How to do pancreatic mass FNA.

FNA is an important aspect in the diagnosis and management of pancreatic masses. Studies have shown that the overall accuracy of EUS-guided FNA ranges between 71% and 90% in this setting. It is important to review all pertinent clinical data (especially cross-sectional imaging) before performing endoscopy. The choice of needle may depend on the location and size of the lesion. Once the lesion is targeted and placed in optimal position, FNA is performed under total EUS guidance while visualizing the needle tip at all times. Factors that may increase the diagnostic yield of FNA include sampling the lesion in multiple planes, targeting the margins or firmer ends of a necrotic mass, and arranging for ROSE.