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EUS‐guided FNA cytology of pancreatic neuroendocrine tumour (Pan NET ): a retrospective study of 132 cases over an 18‐year period in a single institution
Author(s) -
Chen S.,
Lin J.,
Wang X.,
Wu H. H.,
Cramer H.
Publication year - 2014
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12137
Subject(s) - medicine , cytology , adenocarcinoma , fine needle aspiration , histology , endoscopic ultrasound , neuroendocrine tumors , pancreatitis , carcinoma , radiology , biopsy , pathology , cancer
Objective To determine the diagnostic accuracy and pitfalls of endoscopic ultrasound ( EUS )‐guided fine needle aspiration ( FNA ) cytology of pancreatic neuroendocrine tumour (Pan NET ). Methods A search of our laboratory information system was performed from July 1992 to June 2010 to identify all FNA cytology and corresponding surgical specimens in which the diagnosis of Pan NET was rendered or considered. Results One hundred and thirty‐two cases diagnosed by EUS ‐guided FNA were collected. Histological correlation was available for 77 (58%) of FNA s; 55 patients may have been treated elsewhere or had no surgery because of advanced disease or co‐morbidity. Among 56 cases diagnosed as Pan NET on FNA , 54 (96%) were confirmed histologically; the remaining two were poorly differentiated adenocarcinoma with focal neuroendocrine features in one case and no tumour was found in the other. Follow‐up histology of nine patients diagnosed as suspicious for Pan NET on FNA showed four Pan NET s, two pancreatic ductal adenocarcinomas ( PDA ), one solid pseudopapillary tumour ( SPT ) and two cases of chronic pancreatitis. Nine cases rendered by FNA as atypical ( n = 3), no atypical cells identified ( n = 4) or unsatisfactory ( n = 2) were Pan NET s on histology. Lastly, three cases of oncocytic variant of Pan NET were misdiagnosed on FNA as either adenocarcinoma ( n = 2) or as suspicious for carcinoma ( n = 1). Conclusions Overall, 54 of the 70 histologically confirmed Pan NET cases (77%) were correctly diagnosed by preoperative FNA as Pan NET . FNA cases designated as no atypical cells identified and unsatisfactory (7/132, 5%) were attributable to sampling error. Diagnostic pitfalls in our study mainly included PDA , SPT and chronic pancreatitis.