title: Intraoperative pancreatic fine needle aspiration biopsy. Results in 166 patients.
abstract: Intraoperative fine needle aspiration biopsy (NAB) of undiagnosed pancreatic masses was studied in 166 patients over a 17-year period. The cytologic diagnoses were correlated with histologic specimens, autopsy results, or clinical follow-up (benign disease was documented if the patient was alive without malignancy at least 2 years after laparotomy). Aspirates were interpreted as benign, suspicious, malignant, or unsatisfactory. Malignant disease was the final diagnosis in 109 patients; the cytology was concordant in 101 and was interpreted as suspicious in four. Four patients with benign cytology later proved to have malignant disease--a false-negative rate of 2.5 per cent. A total of 57 patients had benign disease; 51 of these had benign cytology. The remaining patients had "unsatisfactory" cytology reports. A 93 per cent sensitivity, 100 per cent specificity, and 0 per cent complication rate are reported. There were no false-positive cytology reports. Complications are rare and represent case reports, thus, additional sampling is at minimal risk. Intraoperative pancreatic NAB is a safe, easy, more accurate biopsy technique than historical wedge or core needle biopsies. It is the biopsy method of choice for pancreatic masses found at laparotomy.
authors.affiliation: Department of Surgery Lankenau Hospital, Philadelphia, Pennsylvania.
authors.forename: M E
authors.initials: ME
authors.lastname: Schadt
authors.forename: T S
authors.initials: TS
authors.lastname: Kline
authors.forename: H S
authors.initials: HS
authors.lastname: Neal
authors.forename: R S
authors.initials: RS
authors.lastname: Scoma
authors.forename: S
authors.initials: S
authors.lastname: Naryshkin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D012680:Sensitivity and Specificity