title: Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses.
abstract: OBJECTIVE
  To assess the feasibility and diagnostic accuracy of endoscopic ultrasound guided fine needle biopsy (EUS-FNAB) in patients with solid pancreatic masses.
  
  
  METHODS
  Ninety nine consecutive patients with pancreatic masses were studied. Histological findings obtained by EUS-FNAB were compared with the final diagnosis assessed by surgery, biopsy of other tumour site or at postmortem examination, or by using a combination of clinical course, imaging features, and tumour markers.
  
  
  RESULTS
  EUS-FNAB was feasible in 90 patients (adenocarcinomas, n = 59; neuroendocrine tumours, n = 15; various neoplasms, n = 6; pancreatitis, n = 10), and analysable material was obtained in 73. Tumour size (>/= or < 25 mm in diameter) did not influence the ability to obtain informative biopsy samples. Diagnostic accuracy was 74.4% (adenocarcinomas, 81.4%; neuroendocrine tumours, 46.7%; other lesions, 75%; p<0.02). Overall, the diagnostic yield in all 99 patients was 68%. Successful biopsies were performed in six patients with portal hypertension. Minor complications (moderate bleeding or pain) occurred in 5% of cases.
  
  
  CONCLUSIONS
  EUS-FNAB is a useful and safe method for the investigation of pancreatic masses, with a high feasibility rate even when lesions are small. Overall diagnostic accuracy of EUS-FNAB seems to depend on the tumour type.
authors.affiliation: Medical-Surgical Federation of Hepato-Gastroenterology, Beaujon Hospital, Clichy, France.
authors.forename: M
authors.initials: M
authors.lastname: Voss
authors.forename: P
authors.initials: P
authors.lastname: Hammel
authors.forename: G
authors.initials: G
authors.lastname: Molas
authors.forename: L
authors.initials: L
authors.lastname: Palazzo
authors.forename: A
authors.initials: A
authors.lastname: Dancour
authors.forename: D
authors.initials: D
authors.lastname: O'Toole
authors.forename: B
authors.initials: B
authors.lastname: Terris
authors.forename: C
authors.initials: C
authors.lastname: Degott
authors.forename: P
authors.initials: P
authors.lastname: Bernades
authors.forename: P
authors.initials: P
authors.lastname: Ruszniewski
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods*; D016009:Chi-Square Distribution; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity