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Kumar P, Rana SS, Kundu R, Gupta P, Rohilla M, Gupta N, Srinivasan R, Dey P. Endoscopic ultrasound-guided fine-needle aspiration cytology in diagnosing intra-abdominal lesions. Cytojournal 2022; 19:56. [DOI: 10.25259/cytojournal_31_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 04/10/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives:
Endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNAC) is an effective method to acquire tissue from the mucosal, submucosal, and peri-intestinal structure with the pancreas being the most common organ to be targeted. This study is aimed to evaluate the role of EUS-FNAC in pancreatic lesions as well as other gastrointestinal (GI) structures including lymph nodes, upper GI tract, liver, and spleen.
Material and Methods:
A total of 71 cases were taken in which EUS FNAC was performed over 19 months (2018–July 2019). The details analysis of the cytological features was performed in all these cases along with the clinical outcome. The diagnostic efficacy of the EUS-FNAC was evaluated in these cases.
Results:
Out of 71 cases, 36 (50.7%) were male. The most common site being the pancreas 45 (60%) followed by intra-abdominal lymph nodes in 13(17.3%) cases and stomach 7 (9.3%). The neoplastic aspirate was noted in 38 (50.7%) cases. Among malignant lesion, adenocarcinoma was the most common; however, uncommon malignancies such as metastatic malignant melanoma and acinar cell carcinoma were also noted. Malignant lesion in pancreas includes adenocarcinoma (n = 11, 24.4%) followed by neuroendocrine tumor (n = 7, 15.6%). Tuberculosis was one of the common benign lesions to be reported.
Conclusion:
EUS-FNAC is an effective tool in the diagnosis of GI lesion particularly in the pancreas where it can avoid unnecessary surgical intervention in advanced malignancies. It can effectively obtain samples for molecular markers for pancreatic cancers. Nonetheless, diagnosing tuberculosis in inaccessible lymph nodes with its help is a lifesaving approach especially in developing countries.
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Affiliation(s)
- Pankaj Kumar
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Reetu Kundu
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Parikshaa Gupta
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Manish Rohilla
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Nalini Gupta
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Radhika Srinivasan
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
| | - Pranab Dey
- Department of Cytology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,
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Ieni A, Tuccari G. Re: Assessment of preoperative pancreatic biopsy, cytological/histological review of cell-block-specimens obtained by endoscopic ultrasound-guided fine-needle aspiration: Laboratory based study. Diagn Cytopathol 2020; 48:1153-1154. [PMID: 32716581 DOI: 10.1002/dc.24555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/02/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Antonio Ieni
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
| | - Giovanni Tuccari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Section of Pathology, University of Messina, Messina, Italy
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Nambirajan A, Jain D. Cell blocks in cytopathology: An update. Cytopathology 2018; 29:505-524. [DOI: 10.1111/cyt.12627] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/17/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Aruna Nambirajan
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - Deepali Jain
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
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Angelico G, Ieni A, Caltabiano R, Zeppa P, Tuccari G. Aquaporin-1 expression in fluoro-edenite-induced mesothelioma effusions: An approach by cell-block procedure. Cytopathology 2018; 29:455-460. [PMID: 29873855 DOI: 10.1111/cyt.12583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Aquaporin 1 (AQP-1) is a water channel protein found in cell membranes, whose expression has been considered an independent favourable prognostic factor in pleural malignant mesothelioma (MM). The aim of this study was to evaluate the expression of AQP-1 and its prognostic value in a series of pleural MM effusions, from a geographical area with high concentrations of fluoro-edenite (FE). METHODS We selected 25 MM cases from Biancavilla (Italy), an area with high environmental concentrations of FE. Cytological samples, cell-blocks (CB), clinical and follow-up data were available for all cases. Immunohistochemistry for calretinin, CK5/6, WT1, CK7 and TTF1 was used on CB sections to confirm the cytological diagnosis of MM. Immunohistochemistry for AQP-1 was performed and high expression was defined when ≥50% of tumour cells showed linear and circumferential membranous staining. RESULTS The cohort included 16 men and nine women (median age: 67.5 years; range: 49-88 years). The median survival was 14 months (range 1.5-60 months), with a significant value (P = 0.006). All cases have been histologically confirmed and classified as epithelioid (16 cases), biphasic (seven cases) and sarcomatoid (two cases). AQP-1 high expression has been observed in 16 cases. Comparing AQP-1 high expression to the survival of corresponding patients, a significant association with a slight increased overall survival of 12 months has been demonstrated. Nine patients with a AQP-1 score less than 50% showed a shorter median overall survival (7 months). CONCLUSIONS AQP-1 high expression is detectable on cytological samples of FE-induced MM with a prognostic value.
