Diagnostic accuracy of ultrasound-guided fine-needle pancreatic biopsy

We reviewed the results of 187 consecutive ultrasound-guided fine-needle biopsies of the pancreas in 171 patients to assess the diagnostic accuracy of the method. The final diagnosis obtained at operation, autopsy or follow-up were: adenocarcinoma (n = 83), metastatic cancer (n = 11), cystadenocarcinoma (n = 2), lymphoma (n = 2), malignant gastrinoma (n = 1), pseudocyst (n = 25), cyst (n = 13), chronic pancreatitis (n = 9), normal pancreas (n = 10), abscess (n = 7), benign islet-cell tumour (n = 5), cystadenoma (n = 3). Sufficient cytologic material was obtained in 95.3% of biopsies and the overall accuracy in distinguishing benign from malignant disease was 85.4%. False negative results were obtained in 12 patients (13.1%). Inconclusive results (CIII) were found in aspirates from one cyst and two islet cell tumours. There were no false-positive results. The only complication was a post-biopsy haematoma around the head of pancreas, which resolved spontaneously. Ultrasound-guided pancreatic fine-needle biopsy is a safe method and allows of a high degree of diagnostic accuracy. It has a high specificity. Its sensitivity in the detection of malignancy improves if biopsies are repeated in doubtful cases. It further permits tumours to be graded and allows complications of pancreatitis to be diagnosed.