Abstract
Most of pancreatic masses are represented by neoplastic processes, primarily ductal adenocarcinoma and less frequently neuroendocrine tumor, lymphoma and metastasis. On the contrary, non-neoplastic lesions are represented by chronic, autoimmune pancreatitis and cysts [1, 2]. Pancreatic cancer is the fourth and fifth most common cancer in men and women, respectively [3]. Due to local invasion or distant metastasis, only 15–20% of patients are surgical candidates at presentation. Among them, the five-year survival rate is only 10–15% [4]. About 70% of pancreatic cancers develop in the head while 10– 20% in the body and tail [5]. In many cases, pancreatic cancer is diagnosed in the advanced stage of the disease and at this point the tumor cannot be surgically excised. In fact, at the moment of diagnosis, 52% patients show distant disease and 26% have regional spread [6]. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a rapid, safe, cost-effective and accurate technique to evaluate and stage pancreatic tumors [7]. In addition, this technique has proved a very useful in discriminating between suspicious lesions, inflammation and cancer, especially adenocarcinomas. The EUS-FNA demonstrates a low percentage of major complications and a low risk of disseminating neoplastic cells when compared to the percutaneous approach. Cytological evaluation may have some disadvantages such as a limited
Highlights
Most of pancreatic masses are represented by neoplastic processes, primarily ductal adenocarcinoma and less frequently neuroendocrine tumor, lymphoma and metastasis
The synergy between the cytopathologist and experienced ultrasonographer, demonstrates that it is possible to increase the accuracy of diagnosis
We observed that one important factor impacting on transbronchial needle aspiration (TBNA) sensitivity, during fiberoptic bronchoscopy or mediastinoscopy, is the rapid on-site cytological examination (ROSE) [14]
Summary
Most of pancreatic masses are represented by neoplastic processes, primarily ductal adenocarcinoma and less frequently neuroendocrine tumor, lymphoma and metastasis.
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