FINE-NEEDLE ASPIRATION BIOPSY OF PANCREATIC DUCTAL ADENOCARCINOMA - LOSS OF DIAGNOSTIC-ACCURACY WITH SMALL TUMORS

Eighty-three patients underwent CT-directed fine-needle aspiration bio psies (FNAB) for pancreatic ductal adenocarcinoma. Five factors that m ight have influenced the diagnostic sensitivity of FNAB were analyzed: clinical history, the number of passes for each FNAB, and three radio logic criteria including tumor size, tumor location, and the presence or absence of suspected tumor necrosis by CT scan. Sixty-three patient s had a diagnosis of pancreatic carcinoma confirmed by FNAB (overall s ensitivity = 76%). Tumor size was the only factor that correlated with the diagnostic sensitivity of FNAB. [GRAPHICS] Of 12 patients whose F NAB was negative but suspicious for malignancy, 10 had a repeat FNAB a nd 4 were positive for carcinoma. We conclude that the diagnostic sens itivity of FNAB decreases significantly with decreasing tumor size and that a repeat FNAB for suspicious biopsies should be done to increase the diagnostic yield. (C) 1994 Wiley-Liss, Inc.