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Endoscopic Ultrasound-guided Tissue Acquisition of Pancreatic Malignancy: A Retrospective Study at a Tertiary Center Cover

Endoscopic Ultrasound-guided Tissue Acquisition of Pancreatic Malignancy: A Retrospective Study at a Tertiary Center

Open Access
|Apr 2025

Figures & Tables

Figure 1.

FNA (1A) and FNB (1B) EUS-guided biopsies from pancreatic tumors
FNA (1A) and FNB (1B) EUS-guided biopsies from pancreatic tumors

Figure 2.

Histological evaluation of with hematoxylin and eosin staining of pancreatic ductal adenocarcinoma
Histological evaluation of with hematoxylin and eosin staining of pancreatic ductal adenocarcinoma

Figure 3.

Cytological examination with hematoxylin-eosin (3A) and Giemsa (3B) staining of a pancreatic neuroendocrine tumor
Cytological examination with hematoxylin-eosin (3A) and Giemsa (3B) staining of a pancreatic neuroendocrine tumor

Technical aspects and outcomes of FNA and FNB

Total number of procedures (n=426)p

FNA (n=334, 78.4%)FNB (n=92, 21.6%)
Technical EUS success, no. (%)334 (100%)92 (100%)

Diagnostic EUS yield, no. (%)
  Positive281 (84.1%)84 (91.3%)0.048
  False-negative53 (15.9%)8 (8.7%)

Number of passes, mean±SD1.99±0.521.63±0.60<0.001

Lesion diameter, mean±SD, mm36.11±15.6837.74±17.080.388

Tumor localization, no. (%)
  Head/uncinate258(77.2%)64(69.6%)
  Body58 (17.4%)21 (22.8%)0.312
  Tail18 (5.4%)7 (7.6%)

Presence of biliary/pancreatic stent, no. (%)
  Yes90 (26.9%)36 (39.1%)0.017
  No244 (73.1%)56 (60.9%)

Major complications, no. (%)0 (0)0 (0)

Positive and false-negative results of the 401 patients included in the study

Patients with pancreatic neoplasia detected through EUS-FNA/FNB365 (91.02%)
  Positive results after first EUS, n (%)348(95.34%)
  Positive results after second EUS, n (%)16 (4.38%)
  Positive results after third EUS, n (%)1 (0.27%)

Patients with pancreatic neoplasia false-negative at EUS examination, confirmed by surgery36 (8.97%)
  Negative results after first EUS, n (%)31 (86.11%)
  Negative results after second EUS, n (%)3 (8.33%)
  Negative results after third EUS, n (%)2 (5.55%)

Histopathological results of EUS-FNA, FNB and surgery

Histopathological diagnosisFNA positiveFNB positiveFNA/FNB false-negative (surgery positive)
Pancreatic adenocarcinoma (n=332)2326535
Pancreatic cystadenocarcinoma (n=18)1530
Pancreatic neuroendocrine tumor (n=26)1691
Non-Hodgkin lymphoma/leukemia (n=7)520
Neoplastic gastric GIST (n=3)120
Neoplastic IPMN (n=3)210
Breast carcinoma metastasis (n=3)210
Clear-cell renal carcinoma metastasis (n=3)210
Colonic carcinoma metastasis (n=2)200
Pulmonary neuroendocrine metastasis (n=1)100
Hepatocellular carcinoma metastasis (n=1)100
Pancreatic acinary carcinoma (n=1)100
Solid pseudopapillary neoplasia (n=1)100

Demographics of the patients and pancreatic tumor details in the current lot

ParametersTotal number of patients (n=401)
Mean age ±SD, years63.99±10.91

Gender, no. (%)
  Male211 (52.6%)
  Female190 (47.4%)

Lesion diameter, mean±SD, mm36.59±16.23

Tumor localization, no. (%)
  Head/uncinate301 (75.1%)
  Body75 (18.7%)
  Tail25 (6.2%)

Presence of biliary/pancreatic stent, no. (%)
  Yes118 (29.4%)
  No283 (70.6%)

Number of EUS procedures per pacient, no. (%)
  One procedure379 (94.5%)
  Two procedures19 (4.8%)
  Three procedures3 (0.7%)

Final malignant diagnosis, no. (%)
  EUS-FNA/FNB365 (91.02%)
  Surgery36 (8.97%)
DOI: https://doi.org/10.2478/rjim-2025-0008 | Journal eISSN: 2501-062X | Journal ISSN: 1220-4749
Language: English
Page range: 175 - 184
Submitted on: Jan 27, 2025
Published on: Apr 22, 2025
Published by: N.G. Lupu Internal Medicine Foundation
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Alexandru Constantinescu, Christopher Pavel, Oana-Mihaela Plotogea, Octavian Andronic, Andreea Pușcașu, Florentina Gherghiceanu, Mădălina Cristina Stan-Ilie, Vasile Șandru, published by N.G. Lupu Internal Medicine Foundation
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.