Endoscopic Ultrasound

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 8  |  Issue : 5  |  Page : 334--341

Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle


Erminia Manfrin, Claudia Perini, Serena Di Stefano, Laura Bernardoni, Alice Parisi, Luca Frulloni, Sokol Sina, Andrea Remo, Armando Gabbrielli, Stefano Francesco Crinò 
 Unit of Digestive Endoscopy, The Pancreas Institute, University of Verona, Verona, Italy

Correspondence Address:
Dr. Stefano Francesco Crinò
Unit of Digestive Endoscopy, The Pancreas Institute, University of Verona, Verona
Italy

Background and Objectives: Despite rarely, serous cystic adenoma (SCA) can assume a pseudo-solid aspect mimicking other pancreatic neoplasm as neuroendocrine tumor. EUS-FNA cytology has low diagnostic accuracy due to the scant cellularity of the collected samples. Histological diagnosis is usually made after resection. Recently, end-cutting needles for EUS-fine-needle biopsy (EUS-FNB), which obtain tissue cores by penetrating the lesions, have been developed. We aimed to assess the capability of EUS-FNB with SharkCore™ needles in the preoperative diagnosis of serous cystic adenoma pseudo-solid-appearing on imaging (Sa-SCA). Materials and Methods: Between January 2016 and January 2018, data from consecutive adult patients, who were referred for EUS-FNB of a solid pancreatic lesion and were diagnosed with having SCA, were retrieved from a single-center institutional database. Results: Two patients were excluded because of microcystic aspect at EUS. Histological diagnosis of SCA was made by EUS-FNB in the remaining 7 patients (5 females; mean age of 62.5 years). Lesions (mean size of 19.8 mm) were hypervascular on cross-sectional imaging, slightly hyperdense magnetic resonance imaging with T2-weighted images can, and negative at 68Ga-somatostatin receptor positron emission tomography and 18fluoro-deoxyglucose positron emission tomography. EUS-FNB samples were judged adequate for a definitive diagnosis in all cases, achieving specimens suitable for histological evaluation and several ancillary stains. Histochemical positivity for periodic acid-Schiff (PAS) and PAS with diastase digestion was observed in 7/7 cases. Immunohistochemical positivity for α-inhibin (7/7), GLUT1 (6/6), MUC6 (5/5), and negativity for synaptophysin (7/7) and chromogranin A (2/2) favored SCA diagnosis. Conclusions: In the case of preoperative workup suspected for Sa-SCA, a “forward acquiring” needle could improve the rate of preoperative histological diagnosis.


How to cite this article:
Manfrin E, Perini C, Di Stefano S, Bernardoni L, Parisi A, Frulloni L, Sina S, Remo A, Gabbrielli A, Crinò SF. Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle.Endosc Ultrasound 2019;8:334-341


How to cite this URL:
Manfrin E, Perini C, Di Stefano S, Bernardoni L, Parisi A, Frulloni L, Sina S, Remo A, Gabbrielli A, Crinò SF. Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle. Endosc Ultrasound [serial online] 2019 [cited 2020 Aug 4 ];8:334-341
Available from: http://www.eusjournal.com/article.asp?issn=2303-9027;year=2019;volume=8;issue=5;spage=334;epage=341;aulast=Manfrin;type=0