Multiple Cystic Pancreatic Neuroendocrine Neoplasms in a Patient Diagnosed via Endoscopic Ultrasound–Fine-Needle Aspiration

2007 ◽  
Vol 5 (1) ◽  
pp. A26 ◽  
Author(s):  
Sven Hida ◽  
David M. Friedel ◽  
Hazar Michael
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Neuroendocrine Neoplasms ◽  
Fine Needle ◽  
Pancreatic Neuroendocrine Neoplasms

Dynamic telecytopathology for on-site preliminary diagnosis of endoscopic ultrasound-guided fine needle aspiration of pancreatic masses

2012 ◽  
Vol 18 (5) ◽  
pp. 253-259 ◽  
Author(s):  
Kamal K Khurana ◽  
Rong Rong ◽  
Dongliang Wang ◽  
Ajoy Roy
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Neuroendocrine Neoplasms ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Preliminary Diagnosis ◽  
Site Evaluation ◽  
Conventional Microscopy

We evaluated dynamic telecytopathology for on-site-evaluation of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples of the pancreas. Realtime images of stained cytology smears were assessed by a cytopathologist while communicating with the on-site operator by telephone. A total of 55 consecutive cases was assessed; preliminary diagnoses of benign, atypical/suspicious and positive for malignancy were 69%, 7% and 24%. We also reviewed 55 consecutive cases of EUS-guided FNA of pancreas which had had conventional microscopic on-site evaluation prior to the introduction of telecytopathology. Preliminary diagnoses of benign, atypical/suspicious and positive for malignancy were 60%, 9% and 31%. The overall concordance between the preliminary and final diagnosis was 84% for telecytopathology and 87% for conventional microscopy. Neuroendocrine neoplasms and well-differentiated adenocarcinoma were diagnostically challenging for both telecytopathology and conventional microscopy. Telecytopathology was similar in accuracy of preliminary diagnosis to conventional microscopy during EUS-FNA of pancreas.

scholarly journals Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Biopsy In Mixed Ductal-Neuroendocrine Neoplasms of The Pancreas

2021 ◽  
Author(s):  
pengyan Wang ◽  
Yan Wu ◽  
Jingci Chen ◽  
Ying Jiang ◽  
Xiaowei Xue ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
High Sensitivity ◽  
Needle Aspiration ◽  
Ductal Adenocarcinoma ◽  
Neuroendocrine Neoplasms ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Pancreatic Masses

Abstract Background: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy is the first line diagnostic tool used in the evaluation of solid pancreatic masses with high sensitivity and specificity prior to the surgery. Mixed ductal-neuroendocrine neoplasms of the pancreas are rare entity consisting of both ductal adenocarcinoma and neuroendocrine neoplasms, with each component representing at least 30%. Methods: We performed a retrospective analysis of patients with a diagnosis of pancreatic mixed ductal adenocarcinoma and neuroendocrine neoplasms by EUS-FNA specimens at Peking Union Medical College Hospital between 2010-2019 and presented a review of the literature.Results: A total of 3 cases (1 male and 2 females) were evaluated, aged 46, 38 and 62 years, and presented with 3-cm, 2.3-cm and 1.8-cm pancreatic masses, respectively. All the patients presented with abdominal pain and underwent EUS-FNA biopsy. FNA smears revealed a mixture of ductal adenocarcinoma and neuroendocrine neoplasms, identified by immunohistochemistry. According to Ki-67 proliferation index and mitotic count, the tumor grades of the neuroendocrine component were classified as NET G2 in 2 cases (cases 2 and 3) and NEC in 1 (case 1). All of the patients received adjuvant therapy. The diagnosis of patient 1 was confirmed on surgical excision, and she died 5 months after surgery due to hepatic metastases. The other two patients did not undergo surgery, but achieved long – term survival of 3 and 5 years, respectively. To date, 34 cases of pancreatic mixed ductal adenocarcinoma and neuroendocrine neoplasms have been reported in the English language literature including our present three cases. Among them, 5 of 12 patients who underwent preoperative biopsy were diagnosed as combined ductal adenocarcinoma and neuroendocrine neoplasms, of which 3 surgical resection specimens available were identified as mixed ductal-neuroendocrine neoplasms.Conclusion: We suggest that EUS-FNA biopsy is the most effective method for rapid evaluation of pancreatic mixed ductal-neuroendocrine neoplasms with high sensitivity, which is important to determine the most optimum therapy. If the tumor grades of the neuroendocrine component were classified as NET G2 by EUS-FNA biopsy, we propose appropriate adjuvant therapy rather than surgery.

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