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- Iglesias-Garcia, J., et al.
(author)
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Endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) with the Procore (TM) needle provides inadequate material for the histological diagnosis of early chronic pancreatitis
- 2018
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In: Revista Espanola De Enfermedades Digestivas. - : Sociedad Espanola de Patologia Digestiva (SEPD). - 1130-0108. ; 110:8, s. 510-514
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Journal article (peer-reviewed)abstract
- Background: diagnosis of early chronic pancreatitis (CP) is hampered due to the low accuracy of current imaging techniques and the absence of methods for histological confirmation. We aimed to evaluate the efficacy of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for the histological diagnosis of early CP. Methods: a prospective, cross-sectional, single-center study was designed. Consecutive patients referred for EUS with a clinical suspicion of CP were evaluated for inclusion into the study. Inclusion criteria were age > 18 years and indeterminate EUS findings for the diagnosis of CP according to the Rosemont classification. EUS-FNB of the body of the pancreas was performed with Procor(TM) needles.Tissue samples were immersed into a methanol-based buffered preservative solution for cytohistological evaluation.The quality of the samples obtained and the histological findings were evaluated. Procedure-related complications were recorded. Results: the study was stopped after eleven patients were included due to safety concerns and poor diagnostic yield. The mean age of the patients was 50.3 years (range 33-70 years) and six were male. Samples were of poor quality in five cases, but were sufficient for cell-block evaluation. An inflammatory infiltration with mild fibrosis was identified in two cases and neither inflammatory infiltration nor fibrosis was identified in three cases. With regard to the other six cases, isolated inflammatory cells were observed in one case, although the cellularity was poor and unsuitable for cytological evaluation in five cases.There was one major complication (9.1%) of acute pancreatitis that required hospitalization for 48 hours. Conclusion: EUS-FNB is technically feasible in patients with EUS findings categorized as indeterminate for a CP diagnosis. However, the diagnostic yield is poor and there is a non-negligible risk of complications.
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| 2. |
- Iglesias-Garcia, J., et al.
(author)
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Endoscopic ultrasound in the diagnosis of chronic pancreatitis
- 2015
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In: Revista Espanola De Enfermedades Digestivas. - 1130-0108. ; 107:4, s. 221-228
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Journal article (peer-reviewed)abstract
- Diagnosis of chronic pancreatitis (CP) remains a challenge. Endoscopic ultrasound (EUS) can be considered nowadays as the technique of choice for the morphological diagnosis of this disease. More than three or four EUS defined criteria of CP need to be present for the diagnosis of the disease. The development of the more restrictive Rosemont classification aims to standardize the criteria, assigning different values to different features but its impact on the EUS-based diagnosis of CP is debatable. A combined use of endoscopic function test and EUS has even increased the diagnostic yield. Elastography and FNA may be also of help for diagnosing CP. EUS also provides with very valuable information on the severity of the disease, giving key information that may influence in the treatment. Differential diagnosis of solid pancreatic masses in the context of a CP is also challenging, EUS plays a key role in this context. It provides with the possibility of obtaining specimens for histopathological diagnosis. Nowadays, new developed techniques associated to EUS, like elastography and contrast enhancement, are also showing promising results for the differentiating between these pancreatic lesions.
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