title: Definitive diagnosis of neuroendocrine tumors using fine-needle aspiration-puncture guided by endoscopic ultrasonography.
abstract: BACKGROUND
  The detection and diagnosis of neuroendocrine tumors (NETs) is challenging. Endoscopic ultrasonography (EUS) has a significant role in the detection of NETs suspected from clinical manifestations or imaging techniques, as well as in their precise localization and cytological confirmation using EUS-Fine-needle aspiration-puncture (FNA).
  
  
  OBJECTIVE
  To assess the usefulness and precision of EUS-FNAP in the differential diagnosis and confirmation of NETs, in a retrospective review of our experience.
  
  
  METHODS
  in a total of 55 patients with suspected NETs who underwent radial or sectorial EUS, 42 tumors were detected in 40 cases. EUS-FNA using a 22G needle was performed for 16 cases with suspected functional (hormonal disorders: 6 cases) and non-functional NETs (10 cases). Ki 67 or immunocytochemistry (ICC) testing was performed for all.There was confirmation in 9 cases (5 female and 4 male) with a mean age of 51 years (range: 41-81 years).All tumors were located in the pancreas except for one in the mediastinum and one in the rectum, with a mean size of 19 mm (range: 10-40 mm).
  
  
  RESULTS
  There were no complications attributable to FNA. Sensitivity was 100% and both precision and PPV were 89%, as a false positive result suggested a diagnosis with NET during cytology that surgery finally revealed to be a pancreatic pseudopapillary solid tumor.
  
  
  CONCLUSIONS
  EUS-FNA with a 22G needle for NETs has high sensitivity and PPV at cytological confirmation with few complications.
authors: Department of Enchoendoscopy, Service of Digestive Diseases, Pathology, and Digestive and General Surgery, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
authors: J
authors: J
authors: Gornals
authors: M
authors: M
authors: Varas
authors: I
authors: I
authors: Catalá
authors: S
authors: S
authors: Maisterra
authors: C
authors: C
authors: Pons
authors: D
authors: D
authors: Bargalló
authors: T
authors: T
authors: Serrano
authors: J
authors: J
authors: Fabregat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D016292:Procedural Sedation; D019160:Endosonography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen