Evaluation of EUS Guided Sampling for Hypervascular Pancreatic Masses
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- Category: Vol. 91, March 2023
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Evaluation of EUS Guided Sampling for Hypervascular Pancreatic Masses, MOHAMED A. EL-NADY, AMR ABOU-ELMAGD, WAEL ABBAS, HAZEM HAKIM and AHMED ALTONBARY
Abstract
Background: Endoscopic ultrasonography (EUS) has gained an essential role in the detection, characterization, and sampling of biliopancreatic lesions or masses. Hypervascular solid pancreatic masses are frequently encountered secondary to a wide variety of pathologies, that can be benign or malig-nant, with subsequent broad differential diagnosis. Aim of Study: The use of EUS guided fine needle aspiration (EUS-FNA) of pancreatic hypervascular lesions is not well standardized. The objective of our study was to evaluate-different techniques used in sampling this type of masses. Patients and Methods: We identified patients who were referred for EUS examination for solid pancreatic masses detected by prior other radiological modalities, then we extracted EUS reports of hypervascular solid pancreatic masses as well as the details of EUS-FNA procedure. Finally, we joined the cytopathological examination. Results: Data from a total of 388 patients were extracted from the EUS database during the study period. We included 11 patients in whom EUS confirmed the presence of hyper-vascular solid pancreatic mass. As the number of passes increases, the risk of blood contamination increases affecting the cellularity of slides p-value=0.013. In our study, we noted degradation of the score of cellu-larity and an increase in blood contamination as the number of passes needed to acquire enough samples increases. This could be explained by the fact of the increase in the risk of trauma to the vascular network inside the lesion even after the application of color doppler. Conclusion: In our study, we noted degradation of the score of cellularity and an increase in blood contamination as the number of passes needed to acquire enough samples increases. This could be explained by the fact of the increase in the risk of trauma to the vascular network inside the lesion even after the application of color doppler. Though the number of patients is limited, this is the first study to evaluate the impact of vascularity of solid pancreatic masses on the quality of specimen and impact on the final diagnosis. Further rand- omized case-control studies are needed to recommend the best methods to acquire samples in this sub-group of patients.