Endosonografi yapılan pankreatik kitle lezyonlarının cerrahi ve ince iğne aspirasyon biyopsi verilerinin patolojik sonuçlar ile analizi: 6 yıllık deneyim

Yıl 2019, Cilt: 12 Sayı: 1, 1 - 6, 18.01.2019

Memduh Şahin Mehmet Cindoruk

https://doi.org/10.31362/patd.399487

Cited By: 2

Öz

Amaç:
Endoskopik
ultrasonografi (EUS) pankreas lezyonlarının değerlendirilmesinde yaygın olarak
kabul edilen bir tanı yöntemidir. EUS ile yapılan ince iğne aspirasyon
biyopsileri pankreatik lezyonların derecelendirilmesi ve histolojik tanı
almasında önemli rol oynamaktadır. Araştırmamızda EUS ile ortaya çıkan
görüntülemelerin değerlendirilmesini ve patolojik sonuçlarla uyumunu incelemeyi
amaçladık.

Gereç ve Yöntem: Çalışmada abdominal bilgisayarlı tomografi
ile pankreasta kitle tanısı alan 101 hastanın yapılan EUS görüntülemelerinin
özellikleri derlendi. Aynı zamanda bu vakalardan bazılarına eş zamanlı ince
iğne aspirasyon biyopsileri uygulandı. İnce iğne biyopsisi ve cerrahi operasyon
ile elde edilen patolojik tanılar çalışmamızda ek olarak derlendi.

Bulgular: EUS ile
yapılan pankreatik kitle görüntülemelerinde en sık lokalizasyon pankreas baş
kesimindedir (n=46, %45,5). EUS yapılan vakalarda en sık ön tanı pankreas
karsinomu idi (n=49, %48,5). Pankreasta kitle tespit edilen hastalardan 32’sine
(%31,7) cerrahi girişim yapıldı. EUS yapılan 30 (%29,7) vakaya ince iğne
aspirasyon biyopsisi uygulandı. Endosonografik olarak ince
iğne aspirasyon biyopsisi yapılan vakalardan 12’sine (%40), cerrahi uygulanan
vakaların 19’una (%59,4) pankreas karsinomu tanısı konuldu. Araştırmamızda
kitlelerin lokalizasyon, boyut ve tanısal biyopsi alım yöntemlerine göre
cinsiyetler arasında farklılık bulunmamıştır.

Sonuç:
EUS
başta pankreas karsinomları olmak üzere pankreas kitle lezyon tanısında ve
cerrahi kararında önemli bir yöntemdir. Bu görüntülemelerin gerek ince iğne
aspirasyon biyopsileri, gerekse daha sonra cerrahi yöntemler ile desteklenmesi
tanı konulmasında hayati önem taşımaktadır.

ABSTRACT

Purpose:
Endoscopic
ultrasonography (EUS) is a widely accepted diagnostic method for the evaluation
of pancreatic lesions. Fine-needle aspiration biopsies performed with EUS play
an important role in the grading and the histological diagnosis of pancreatic
lesions. We aimed to evaluate the imaging findings with endosonography (EUS)
and try investigate the correspondence with the patients pathological results.

Material
and Methods: In our study, EUS imaging of 101 patients
with pancreatic mass in abdominal computed tomography was compiled.  At the same time, fine needle aspiration
biopsies were applied simultaneously to some of these cases. Pathologic
diagnoses obtained by aspiration needle biopsy and pancreas surgery were
supplemented in our study.

Results:
The
most common localization in pancreatic mass imaging with EUS is in the
pancreatic head (46 cases, 45.5%). The most frequent diagnosis were pancreatic
carcinoma (49 cases, 48.5%) . 32 patients 
(31.7%) underwent surgery for pancreatic mass. Thirty needle aspiration
biopsies were performed in 30 (29.7%) cases after applying EUS.  Pancreatic cancer was diagnosed in 12 (40%)
of the patients who had endosonographically fine needle aspiration biopsy and
19 (59.4%) of the surgical cases. There was no difference in pancreatic
localization between the patients with 
the preliminary diagnosis of pancreatic cancer and other
preliminary  pancreatic mass diagnoses.
In our study, there was no difference between the genders according to
localization, size and diagnostic biopsy methods.

Conclusion:
EUS
is an important method in diagnosing pancreatic mass lesion, especially in
pancreatic carcinomas and in surgical decision. The support of fine needle
aspiration biopsies and surgical methods after these images is of vital
importance in the diagnosis.

Anahtar Kelimeler

Endoskopik, Ultrasonografi, Pankreas, İnce iğne aspirasyon

Analysis of endosonographed pancreatic lesions wıth surgical and needle aspiration biopsy data by pathological results: 6 year experience

Öz

ABSTRACT

Purpose: Endoscopic ultrasonography (EUS) is a widely accepted diagnostic method for the evaluation of pancreatic lesions. Fine-needle aspiration biopsies performed with EUS play an important role in the grading and the histological diagnosis of pancreatic lesions. We aimed to evaluate the imaging findings with endosonography (EUS) and try investigate the correspondence with the patients pathological results.

