Appropriate clinical management of mucinous and cystic tumors of the pancreas requires accurate assessment for the presence of a malignancy. AIM: This multicenter series reports the cancer detection sensitivity of endoscopic pancreatic intraductal tissue and juice sampling methods. METHODS: The Midwest Pancreatobiliary Group has tallied 102 cases of mucinous or cystic tumors of the pancreas. ERCP with tissue and juice sampling was reported in 45 patients who also had resective surgery to establish the final diagnosis Specimens were graded only as benign or malignant (all grades of atypia = benign). RESULTS: Benign Lesions Malignant Lesions Mucinous Duct Ectasia, Mucinous Duct Ectasia, Serous Cystadenoma Mucinous Cystadeno-carcinoma n =13 n = 32 Juice aspirate cytology 0/5* 1/15 Brush cytology 0/9 5/24 Forceps biopsy histology 0/2 1/7 FNA cytology 0/5 2/9 *Fraction of specimens taken showing malignant cells Thirteen benign lesions had at least 1 benign and no malignant tissue specimen. Seven of 32 malignant lesions had at least one specimen positive. SUMMARY: All benign mucinous or cystic tumors of the pancreas sampled had benign tissue specimens. The cancer detection sensitivity was only 22% in 32 malignant lesions. CONCLUSIONS: Improved endoscopic tissue sampling methods are needed in mucinous and cystic tumors of the pancreas.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging