Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies☆,☆☆
Section snippets
PATIENTS AND METHODS
One hundred twenty-one consecutive patients referred for EUS between June 1995 and March 1999 and ultimately diagnosed with pancreatic cancer were evaluated. Fifty-six percent of the patients were men and the average age of all patients was 68.4 years, with a range of 34 to 91 years. A final diagnosis of a pancreatic malignancy was confirmed in all patients either cytologically by EUS or CT-guided FNA or histologically by CT-guided biopsy or operation. Diagnostic EUS and any subsequent
RESULTS
Of the 121 patients eventually found to have pancreatic cancer, 116 (96%) had a pancreatic mass detected on initial EUS. Three patients had chronic pancreatitis seen on initial EUS and no definite mass. Two of these had a mass detected on follow-up EUS 1 month and 4 months later, respectively. The other had an unresectable pancreatic carcinoma found at operation 3 months after EUS. Another 46-year-old patient had a distal bile duct stricture with choledocholithiasis and sludge that precluded
DISCUSSION
This study confirms that EUS can detect almost all pancreatic neoplasms except in the difficult clinical setting of underlying chronic pancreatitis.1, 3, 5, 13, 28 This study also confirms the superiority of EUS compared with CT for detecting pancreatic malignancies. Our results are similar to those of a multicenter trial in which CT either did not detect a lesion or found only nonspecific pancreatic enlargement in 56% of 103 patients with pancreatic cancer examined by EUS-guided FNA.29 When a
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Cytopathology assistance for optimizing interventional diagnostic procedures
2022, Seminars in Diagnostic Pathology
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