BACKGROUND AND AIMS: Through-the-needle microforceps are a recent addition to the EUS armamentarium for evaluation of pancreatic cystic lesions (PCLs). The main aim of this study was to assess the technical feasibility, diagnostic yield, and safety of EUS-guided microforceps biopsy for PCLs. METHODS: Our electronic endoscopy database was queried to identify patients who underwent EUS-guided FNA (EUS-FNA) of PCLs and microforceps biopsies during the same procedure. A biopsy was done on the wall of the cyst with the microforceps through the 19-gauge needle, and cyst fluid was collected for cytology and carcinoembryonic antigen (CEA) levels. Adverse events were recorded per published American Society for Gastrointestinal Endoscopy criteria. RESULTS: Twenty-seven patients underwent EUS-FNA and microforceps biopsy of PCLs from February 2016 to July 2017. Fourteen cysts were located in the pancreatic head and/or uncinate, and 13 were located in the body and/or tail region. Microforceps biopsies were technically successful in all cases and provided a pathology diagnosis in 24 of 27 cases (yield 88.9%). Microforceps biopsies diagnosed mucinous cyst in 9 patients (33.3%), serous cystadenoma in 4 (14.8%), neuroendocrine tumor in 1 (3.7%), and benign and/or inflammatory cyst in 10 (37.1%). In 7 patients (26%), microforceps biopsy results drastically changed the diagnosis, providing diagnoses otherwise not suggested by cytology or cyst fluid CEA levels. However, cytology provided a diagnosis of mucinous cyst in 4 cases (14.8%) not detected by microforceps biopsies. No adverse events were noted. CONCLUSION: Microforceps biopsies were associated with high technical success, and an excellent safety profile and may be a useful adjunctive tool, complementing existing EUS-FNA sampling protocols for PCLs.
BACKGROUND AND AIMS: Through-the-needle microforceps are a recent addition to the EUS armamentarium for evaluation of pancreatic cystic lesions (PCLs). The main aim of this study was to assess the technical feasibility, diagnostic yield, and safety of EUS-guided microforceps biopsy for PCLs. METHODS: Our electronic endoscopy database was queried to identify patients who underwent EUS-guided FNA (EUS-FNA) of PCLs and microforceps biopsies during the same procedure. A biopsy was done on the wall of the cyst with the microforceps through the 19-gauge needle, and cyst fluid was collected for cytology and carcinoembryonic antigen (CEA) levels. Adverse events were recorded per published American Society for Gastrointestinal Endoscopy criteria. RESULTS: Twenty-seven patients underwent EUS-FNA and microforceps biopsy of PCLs from February 2016 to July 2017. Fourteen cysts were located in the pancreatic head and/or uncinate, and 13 were located in the body and/or tail region. Microforceps biopsies were technically successful in all cases and provided a pathology diagnosis in 24 of 27 cases (yield 88.9%). Microforceps biopsies diagnosed mucinous cyst in 9 patients (33.3%), serous cystadenoma in 4 (14.8%), neuroendocrine tumor in 1 (3.7%), and benign and/or inflammatory cyst in 10 (37.1%). In 7 patients (26%), microforceps biopsy results drastically changed the diagnosis, providing diagnoses otherwise not suggested by cytology or cyst fluid CEA levels. However, cytology provided a diagnosis of mucinous cyst in 4 cases (14.8%) not detected by microforceps biopsies. No adverse events were noted. CONCLUSION: Microforceps biopsies were associated with high technical success, and an excellent safety profile and may be a useful adjunctive tool, complementing existing EUS-FNA sampling protocols for PCLs.
Authors: Naveen M Kulkarni; Lorenzo Mannelli; Marc Zins; Priya R Bhosale; Hina Arif-Tiwari; Olga R Brook; Elizabeth M Hecht; Fay Kastrinos; Zhen Jane Wang; Erik V Soloff; Parag P Tolat; Guillermo Sangster; Jason Fleming; Eric P Tamm; Avinash R Kambadakone Journal: Abdom Radiol (NY) Date: 2020-03
Authors: Sachin Wani; Samuel Han; Violette Simon; Matthew Hall; Dayna Early; Eva Aagaard; Wasif M Abidi; Subhas Banerjee; Todd H Baron; Michael Bartel; Erik Bowman; Brian C Brauer; Jonathan M Buscaglia; Linda Carlin; Amitabh Chak; Hemant Chatrath; Abhishek Choudhary; Bradley Confer; Gregory A Coté; Koushik K Das; Christopher J DiMaio; Andrew M Dries; Steven A Edmundowicz; Abdul Hamid El Chafic; Ihab El Hajj; Swan Ellert; Jason Ferreira; Anthony Gamboa; Ian S Gan; Lisa Gangarosa; Bhargava Gannavarapu; Stuart R Gordon; Nalini M Guda; Hazem T Hammad; Cynthia Harris; Sujai Jalaj; Paul Jowell; Sana Kenshil; Jason Klapman; Michael L Kochman; Sri Komanduri; Gabriel Lang; Linda S Lee; David E Loren; Frank J Lukens; Daniel Mullady; Raman V Muthusamy; Andrew S Nett; Mojtaba S Olyaee; Kavous Pakseresht; Pranith Perera; Patrick Pfau; Cyrus Piraka; John M Poneros; Amit Rastogi; Anthony Razzak; Brian Riff; Shreyas Saligram; James M Scheiman; Isaiah Schuster; Raj J Shah; Rishi Sharma; Joshua P Spaete; Ajaypal Singh; Muhammad Sohail; Jayaprakash Sreenarasimhaiah; Tyler Stevens; James H Tabibian; Demetrios Tzimas; Dushant S Uppal; Shiro Urayama; Domenico Vitterbo; Andrew Y Wang; Wahid Wassef; Patrick Yachimski; Sergio Zepeda-Gomez; Tobias Zuchelli; Rajesh N Keswani Journal: Gastrointest Endosc Date: 2019-02-07 Impact factor: 9.427
Authors: Donevan Westerveld; April Goddard; Nieka Harris; Vikas Khullar; Justin Forde; Peter V Draganov; Chris E Forsmark; Dennis Yang Journal: Dig Dis Sci Date: 2018-11-13 Impact factor: 3.199
Authors: Elizabeth M Hecht; Gaurav Khatri; Desiree Morgan; Stella Kang; Priya R Bhosale; Isaac R Francis; Namita S Gandhi; David M Hough; Chenchan Huang; Lyndon Luk; Alec Megibow; Justin M Ream; Dushyant Sahani; Vahid Yaghmai; Atif Zaheer; Ravi Kaza Journal: Abdom Radiol (NY) Date: 2020-11-13
Authors: Charlotte Vestrup Rift; Bojan Kovacevic; John Gásdal Karstensen; Julie Plougmann; Pia Klausen; Anders Toxværd; Evangelos Kalaitzakis; Carsten Palnæs Hansen; Jane Preuss Hasselby; Peter Vilmann Journal: World J Gastrointest Endosc Date: 2018-07-16
Authors: Rintaro Hashimoto; John G Lee; Kenneth J Chang; Nabil El Hage Chehade; Jason B Samarasena Journal: World J Gastrointest Endosc Date: 2019-11-16