Pancreatic cytopathology: a practical approach and review.
ABSTRACT Pancreatic cytopathology plays an important role in the diagnosis and management of patients with solid and cystic lesions of the pancreas.
To serve as a practical guide to pancreatic cytopathology for the practicing pathologist. Data Sources.-A comprehensive assessment of the medical literature was performed.
We review pancreatic cytopathology, with specific discussions of its role in patient management, specimen types and specimen processing, specific diagnostic criteria, and the use of ancillary testing and advanced techniques.
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ABSTRACT: The technological progress within the range of methods of pancreas imaging and their more common accessibility selects a group of patients requiring a microscopic diagnosis. Percutaneous fine needle aspiration biopsy under the control of ultrasonography (PCFNA/USG) is the method commonly used in determining the character of a focal pancreatic lesion. Aim of the Work. An assessment of the accessibility of PCFNA biopsy in the assessment of solid and cystic changes in a pancreas and the correlation of the results of imaging examination, cytological smear and concentration of a serous marker CA19-9. Material and Methodology. In our material we analysed 43 cases of tumors of the pancreas among the patients who were at the average age of 59 ± 10.4 (14 women, 28 men) diagnosed by PCFNA biopsy. Results. In a group we are 23 cases of cancer, 12 cases of inflammation and 7 cases of cellular atypia for which 2 cases of IPMN were included. The sensitivity of the method was 92.5% but specificity was 68%. In our opinion PCFNA/USG is a method of the comparable sensitivity and specificity with fine needle aspiration biopsy with EUS control and its efficiency depends to a considerable degree on experience and interdisciplinary collaboration.Gastroenterology Research and Practice 01/2012; 2012:908963. DOI:10.1155/2012/908963 · 1.50 Impact Factor
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ABSTRACT: Given advances in diagnostic imaging and surgical technique, a variety of neoplastic and non-neoplastic pancreatic lesions are increasingly encountered in clinical practice. The distinction of these lesions has significant therapeutic and prognostic implications. Herein, we review the major clinicoepidemiologic and pathologic features of ductal adenocarcinoma, pancreatic cystic neoplasia, pancreatic endocrine tumor, and related lesions. Emphasis is placed on frozen-section diagnosis and differential diagnostic features. Also, potential diagnostic pitfalls are highlighted, such that they may be avoided. After reading this article, readers should be able to discuss ductal adenocarcinoma, in particular histologic features useful in frozen section evaluation and in its distinction from chronic pancreatitis; recognize distinguishing features of neoplastic and non-neoplastic pancreatic cysts, particularly those useful in the separation of the mucin-producing cystic neoplasms; and describe the clinical, histologic, and immunophenotypic features of the cellular epithelioid tumors including pancreatic endocrine tumor, solid pseudopapillary tumor, acinar cell carcinoma, and pancreatoblastoma.Laboratory Medicine 06/2009; 40(7):417-426. DOI:10.1309/LM5MY3OCDWWKS6NM · 0.49 Impact Factor
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ABSTRACT: The difference in the diagnostic accuracy of 22- versus 25-gauge needles in EUS-FNA is not clear. To compare the rates of technical success, diagnostic accuracy and complications of EUS-FNA performed with 22-gauge and 25-gauge needles on the same solid pancreatic mass. All patients with solid pancreatic masses evaluated from September 2007 to December 2008 were enrolled and underwent EUS-FNA with both 22- and 25-gauge needles with randomisation of needle sequence. The accuracy of the EUS-FNA was determined by comparing the cytological results with the final surgical pathological diagnoses or with the results of a clinical follow-up. A cytological score with different qualitative parameters was created, and a comparison between these parameters was carried out for each needle. Fifty patients with 50 pancreatic masses were recruited. Technical success was 100% and no complications occurred. Diagnostic accuracy was 94% and 86% for the 25- and 22-gauge needles, respectively. Analysis of the cytological score showed a tendency towards the 25-gauge needle, although the difference was not statistically significant. EUS-FNA performed with 22- or 25-gauge needles had the same diagnostic accuracy. Our study results confirm a significant trend towards a better cytological diagnosis for the 25-gauge needle.Digestive and Liver Disease 05/2011; 43(8):647-52. DOI:10.1016/j.dld.2011.04.005 · 2.89 Impact Factor