Performance of endoscopic ultrasound-guided fine needle aspiration in diagnosing pancreatic neuroendocrine tumors

Jane Bernstein, Berrin Ustun, Ahmed Alomari, Fang Bao, Harry R. Aslanian, Uzma Siddiqui, David Chhieng, Guoping Cai

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Pancreatic neuroendocrine tumors (PNETs) are rare tumors of the pancreas, which are increasingly diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this retrospective study, we assessed the performance of EUS-FNA in diagnosing PNETs. Materials and Methods: We identified 48 cases of surgically resected PNETs in which pre-operative EUS-FNA was performed. The clinical features, cytological diagnoses, and surgical follow-up were retrospectively reviewed. The diagnostic performance of EUS-FNA was analyzed as compared to the diagnosis in the follow-up. The cases with discrepancies between cytological diagnosis and surgical follow-up were analyzed and diagnostic pitfalls in discrepant cases were discussed. Results: The patients were 20 male and 28 female with ages ranging from 15 years to 81 years (mean 57 years). The tumors were solid and cystic in 41 and 7 cases, respectively, with sizes ranging from 0.5 cm to 11 cm (mean 2.7 cm). Based on cytomorphologic features and adjunct immunocytochemistry results, when performed, 38 patients (79%) were diagnosed with PNET, while a diagnosis of "suspicious for PNET" or a diagnosis of "neoplasm with differential diagnosis including PNET" was rendered in the 3 patients (6%). One case was diagnosed as mucinous cystic neoplasm (2%). The remaining 6 patients (13%) had non-diagnostic, negative or atypical diagnosis. Conclusions: Our data demonstrated that EUS-FNA has a relatively high sensitivity for diagnosing PNETs. Lack of additional materials for immunocytochemical studies could lead to a less definite diagnosis. Non-diagnostic or false negative FNA diagnosis can be seen in a limited number of cases, especially in those small sized tumors.

Original languageEnglish (US)
Article numberA10
JournalCytoJournal
Volume10
Issue number1
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Neuroendocrine Tumors
Neoplasms
Pancreas
Differential Diagnosis
Retrospective Studies
Immunohistochemistry

Keywords

  • Cytomorphology
  • Fine needle aspiration
  • Immunocytochemistry
  • Neuroendocrine tumor
  • Pancreas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Performance of endoscopic ultrasound-guided fine needle aspiration in diagnosing pancreatic neuroendocrine tumors. / Bernstein, Jane; Ustun, Berrin; Alomari, Ahmed; Bao, Fang; Aslanian, Harry R.; Siddiqui, Uzma; Chhieng, David; Cai, Guoping.

In: CytoJournal, Vol. 10, No. 1, A10, 01.01.2013.

Research output: Contribution to journalArticle

Bernstein, Jane ; Ustun, Berrin ; Alomari, Ahmed ; Bao, Fang ; Aslanian, Harry R. ; Siddiqui, Uzma ; Chhieng, David ; Cai, Guoping. / Performance of endoscopic ultrasound-guided fine needle aspiration in diagnosing pancreatic neuroendocrine tumors. In: CytoJournal. 2013 ; Vol. 10, No. 1.
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abstract = "Background: Pancreatic neuroendocrine tumors (PNETs) are rare tumors of the pancreas, which are increasingly diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this retrospective study, we assessed the performance of EUS-FNA in diagnosing PNETs. Materials and Methods: We identified 48 cases of surgically resected PNETs in which pre-operative EUS-FNA was performed. The clinical features, cytological diagnoses, and surgical follow-up were retrospectively reviewed. The diagnostic performance of EUS-FNA was analyzed as compared to the diagnosis in the follow-up. The cases with discrepancies between cytological diagnosis and surgical follow-up were analyzed and diagnostic pitfalls in discrepant cases were discussed. Results: The patients were 20 male and 28 female with ages ranging from 15 years to 81 years (mean 57 years). The tumors were solid and cystic in 41 and 7 cases, respectively, with sizes ranging from 0.5 cm to 11 cm (mean 2.7 cm). Based on cytomorphologic features and adjunct immunocytochemistry results, when performed, 38 patients (79{\%}) were diagnosed with PNET, while a diagnosis of {"}suspicious for PNET{"} or a diagnosis of {"}neoplasm with differential diagnosis including PNET{"} was rendered in the 3 patients (6{\%}). One case was diagnosed as mucinous cystic neoplasm (2{\%}). The remaining 6 patients (13{\%}) had non-diagnostic, negative or atypical diagnosis. Conclusions: Our data demonstrated that EUS-FNA has a relatively high sensitivity for diagnosing PNETs. Lack of additional materials for immunocytochemical studies could lead to a less definite diagnosis. Non-diagnostic or false negative FNA diagnosis can be seen in a limited number of cases, especially in those small sized tumors.",
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AB - Background: Pancreatic neuroendocrine tumors (PNETs) are rare tumors of the pancreas, which are increasingly diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this retrospective study, we assessed the performance of EUS-FNA in diagnosing PNETs. Materials and Methods: We identified 48 cases of surgically resected PNETs in which pre-operative EUS-FNA was performed. The clinical features, cytological diagnoses, and surgical follow-up were retrospectively reviewed. The diagnostic performance of EUS-FNA was analyzed as compared to the diagnosis in the follow-up. The cases with discrepancies between cytological diagnosis and surgical follow-up were analyzed and diagnostic pitfalls in discrepant cases were discussed. Results: The patients were 20 male and 28 female with ages ranging from 15 years to 81 years (mean 57 years). The tumors were solid and cystic in 41 and 7 cases, respectively, with sizes ranging from 0.5 cm to 11 cm (mean 2.7 cm). Based on cytomorphologic features and adjunct immunocytochemistry results, when performed, 38 patients (79%) were diagnosed with PNET, while a diagnosis of "suspicious for PNET" or a diagnosis of "neoplasm with differential diagnosis including PNET" was rendered in the 3 patients (6%). One case was diagnosed as mucinous cystic neoplasm (2%). The remaining 6 patients (13%) had non-diagnostic, negative or atypical diagnosis. Conclusions: Our data demonstrated that EUS-FNA has a relatively high sensitivity for diagnosing PNETs. Lack of additional materials for immunocytochemical studies could lead to a less definite diagnosis. Non-diagnostic or false negative FNA diagnosis can be seen in a limited number of cases, especially in those small sized tumors.

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KW - Immunocytochemistry

KW - Neuroendocrine tumor

KW - Pancreas

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