Details

Autor(en) / Beteiligte

• Morales‐Oyarvide, Vicente
• Yoon, Won Jae
• Ingkakul, Thun
• Forcione, David G.
• Casey, Brenna W.
• Brugge, William R.
• Fernández‐del Castillo, Carlos
• Pitman, Martha B.

Titel

Cystic pancreatic neuroendocrine tumors: The value of cytology in preoperative diagnosis

Ist Teil von

• Cancer cytopathology, 2014-06, Vol.122 (6), p.435-444

Ort / Verlag

Hoboken, NJ: Wiley

Erscheinungsjahr

2014

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• BACKGROUND Cystic pancreatic neuroendocrine tumors (cPanNETs) account for 13% to 17% of PanNETs. Although the value of endoscopic ultrasound (EUS) imaging and cyst fluid analysis (CFA) in their preoperative diagnosis has been well described, limited information is available about the diagnostic role of cytology samples obtained from fine‐needle aspiration (FNA). METHODS Cytopathology records between 1992 and 2013 were searched for all reports of cysts interpreted as PanNET. Patient demographics, clinical and radiologic information, CFA, histopathology, and cytopathology findings were recorded. Performance characteristics of cytology and EUS for the accurate diagnosis of cPanNET were calculated. RESULTS In total, 35 FNAs from 33 patients with cPanNETs were identified, and 34 EUS were performed. Cytology made a specific diagnosis of a cPanNET in 71% of the biopsies compared with a specific diagnosis by EUS in 38% of cases. An interpretation of suspicious for cPanNET was given in 77% of cases by cytology and in 47% by EUS. Cytology identified 86% of the lesions as high‐risk pancreatic cysts compared with 56% by EUS. Diagnostic morphology was present on both cytology and cell block preparations in 60% of aspirates, on cytology only in 20%, and on cell block only in 20%. CFA was performed on 51% cyst fluids. All cysts but 1 revealed low carcinoembryonic antigen levels (range, 0.2 to >500 ng/mL; mean, 29.5 ng/mL), and amylase levels were <500 U/L in all but 2 cases (range, 16‐1493 U/L; mean, 205 U/L). CONCLUSIONS Cytology is the most accurate test for preoperative diagnosis of cPanNETs. EUS is insufficiently accurate for independent diagnosis, and carcinoembryonic antigen and amylase analyses are noncontributory. Cancer (Cancer Cytopathol) 2014;122:435–444. © 2014 American Cancer Society. Cytopathology is the most accurate test for the preoperative diagnosis of cystic pancreatic neuroendocrine tumors. Endoscopic ultrasound is insufficiently accurate for independent diagnosis, and carcinoembryonic antigen and amylase analyses are noncontributory.