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EUS-FNA diagnosis of pancreatic serous cystadenoma with the aid of cell blocks and α-inhibin immunochemistry: A case series.

Abstract

Serous cystadenoma (SCA) is an uncommon benign pancreatic neoplasm that is most often managed conservatively with follow-up rather than surgical excision. Therefore, to avoid the serious complications of pancreatic surgery, SCA should be diagnosed accurately at the preoperative level. Preoperative SCA diagnosis requires a multimodal diagnostic approach that includes imaging, cystic fluid biochemical analysis and/or endoscopic ultrasound fine-needle aspiration (EUS-FNA). In this brief report, we describe six EUS-FNA cases from five patients that were reported as "benign, consistent with serous cystadenoma". Samples were hypocellular, composed of loose clusters and single cuboidal, bland-looking cells among epithelial sheets representing gastrointestinal contamination. Cell blocks were prepared and all six FNA cases revealed cuboidal cells with a positive α-inhibin immunophenotype, consistent with a diagnosis of SCA. As EUS-FNAs of SCA commonly result in non-diagnostic interpretations, cell block preparations with subsequent immunochemistry can increase their diagnostic accuracy and guide patient management.

Authors+Show Affiliations

School of Medicine, European University Cyprus, Nicosia, Cyprus.School of Medicine, European University Cyprus, Nicosia, Cyprus.School of Medicine, European University Cyprus, Nicosia, Cyprus. First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.Department of Cytopathology, Hygeia & Mitera Hospital, Athens, Greece.Department of Surgery, Hygeia & Mitera Hospital, Athens, Greece.First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.Department of Cytopathology, Hygeia & Mitera Hospital, Athens, Greece.School of Medicine, European University Cyprus, Nicosia, Cyprus. First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31785091

Citation

Sydney, Guy I., et al. "EUS-FNA Diagnosis of Pancreatic Serous Cystadenoma With the Aid of Cell Blocks and Α-inhibin Immunochemistry: a Case Series." Diagnostic Cytopathology, 2019.
Sydney GI, Ioakim KJ, Michaelides C, et al. EUS-FNA diagnosis of pancreatic serous cystadenoma with the aid of cell blocks and α-inhibin immunochemistry: A case series. Diagn Cytopathol. 2019.
Sydney, G. I., Ioakim, K. J., Michaelides, C., Sepsa, A., Sopaki-Valalaki, A., Tsiotos, G. G., ... Nikas, I. (2019). EUS-FNA diagnosis of pancreatic serous cystadenoma with the aid of cell blocks and α-inhibin immunochemistry: A case series. Diagnostic Cytopathology, doi:10.1002/dc.24348.
Sydney GI, et al. EUS-FNA Diagnosis of Pancreatic Serous Cystadenoma With the Aid of Cell Blocks and Α-inhibin Immunochemistry: a Case Series. Diagn Cytopathol. 2019 Nov 29; PubMed PMID: 31785091.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - EUS-FNA diagnosis of pancreatic serous cystadenoma with the aid of cell blocks and α-inhibin immunochemistry: A case series. AU - Sydney,Guy I, AU - Ioakim,Kalliopi J, AU - Michaelides,Constantinos, AU - Sepsa,Athanasia, AU - Sopaki-Valalaki,Anastasia, AU - Tsiotos,Gregory G, AU - Theocharis,Stamatios, AU - Salla,Charitini, AU - Nikas,Ilias, Y1 - 2019/11/29/ PY - 2019/03/11/received PY - 2019/10/24/revised PY - 2019/11/12/accepted PY - 2019/12/1/entrez PY - 2019/12/1/pubmed PY - 2019/12/1/medline KW - cytopathology KW - differential diagnosis KW - immunocytochemistry KW - immunohistochemistry KW - pancreas KW - pancreatic cyst cytology JF - Diagnostic cytopathology JO - Diagn. Cytopathol. N2 - Serous cystadenoma (SCA) is an uncommon benign pancreatic neoplasm that is most often managed conservatively with follow-up rather than surgical excision. Therefore, to avoid the serious complications of pancreatic surgery, SCA should be diagnosed accurately at the preoperative level. Preoperative SCA diagnosis requires a multimodal diagnostic approach that includes imaging, cystic fluid biochemical analysis and/or endoscopic ultrasound fine-needle aspiration (EUS-FNA). In this brief report, we describe six EUS-FNA cases from five patients that were reported as "benign, consistent with serous cystadenoma". Samples were hypocellular, composed of loose clusters and single cuboidal, bland-looking cells among epithelial sheets representing gastrointestinal contamination. Cell blocks were prepared and all six FNA cases revealed cuboidal cells with a positive α-inhibin immunophenotype, consistent with a diagnosis of SCA. As EUS-FNAs of SCA commonly result in non-diagnostic interpretations, cell block preparations with subsequent immunochemistry can increase their diagnostic accuracy and guide patient management. SN - 1097-0339 UR - https://www.unboundmedicine.com/medline/citation/31785091/EUS-FNA_diagnosis_of_pancreatic_serous_cystadenoma_with_the_aid_of_cell_blocks_and_α-inhibin_immunochemistry:_A_case_series L2 - https://doi.org/10.1002/dc.24348 DB - PRIME DP - Unbound Medicine ER -