title: Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of anaplastic pancreatic carcinoma: a single-center experience.
abstract: OBJECTIVE
  Anaplastic carcinoma of the pancreas (ACP) is an aggressive variant of ductal adenocarcinoma. The aim of this study was to describe a single-center experience with the use of endoscopic ultrasound (EUS) with or without fine-needle aspiration (FNA) for the diagnosis of ACP.
  
  
  METHODS
  The cytology and surgical pathology databases were searched for a diagnosis of ACP between 1992 and 2008. Demographic, clinical,surgical, radiographic, pathological, and EUS data were abstracted.
  
  
  RESULTS
  Thirteen patients with ACP were identified, which represented 0.8% of all pancreatic cancers diagnosed during the study period. Six of 13 patients had EUS. Features of these 6 tumors: median diameter of 42 mm (range, 20-100 mm), hypoechoic (n = 6), solid (n = 3) or mixed solid and cystic (n = 3), heterogeneous (n = 5) or homogeneous (n = 1),and well defined (n = 2) or poorly defined (n = 4) borders. Five underwent EUS-FNA of a pancreatic mass, and cytology demonstrated ACP in 4 and ductal adenocarcinoma in 1. The diagnosis of ACP was confirmed after surgical resection in 2 of these 5, including one in whom cytology demonstrated only adenocarcinoma. The sixth patient had EUS without FNA, and surgical pathology after distal pancreatectomy found ACP.
  
  
  CONCLUSIONS
  Anaplastic carcinoma of the pancreas has variable endosonographic features. Endoscopic ultrasound-FNA may assist in the cytological diagnosis of these tumors.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Mouen A
authors.initials: MA
authors.lastname: Khashab
authors.forename: Robert E
authors.initials: RE
authors.lastname: Emerson
authors.forename: John M
authors.initials: JM
authors.lastname: DeWitt
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D002277:Carcinoma / Q000473:pathology*; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology; D003937:Diagnosis, Differential; D019160:Endosonography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D016019:Survival Analysis