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Background: Cytology and core-needle biopsies are not always sufficient to exclude malignancy in benign breast lesions (BBL) that are at risk of developing cancer, and open biopsy often is mandatory. In screening programs, open biopsies performed for lesions that are at risk of developing malignancy are considered benign. The authors of this report evaluated the impact of the screen-detected BBL at risk of developing cancer that were counted in the quota of benign breast open biopsies in the Breast Cancer Screening Program of Verona., Methods: Benign open biopsies were subdivided into 4 groups according to their risk of developing cancer: Histo1, normal histology; Histo2, 'pure' BBL (fibroadenoma, fibrocystic disease, mastitis, adenosis); Histo3, BBL with a low risk of developing cancer (radial scar, papilloma, papillomatosis, phyllodes tumor, mucocele-like lesion); and Histo4, BBL with a high risk of developing cancer (atypical columnar cell hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia)., Results: Of 510 open biopsies, 83 biopsies were benign, and the ratio of benign to malignant biopsies was 1:5. Histo1 was observed in 4.8% of all benign open biopsies, Histo2 was observed in 37.4%, Histo3 was observed in 31.3%, and Histo4 was observed 26.5%., Conclusions: BBL at risk of developing cancer may be numerous in screening programs. It is inappropriate to include BBL at risk of developing cancer in the overall benign open biopsy rate. The authors propose separating pure BBL from lesions at higher risk of developing cancer. To date, there is no evidence to support the premise that detecting high-risk proliferative lesions leads to benefits in terms of reduced mortality; however, these lesions need to be counted separately for future evaluations., ((c) 2008 American Cancer Society.)

Due to their aspecific macroscopic appearance, uncommon pancreatic cystic lesions (PCLs) are often misdiagnosed as mucinous lesions and improperly resected. We aimed to evaluate the endoscopic ultrasound (EUS)-guided through-the-needle biopsy (TTNB) capacity of the preoperative diagnosis of uncommon PCLs. Overall, 136 patients with PCLs who underwent EUS-TTNB between 2016 and 2022 were retrospectively identified. Common histotypes (e.g., IPMN, serous cystadenoma, and mucinous cystadenoma) were excluded and 26 (19.1%) patients (15 female, mean age 52.9 ± 10.4) were analyzed. The EUS findings, adverse events (AEs), and TTNB outcomes in uncommon PCLs were evaluated. The cysts histotype was accurately diagnosed by TTNB in 24/26 (92.3%) cases (seven cystic neuroendocrine tumors, four squamoid cysts, three acinar cells cystadenomas, two lymphoepithelial cysts, two mucinous non-neoplastic cysts, two bronchogenic cysts, two cystic lymphangiomas, one solid-pseudopapillary neoplasm, and one schwannoma). In the remaining two cases, lymphangioma was eventually diagnosed after resection. Surgery was performed in 15/26 (57.7%) patients. The mean follow-up of non-surgical patients was 32.5 months. One severe acute case of pancreatitis (3.8%) that required surgery occurred after EUS-TTNB. Uncommon pancreatic/peripancreatic lesions represent the 19.1% of PCLs in our series, with mainly benign histotypes. TTNB demonstrated a high diagnostic performance with a low rate of AEs in this setting, representing a reliable tool with which to avoid useless surgery. [ABSTRACT FROM AUTHOR]

Background It is unknown whether there is an advantage to using the wet-suction or slow-pull technique during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) with new-generation needles. We aimed to compare the performance of each technique in EUS-FNB. Methods This was a multicenter, randomized, single-blind, crossover trial including patients with solid lesions of ≥ 1 cm. Four needle passes with 22 G fork-tip or Franseen-type needles were performed, alternating the wet-suction and slow-pull techniques in a randomized order. The primary outcome was the histological yield (samples containing an intact piece of tissue of at least 550 μm). Secondary end points were sample quality (tissue integrity and blood contamination), diagnostic accuracy, and adequate tumor fraction. Results Overall, 210 patients with 146 pancreatic and 64 nonpancreatic lesions were analyzed. A tissue core was retrieved in 150 (71.4 %) and 129 (61.4 %) cases using the wet-suction and the slow-pull techniques, respectively (P = 0.03). The mean tissue integrity score was higher using wet suction (P = 0.02), as was the blood contamination of samples (P < 0.001). In the two subgroups of pancreatic and nonpancreatic lesions, tissue core rate and tissue integrity score were not statistically different using the two techniques, but blood contamination was higher with wet suction. Diagnostic accuracy and tumor fraction did not differ between the two techniques. Conclusion Overall, the wet-suction technique in EUS-FNB resulted in a higher tissue core procurement rate compared with the slow-pull method. Diagnostic accuracy and the rate of samples with adequate tumor fraction were similar between the two techniques. [ABSTRACT FROM AUTHOR]

