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Impact of cytopathologist expert on diagnosis and treatment of pancreatic lesions in current clinical practice. A series of 106 endoscopic ultrasound-guided fine needle aspirations.
Cytopathology. 2006 Feb; 17(1):18-26.C

Abstract

OBJECTIVES

To evaluate the role of a cytopathologist expert in interpreting difficult pancreatic endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in terms of impact on diagnostic yield and therapy in current clinical practice.

METHODS

Retrospective study of 106 EUS-FNA performed between January 2002 and September 2004. Forty-seven cases of difficult interpretation by the local cytopathologist were mailed to an expert cytopathologist. The final diagnosis was established by histology obtained by either surgery (n=30), non-equivocal FNA (n=40) or core (n=8) biopsies, or by a mean follow-up of 14 months (n=28).

RESULTS

EUS-FNA involved 68 solid lesions (SL). Specimens collected were adequate in 63%. The overall sensitivity of EUS-FNA for the diagnosis of malignancy of SL was 88% versus 72% for local cytopathologist and 89% for expert. EUS-FNA with the reevaluation by expert of 39 SL gave a therapeutic impact in 47% of SL. Thirty-eight cystic lesions (CL) were evaluated. Specimens collected were adequate for cytology in 84% of cases and for biochemistry in 79%. The sensitivity of imaging+EUS-FNA+/-biochemistry for the diagnosis of a surgical CL was 58% with a therapeutic impact in 39.5%.

CONCLUSION

Pancreatic EUS-FNA is an easy technique for experienced endosonographers, which can be safely performed on an outpatient basis. The possibility of mailing difficult cases to an expert cytopathologist increases the diagnostic yield. In these circumstances, EUS-FNA has a therapeutic impact in current practice in nearly one out of two pancreatic lesions.

Authors+Show Affiliations

Department of Pathology, Bicêtre University Hospital, AP-HP, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16417561

Citation

Alsibai, K Drak, et al. "Impact of Cytopathologist Expert On Diagnosis and Treatment of Pancreatic Lesions in Current Clinical Practice. a Series of 106 Endoscopic Ultrasound-guided Fine Needle Aspirations." Cytopathology : Official Journal of the British Society for Clinical Cytology, vol. 17, no. 1, 2006, pp. 18-26.
Alsibai KD, Denis B, Bottlaender J, et al. Impact of cytopathologist expert on diagnosis and treatment of pancreatic lesions in current clinical practice. A series of 106 endoscopic ultrasound-guided fine needle aspirations. Cytopathology. 2006;17(1):18-26.
Alsibai, K. D., Denis, B., Bottlaender, J., Kleinclaus, I., Straub, P., & Fabre, M. (2006). Impact of cytopathologist expert on diagnosis and treatment of pancreatic lesions in current clinical practice. A series of 106 endoscopic ultrasound-guided fine needle aspirations. Cytopathology : Official Journal of the British Society for Clinical Cytology, 17(1), 18-26.
Alsibai KD, et al. Impact of Cytopathologist Expert On Diagnosis and Treatment of Pancreatic Lesions in Current Clinical Practice. a Series of 106 Endoscopic Ultrasound-guided Fine Needle Aspirations. Cytopathology. 2006;17(1):18-26. PubMed PMID: 16417561.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of cytopathologist expert on diagnosis and treatment of pancreatic lesions in current clinical practice. A series of 106 endoscopic ultrasound-guided fine needle aspirations. AU - Alsibai,K Drak, AU - Denis,B, AU - Bottlaender,J, AU - Kleinclaus,I, AU - Straub,P, AU - Fabre,M, PY - 2006/1/19/pubmed PY - 2006/3/17/medline PY - 2006/1/19/entrez SP - 18 EP - 26 JF - Cytopathology : official journal of the British Society for Clinical Cytology JO - Cytopathology VL - 17 IS - 1 N2 - OBJECTIVES: To evaluate the role of a cytopathologist expert in interpreting difficult pancreatic endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in terms of impact on diagnostic yield and therapy in current clinical practice. METHODS: Retrospective study of 106 EUS-FNA performed between January 2002 and September 2004. Forty-seven cases of difficult interpretation by the local cytopathologist were mailed to an expert cytopathologist. The final diagnosis was established by histology obtained by either surgery (n=30), non-equivocal FNA (n=40) or core (n=8) biopsies, or by a mean follow-up of 14 months (n=28). RESULTS: EUS-FNA involved 68 solid lesions (SL). Specimens collected were adequate in 63%. The overall sensitivity of EUS-FNA for the diagnosis of malignancy of SL was 88% versus 72% for local cytopathologist and 89% for expert. EUS-FNA with the reevaluation by expert of 39 SL gave a therapeutic impact in 47% of SL. Thirty-eight cystic lesions (CL) were evaluated. Specimens collected were adequate for cytology in 84% of cases and for biochemistry in 79%. The sensitivity of imaging+EUS-FNA+/-biochemistry for the diagnosis of a surgical CL was 58% with a therapeutic impact in 39.5%. CONCLUSION: Pancreatic EUS-FNA is an easy technique for experienced endosonographers, which can be safely performed on an outpatient basis. The possibility of mailing difficult cases to an expert cytopathologist increases the diagnostic yield. In these circumstances, EUS-FNA has a therapeutic impact in current practice in nearly one out of two pancreatic lesions. SN - 0956-5507 UR - https://www.unboundmedicine.com/medline/citation/16417561/Impact_of_cytopathologist_expert_on_diagnosis_and_treatment_of_pancreatic_lesions_in_current_clinical_practice__A_series_of_106_endoscopic_ultrasound_guided_fine_needle_aspirations_ L2 - https://doi.org/10.1111/j.1365-2303.2006.00312.x DB - PRIME DP - Unbound Medicine ER -