P-HPB-02: Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of pancreatic mass: A single-center experience

BACKGROUND AND OBJECTIVES: It is difficult to evaluate patients with suspected pancreatic neoplasm based on imaging studies such as computed tomographic (CT) scan/magnetic resonance image (MRI), especially in getting a tissue diagnosis and differentiating from benign conditions such as autoimmune pancreatitis, tuberculosis. The objective of the study was to evaluate the different etiologies and the accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic mass. METHODS: This was a retrospective analysis and included patients who underwent EUS-FNA at a tertiary care hospital in the past 6 months for pancreatic masses or space-occupying lesion noted on imaging modalities such as CT/MRI. The main outcome measurements were (1) prevalence of pancreatic adenocarcinoma, (2) diagnosis of other benign etiologies, and (3) performance characteristics of EUS-FNA for identifying malignancy. RESULTS: A total of 46 patients were included in the analysis; a pancreatic lesion/mass was identified on EUS in 44 patients. The final diagnosis includes adenocarcinoma (n = 28), neuroendocrine tumor (n = 4), gastric gastrointestinal stromal tumor infiltrating pancreas (n = 1), necrotic abscess (n = 2), pancreatic tuberculosis (n = 2), inflammatory head mass (n = 4), and autoimmune pancreatitis (n = 3). Those patients without any pancreatic mass were two (chronic pancreatitis [n = 1], and normal pancreas [n = 1]). EUS-FNA had an accuracy of 96% for diagnosing malignant neoplasm, with 95% sensitivity and 99.0% specificity. CONCLUSIONS: EUS-FNA is a highly accurate and accepted diagnostic modality for diagnosis of pancreatic mass.