False-positive EUS-guided FNA cytology for solid pancreatic lesions - 27/08/11
Reprint requests: Ali A. Siddiqui, MD, Associate Professor of Medicine, Thomas Jefferson University Hospital, Department of Medicine, Division of Gastroenterology, 132 S. 10th St 480 Main Building, Philadelphia, PA 19107Résumé |
Background |
The currently accepted paradigm is that the false-positive (FP) rate for EUS-guided fine-needle aspiration (EUS-FNA) cytologic analysis of a pancreatic lesion is less than 1%.
Objective |
To assess the FP rate of EUS-FNA in patients who underwent surgical resection for presumed pancreatic cancer.
Design |
Retrospective study.
Setting |
Tertiary-care referral center.
Patients |
This study involved 367 patients with solid pancreatic lesions in whom EUS-FNA cytology results were interpreted as positive or suspicious for malignancy, which resulted in subsequent surgical resection.
Intervention |
Surgical resection.
Main Outcome Measurements |
The FP diagnosis was defined as EUS-FNA cytology specimens being reported as “positive” or “suspicious for malignancy” but that were later proven to be benign on surgical pathology.
Results |
The FP rate for EUS-FNA was 4 of 367 (1.1%) when only “positive” cytology findings were interpreted as malignant and 14 of 367 (3.8%) when both suspicious and positive cytology findings were interpreted as malignant. Among the 4 cases falsely interpreted as positive, 1 was falsely diagnosed cytologically as a neuroendocrine tumor and 3 as adenocarcinomas. All FP specimens showed chronic pancreatitis on surgical pathology. The incidence of discordance between cytology and surgical pathology did not change over time (2000-2006: 8/188 [4.3%] vs 2007-2010: 6/179 [3.4%]; P = .79).
Limitations |
Retrospective study at a single center.
Conclusion |
In a retrospective cohort trial, the FP rate for EUS-FNA of solid pancreatic lesions was 1.1%. Findings of the current study are in line with previous studies that have evaluated the FP cytology rates with EUS-FNA of solid lesions. FP cases transpired primarily as a result of cytologic misinterpretation in the setting of chronic pancreatitis.
Le texte complet de cet article est disponible en PDF.Abbreviations : EUS-FNA, FP
Plan
| DISCLOSURE: This study was funded entirely by Thomas Jefferson University Hospital through existing intramural funds and salary support. No other financial relationships relevant to this publication were disclosed. |
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| If you would like to chat with an author of this article, you may contact Dr Siddiqui at ali.siddiqui@jefferson.edu. |
Vol 74 - N° 3
P. 535-540 - septembre 2011 Retour au numéro
Article précédent
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