Objectives: Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is the gold standard for the diagnosis of solid pancreatic lesions (SPLs). Cytological samples can also be obtained using touch imprint cytology (TIC) on EUS fine‐needle biopsy (FNB) specimens. We aimed to compare sample quality and diagnostic yield of EUS‐FNA‐standard cytology (EUS‐FNA‐SC) to that of EUS‐FNB‐TIC in a series of patients with SPLs. Methods: Thirty‐two consecutive patients referred for EUS‐tissue acquisition of SPLs who underwent rapid on‐site evaluation of both EUS‐FNA‐SC and paired EUS‐FNB‐TIC during the same endoscopic session were retrospectively identified. Sample quality (evaluated in terms of blood contamination, presence of clots, tissue casts, cellularity, and necrosis) and diagnostic yield were compared between the techniques. Results: The mean number of passes to reach diagnosis at rapid on‐site evaluation was similar between EUS‐FNA‐SC and EUS‐FNB‐TIC (1.09 ± 0.3 vs 1.13 ± 0.34, P =.711). EUS‐FNA‐SC scores of sample quality were comparable to those of EUS‐FNB‐TIC (blood contamination, 2.47 ± 1.11 vs 2.25 ± 1.14, P =.109; clots, 1.25 ± 0.76 vs 1.19 ± 0.69, P =.624; tissue casts, 3.56 ± 0.88 vs 3.59 ± 1.09, P =.872; cellularity, 2.84 ± 1.11 vs 3.09 ± 1.09, P =.244; necrosis, 2.25 ± 1.08 vs 2.53 ± 1.02 P =.059; total score, 12.38 ± 2.88 vs 17.66 ± 2.38, P =.536). Adequacy, sensitivity and diagnostic accuracy of the two sampling techniques were equal (93.7%, 90.6% and 90.6%, respectively). Conclusions: EUS‐FNB‐TIC provides comparable samples to those of EUS‐FNA‐SC and combines the benefits of cytology and histology for the evaluation of SPLs by employing a single needle during the same endoscopic procedure. Cytology and histology present pros and cons in the preoperative evaluation of solid pancreatic lesions, and which one should be preferred is still a matter of debate. The use of the touch imprint cytology on EUS‐fine‐needle‐biopsy specimens allows to combine the benefits by providing cytological and histological samples acquired during the same procedure and with the same needle. In our study sample quality and diagnostic yield of EUS standard cytology and EUS touch imprint cytology were evaluated in patients who underwent EUS‐FNA and paired EUS‐FNB with rapid‐on‐site assessment of the same lesion. [ABSTRACT FROM AUTHOR]

The article presents the study on fine-needle aspiration cytology (FNAC) performed at the Breast Cancer Screening Program in Verona (BCSPV) in Italy. The objective of the study is to emphasize accuracy of FNAC when cytologic sample results are immediately matched with clinical and imaging findings. FNAC has been widely used in the diagnosis of breast lesions due to its many benefits such as fast results, patient compliance and simple and cost-effective method, but has been criticized of having high inadequate rate (IR) and suboptimal accuracy.

Simple Summary: Traditionally, liver biopsy has been performed by percutaneous radiology-guided methods. Advances in endoscopic ultrasound have demonstrated the efficacy of endoscopic based techniques for liver biopsy. Studies comparing both methods are scarce and have conflicting results. Our study compares percutaneous and endoscopic ultrasound methods for liver biopsy. Our analysis shows no evidence to support the wide use of endoscopic ultrasound. Percutaneous liver biopsy remains the sampling method of choice in this field. There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4; p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB; p < 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures. [ABSTRACT FROM AUTHOR]