scholarly journals EUS – Fine- Needle Aspiration Biopsy (FNAB) in the Diagnosis of Pancreatic Adenocarcinoma: A Review

2016 ◽  
Vol 54 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Alexandra Kalogeraki ◽  
Georgios Z. Papadakis ◽  
Dimitrios Tamiolakis ◽  
Iliana Karvela-Kalogeraki ◽  
Mihailos Karvelas-Kalogerakis ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Malignant Neoplasms ◽  
Fine Needle ◽  
Tissue Diagnosis ◽  
Highly Sensitive ◽  
Needle Aspiration Biopsy

Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS) is a relatively new technology that employs endoscopy and high-frequency ultrasound (US). EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT) scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP) brushing, CT-guided biopsies, and transabdominal ultrasound (US) have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB) has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities such as tumors and cysts of the pancreas can be carefully evaluated using EUS and then biopsied with FNAB. There are many new applications of EUS using FNAB. Researchers are looking to deliver chemotherapeutics into small pancreatic cancers and cysts. Nerve blocks using EUS/FNAB to inject numbing medicines into the celiac ganglia, a major nerve cluster, are now routinely performed in patients with pain due to pancreatic cancer. The aim of this study is to perform a review of the literature regarding the usefulness of EUS/FNAB in the diagnosis of pancreatic adenocarcinoma.

Misinterpretation of Normal Cellular Elements in Fine-Needle Aspiration Biopsy Specimens

2002 ◽  
Vol 126 (6) ◽  
pp. 670-675 ◽  
Author(s):  
Nancy A. Young ◽  
Dina R. Mody ◽  
Diane D. Davey
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Malignant Neoplasms ◽  
Fine Needle ◽  
Biopsy Specimens ◽  
Needle Aspiration Biopsy ◽  
Cellular Components

Abstract Context.—The College of American Pathologists Interlaboratory Comparison Program in Non-Gynecologic Cytopathology is a popular educational program for nongynecologic cytology, with 1018 participating laboratories by the end of 2000. Data generated from this program allow tracking pathologist performance in a wide variety of laboratory practices. Objective.—To review performance of participating pathologists in making patient diagnoses with fine-needle aspiration biopsy specimens, with particular interest in the false neoplastic diagnoses (both benign and malignant neoplasms) that were submitted for benign aspirates containing only normal cellular components. Design.—We reviewed the diagnoses made from 1998 through 2000 by participating pathologists through the use of glass slides containing benign fine-needle aspiration biopsy specimens of the liver, kidney, pancreas, and salivary gland that contained only normal cellular components. Results.—The false neoplastic rate for kidney (60%) was the highest, followed by liver (37%), pancreas (10%), and salivary gland (6%). These rates are much higher than what has previously been reported in the literature. Conclusions.—This study illustrates that normal cellular elements are a significant pitfall for overinterpretation of fine-needle aspiration biopsy specimens.

Fine-Needle Aspiration Cytology in Ethiopia

2013 ◽  
Vol 137 (6) ◽  
pp. 791-797 ◽  
Author(s):  
Melisachew M. Yeshi ◽  
Rosemary H. Tambouret ◽  
Elena F. Brachtel
Keyword(s):  
Health Care ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Addis Ababa ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Malignant Neoplasms ◽  
Northern Ethiopia ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

Context.—Most of the population in Ethiopia lives below the poverty line with severely limited access to health care. The burden of infectious diseases is high, but benign and malignant neoplasms are also encountered frequently. For diagnosis of palpable lesions in this setting, fine-needle aspiration biopsy is the method of choice. Objective.—To present findings from several patients from 3 major hospitals in Ethiopia who underwent fine-needle aspiration biopsy. Data Sources.—Representative cytopathology cases of routinely encountered problems are shown. Often patients present with clinically advanced lesions. Staffing, technique, and equipment used for fine-needle aspiration biopsy are described at Black Lion Hospital (Addis Ababa), the University of Gonder Hospital (Gonder), and Ayder Referral Hospital of Mekelle University in the Tigray region of northern Ethiopia. Conclusions.—Fine-needle aspiration biopsy is a highly effective method for diagnosis of mass lesions, especially in an environment with sparse health care resources, such as Ethiopia. This article illustrates the work of Ethiopian cytopathologists and emphasizes the constraints under which they perform their work.

Endoscopic ultrasound-guided real-time fine-needle aspiration biopsy of the pancreas in cancer patients with pancreatic lesions.

1997 ◽  
Vol 15 (4) ◽  
pp. 1439-1443 ◽  
Author(s):  
D O Faigel ◽  
G G Ginsberg ◽  
J S Bentz ◽  
P K Gupta ◽  
D B Smith ◽  
...  
Keyword(s):  
Real Time ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Tissue Diagnosis ◽  
Tumor Stages ◽  
Needle Aspiration Biopsy

BACKGROUND Endoscopic ultrasound (EUS) is an important new tool in the staging of pancreatic malignancies. Using new curved linear-array instruments, real-time fine-needle aspiration biopsy (RTFNA) of pancreatic lesions can be performed. METHODS Forty-five patients with pancreatic lesions (22 males and 23 females) underwent staging with the Olympus EUM-20 (Olympus America Corp, Melville, NY) followed by EUS-RTFNA with the Pentax FG-32PUA (Pentax-Precision Instrument Corp, Orangeburg, NY) and the 22-gauge GIP needle (GIP Medizin Technik, Grassau, Germany). RESULTS EUS tumor stages were as follows: TO, n = 1; T1, n = 8; T2, n = 9; and T3 n = 27. Aspiration attempts were unsuccessful in four patients (two technical failures and two inadequate specimens). The remaining 41 lesions (mean size, 3.3 cm) were aspirated under EUS guidance (median passes, three) and the cytologic diagnoses were 25 definite adenocarcinoma, five suspicious for adenocarcinoma (three subsequently confirmed and two clinical course consistent with adenocarcinoma), and 11 negative for malignancy. Of 11 negatives, two were found to have adenocarcinoma, seven were confirmed benign at surgery (four cystadenomas and three inflammatory), one had a benign pseudocyst, and one had abundant inflammatory cells on RTFNA and follow-up time greater than 12 months with computed tomographic (CT) scans consistent with resolving inflammation. There were no false-positive RTFNAs. There were no procedure-related complications. Among those with diagnostic EUS-RTFNA (91%), the sensitivity for malignancy (confirmed plus suspicious) was 94% and negative predictive value 82%. CONCLUSION EUS-guided RTFNA is a safe and accurate method for performing pancreatic biopsy. It should be considered in patients with suspected pancreatic malignancies in whom a tissue diagnosis is required or when other modalities have failed. EUS-RTFNA allows for local staging and tissue diagnosis in one procedure.

scholarly journals Overview of foreign clinical guidelines for the use of fine-needle aspiration biopsy of thyroid nodules

2020 ◽  
Vol 15 (3) ◽  
pp. 96-109 ◽  
Author(s):  
Viktor G. Petrov ◽  
Alsu A. Nelaeva ◽  
Ekaterina V. Molozhavenko ◽  
Elena G. Ivashina
Keyword(s):  
Fine Needle Aspiration ◽  
Clinical Guidelines ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Malignant Neoplasms ◽  
Fine Needle ◽  
Sonographic Patterns ◽  
Needle Aspiration Biopsy

Fine-needle aspiration biopsy (FNA) is the most accurate and cost-effective method for evaluating thyroid nodules. FNA results are useful for stratifying the risk of malignant neoplasms and provide key information to determine the appropriateness of an operation. However, we should keep in mind that FNA is an invasive diagnostic method, sothere is a possibility of complications. There is a likelihood of nondiagnostic, false positive and false negative results that can lead to a late or unnecessary operation. We see a growing incidence of thyroid nodules, associated mainly with the increased availability of ultrasound diagnostic of this organ. So the leading organizations involved in the development of clinical guidelines for diagnostics and treatment of thyroid pathologies suggest limiting the conduct of FNA. The use of this method in some cases is not necessary and at times can be even dangerous to apatient. When making clinical decisions, sonographic patterns of thyroid nodules and individual anamnestic and clinical factors ofthe patient should be considered. For small thyroid nodules, the FNA in most cases is not necessary. It is more rational to make a decision based on sonographic patterns rather than be guided by a threshold node size of 1 cm. The specific sonographic patterns of malignancy are: presence of calcifications, irregular margins, hypoechoic nodule, taller-than-wide shape, metastases to the cervical lymph nodes, and extrathyroidal extension. The totality of these signs is useful for stratifying the risk of malignancy of the thyroid nodules and deciding on the need for FNA.

Sign in / Sign up

Export Citation Format

Share Document