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Affiliation(s)
- G Angelico
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Unit of Pathological Anatomy, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - A Ieni
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Unit of Pathological Anatomy, University of Messina, AOU Policlinico G. Martino, Messina, Italy
| | - R Caltabiano
- Department "G.F. Ingrassia", Section of Pathologic Anatomy, University of Catania, Catania, Italy
| | - P Zeppa
- Pathological Anatomy, AOU San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - G Tuccari
- Department of Human Pathology of Adult and Developmental Age "Gaetano Barresi", Unit of Pathological Anatomy, University of Messina, AOU Policlinico G. Martino, Messina, Italy
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Kato A, Naitoh I, Kato H, Hayashi K, Miyabe K, Yoshida M, Hori Y, Natsume M, Jinno N, Yanagita T, Takiguchi S, Takahashi S, Joh T. Case of pancreatic metastasis from colon cancer in which cell block using the Trefle ® endoscopic scraper enables differential diagnosis from pancreatic cancer. World J Gastrointest Oncol 2018; 10:91-95. [PMID: 29564039 PMCID: PMC5852400 DOI: 10.4251/wjgo.v10.i3.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/09/2018] [Accepted: 02/04/2018] [Indexed: 02/05/2023] Open
Abstract
Endoscopic transpapillary brush cytology and forceps biopsy during endoscopic retrograde cholangiopancreatology are generally used to obtain pathological evidence of biliary strictures. Recently, the new endoscopic scraper Trefle® has been reported and demonstrated high cancer detectability in malignant biliary strictures. This device is used to scrape the stricture over the guidewire, and, in the original method, the tissue and/or cell samples obtained are subjected to histological and/or cytological analysis separately. However, discrimination of chunks of tissue is hampered by the opacity of the surrounding fluid. We have developed a cell block technique for the Trefle® device without dividing obtained specimens into tissue and cellular components, which is the simplest method and enables immunohistochemical analysis. We present a case of obstructive jaundice diagnosed immunohistochemically as pancreatic metastasis from colon cancer using cell block sections obtained with the Trefle® device, which procedure is as easy as conventional brush cytology.
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Affiliation(s)
- Akihisa Kato
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Itaru Naitoh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Hiroyuki Kato
- Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Kazuki Hayashi
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Katsuyuki Miyabe
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Michihiro Yoshida
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Yasuki Hori
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Makoto Natsume
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Naruomi Jinno
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Takeshi Yanagita
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Shuji Takiguchi
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Satoru Takahashi
- Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
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Crinò SF, Conti Bellocchi MC, Bernardoni L, Manfrin E, Parisi A, Amodio A, De Pretis N, Frulloni L, Gabbrielli A. Diagnostic yield of EUS-FNA of small (≤15 mm) solid pancreatic lesions using a 25-gauge needle. Hepatobiliary Pancreat Dis Int 2018; 17:70-74. [PMID: 29428108 DOI: 10.1016/j.hbpd.2018.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/22/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation. METHODS In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups (≤15 mm, 16-25 mm and >25 mm), and the outcomes were compared. RESULTS We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%, 81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size (P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor (P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate (P = 0.018, OR = 1.08). CONCLUSION Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.
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Affiliation(s)
- Stefano Francesco Crinò
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy.
| | - Maria Cristina Conti Bellocchi
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Laura Bernardoni
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Erminia Manfrin
- Department of Pathology, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Alice Parisi
- Department of Pathology, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Antonio Amodio
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Nicolò De Pretis
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Luca Frulloni
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
| | - Armando Gabbrielli
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy
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