Material and Methods: In our study, EUS imaging of 101 patients with pancreatic mass in abdominal computed tomography was compiled.  At the same time, fine needle aspiration biopsies were applied simultaneously to some of these cases. Pathologic diagnoses obtained by aspiration needle biopsy and pancreas surgery were supplemented in our study.

Results: The most common localization in pancreatic mass imaging with EUS is in the pancreatic head (46 cases, 45.5%). The most frequent diagnosis were pancreatic carcinoma (49 cases, 48.5%) . 32 patients  (31.7%) underwent surgery for pancreatic mass. Thirty needle aspiration biopsies were performed in 30 (29.7%) cases after applying EUS.  Pancreatic cancer was diagnosed in 12 (40%) of the patients who had endosonographically fine needle aspiration biopsy and 19 (59.4%) of the surgical cases. There was no difference in pancreatic localization between the patients with  the preliminary diagnosis of pancreatic cancer and other preliminary  pancreatic mass diagnoses. In our study, there was no difference between the genders according to localization, size and diagnostic biopsy methods.

Conclusion: EUS is an important method in diagnosing pancreatic mass lesion, especially in pancreatic carcinomas and in surgical decision. The support of fine needle aspiration biopsies and surgical methods after these images is of vital importance in the diagnosis.

Anahtar Kelimeler

Ensoscopic Ultrasonography, Pancreas, Fine needle aspiration

Kaynakça

• 1-Klimstra DS. Non ductal neoplasms of thepancreas. Mod Pathol 2007; 20 Suppl 1:S94.2-Hruban RH, Pitman MB, Klimstra DS. Tumors of thepancreas. In: Atlas of tumorpathology, Fascicle 6, ArmedForcesInstitute of Pathology, Washington, DC 2007. Vol 4th series3-Scheithauer K, Miederer M, Gaertner FC.PET-CT bei neu- roendokrinen Tumoren und nuklear medizinische Thera- piemöglichkeiten. Radiologe. 2009;49:217–23.4-Rösch T, Lorenz R, Braig C, Classen M.Endoscopic ultrasonography in diagnosis and staging of pancreatic and biliary tumors. Endoscopy. 1992;24 Suppl1:304-8.5-Gress FG, Hawes RH, Savides TJ, Ikenberry SO, Cummings O, Kopecky K, Sherman S, Wiersema M, Lehman GA.Role of EUS in thepreoperativestaging of pancreaticcancer: a largesingle-centerexperience.Gastrointest Endosc. 1999 ;50(6):786-91.6-Lepanto L, Arzoumanian Y, Gianfelice D, Perreault P, Dagenais M, Lapointe R, Létourneau R, Roy A.Helical CT with CT angiography in assessing periampullary neoplasms: identification of vascular invasion.Radiology. 2002 ;222(2):347-52.7-Hewitt MJ, McPhail MJ, Possamai L, Dhar A, Vlavianos P, Monahan KJ. EUS-guided FNA fordiagnosis of solid pancreatic neoplasms: a meta-analysis.GastrointestEndosc. 2012 ;75(2):319-31.8-Klapman JB, Logrono R, Dye CE, Waxman I.Clinicalimpact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol. 2003 ;98(6):1289-94.9-Legmann P, Vignaux O, Dousset B, Baraza AJ, Palazzo L, Dumontier I, Coste J, Louvel A, Roseau G, Couturier D, Bonnin A. Pancreatic tumors: comparison of dual-phasehelical CT and endoscopic sonography.AJR Am J Roentgenol. 1998;170(5):1315-22.10-Du T, Bill KA, Ford J, Barawi M, Hayward RD, Alame A, Berri RN. The diagnosis and staging of pancreatic cancer: A comparison of endoscopic ultrasound and Computed Tomography with pancreas protocol.Am J Surg. 2017 (17) 31087-5.11-Lai JP, Yue Y, Zhang W, Zhou Y, Frishberg D, Jamil LH, Mirocha JM, Guindi M, Balzer B, Bose S, Cao D, Lo S, Fan X, RutgersJK. Comparison of endoscopic ultrasound guided fine needle aspiration and PET/CT in preoperative diagnosis of pancreatic adenocarcinoma. Pancreatology. 2017 17(4):617-22.12-Malak M, Masuda D, Ogura T, Imoto A, Abdelaal UM, Sabet EA, AboDahab LH, Higuchi K.Yield of endoscopicultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for solid pancreatic neoplasms. Scand J Gastroenterol. 2016;51(3):360-7.