Differential diagnosis of pancreatic mass lesion with percutaneous fine-needle aspiration biopsy under ultrasonic guidance.

Ultrasonically guided percutaneous fine-needle aspiration biopsy for cytological diagnosis was performed on 28 patients with ultrasonically scanned solid mass lesions of the pancreas in an attempt to make a differential diagnosis between pancreatic cancer and chronic pancreatitis. In 25 of the 28 patients, enough cells were aspirated to enable a cytological diagnosis to be made. In 19 of these 25 patients, malignant cells were obtained, while the aspirates from 6 patients contained only normal pancreatic cells. In 3 of the 28 patients, insufficient numbers of cells were obtained to allow the establishment of a cytological diagnosis. Pancreatic cancers were present in 22 of the 28 patients, and among these a positive diagnosis of cancer was made by aspiration biopsy in 86.4% (19/22). The technique resulted in no false positive diagnoses of cancer among 6 patients with chronic pancreatitis. No complications, such as bleeding, fistula formation, and elevation of the serum amylase, followed the procedure. This new method appears to be extremely useful in the diagnosis of pancreatic mass lesions.