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Neoplasia in Chronic Pancreatitis: How to Maximize the Yield of Endoscopic Ultrasound-Guided Fine Needle Aspiration

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...

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Detalles Bibliográficos
Autores principales: Bang, Ji Young, Varadarajulu, Shyam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Gastrointestinal Endoscopy 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198558/
https://www.ncbi.nlm.nih.gov/pubmed/25325001
http://dx.doi.org/10.5946/ce.2014.47.5.420
Descripción
Sumario: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.