Identification of gastrointestinal contamination in endoscopic ultrasound-guided pancreatic fine needle aspiration.
OBJECTIVE
To evaluate whether B72.3 and CEA could identify duodenal and gastric contamination in cell blocks of clinically proven cases of pancreatic ductal carcinoma, intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN).


METHODS
Cell blocks of pancreatic fine needle aspirates from 19 ductal adenocarcinomas, 9 IPMNs, 5 MCNs, and 22 cases containing gastrointestinal epithelial contamination (GIC) (7 gastric, 15 duodenal) were stained with antibody to carcinoembryonic antigen (CEA) and B72.3.


RESULTS
CEA was positive in 89% of adenocarcinomas and 92% of mucinous lesions. It was never expressed in gastric contamination and was positive in 2/15 (13%) duodenal contaminants. B72.3 was positive in 95% of adenocarcinomas and 85% of mucinous lesions. It was positive in 2/7 (28%) gastric and 7/15 (47%) duodenal contaminants.


CONCLUSIONS
In contrast to previous work, our preliminary results indicate that B72.3 expression cannot be reliably used to identify GIC. A lack of CEA expression, however, can be used to identify both gastric and duodenal contamination. This represents an important diagnostic aid in the evaluation of suspected low grade mucinous lesions.
Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, 132 South 10th Street, 285 Main Building, Philadelphia, Pennsylvania 19107, USA. adam.toll@jeffersonhospital.org
Adam D
AD
Toll
Marluce
M
Bibbo
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000378:metabolism; D000912:Antibodies, Neoplasm / Q000378:metabolism; D016477:Artifacts; D015415:Biomarkers / Q000378:metabolism; D044963:Biopsy, Fine-Needle; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000378:metabolism; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000378:metabolism; D003951:Diagnostic Errors / Q000517:prevention & control; D004386:Duodenum / Q000378:metabolism / Q000473:pathology*; D019160:Endosonography; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D013270:Stomach / Q000473:pathology*
D000912:Antibodies, Neoplasm; C091202:B72.3 antibody; D015415:Biomarkers; D002272:Carcinoembryonic Antigen