[Ultrasound controlled fine needle cytology and fine needle histology in circumscribed pancreatic processes]

Using a biopsy transducer 171 fine-needle punctures of focal pancreatic processes were done in 158 patients. The final diagnosis was made in the first group by surgical operation or autopsy, in the second by the further clinical course. The sensitivity of the cytological examination alone was 78% in the first group and 90% in the second. The histological examination alone had a sensitivity of 79% to 100%. Combining both ways of examination according to defined criteria the sensitivity in the first group was 84% and in the second 100%. The specificity was 100% for both. The complications were 2.9%. Of these 5 cases one pancreatitis had to be operated. There were no lethal complications. To optimize the sensitivity and specificity of the ultrasound guided fine needle puncture technique we want to recommend the following points: A biopsy transducer or puncture-aid must be available. The fine needle technique only should be done under the prerequisite of a high frequency of punctures and a high constancy in the relation between puncturer and pathologist. To receive representative material it can be necessary to make several needle passes during one session. Material for cytological und histological examination should always be taken simultaneously.