Neoplasia in Chronic Pancreatitis: How to Maximize the Yield of Endoscopic Ultrasound-Guided Fine Needle Aspiration.
- Author:
Ji Young BANG
1
;
Shyam VARADARAJULU
Author Information
- Publication Type:Review
- Keywords: Endosonography; Biopsy; Biopsy, fine-needle; Pancreatitis, chronic; Pancreatic neoplasms
- MeSH: Biopsy; Biopsy, Fine-Needle; Elasticity Imaging Techniques; Endoscopic Ultrasound-Guided Fine Needle Aspiration*; Endosonography; Pancreatic Neoplasms; Pancreatitis, Chronic*; Pathology; Stents; Tissue and Organ Procurement
- From:Clinical Endoscopy 2014;47(5):420-424
- CountryRepublic of Korea
- Language:English
- Abstract: When performing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), identifying neoplasia in the setting of chronic pancreatitis can be technically challenging. The morphology of an ill-defined mass on sonography, presence of calcifications or intervening collaterals, reverberation from a biliary stent, low yield of tissue procurement, and interpretative errors in cytopathology can result in both false-negative and false-positive results. Although these challenges cannot be completely eliminated, elastography or contrast-enhanced imaging can aid in differentiating an inflammatory mass from a neoplasm. Also, performing more passes of FNA, procuring core biopsy material, performing rapid onsite evaluation, conducting ancillary pathology studies, and even repeating the procedure on a different day can aid in improving the diagnostic performance of EUS-FNA. This review provides a concise update and offers practical tips to improving the diagnostic yield of EUS-FNA when sampling solid pancreatic mass lesions in the setting of chronic pancreatitis.
