources.— Review of current literature on the cytopathology of cystic/intraductal pancreatobiliary tract lesions. Conclusions.— Our knowledge/understanding of recent updates in cystic/intraductal pancreatobiliary lesions can ensure that cytopathologists appropriately triage specimens, judiciously use and interpret ancillary studies, and incorporate the studies into reporting.

Mucinous Cystic Neoplasms of the Pancreas: How Much Preoperative Evaluation is Needed?

2010 ◽  
Vol 76 (8) ◽  
pp. 812-817 ◽  
Author(s):  
Tom P. Theruvath ◽  
Katherine A. Morgan ◽  
David B. Adams
Keyword(s):  
Operative Treatment ◽  
Endoscopic Ultrasound ◽  
Preoperative Evaluation ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Cystic Lesions ◽  
Mri Imaging ◽  
Diagnostic Dilemma ◽  
Cystic Neoplasms ◽  
Preoperative Workup

Cystic lesions of the pancreas are identified with increasing frequency by modern imaging. The mucinous cystic neoplasm (MCN) is treated with resection for its malignant potential. How much preoperative evaluation is needed before undertaking operation is frequently a diagnostic dilemma. A retrospective review of 32 patients who underwent resection of a MCN between 1994 and 2007 was performed to define the preoperative evaluation and operative treatment of MCN patients. Thirty-two patients (30 women; mean age 49) had histology-proven MCN. Twenty-seven patients had symptomatic cysts (84%). Five had a history of gallstones and/or acute pancreatitis. All patients were worked up with CT and/or MRI. Endoscopic ultrasound was performed in 14 (44%) and endoscopic retrograde cholangiopancreatography in six (18%). Cytology was obtained in 13 (40%). Pathology revealed 22 benign MCNs (68%), five malignant MCNs (16%), and five MCNs with borderline pathology. Preoperative workup including CT or MRI imaging and cytology suggested MCN as the lesion in 15 patients (46%). CT features by itself predicted MCN in three patients (9%). Cytology revealed another six patients (19%) with possible MCN. In this series, preoperative workup did not identify three of five patients with MCN malignancy. A preoperative diagnosis cannot be made in most patients with MCN. Operative treatment can be based on clinical presentation and CT imaging because endoscopic ultrasound and fine needle aspiration for evaluation may be misleading. Middle-aged women with cystic lesions in the tail of the pancreas without prior gallstone or pancreatitis history most typically fit the profile of the MCN patient.

scholarly journals Role of Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Cystic Pancreatic Lesions

2021 ◽  
pp. 134-147
Author(s):  
Ahmed Metawea Elsefy ◽  
Mohamed Ali Elnady ◽  
Mervat Abd El-Hamed Elkhateb ◽  
Hegazy Mohammed Hegazy
Keyword(s):  
Predictive Value ◽  
Needle Aspiration ◽  
Cyst Fluid ◽  
Cystic Lesions ◽  
Ultrasound Guided ◽  
Cystic Neoplasms ◽  
Fine Needle ◽  
Potentially Malignant ◽  
Cystic Pancreatic Lesions

Background: The diagnosis and management of cystic lesions of the pancreas is an increasingly recognized problem in clinical practice and many of the cystic pancreatic lesions are neoplastic and asymptomatic. Despite the significant advances occurred over the last decades, it remains difficulty to accurately distinguish between benign (serous cystic lesions) and malignant or potentially malignant (mucinous cystic lesions) pancreatic cysts before resecting them. Mucinous cystic neoplasms (MCNs), intrapapillary mucinous neoplasms (IPMN) and serous cystic neoplasms (SCNs) can display differences when examined by imaging modalities, endoscopic ultrasonography (EUS) and cytological and biochemical analyses of cyst fluid. The performance characteristics of high-resolution computed tomography (CT) scanning and magnetic resonance imaging (MRI) in making these distinctions are, however, disappointing. The aim of this study is to evaluate the role of endoscopic ultrasound guided fine needle aspiration (FNA) in diagnosis of cystic pancreatic lesions and its accuracy in discrimination between benign, malignant and potentially malignant cysts. Methods: The study was organized as a prospective study and conducted over 51 patients with identified cystic pancreatic lesions from prior radiological imaging (CT or MRI). Results: EUS guided FNA has shown superior sensitivity, specificity, positive predictive value and negative predictive value in comparison to EUS alone in discriminating mucinous from non-mucinous cysts. This difference was remarkable specially for malignant cysts (mucinous cystadenocarcinoma, adenocarcinoma) and cystic lymphangioma. EUS-FNA associated with chemical and physical analysis of cyst fluid was 100% sensitive and specific. Cyst fluid CEA revealed significant importance in differentiating mucinous from non mucinous cysts. Cyst fluid amylase was significantly high in pseudocysts while mucin stain was important to discriminate mucinous from non-mucinous cystic lesions. Conclusion: EUS-FNA has proven greater sensitivity and specificity, positive predictive, negative predictive value in differentiating mucinous and non-mucinous pancreatic cystic lesions as well as pathological categorization into subtypes.

KRAS in Cyst Fluid Obtained by Endoscopic Ultrasound–Fine-Needle Aspiration in Pancreatic Cystic Lesions

Pancreas ◽  
2019 ◽  
Vol 48 (6) ◽  
pp. 749-758 ◽  
Author(s):  
Sandra Faias ◽  
Luisa Pereira ◽  
Ângelo Luís ◽  
Marília Cravo ◽  
António Dias Pereira ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Cyst Fluid ◽  
Cystic Lesions ◽  
Fine Needle
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