Result and Efficacy of Endoscopic Ultrasound Guided FNA in Patients with Solid Pancreatic Neoplasm

Endosonography is a distinct method in evaluating gastrointestinal (GI) structural lesions, particularly in the pancreatobiliary system. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesions through fine needle aspiration (FNA). This study aims to evaluate the results and efficacy of endosonographic fine needle aspiration (EUS-FNA) in patients presenting with solid pancreatic masses. This was a descriptive, prospective, case series study of patients who presented with solid pancreatic masses to Imam Khomeini Hospital, Tehran, Iran over a one year period (from November 20092010-) In order to determine false negative cases, patients were followed for 6 to 12 months. A total of 53 patients underwent EUS-FNA with no complications. The results were diagnostic in 46 (87%) cases. The majority of patients were male (68%) and 81% had a mass in the pancreatic head. Cytopathology results revealed 36 (68%) adenocarcinomas, 7 (13%) other malignancies, 3 (6%) benign lesions and 7 (13%) nondiagnostic cases. The frequency of nondiagnostic results was significantly more in masses smaller than 3 cm (6 vs. 1, p < 0.002). Patients with nondiagnostic results were younger than those with malignant cytopathologies (52 ± 7.5 vs. 66 ± 7.5 years, p < 0.001). Sensitivity, specificity, PPV, NPV and accuracy of EUS-FNA in adenocarcinoma cases were 88%, 100%, 100%, 70% and 90%, respectively. EUS–FNA is an effective and safe procedure in the histopathologic diagnosis of pancreatic tumors.