Diagnostic utility of endoscopic ultrasound guided aspiration cytology in evaluation of pancreatic masses

Objective: To determine the sensitivity and specificity of endoscopic ultrasound (EUS) guided fine needle aspirationcytology (FNAC) in the evaluation of pancreatic masses.Study Design: Analytical study.Place and Duration of Study: Department of Pathology, Shaukat Khanum Cancer Hospital and Research Centre, fromJanuary 2006 to June 2011.Methodology: Patients of either gender aged above 18 years who underwent EUS guided FNAC of pancreatic massesdetected on abdominal CT, were included in the study. Biphasic abdominal CT scans were carried out for all the patients,followed by EUS guided FNAC. All material aspirated for cytologic evaluation was assessed for sample adequacy on-site,followed by formal examination for diagnostic purposes.Results: The mean age of patients tested was 58.94 ± 12.84 years with age ranging from 23 to 78 years. Regardinggender 23/42 (54.76%) patients were male and 19/42 (45.24%) were female. Out of 42 cases, 27 (64%) cases werediagnosed as adenocarcinoma, 4 (9.5%) as benign, 4 (9.5%) as mucinous cystic neoplasm, 2 (4.7%) as chronicpancreatitis, 2 (4.7%) as non-diagnostic, 2 (4.7%) as atypical cells seen and 1 (2.38%) as non-Hodgkin's lymphoma. Theresults were in full concordance with radiologic findings.Conclusion: EUS guided FNA is an excellent procedure for evaluation of pancreatic masses. The overall sensitivity ofthis procedure is 89% and the specificity is 67%.