Histopathological and Cytological Insights from EUS-FNA/B Using the ProCore 20G Needle in Periampullary Lesions

Aims This study aimed to evaluate the diagnostic accuracy of histopathology and cytology using a 20-gauge ProCore biopsy needle during endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) in patients with periampullary tumors.

Methods A retrospective analysis was conducted at a tertiary care center in Marrakech, Morocco, including patients with periampullary tumors who underwent EUS-FNA/B with the 20-gauge ProCore needle between January 2021 and November 2023. Clinical characteristics, diagnostic accuracy, and procedural safety were assessed. The primary outcome was the accuracy in diagnosing malignancy, while secondary outcomes included technical success and complications associated with the procedure.

Results A total of 23 patients were included in the study, with ages ranging from 49 to 84 years. Patients were divided into two groups: those with confirmed malignancy (60%) and those with benign disease (30%). Among patients with malignancies, adenocarcinoma was the most commonly diagnosed type, demonstrating a histopathology-to-cytology correlation rate of 75%. However, in cases of neuroendocrine tumors, the correlation rate was lower, at 33%. The procedure showed high technical success, with adequate tissue acquisition achieved in all cases. No major complications were reported during or after the procedure, underscoring the safety profile of the 20-gauge ProCore needle.

Conclusions EUS-FNA/B using the 20-gauge ProCore biopsy needle (PC20) is a safe, effective, and feasible method for diagnosing periampullary tumors. It demonstrated a high correlation between histopathology and cytology in neoplastic biliodigestive diseases, particularly adenocarcinomas, while correlation was lower in neuroendocrine tumors. These findings suggest that the ProCore 20G needle is a valuable tool for obtaining reliable diagnostic samples with minimal risk of complications. Further studies with larger cohorts are recommended to confirm these results and optimize the approach for challenging tumor types.

Publication History

Article published online:
27 March 2025