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Fine-needle aspiration of cystic pancreatic mucinous tumor: oncotic cell as an aiding diagnostic feature in paucicellular specimens.
Diagn Cytopathol. 2009 Feb; 37(2):111-6.DC

Abstract

In juxtaposition with imaging studies, endoscopic ultrasound-guided fine-needle aspiration has gained popularity in the initial evaluation of pancreatic masses, especially cystic lesions of pancreas. Cystic pancreatic mucinous tumors include mucinous cystic neoplasm and intraductal papillary mucinous tumor, both of which have been known to have a low malignant potential and a high rate of association with invasive adenocarcinoma. As such, preoperative diagnosis is of great significance in guiding patient management. Although fine-needle aspiration cytological diagnosis of pancreatic tumor in cellular specimens has been well described, as with other cystic lesions, the yield of diagnostic cells from needle aspiration of cystic pancreatic mucinous tumors is typically low. Cytological diagnosis from these paucicellular specimens remains challenging. An additional compounding problem is the high frequency of gastrointestinal mucin and epithelial contamination. The diagnostic morphology and criteria in these paucicellular specimens have not been well addressed in the literature. The cytopathologists' ongoing efforts tend to improve the diagnostic accuracy. In this current study, oncotic cells, characterized by cytoplasmic swelling and karyolysis, were analyzed from 17 cases of cystic pancreatic mucinous tumor, of which the diagnosis was either confirmed by surgical resection or supported by cell block and/or increased CEA. Oncotic cells were found in variable amounts in almost all the cystic pancreatic mucinous tumors in this series. None of the five fine-needle aspirations intended for aspirations of hypoechoic nonlesional pancreas, which yielded either gastrointestinal tract material only or admixture of gastrointestinal and normal pancreatic components, was found to contain oncotic cells, evidencing the utility of oncotic cell as a surrogate morphologic marker in aiding the diagnosis of cystic pancreatic mucinous tumor as well as its differentiation from gastrointestinal contaminant, particularly in paucicellular specimens.

Authors+Show Affiliations

Department of Pathology, Staten Island University Hospital, Staten Island, New York 10029, USA. guang-qian.xiao@mountsinai.org

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19021219

Citation

Xiao, Guang-Qian. "Fine-needle Aspiration of Cystic Pancreatic Mucinous Tumor: Oncotic Cell as an Aiding Diagnostic Feature in Paucicellular Specimens." Diagnostic Cytopathology, vol. 37, no. 2, 2009, pp. 111-6.
Xiao GQ. Fine-needle aspiration of cystic pancreatic mucinous tumor: oncotic cell as an aiding diagnostic feature in paucicellular specimens. Diagn Cytopathol. 2009;37(2):111-6.
Xiao, G. Q. (2009). Fine-needle aspiration of cystic pancreatic mucinous tumor: oncotic cell as an aiding diagnostic feature in paucicellular specimens. Diagnostic Cytopathology, 37(2), 111-6. https://doi.org/10.1002/dc.20953
Xiao GQ. Fine-needle Aspiration of Cystic Pancreatic Mucinous Tumor: Oncotic Cell as an Aiding Diagnostic Feature in Paucicellular Specimens. Diagn Cytopathol. 2009;37(2):111-6. PubMed PMID: 19021219.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fine-needle aspiration of cystic pancreatic mucinous tumor: oncotic cell as an aiding diagnostic feature in paucicellular specimens. A1 - Xiao,Guang-Qian, PY - 2008/11/21/pubmed PY - 2009/3/10/medline PY - 2008/11/21/entrez SP - 111 EP - 6 JF - Diagnostic cytopathology JO - Diagn Cytopathol VL - 37 IS - 2 N2 - In juxtaposition with imaging studies, endoscopic ultrasound-guided fine-needle aspiration has gained popularity in the initial evaluation of pancreatic masses, especially cystic lesions of pancreas. Cystic pancreatic mucinous tumors include mucinous cystic neoplasm and intraductal papillary mucinous tumor, both of which have been known to have a low malignant potential and a high rate of association with invasive adenocarcinoma. As such, preoperative diagnosis is of great significance in guiding patient management. Although fine-needle aspiration cytological diagnosis of pancreatic tumor in cellular specimens has been well described, as with other cystic lesions, the yield of diagnostic cells from needle aspiration of cystic pancreatic mucinous tumors is typically low. Cytological diagnosis from these paucicellular specimens remains challenging. An additional compounding problem is the high frequency of gastrointestinal mucin and epithelial contamination. The diagnostic morphology and criteria in these paucicellular specimens have not been well addressed in the literature. The cytopathologists' ongoing efforts tend to improve the diagnostic accuracy. In this current study, oncotic cells, characterized by cytoplasmic swelling and karyolysis, were analyzed from 17 cases of cystic pancreatic mucinous tumor, of which the diagnosis was either confirmed by surgical resection or supported by cell block and/or increased CEA. Oncotic cells were found in variable amounts in almost all the cystic pancreatic mucinous tumors in this series. None of the five fine-needle aspirations intended for aspirations of hypoechoic nonlesional pancreas, which yielded either gastrointestinal tract material only or admixture of gastrointestinal and normal pancreatic components, was found to contain oncotic cells, evidencing the utility of oncotic cell as a surrogate morphologic marker in aiding the diagnosis of cystic pancreatic mucinous tumor as well as its differentiation from gastrointestinal contaminant, particularly in paucicellular specimens. SN - 1097-0339 UR - https://www.unboundmedicine.com/medline/citation/19021219/Fine_needle_aspiration_of_cystic_pancreatic_mucinous_tumor:_oncotic_cell_as_an_aiding_diagnostic_feature_in_paucicellular_specimens_ L2 - https://doi.org/10.1002/dc.20953 DB - PRIME DP - Unbound Medicine ER -