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For: Moura DTH, McCarty TR, Jirapinyo P, Ribeiro IB, Farias GFA, Madruga-Neto AC, Ryou M, Thompson CC. Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions: A multi-center analysis. World J Clin Cases 2021; 9(34): 10507-10517 [PMID: 35004982 DOI: 10.12998/wjcc.v9.i34.10507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] Open

For:	Moura DTH, McCarty TR, Jirapinyo P, Ribeiro IB, Farias GFA, Madruga-Neto AC, Ryou M, Thompson CC. Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions: A multi-center analysis. World J Clin Cases 2021; 9(34): 10507-10517 [PMID: 35004982 DOI: 10.12998/wjcc.v9.i34.10507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] Open

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Cited by Other Article(s)

Okasha HH, Hussein HA, Ragab KM, Abdallah O, Rouibaa F, Mohamed B, Ghalim F, Farouk M, Lasheen M, Elbasiony MA, Alzamzamy AE, El Deeb A, Atalla H, El-Ansary M, Mohamed S, Elshair M, Khannoussi W, Abu-Amer MZ, Elmekkaoui A, Naguib MS, Ait Errami A, El-Meligui A, El-Habashi AH, Ameen MG, Abdelfatah D, Kaddah M, Delsa H. Role of macroscopic on-site evaluation of endoscopic ultrasound-guided fine-needle aspiration/biopsy: Results of a multicentric prospective study. World J Gastrointest Endosc 2024;16:595-606. [PMID: 39600556 PMCID: PMC11586721 DOI: 10.4253/wjge.v16.i11.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 09/20/2024] [Accepted: 10/15/2024] [Indexed: 10/30/2024] Open

Abstract

BACKGROUND

The concept of macroscopic on-site evaluation (MOSE) was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 mm. Recent studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation, and some classifications have been published. Few studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB).

AIM

To evaluate the performance of MOSE during EUS-FNA/FNB.

METHODS

This multicentric prospective study was conducted in 16 centers in 3 countries (Egypt, Iraq, and Morocco) and included 1108 patients with pancreatic, biliary, or gastrointestinal pathology who were referred for EUS examination. We prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core samples. Data management and analysis were performed using a Statistical Package for Social Sciences (SPSS) version 27.

RESULTS

A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological reports. Mean age was 59 years, and 509 patients (50.5%) were male. The mean lesion size was 38 mm. The most frequently utilized needles were FNB-Franseen (74.5%) and 22 G (93.4%), with a median of 2 passes. According to 2 classifications, 618 non-bloody cores (61.3%) and 964 good samples (95.6%) were adequate for histological evaluation. The overall diagnostic yield of cytopathology was 95.5%. The cytological examination confirmed the diagnosis of malignancy in 861 patients (85.4%), while 45 samples (4.5%) were inconclusive. Post-procedural adverse events occurred in 33 patients (3.3%). Statistical analysis showed a difference between needle types (P = 0.035) with a high sensitivity of FNB (97%). The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different scores of the MOSE (P < 0.001).

CONCLUSION

MOSE is a simple method that allows endoscopists to increase needle passes to improve sample quality. There is significantly higher FNB sensitivity and cytopathology diagnostic yield with good MOSE cores.

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Affiliation(s)

