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Cyst wall puncture and aspiration during EUS-guided fine needle aspiration may increase the diagnostic yield of mucinous cysts of the pancreas.
- Source :
-
Journal of clinical gastroenterology [J Clin Gastroenterol] 2011 Feb; Vol. 45 (2), pp. 164-9. - Publication Year :
- 2011
-
Abstract
- Background: Pancreatic cysts are common, however, their diagnosis and classification remains a challenge despite advances in cross-sectional imaging and endoscopic ultrasound with fine needle aspiration (EUS-FNA).<br />Objective: To determine the incremental yield of cytologic examination of material obtained from targeted fine needle aspiration ("puncture") of the cyst wall after aspiration of fluid for CEA.<br />Design: Retrospective consecutive series.<br />Patients and Setting: Consecutive patients undergoing EUS-FNA of a pancreatic cyst by 2 expert endoscopists at a single tertiary care center between January 2006 and June 2008.<br />Intervention: Standard EUS-FNA of pancreatic cysts was carried out, and after cyst fluid aspiration the cyst wall was punctured and aspirated (CWP) to obtain epithelium for cytologic analysis.<br />Main Outcome Measurements: The diagnostic yields of carcinoembryonic antigen (CEA) obtained from cyst fluid and of cytology obtained from CWP. CEA greater than192 ng/mL was considered diagnostic of a mucinous cyst.<br />Results: One hundred seven patients underwent EUS-FNA with CWP. Sixteen (31%) of 52 patients with CEA <192 ng/mL had cytology positive for mucinous epithelium, whereas 15 (47%) of 32 cysts with an insufficient amount of fluid for CEA analysis had positive cytology from CWP. The additional, cumulative diagnostic yield for mucinous cysts was therefore, 37%. Of 55 cysts diagnosed as mucinous, more (56%) were diagnosed by CWP cytology alone than by CEA (P<0.05).<br />Limitations: Retrospective design and limited surgical pathology.<br />Conclusions: Cyst wall puncture and aspiration during routine EUS-FNA may be a safe, easily applied, and inexpensive technique for improving the diagnostic yield for mucinous cysts of the pancreas.
- Subjects :
- Carcinoembryonic Antigen analysis
Cyst Fluid chemistry
Cysts diagnostic imaging
Epithelium
Humans
Pancreas diagnostic imaging
Pancreas pathology
Pancreatic Cyst pathology
Pancreatic Neoplasms pathology
Punctures
Biopsy, Fine-Needle methods
Cysts pathology
Endosonography
Pancreatic Cyst diagnosis
Pancreatic Cyst diagnostic imaging
Pancreatic Neoplasms diagnosis
Pancreatic Neoplasms diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1539-2031
- Volume :
- 45
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of clinical gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 20818233
- Full Text :
- https://doi.org/10.1097/MCG.0b013e3181eed6d2