Evaluation of endoscopic ultrasound-guided fine needle aspiration of space-occupying lesion of the pancreas

Objective: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has become a widely accepted effective modality for obtaining tissue for primary diagnosis of the pancreatic lesions. The aim of this paper is to report our initial experience of this procedure for 35 patients with space-occupying lesion of the pancreas. Methods: We retrospectively reviewed the data on 35 EUS-FNA procedures performed in 35 patients for evaluation of the space-occupying lesion of the pancreas detected by CT scanning, ultrasonography or clinically suspected diagnosis. The sensitivity, accuracy and safety of EUS-FNA were evaluated. Final diagnosis was based on histological and cytological evidence or on follow-up. Results: All these 35 patients with pancreatic lesions were detected by EUS, however 20 patients and 29 patients were detected by transabdominal ultrasonography or CT scanning, respectively. A total of 35 EUS-FNAs were performed during the study period and the diagnosis was made in 23 cases of pancreatic cancer, 9 cases of pancreatitis, 1 case of intraductal papillary mucinous neoplasm (IPMN), 1 case of pancreatic pseudocyst, and 1 case of serous cystadenoma. The sensitivity and accuracy of EUS-FNA for suspected pancreatic cancer were 73.91% and 82.86% respectively. After EUS-FNA, 5 patients developed acute mild pancreatitis, and recovered soon following the treatment. Conclusion: Our experience confirms that EUS-FNA is a safe and valuable diagnostic method in patients with suspected space-occupying lesion of the pancreas. This technique should be considered the preferred test when a pathological diagnosis of a pancreatic lesion is required.

Keywords: Pancreatic space-occupying lesion, Endosonography, Fine-needle aspiration, Pathology