Endoscopic ultrasound-guided fine needle aspiration cytology in pancreatic mass lesions: Our experience

Abstract

Background and Objectives:Endoscopic ultrasound (EUS) is considered as the most reliable, accurate test in the detection of pancreatic masses, in whom a need for early, accurate detection, and confirmation of neoplasm is important, at the same time avoidance of surgery.Materials and Methods:This was a prospective study of EUS and fine needle aspiration (FNA)/fine needle aspiration biopsy in patients with pancreatic mass between January 2014 and 2017 at Gandhi Hospital, a tertiary government hospital in the state of Telangana. At the time of EUS size, echo characteristics of lesions, vascularity, lymph nodes (LNs) were noted. In 22 patients, 22-gauge, and in 3 patients, 25-gauge were used.Results:Male to female ratio was18:7, with mean age of 54 years. All had pain abdomen - 100%, mass per abdomen - 5, jaundice, vomiting - 3, and hypoglycemic attacks - 2 (8%). 14 (56%) had lesion in head, 3 - head and body, 2 - isthmus, and 5 - body and tail. Metastasis to LN and liver in 2 (8%). FNA results: Adenocarcinoma - 5 (25%), papillary adenoma - 1 (4%), serous cystadenoma - 1 (4%), mucinous cyst adenoma - 1 (4%), insulinoma - 1 (4%) each, gastrointestinal stromal tumor - 2 (8%), atypical cells - 4 (16%), neuroendocrine tumor - 2 (8%), negative for malignancy - 6 (24%). Minor hemorrhage and abdominal pain were noted in three. All positive and atypical cells patients treated accordingly. All negative cases were followed.Conclusion:EUS is a safe, reliable method in the diagnosis of pancreatic mass in providing accurate cytological diagnosis and exact location of small lesions.