Abstract
OBJECTIVE: Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) is regarded as a safe and reliable procedure for diagnosing and staging of pancreatic neoplasms. This study retrospectively evaluated both the diagnostic utility and accuracy of pancreatic EUS-FNABs and potential cytologic pitfalls when using Diff-Quik® stain for on-site evaluation. STUDY DESIGN: Pancreatic EUS-FNABs performed between 1995 and 1998 were identified from the files of the Department of Pathology. All patients were studied via a linear-array ultrasound endoscope with an FNAB device. Immediate evaluation of the specimen by a pathologist using air-dried slides and Diff-Quik® stain was done on all cases. An average of five passes (range, three to nine) were performed. Five cytologic categories were identified: nondiagnostic, benign, atypical, suspicious and malignant. EUS disease staging, histologic correlation and clinical follow-up were reviewed. RESULTS: Sixty-nine consecutive pancreatic FNABs were evaluated in the study period. The patients comprised 38 females and 31 males with a mean age of 65 years (range, 36-83). Histologic correlation was available on 40 patients, and followup was available on the remaining 29. The cytologic diagnoses included: 31 malignant, 8 suspicious, 6 atypical, 20 benign and 4 nondiagnostic. Forty-three cases were true positive, 9 were true negative, 2 were false positive, and 11 were false negative. The overall sensitivity was 80% and specificity was 82%. CONCLUSION: The study showed that cytologic evaluation of pancreatic EUS-FNABs has 80% sensitivity and 82% specificity. False negative diagnosis was usually due to sampling error. A nondiagnostic cytologic diagnosis should be rendered in the absence of adequate sampling of a lesion. On-site cytologic evaluation of EUSFNABs aids in guaranteeing specimen adequacy, and the pathologist should be trained to evaluate Diff Quik®-stained samples.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 341-348 |
| Number of pages | 8 |
| Journal | Acta Cytologica |
| Volume | 47 |
| Issue number | 3 |
| State | Published - 2003 |
| Externally published | Yes |
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Keywords
- Aspiration biopsy
- Endoscopy, gastrointestinal
- Pancreatic cancer
- Pancreatic diseases
- Pancreatic neoplasms
ASJC Scopus subject areas
- Anatomy
- Cell Biology
- Histology
Cite this
Endoscopic ultrasound-guided fine needle aspiration of the pancreas : Diagnostic utility and accuracy. / Afify, Alaa M; Al-Khafaji, Basim M.; Kim, Byungki; Scheiman, James M.
In: Acta Cytologica, Vol. 47, No. 3, 2003, p. 341-348.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Endoscopic ultrasound-guided fine needle aspiration of the pancreas
T2 - Diagnostic utility and accuracy
AU - Afify, Alaa M
AU - Al-Khafaji, Basim M.
AU - Kim, Byungki
AU - Scheiman, James M.
PY - 2003
Y1 - 2003
N2 - OBJECTIVE: Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) is regarded as a safe and reliable procedure for diagnosing and staging of pancreatic neoplasms. This study retrospectively evaluated both the diagnostic utility and accuracy of pancreatic EUS-FNABs and potential cytologic pitfalls when using Diff-Quik® stain for on-site evaluation. STUDY DESIGN: Pancreatic EUS-FNABs performed between 1995 and 1998 were identified from the files of the Department of Pathology. All patients were studied via a linear-array ultrasound endoscope with an FNAB device. Immediate evaluation of the specimen by a pathologist using air-dried slides and Diff-Quik® stain was done on all cases. An average of five passes (range, three to nine) were performed. Five cytologic categories were identified: nondiagnostic, benign, atypical, suspicious and malignant. EUS disease staging, histologic correlation and clinical follow-up were reviewed. RESULTS: Sixty-nine consecutive pancreatic FNABs were evaluated in the study period. The patients comprised 38 females and 31 males with a mean age of 65 years (range, 36-83). Histologic correlation was available on 40 patients, and followup was available on the remaining 29. The cytologic diagnoses included: 31 malignant, 8 suspicious, 6 atypical, 20 benign and 4 nondiagnostic. Forty-three cases were true positive, 9 were true negative, 2 were false positive, and 11 were false negative. The overall sensitivity was 80% and specificity was 82%. CONCLUSION: The study showed that cytologic evaluation of pancreatic EUS-FNABs has 80% sensitivity and 82% specificity. False negative diagnosis was usually due to sampling error. A nondiagnostic cytologic diagnosis should be rendered in the absence of adequate sampling of a lesion. On-site cytologic evaluation of EUSFNABs aids in guaranteeing specimen adequacy, and the pathologist should be trained to evaluate Diff Quik®-stained samples.
AB - OBJECTIVE: Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) is regarded as a safe and reliable procedure for diagnosing and staging of pancreatic neoplasms. This study retrospectively evaluated both the diagnostic utility and accuracy of pancreatic EUS-FNABs and potential cytologic pitfalls when using Diff-Quik® stain for on-site evaluation. STUDY DESIGN: Pancreatic EUS-FNABs performed between 1995 and 1998 were identified from the files of the Department of Pathology. All patients were studied via a linear-array ultrasound endoscope with an FNAB device. Immediate evaluation of the specimen by a pathologist using air-dried slides and Diff-Quik® stain was done on all cases. An average of five passes (range, three to nine) were performed. Five cytologic categories were identified: nondiagnostic, benign, atypical, suspicious and malignant. EUS disease staging, histologic correlation and clinical follow-up were reviewed. RESULTS: Sixty-nine consecutive pancreatic FNABs were evaluated in the study period. The patients comprised 38 females and 31 males with a mean age of 65 years (range, 36-83). Histologic correlation was available on 40 patients, and followup was available on the remaining 29. The cytologic diagnoses included: 31 malignant, 8 suspicious, 6 atypical, 20 benign and 4 nondiagnostic. Forty-three cases were true positive, 9 were true negative, 2 were false positive, and 11 were false negative. The overall sensitivity was 80% and specificity was 82%. CONCLUSION: The study showed that cytologic evaluation of pancreatic EUS-FNABs has 80% sensitivity and 82% specificity. False negative diagnosis was usually due to sampling error. A nondiagnostic cytologic diagnosis should be rendered in the absence of adequate sampling of a lesion. On-site cytologic evaluation of EUSFNABs aids in guaranteeing specimen adequacy, and the pathologist should be trained to evaluate Diff Quik®-stained samples.
KW - Aspiration biopsy
KW - Endoscopy, gastrointestinal
KW - Pancreatic cancer
KW - Pancreatic diseases
KW - Pancreatic neoplasms
UR - http://www.scopus.com/inward/record.url?scp=0038702434&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038702434&partnerID=8YFLogxK
M3 - Article
VL - 47
SP - 341
EP - 348
JO - Acta Cytologica
JF - Acta Cytologica
SN - 0001-5547
IS - 3
ER -