• Postgraduate medicine · Jan 2024

    EUS-guided tissue acquisition in patients with solid pseudopapillary neoplasms of the pancreas.

    • José M Jiménez-Gutiérrez, José G de la Mora-Levy, Juan O Alonso-Lárraga, Angélica I Hernández-Guerrero, Betsabé A Soriano-Herrera, Lidia F Villegas-González, Luis F Uscanga-Domínguez, Stephanie López-Romero, and Félix I Téllez-Ávila.
    • Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México.
    • Postgrad Med. 2024 Jan 1; 136 (1): 788378-83.

    ObjectivesEndoscopic ultrasound-guided tissue acquisition (EUS-TA) has been the most common method used for the preoperative cytopathological diagnosis of solid tumors of the pancreas. There are only a few reported cases about the role of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in the pre-operative diagnosis of solid pseudopapillary neoplasms (SPN). This study aimed to evaluate the diagnostic yield of EUS-TA,including endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) andEUS-FNB, in patients with SPN.MethodsWe performed a retrospective analysis of patients with EUS-TA for SPN diagnosis in 2 referral centers. The primary outcome was the diagnostic yield of EUS-TA compared to the surgical specimen.ResultsSeventy-four patients with SPN of the pancreas were identified. Eighteen had a EUS-TA (10 EUS-FNB and 8 EUS-FNA). The median age of the patients was 31 years (IQR 21-38), and all patients were women. The most common presenting symptom was abdominal pain. Most of the tumors were in the head of the pancreas (9/18; 50%). The median tumor size by EUS was 4.5 cm (min-max 2-15 cm). The most common appearance on EUS was a solid lesion (n = 8/18, 44.4%). A definitive presurgical cytopathological diagnosis was obtained in 16/18 patients (88.8%) with EUS-TA. The sensitivity and positive predictive value of the EUS-TA were 94% each. One patient in the EUS-FNB group developed mild acute pancreatitis.ConclusionThe diagnostic yield of the EUS-TA in SPN is high. In most cases, the diagnosis was obtained with the first procedure. No differences in the diagnostic yield or AEs between EUS-FNA vs. EUS-FNB needles were seen.

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