title: Utility of endoscopic ultrasound (EUS)-guided fine-needle aspiration for peri-arterial soft tissue cuffs without identifiable pancreas mass on CT and EUS: a prospective comparative study.
abstract: Pancreatic cancer may present as a peri-arterial soft tissue cuff (PSTC) around the superior mesenteric artery or celiac axis without an identifiable pancreatic mass. We evaluated the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with a PSTC without definite pancreas involvement and those with a typical pancreatic mass. The patients who underwent EUS-FNA of a PSTC without pancreatic involvement were prospectively enrolled. The patients who underwent EUS-FNA for a pancreatic mass were recruited as a control group. A total of 224 patients underwent 247 EUS-FNAs. Among the 13 patients with a PSTC, 11 were positive for malignancy as determined by EUS-FNA, with 5 diagnosed after the first session and 6 after the second session. The diagnostic yield of PSTCs by EUS-FNA was significantly lower than that for typical pancreatic masses (65% vs. 87%, p = 0.02). An on-site cytopathologist and repeated EUS-FNA are recommended to improve the diagnostic accuracy of this disease entity.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Paik
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hwan
authors.initials: H
authors.lastname: Yoon
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. Electronic address: dhpark@amc.seoul.kr.
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Kyoungwon
authors.initials: K
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Seo
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Celiac artery; Locally advanced pancreatic cancer; Pancreatic neoplasm; Superior mesenteric artery