Value of endoscopic ultrasound guided fine needle aspiration biopsy in thediagnosis of solid pancreatic masses

Aim-To assess the feasibility and diagnostic accuracy of endoscopic ultraso und guided fine needle biopsy (EUS-FNAB) in patients with solid pancreatic masses. Methods-Ninety nine consecutive patients with pancreatic masses were studie d. Histological findings obtained by EUS-FNAB were compared with the final diagnosis assessed by surgery, biopsy of other tumour site or at postmortem examination, or by using a combination of clinical course, imaging feature s, and tumour markers. Resutlts-EUS-FNAB was feasible in 90 patients (adenocarcinomas, n = 59; neu roendocrine tumours, n = 15; various neoplasms, n = 6; pancreatitis, n = 10 ), and analysable material was obtained in 73. Tumour size (greater than or equal to or < 25 mm in diameter) did not influence the ability to obtain i nformative biopsy samples. Diagnostic accuracy was 74.4% (adenocarcinomas, 81.4%; neuroendocrine tumours, 46.7%; other lesions, 75%; p<0.02). Overall, the diagnostic yield in all 99 patients was 68%. Successful biopsies were performed in six patients with portal hypertension. Minor complications (mo derate bleeding or pain) occurred in 5% of cases. Conclusions-EUS-FNAB is a useful and safe method for the investigation of p ancreatic masses, with a high feasibility rate even when lesions are small. Overall diagnostic accuracy of EUS-FNAB seems to depend on the tumour type .