Given the difficulty regarding pancreatic biopsy procedures, a research group led by Dr. Chatzipantelis investigates the relatively novel preoperative and bloodless technique of image-guided fine-needle aspiration (FNA), and explores its value in diagnosing pancreatic lesions. Endoscopic ultrasound (EUS)-guided FNA cytology can provide an accurate preoperative diagnosis of solid pseudopapillary tumor (SPTP), differentiating it from other pancreatic neoplasms with different biologic behavior and treatment. The article published in the October 14 issue of the World Journal of Gastroenterology describes the success of the above mentioned technique in the diagnostic procedure of SPTP.
EUS-FNA was conducted in the Endoscopy Department (Head: Dr. Karoumpalis I, MD), and the FNA cytologic material was interpreted by two experts (Dr. Chatzipantelis P and Dr. Salla C), who provided the final cytopathologic diagnosis.
In this study, a 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic pain for 2 months and a short history of hypertension. Computed tomography scan (CT-scan) revealed a mass of the pancreatic tail, and an operation was scheduled to take place within 2 days. In order to accurately diagnose this tumor in such a young woman, we decided to perform the EUS-guided FNA procedure, preoperatively. The procedures were completed the next day.
EUS confirmed a mass, both in the body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct. The EUS differential diagnosis included a series of benign and malignant pancreatic tumors. EUS-FNA cytology was performed using a needle, and smears of tumor cells of the pancreas were taken in the endoscopy suite for cytopathologic diagnosis. Additional immunohistochemical stains were performed. The final diagnosis of SPTP was made with great accuracy.
Based on this research, Dr. Chatzipantelis believes the performance of FNA cytopathology under EUS guidance helps us to accurately define the pancreatic lesions preoperatively, so the patient enters the operating theatre with an accurate and safe diagnosis. The value of the procedure, according to Dr. Chatzipantelis, consists of the accuracy of the preoperative diagnosis coupled with the reduction of the patient¡¯s discomfort. Therefore, it is suggested as a successful technique in diagnosing pancreatic lesions.
Reference: Salla C, Chatzipantelis P, Konstantinou P, et al. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: A case report and literature review. World J Gastroenterology 2007; 13(38): 5158-5163 http://www.wjgnet.com/1007-9327/13/5158.asp
Correspondence to: Paschalis Chatzipantelis MD, PhD, Department of Pathology, Areteion University Hospital, 6-8 Stasinou Street, Athens 11635, Greece, pchatzipantelis@yahoo.com Telephone: +30 210 7259424 Fax: +30 210 9480375
About World Journal of Gastroenterology:
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection, and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology