Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Pancreatic masses are often initially identified by magnetic resonance imaging or computed tomography, during evaluation of varied symptoms. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) has been proved to be safe and useful method for tissue sampling including the pancrease.
OBJECTIVE:
In this study we aim to find out some of the factors which may influence successful EUS-FNA of pancreatic masses, like: location of the mass, size, consistency and other significant factors.
PATIENTS AND METHODS:
A retrospective study of 40 patients underwent EUS-FNA of pancreatic masses, referred to Gastroenterology and Hepatology Teaching Hospital in Baghdad, from March 2005 to December 2007 (this is the first study done in Iraq); all patients were clinically suspected to have pancreatic malignancy. Cytology samples were evaluated and many other clinical variables were examined for association with EUS-FNA diagnosis.
RESULT:
Twenty six (65%) patients were males, and 14(35%) patients were females. Age ranged between 13-65 years with a mean of 46.6 years, the size of pancreatic masses range between 1.7-13cm, the masses were divided into 3 groups according to their sizes: <5cm 26(65%) cases, between 5-10cm 13(32.5%) cases, and >10 cm 1(2.5%) case. Consistency wise the masses were characterized as solid 34(85%) cases, mixed solid and cystic 6(14%) cases. In 13(32.5%) cases the mass was located in the body of pancrease, 25(62.5%) cases in the head, and 2(5%) cases in the tail. Regarding the cytological diagnosis: 19(47.5%) cases were benign (inflammatory conditions), and 21(52.5%) cases were malignant; including 17(80.9%) cases adenocarcinoma, 2(9.5%) cases malignant mucinous tumor, and small cell carcinoma 1(4.8%)case, and papillary and solid epithelial neoplasm (solid pseudopapillary tumor SPPT) 1(4.8%)case. Lymph node enlargement was found in 10(25%) cases.
CONCLUSION:
EUS-FNA can be used to sample pancreatic tumors in most patients. Communication clinical background information and imaging findings to the cytopathologist can facilitate the interpretation of the FNA specimens.