Cytodiagnosis of lesions of the pancreas and related areas.

Our experience of six and one-half years with cyto-diagnosis of pancreatic and related lesions is presented. We studied 22 cases of direct (perioperative and endoscopic) aspiration (group A) and 14 cases of percutaneous aspiration using ultrasound guidance (group B). Cytohistologic correlation in the direct aspiration cases and cytoclinical correlation in the percutaneous aspiration cases showed a specificity of 90% in group A and 100% in group B. Sensitivity was 100% in group A and 72.7% in group B. Predictive value of positive results was 92% in group A and 100% in group B. Eight of ten positive cancer cases in group A were confirmed by initial endoscopic tissue biopsies. One periampullary duodenal aspiration and one bile aspirate were cytologically positive, with negative endoscopic biopsy; final clinical evaluation with laparotomy confirmed these two cases as cancer. Thus, cytodiagnosis was more sensitive than tissue biopsy.