Efficacy of endoscopic ultrasound fine needle aspiration in diagnosing the rare (non-adenocarcinoma) tumors of pancreas

Background : Five percent of pancreatic neoplasms are non- adenocarcinoma tumors. Clinical presentation and imaging char- acteristics of these tumors are similar to adenocarcinoma. This study aims at evaluating the results and efficacy of Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in diagnosing the pancreatic non-adenocarcinoma tumor in patients with solid pancreatic mass. Methodology : The present study which is of a descriptive, pro- spective and case series nature, has been studying the diagnostic value of EUS-FNA in pancreatic non-adenocarcinoma tumor in 60 patients with pancreatic solid neoplasm. Cytopathologic diagnosis founded on EUS-FNA accepted as final diagnosis in unresectable ones. But the reference standard for the final diagnosis in patients with resectable tumor was surgical pathology. In patients with non diagnostic EUS-FNA specimen, final diagnosis achieved by re- FNA, Computerized Tomography (CT) guided biopsy, or surgery. Results : Ten patients (17%) found to have non-adenocarcinoma tumor. Half of them were male. EUS-FNA was diagnostic in 8 cases (80%) including the 4 neuroendocrine tumors, one gastrointestinal stromal tumor, one mucinous neoplasm, one pseudopapillary tumor, and one geant cell tumor. Surgical pathology confirmed the EUS-FNA diagnosis in five patients that had resectable tumor. However EUS-FNA recognition accepted as final diagnosis in three patients that had unresectable tumor. EUS-FNA was non-diagnos- tic in one patient with pancreatic lymphoma and another patient with colon cancer metastasis. Conclusion : EUS FNA is a safe and effective for diagnosing the solid non- adenocarcinoma tumors as well as adenocarcinomas of pancreas. (Acta gastroenterol. belg., 2014, 77, 312-317).