Diagnostic yield of computed tomography guided fine-needle aspiration for pancreatic cancer

Fine-needle aspiration (FNA) for the histological diagnosis of occupying lesions in the pancreas as opposed to tru-cut needle biopsy to obtain tissue for analysis has been associated with a lower incidence of post-procedure complications, with almost immediate recovery and no need for hospital stay. Nevertheless, the question of the diagnostic effectiveness of percutaneous computed axial tomography (CT)-guided FNA in solid pancreatic lesions has been raised. The aim of this study was to confirm the diagnostic effectivity of percutaneous CT-guided FNA in pancreatic space-occupying lesions and to assess short-term complications. All percutaneous CT-guided FNA with real-time monitoring, performed between April 2010 and December 2015, were retrospectively analyzed. In all cases 21-gauge needles were used. All FNA were performed in the presence of a pathologist who immediately stained and reported as adequate for analysis in all cases. The diagnosis was confirmed by histopathological evaluation. Of 54 FNA performed, final histopathological evaluation revealed neoplastic cells compatible with adenocarcinoma in 52 patients (96%) and was negative for neoplastic cells in two patients (4%). The sensitivity was 94%, and the specificity 100%. Post-FNA morbidity was observed in four patients, consisting of epigastric pain in two and abdominal wall hematoma in two other patients. Percutaneous CT-guided FNA of pancreatic space-occupying lesions was found to be a good, minimally invasive and safe method with low morbidity. The presence of the pathologist in the procedure allowed for immediate cytological diagnosis.