The Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology in Diagnosis of Pancreatic Masses: Review of 40 Cases in Iraq
Iraqi Postgraduate Medical Journal,
2009, Volume 8, Issue 3, Pages 259-265
Pancreatic masses are often initially identified by magnetic resonance imaging or computed tomography, during evaluation of varied symptoms. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) has been proved to be safe and useful method for tissue sampling including the pancrease.
In this study we aim to find out some of the factors which may influence successful EUS-FNA of pancreatic masses, like: location of the mass, size, consistency and other significant factors.
PATIENTS AND METHODS:
A retrospective study of 40 patients underwent EUS-FNA of pancreatic masses, referred to Gastroenterology and Hepatology Teaching Hospital in Baghdad, from March 2005 to December 2007 (this is the first study done in Iraq); all patients were clinically suspected to have pancreatic malignancy. Cytology samples were evaluated and many other clinical variables were examined for association with EUS-FNA diagnosis.
Twenty six (65%) patients were males, and 14(35%) patients were females. Age ranged between 13-65 years with a mean of 46.6 years, the size of pancreatic masses range between 1.7-13cm, the masses were divided into 3 groups according to their sizes: <5cm 26(65%) cases, between 5-10cm 13(32.5%) cases, and >10 cm 1(2.5%) case. Consistency wise the masses were characterized as solid 34(85%) cases, mixed solid and cystic 6(14%) cases. In 13(32.5%) cases the mass was located in the body of pancrease, 25(62.5%) cases in the head, and 2(5%) cases in the tail. Regarding the cytological diagnosis: 19(47.5%) cases were benign (inflammatory conditions), and 21(52.5%) cases were malignant; including 17(80.9%) cases adenocarcinoma, 2(9.5%) cases malignant mucinous tumor, and small cell carcinoma 1(4.8%)case, and papillary and solid epithelial neoplasm (solid pseudopapillary tumor SPPT) 1(4.8%)case. Lymph node enlargement was found in 10(25%) cases.
EUS-FNA can be used to sample pancreatic tumors in most patients. Communication clinical background information and imaging findings to the cytopathologist can facilitate the interpretation of the FNA specimens.
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