Hussein H Okasha Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11562, Egypt
Hiwa A Hussein Sulaimani Center for Advanced Gastrointestinal Endoscopy, Sulaimani College of Medicine, Sulaymaniyah 46001, Iraq
Khaled M Ragab Department of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Cairo 11211, Egypt
Omar Abdallah Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura University, Faculty of Medicine, Mansoura 35516, Egypt
Fedoua Rouibaa Gastrointestinal Endoscopy Center, Military Hospital Mohamed V, Faculty of Medicine of Rabat, Rabat 10100, Rabat-Salé-Kénitra, Morocco
Borahma Mohamed Department of Gastroenterology “C”, Ibn Sina Hospital, Mohammed V University in Rabat, Rabat 10000, Rabat-Salé-Kénitra, Morocco
Fahd Ghalim Digestive Endoscopy Unit, Mekka Clinic, Casablanca 20000, Casablanca-Settat, Morocco
Mahmoud Farouk Department of Tropical Medicine and Gastroenterology, Luxor University, Luxor 85951, Egypt
Mohamed Lasheen Department of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Cairo 11211, Egypt
Mohamed A Elbasiony Hepatology and Gastroenterology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
Ahmed E Alzamzamy Department of Gastroenterology and Hepatology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo 11841, Egypt
Ahmed El Deeb Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo 12556, Egypt
Hassan Atalla Hepatology and Gastroenterology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
Mahmoud El-Ansary Department of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Cairo 11211, Egypt
Sahar Mohamed Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo 12556, Egypt
Moaz Elshair Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt
Wafaa Khannoussi Department of Gastroenterology and Endoscopy Center, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health, Casablanca 82403, Casablanca-Settat, Morocco Research Unit, Mohammed VI Center for Research and Innovation, Rabat 10100, Rabat-Salé-Kénitra, Morocco
Mohamed Z Abu-Amer Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Cairo 11651, Egypt
Amine Elmekkaoui Department of Hepato-Gastroenterology, Hassan II University Hospital of Fez, Faculty of Medicine, Pharmacy and Dentistry of Fez, Sidi Mohamed Ben Abdellah University, Fes 30003, Fès-Meknès, Morocco
Mohammed S Naguib Department of Gastroenterology, Ahmed Maher Teaching Hospital, Cairo 11451, Egypt
Adil Ait Errami Department of Gastroenterology, Cadi Ayyad University, Mohammed VIth University Hospital, Marrakech 40000, Morocco
Ahmed El-Meligui Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11562, Egypt
Ahmed H El-Habashi Department of Pathology, National Cancer Institute, Cairo University, Cairo 11451, Egypt
Mahmoud G Ameen Oncological Pathology, South Egypt Cancer Institute, Assiut University, Assiut 71516, Egypt
Dalia Abdelfatah Department of Cancer Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo 11451, Egypt
Mona Kaddah Department of Endemic Medicine, Faculty of Medicine, Cairo University, Cairo 11451, Egypt
Hanane Delsa Department of Gastroenterology and Endoscopy Center, Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health, Casablanca 82403, Casablanca-Settat, Morocco Research Unit, Mohammed VI Center for Research and Innovation, Rabat 10100, Rabat-Salé-Kénitra, Morocco

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Gonzalez RS, Yin T, Rosenbaum MW, Quintana L. Evaluation of fine-needle core biopsy specimens for pancreatic ductal adenocarcinoma: Diagnostic utility and helpful histological features. Histopathology 2024;85:275-284. [PMID: 38659189 DOI: 10.1111/his.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/04/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]

Abstract

AIMS

With the advent of new biopsy devices, fine-needle core biopsy specimens can be obtained from pancreas masses. This study aimed to report the histological spectrum of intrapancreatic adenocarcinoma on fine-needle core biopsy and the accuracy of sampling.

METHODS AND RESULTS

We identified 423 SharkCore™ fine-needle core biopsies taken from patients with a high clinical concern for pancreatic adenocarcinoma. For each, we recorded patient age and sex, percentage of diagnostic tissue in each sample and tumour site, size and histological findings. The cases came from 392 patients (193 men, 199 women; mean age 69 years). Median diagnostic tissue amount in the samples was 30%. Common histological findings included desmoplasia (36%), single atypical cells (44%), haphazard glandular growth pattern (68%), nuclear pleomorphism > 4:1 (39%), incomplete gland lumens (18%) and detached atypical epithelial strips (37%). Additional levels were ordered on 143 cases. Final clinical diagnoses associated with the 423 cases were adenocarcinoma (n = 343), pancreatitis (n = 22), intraductal neoplasm or other benign/low-grade process (n = 16) and unknown (n = 42, patients lost to follow-up). Of the adenocarcinoma cases, the diagnosis was established by the evaluated fine-needle core biopsy sample alone in 178, by fine-needle aspiration biopsy alone in 30, by both concurrently in 89 and by subsequent biopsy or resection in 37 cases. Among 68 cases called suspicious on fine-needle core biopsy, 78% ultimately represented adenocarcinoma.

CONCLUSIONS

Fine-needle core biopsy allows for histological diagnosis of pancreatic adenocarcinoma, using known histological parameters. Common findings include single atypical cells, desmoplasia, haphazard gland growth and nuclear pleomorphism. Cases interpreted as suspicious often represent malignancy.

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Bor R, Vasas B, Fábián A, Szűcs M, Bősze Z, Bálint A, Rutka M, Farkas K, Tóth T, Resál T, Bacsur P, Molnár T, Szepes Z. Risk Factors and Interpretation of Inconclusive Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of Solid Pancreatic Lesions. Diagnostics (Basel) 2023;13:2841. [PMID: 37685379 PMCID: PMC10486755 DOI: 10.3390/diagnostics13172841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open

Affiliation(s)

Renáta Bor Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Béla Vasas Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary;
Anna Fábián Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Mónika Szűcs Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School, University of Szeged, H-6720 Szeged, Hungary;
Zsófia Bősze Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Anita Bálint Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Mariann Rutka Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Klaudia Farkas Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Tibor Tóth Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Tamás Resál Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Péter Bacsur Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Tamás Molnár Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)
Zoltán Szepes Department of Internal Medicine, Albert Szent-Györgyi Medical School, University of Szeged, H-6725 Szeged, Hungary; (A.F.); (Z.B.); (A.B.); (M.R.); (K.F.); (T.T.); (T.R.); (P.B.); (T.M.); (Z.S.)

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