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Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle
| Content Provider | Scilit |
|---|---|
| Author | Perini, Claudia Stefano, Serena Di Parisi, Alice Frulloni, Luca Sina, Sokol Manfrin, Erminia Bernardoni, Laura Remo, Andrea Gabbrielli, Armando Stefano, Francesco Crinò |
| Copyright Year | 2019 |
| Abstract | Background and Objectives: Despite rarely, serous cystic adenoma (SCA) can assume a pseudo-solid aspect mimicking other pancreatic neoplasm as neuroendocrine tumor. EUS-FNA cytology has low diagnostic accuracy due to the scant cellularity of the collected samples. Histological diagnosis is usually made after resection. Recently, end-cutting needles for EUS-fine-needle biopsy (EUS-FNB), which obtain tissue cores by penetrating the lesions, have been developed. We aimed to assess the capability of EUS-FNB with SharkCore™ needles in the preoperative diagnosis of serous cystic adenoma pseudo-solid-appearing on imaging (Sa-SCA). Materials and Methods: Between January 2016 and January 2018, data from consecutive adult patients, who were referred for EUS-FNB of a solid pancreatic lesion and were diagnosed with having SCA, were retrieved from a single-center institutional database. Results: Two patients were excluded because of microcystic aspect at EUS. Histological diagnosis of SCA was made by EUS-FNB in the remaining 7 patients (5 females; mean age of 62.5 years). Lesions (mean size of 19.8 mm) were hypervascular on cross-sectional imaging, slightly hyperdense magnetic resonance imaging with T2-weighted images can, and negative at$ ^{68}$Ga-somatostatin receptor positron emission tomography and$ ^{18}$fluoro-deoxyglucose positron emission tomography. EUS-FNB samples were judged adequate for a definitive diagnosis in all cases, achieving specimens suitable for histological evaluation and several ancillary stains. Histochemical positivity for periodic acid-Schiff (PAS) and PAS with diastase digestion was observed in 7/7 cases. Immunohistochemical positivity for α-inhibin (7/7), GLUT1 (6/6), MUC6 (5/5), and negativity for synaptophysin (7/7) and chromogranin A (2/2) favored SCA diagnosis. Conclusions: In the case of preoperative workup suspected for Sa-SCA, a “forward acquiring” needle could improve the rate of preoperative histological diagnosis. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791108/pdf |
| Ending Page | 341 |
| Page Count | 8 |
| Starting Page | 334 |
| File Format | XHTML |
| ISSN | 23039027 |
| e-ISSN | 22267190 |
| DOI | 10.4103/eus.eus_11_19 |
| Journal | Endoscopic Ultrasound |
| Issue Number | 5 |
| Volume Number | 8 |
| Language | English |
| Publisher | Medknow |
| Access Restriction | Open |
| Subject Keyword | Gastroenterology and Hepatology Eus Fine-needle Biopsy Eus-fna Pancreatic Cysts Pancreatic Neuroendocrine Pancreatic Solid Neoplasm Serous Cystadenoma Serous Cystic Neoplasia Endoscopic Ultrasound, Volume 8, Issue 5 |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hepatology Radiology, Nuclear Medicine and Imaging Gastroenterology |
