Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses
- M Vossa,
- P Hammela,
- G Molasb,
- L Palazzoa,
- A Dancoura,
- D O'Toolea,
- B Terrisb,
- C Degottb,
- P Bernadesa,
- P Ruszniewskia
- aMedical-Surgical Federation of Hepato-Gastroenterology, Beaujon Hospital, Clichy, France, bDepartment of Pathology, Beaujon Hospital
- Dr P Hammel, Service de Gastroentérologie, hôpital Beaujon, 92110 Clichy, France.
- Accepted 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.
METHODS Ninety 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.
RESULTS EUS-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.
CONCLUSIONS EUS-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.
- Abbreviations used in this paper:
- endoscopic ultrasound guided fine needle aspiration biopsy
- computed tomography