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a Medical-Surgical
Federation of Hepato-Gastroenterology, Beaujon Hospital, Clichy, France, b Department of Pathology, Beaujon Hospital
Correspondence to: Dr P Hammel, Service de Gastroentérologie, hôpital Beaujon, 92110 Clichy, France.
Accepted for publication 9 August 1999
AIM
To assess the
feasibility and diagnostic accuracy of endoscopic ultrasound guided
fine needle biopsy (EUS-FNAB) in patients with solid pancreatic masses.
METHODSNinety nine
consecutive patients with pancreatic masses were studied. Histological
findings obtained by EUS-FNAB were compared with the final diagnosis
assessed by surgery, biopsy of other tumour site or at postmortem
examination, or by using a combination of clinical course, imaging
features, and tumour markers.
RESULTSEUS-FNAB was
feasible in 90 patients (adenocarcinomas, n = 59; neuroendocrine
tumours, n = 15; various neoplasms, n = 6; pancreatitis, n = 10), and
analysable material was obtained in 73. Tumour size (
or < 25 mm in
diameter) did not influence the ability to obtain informative biopsy
samples. Diagnostic accuracy was 74.4% (adenocarcinomas, 81.4%;
neuroendocrine tumours, 46.7%; other lesions, 75%; p<0.02). Overall,
the diagnostic yield in all 99 patients was 68%. Successful biopsies
were performed in six patients with portal hypertension. Minor
complications (moderate bleeding or pain) occurred in 5% of cases.
CONCLUSIONSEUS-FNAB
is a useful and safe method for the investigation of pancreatic masses,
with a high feasibility rate even when lesions are small. Overall
diagnostic accuracy of EUS-FNAB seems to depend on the tumour type.
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