EUS-guided tissue acquisition in patients with solid pseudopapillary neoplasms of the pancreas.

Autor: Jiménez-Gutiérrez JM; Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México., de la Mora-Levy JG; Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México., Alonso-Lárraga JO; Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México., Hernández-Guerrero AI; Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México., Soriano-Herrera BA; Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México., Villegas-González LF; Department of Surgical Pathology, Instituto Nacional de Cancerología, Ciudad de México, México., Uscanga-Domínguez LF; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México., López-Romero S; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México., Téllez-Ávila FI; Division of Gastroenterology & Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Jazyk: angličtina
Zdroj: Postgraduate medicine [Postgrad Med] 2024 Jan; Vol. 136 (1), pp. 78-83. Date of Electronic Publication: 2024 Feb 06.
DOI: 10.1080/00325481.2024.2313446
Abstrakt: Objectives: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has been the most common method used for the preoperative cytopathological diagnosis of solid tumors of the pancreas. There are only a few reported cases about the role of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in the pre-operative diagnosis of solid pseudopapillary neoplasms (SPN). This study aimed to evaluate the diagnostic yield of EUS-TA,including endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) andEUS-FNB, in patients with SPN.
Methods: We performed a retrospective analysis of patients with EUS-TA for SPN diagnosis in 2 referral centers. The primary outcome was the diagnostic yield of EUS-TA compared to the surgical specimen.
Results: Seventy-four patients with SPN of the pancreas were identified. Eighteen had a EUS-TA (10 EUS-FNB and 8 EUS-FNA). The median age of the patients was 31 years (IQR 21-38), and all patients were women. The most common presenting symptom was abdominal pain. Most of the tumors were in the head of the pancreas (9/18; 50%). The median tumor size by EUS was 4.5 cm (min-max 2-15 cm). The most common appearance on EUS was a solid lesion ( n  = 8/18, 44.4%). A definitive presurgical cytopathological diagnosis was obtained in 16/18 patients (88.8%) with EUS-TA. The sensitivity and positive predictive value of the EUS-TA were 94% each. One patient in the EUS-FNB group developed mild acute pancreatitis.
Conclusion: The diagnostic yield of the EUS-TA in SPN is high. In most cases, the diagnosis was obtained with the first procedure. No differences in the diagnostic yield or AEs between EUS-FNA vs. EUS-FNB needles were seen.
Databáze: MEDLINE