Cell block processing is optimal for assessing endoscopic ultrasound fine needle aspiration specimens of pancreatic mucinous cysts
| Autor: | Efstratios Alexandridis, Sally Norton, Timothy Murigu, Paida Gwiti, Sophie Beavers, Zsombor Melegh, Fiona H. Gordon, Newton A C S Wong |
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| Rok vydání: | 2019 |
| Předmět: |
Endoscopic ultrasound
Pathology medicine.medical_specialty Tissue Fixation Pathology and Forensic Medicine Carcinoembryonic antigen Predictive Value of Tests Medicine Humans Cyst Prospective Studies Endoscopic Ultrasound-Guided Fine Needle Aspiration Cell block Retrospective Studies Paraffin Embedding biology medicine.diagnostic_test business.industry Mucin Mucins Reproducibility of Results General Medicine medicine.disease Carcinoembryonic Antigen medicine.anatomical_structure Fine-needle aspiration biology.protein Sample collection Pancreatic Cyst business Pancreas Biomarkers |
| Zdroj: | Journal of clinical pathology. 73(2) |
| ISSN: | 1472-4146 |
| Popis: | AimsThe cell block technique for assessing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) specimens from pancreatic mucinous cystic lesions (MCLs) was systematically evaluated for the first time, including comparisons with three traditional methods of assessing such specimens.MethodsThe prospective arm comprised EUS-FNA specimens from EUS-suspected pancreatic MCLs. The retrospective arm comprised EUS-FNA specimens from pancreatic MCLs surgically resected before the study start. For each specimen, these data points were collected: macroscopic likelihood of mucin, cyst fluid carcinoembryonic antigen (CEA) level and presence of mucin in air-dried, direct smears and in cell block preparations.ResultsThe prospective and retrospective arms of the study comprised 80 and 30 EUS-FNA specimens, respectively. Seven prospective cases led to surgical resections during the study, and therefore, 37 EUS-FNA specimens were confirmed to have originated from MCLs. In the prospective arm, macroscopic mucin was suspected, cyst fluid CEA level exceeded 192 ng/mL, mucin was detected in direct smears and cell block preparations in 78%, 30%, 39% and 73% of cases, respectively. Of the 37 specimens confirmed to originate from MCLs, macroscopic mucin assessment, cyst fluid CEA level, direct smear mucin assessment and cell block mucin assessment had sensitivities for diagnosing MCL of 87%, 45%, 45% and 81%, respectively.ConclusionsCell block preparations are as likely to identify mucin from pancreatic MCLs as macroscopic assessment but are twice as likely to diagnose MCL than direct smears and fluid CEA biochemistry. The cell block technique is easy for sample collection and processing especially because these are identical for solid and cystic pancreatic lesions. |
| Databáze: | OpenAIRE |
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