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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

Figure 2.

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

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
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.