Raddaoui Emad
Department of Pathology, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Acta Cytol. 2011;55(1):26-9. doi: 10.1159/000320908. Epub 2010 Nov 26.
BACKGROUND/AIMS: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has emerged as a new and effective tool in the evaluation of pancreatic mass lesions. It has proven to be a safe, accurate, and reliable diagnostic procedure and should be performed in centers with experienced gastroenterologists and cytopathologists for optimum results. In this study, we elaborate on our experience of specimen adequacy criteria, overall efficiency of the technique, and the cytomorphologic features of various pancreatic lesions.
EUS-FNA of the pancreas and subsequent surgical and/or clinical follow-up of all cases performed at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from November 2006 to January 2010, were retrospectively reviewed. Diff-Quik and Papanicolaou staining methods were used. Immunohistochemistry stains on cell-block preparations were applied whenever available and required. A total of 43 aspirates from 42 patients were available for retrospective review, including 37 (86%) adequate/diagnostic and 6 (14%) inadequate/non-diagnostic cases. The diagnostic group included 17 (46%) malignant and 20 (54%) benign cases. Of the malignant category (17 cases), 11 (65%) were diagnosed as positive for adenocarcinoma, 4 (23%) as neuroendocrine tumor, 1 (6%) as solid pseudo-papillary neoplasm, and 1 (6%) as non-Hodgkin's lymphoma. The benign category (20 cases) included 5 (25%) cysts/pseudo-cysts, 8 (40%) non-specific pancreatitis, 4 (20%) granulomatous/tuberculous pancreatitis, 1 (5%) benign neoplasm, and 2 (10%) benign not otherwise specified, both were proven to be false-negative cases. The sensitivity, specificity and accuracy rate for the diagnosis of cancers were 74, 100, and 86%, respectively. No false-positive results were reported. All malignant cases showed characteristic cytomorphologic features that were sufficient for their diagnosis.
EUS-FNA in adequate samples is an efficient and accurate modality in the diagnosis of pancreatic lesions. Applying immunohistochemical studies on cell-block preparation can facilitate the final, definitive, and specific diagnosis of some difficult pancreatic neoplasms.
背景/目的：内镜超声引导下细针穿刺抽吸术（EUS-FNA）已成为评估胰腺肿块病变的一种新型有效工具。它已被证明是一种安全、准确且可靠的诊断方法，应在有经验丰富的胃肠病学家和细胞病理学家的中心进行，以获得最佳结果。在本研究中，我们详细阐述了我们在标本充足标准、该技术的整体效率以及各种胰腺病变的细胞形态学特征方面的经验。
回顾性分析了2006年11月至2010年1月在沙特阿拉伯利雅得国王沙特大学国王哈立德大学医院进行的所有胰腺EUS-FNA病例及其后续的手术和/或临床随访情况。采用Diff-Quik和巴氏染色法。必要时对细胞块制备物进行免疫组织化学染色。共有来自42例患者的43份抽吸物可供回顾性分析，其中37份（86%）为充足/诊断性标本，6份（14%）为不足/非诊断性标本。诊断组包括17例（46%）恶性病例和20例（54%）良性病例。在恶性病例组（17例）中，11例（65%）被诊断为腺癌阳性，4例（23%）为神经内分泌肿瘤，1例（6%）为实性假乳头状肿瘤，1例（6%）为非霍奇金淋巴瘤。良性病例组（20例）包括5例（25%）囊肿/假性囊肿，8例（40%）非特异性胰腺炎，4例（20%）肉芽肿性/结核性胰腺炎，1例（5%）良性肿瘤，以及2例（10%）未另行说明的良性病变，这2例均被证明为假阴性病例。癌症诊断的敏感性、特异性和准确率分别为74%、100%和86%。未报告假阳性结果。所有恶性病例均显示出足以确诊的特征性细胞形态学特征。
对充足样本进行EUS-FNA是诊断胰腺病变的一种有效且准确的方法。对细胞块制备物进行免疫组织化学研究有助于对一些疑难胰腺肿瘤做出最终、明确和特异性的诊断。
