PANCREATIC MASSES - A MULTIINSTITUTIONAL STUDY OF 364 FINE-NEEDLE ASPIRATION BIOPSIES WITH HISTOPATHOLOGIC CORRELATION

Only 15% of primary malignant tumors are confined to the gland at the time of presentation. Fine-needle aspiration (FNA) is valuable in conf irming the malignant nature of these unresectable lesions. Benign panc reatic lesions and metastatic neoplasms can also be evaluated by fine- needle aspiration. We undertook a retrospective study to evaluate the efficacy of FNA in assessing pancreatic masses, Three hundred and sixt y-four radiologically guided FNAs of the pancreas performed between 19 86-1996 were reviewed. Surgical material was also evaluated when avail able and compared to the FNA material. There were 223 men and 141 wome n. Their ages ranged from 23-90, with a mean of 64 ye Two hundred and twelve patients (58%) had primary malignant tumors, 183 had adenocarci nomas, 15 had mucinous cystadenocarcinomas, 12 had neuroendocrine tumo rs, and 2 had pleomorphic giant-cell carcinomas. Ninety-one (43%) had available surgical material which showed adenocarcinoma. Ninety-one pa tients (25%) had benign aspirates, including 53 showing benign ductal epithelium, 23 showing pancreatitis/inflammation, 10 showing pseudocys ts, and 7 showing serous cystadenomas. Surgical material was available in 24 (26%) of these patients. Two of these showed adenocarcinoma, Si xteen aspirates (4%) were suspicious for malignancy, 13 (81%) of which showed adenocarcinoma on follow-up biopsies. Twenty-three aspirates ( 6%) showed metastatic neoplasms. Twenty-three (6%) had unsatisfactory specimens. Ten (43%) of these had follow-up biopsies, 3 of which were malignant. FNA of primary benign and malignant pancreatic masses is hi ghly sensitive (98%) and specific (100%). Eighty-one percent of the su spicious lesions showed adenocarcinoma on follow-lip biopsy FNA of met astatic neoplasms to the pancreas is also very accurate. This techniqu e can be useful in avoiding unnecessary surgery (C) 1998 Wiley-Liss, I nc.