Yield of EUS-guided FNA on the diagnosis of pancreatic/peripancreatic tuberculosis.
BACKGROUND
Pancreatic/peripancreatic tuberculosis (TB) is a very rare clinical entity, even in countries with high incidences of TB. The diagnosis of pancreatic/peripancreatic TB with EUS-guided FNA (EUS-FNA) remains a diagnostic challenge because of limitations of the endoscopists' expertise on this condition.


OBJECTIVE
This study evaluated the yield and usefulness of EUS-FNA in patients with pancreatic/peripancreatic TB.


METHODS
A retrospective analysis was performed.


METHODS
A tertiary teaching hospital in Seoul, Korea.


METHODS
Baseline demographic and clinical features were evaluated in 21 consecutive patients with pancreatic/peripancreatic TB who underwent EUS-FNA between September 2003 and April 2007.


RESULTS
The mean lesion diameter was 31.3 +/- 14.6 mm. Thirteen patients (61.9%) showed granulomatous inflammation on histopathologic examination, and 10 of 15 patients (66.7%) were positive on a TB polymerase chain reaction assay. Ziehl-Neelsen staining was positive in 4 of 15 patients (26.7%), and 3 of 8 patients (37.5%) had cultures positive for Mycobacterium tuberculosis. EUS-FNA correctly diagnosed pancreatic/peripancreatic TB in 16 patients (76.2%). Therefore, unnecessary surgery was avoided for these patients.


CONCLUSIONS
A retrospective study.


CONCLUSIONS
EUS-FNA is a safe and promising method for the diagnosis of pancreatic/peripancreatic TB. Use of this method may help us to avoid the use of surgery and provide timely and accurate diagnosis.
Song
Tae Jun
TJ
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Lee
Sang Soo
SS
Park
Do Hyun
DH
Lee
Tae Yoon
TY
Lee
Sang Oh
SO
Seo
Dong Wan
DW
Lee
Sung Koo
SK
Kim
Myung-Hwan
MH
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies; D014376:Tuberculosis / Q000000981:diagnostic imaging* / Q000473:pathology*