Cystic pancreatic endocrine tumors: an endoscopic ultrasound-guided fine-needle aspiration biopsy study with histologic correlation.
BACKGROUND
Cystic pancreatic endocrine tumors (PETs) are rare neoplasms with a preoperative diagnostic challenge. The aim of this study was to evaluate the preoperative diagnostic strategy for these tumors and to assess the clinical and pathologic characteristics.


METHODS
Six cases of cystic PET were retrospectively enrolled. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) was performed in 4 cases. All cytomorphologic data from conventional smears, ThinPrep preparations, and cell block preparations were reported in detail.


RESULTS
There were 3 male and 3 female patients with a mean age of 52.3 years. Tumor size ranged from 10 mm to 60 mm (mean, 29.8 mm). EUS-FNAB contributed to an accurate diagnosis in all cases. Cytologically, loosely cohesive aggregates and single cells were predominant. Cells were small and typically plasmacytoid, with occasional cytoplasmic vacuolization. Nuclei were round or oval, uniform, with finely and evenly distributed chromatin. Immunocytochemistry confirmed the endocrine differentiation. Histologic findings were typical for endocrine proliferation. All tumors were well differentiated.


CONCLUSIONS
Cystic PET is an unusual finding that presents diagnostic challenges for both endoscopists and cytologists. EUS-FNAB with the Thinprep preparation technique and cell block material were found to be helpful in improving diagnostic accuracy. Immunocytochemical staining with endocrine markers confirmed the diagnosis.
Department of Pathology, Paoli-Calmettes Institute, Marseille, France. charfislim@gmail.com
Slim
S
Charfi
Myriam
M
Marcy
Erwan
E
Bories
Christian
C
Pesanti
Fabrice
F
Caillol
Marc
M
Giovannini
Fréderic
F
Viret
Jean
J
Robert Delpero
Luc
L
Xerri
Genevieve
G
Monges
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003937:Diagnosis, Differential; D004724:Endoscopy; D019160:Endosonography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000473:pathology*; D010179:Pancreas / Q000737:chemistry / Q000473:pathology*; D010181:Pancreatic Cyst / Q000378:metabolism / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology*; D012189:Retrospective Studies
D019394:Ki-67 Antigen