title: Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) material in the differential diagnosis of pancreatic solid masses.
  
  
  METHODS
  Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs (22G needle) were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Materials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study.
  
  
  RESULTS
  Length of the core specimen obtained for histological analysis was 6.5 +/- 5.3 mm (range 1-22 mm). Cytological and histological samples were considered as adequate in 51 (82.3%) and 52 cases (83.9%), respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Contrary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases (90.3%), with a global sensitivity of 84.21%, specificity of 100% and an overall accuracy of 90.32%. The complication rate was 1.6%.
  
  
  CONCLUSIONS
  Adequate pancreatic core specimens for histological examination can be obtained by EUS-guided FNA. This technique is mainly useful for the diagnosis of different types of pancreatic tumours and evaluation of benign diseases.
authors.affiliation: Gastroenterology Department, University Hospital, c/Choupana s/n 15706 Santiago de Compostela, Spain. jiglesiasg@fienad.com
authors.forename: Julio
authors.initials: J
authors.lastname: Iglesias-Garcia
authors.forename: Enrique
authors.initials: E
authors.lastname: Dominguez-Munoz
authors.forename: Antonio
authors.initials: A
authors.lastname: Lozano-Leon
authors.forename: Ihab
authors.initials: I
authors.lastname: Abdulkader
authors.forename: Jose
authors.initials: J
authors.lastname: Larino-Noia
authors.forename: Jose
authors.initials: J
authors.lastname: Antunez
authors.forename: Jeronimo
authors.initials: J
authors.lastname: Forteza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology