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.

scholarly journals Role of ultrasound guided fine needle aspiration cytology of right hypochondrial masses

2017 ◽  
Vol 5 (12) ◽  
pp. 5312
Author(s):  
Nidhi Verma ◽  
. Neetu ◽  
S. P. Sharma ◽  
Preeti Singh ◽  
Anuj Kumar
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Single Case ◽  
Needle Aspiration ◽  
Primary Hepatocellular Carcinoma ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Abdominal Masses ◽  
Sensitivity Specificity

Background: Patients having right hypochondrial intra-abdominal masses are commonly encountered in clinical practice. The study was done to know the role of ultrasound guided fine needle aspiration in diagnosing right hypochondrial masses and its most common cause.Methods: 112 cases were collected from department of surgery, SVBP hospital meerut. FNAC was done using 22-23 G disposable lumbar puncture needle with trochar fitted with 20 ml syringe, introduced under radiological guidance and aspiration is done under negative pressure. Smears were stained with Leishman’s stain, May Grunwald Geimsa (MGG) and Papnicolou stain.Results: Out of total 112 cases, 12 cases excluded from study as only blood was aspirated. Therefore, out of 100 cases, 83% (83/100) cases were malignant, 7% (7/100) benign and 10% (10/100) inconclusive/ due to low cellularity. Among the malignant masses, majority 52 (52.0%) cases were of liver secondaries followed by 24 (24.0%) cases of adenocarcinoma gall bladder, 5 (5.0%) cases of primary hepatocellular carcinoma (HCC) and single case (1%), each of cholangiocarcinoma GB and squamous cell carcinoma GB. Among the benign lesions, 3 (3.0%) cases of liver abscess, 2 (2.0%) cases of hydatid disease followed by single case (1.0%) of hepatic adenoma and cysticercosis liver. In this study, overall accuracy of USG guided FNAC was 96.66%. Sensitivity, specificity, positive predictive value, negative predictive value and efficacy of USG guided FNAC in right hypochondrial masses were 96.66%, 100%, 100%, 66.67% and 96.87% respectively.Conclusions: USG guided FNAC is simple, quick, safe, reliable and economical tool without any significant complication in diagnosing right hypochondrial masses.

scholarly journals Pancreatic cystic lesions: comparison of preoperative cytological results by eus-fna with surgical pathologist diagnosis

2016 ◽  
Vol 2 (2) ◽  
pp. 140
Author(s):  
Maria Tsimperleniou ◽  
Ioannis Karoumpalis ◽  
Christina Marvaki ◽  
Olga Kadda ◽  
Dimitrios Exarchos ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Needle Aspiration ◽  
Pancreatic Cysts ◽  
Cystic Lesions ◽  
Operating Characteristics ◽  
Fine Needle ◽  
Duration Of Hospitalization ◽  
Sensitivity Specificity ◽  
Cystic Pancreatic Lesions

Introduction: The preoperative cytological examination of pancreatic cystic lesions with endoscopic ultrasound and fine needle aspiration biopsy [Endoscopic Ultrasonography (EUS)-Fine Needle Aspiration (FNA)] is of great importance for avoiding unnecessary surgery.Aim:  The aim of the present study was to show the importance of EUS-FNA in patients with cystic pancreatic lesions by comparing its results with surgical pathology diagnosis, intending by the selection of appropriate patients for surgery, to reduce preoperative morbidity and mortality and long duration of hospitalization conditions which are responsible for hospital infections as well as public health costs.Material and Methods: This was a prospective observational study. The studied sample consisted of 40 patients with pancreatic cysts. For data collection a specific registration form was used; the demographic characteristics, imaging methods and their results, the symptoms, any previous episodes of pancreatitis, the visualization with EUS, cytological analysis of fluid of pancreatic cysts, and CEA levels  and fluid amylase, whenever was possible, as well as the pathologist results of the resected lesions were recorded. Data analysis was performed with the Statistical Package for Social Sciences (SPSS).Results: The sample included 40 patients, 17 men (42.5%) and 23 women (57.5%). The overall operating characteristics of EUS-FNA for pancreatic lesions which were resected, were as follows: sensitivity specificity 81.8% 100.0%, positive predictive value of 100%, negative predictive value 66.0% and 86.7% diagnostic accuracy.Conclusions: The present study confirmed that the EUS-FNA is the method which has high accuracy to select the appropriate patients with pancreatic cystic lesions for therapeutic pancreatectomy.

The role of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in distinguishing pancreatic cystic lesions

2006 ◽  
Vol 35 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Bhavani Moparty ◽  
Roberto Logroño ◽  
William H. Nealon ◽  
Irving Waxman ◽  
G. S. Raju ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Cystic Lesions ◽  
Ultrasound Guided ◽  
Fine Needle
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