Operative fine needle aspiration cytology of pancreatic tumours

Thirty-one patients undergoing laparotomy for tumours in the region of the pancreas had both fine needle aspiration cytology (FNAC) and histological biopsy specimens taken to assess the accuracy of the FNAC technique. There were no false positive results but there were six false negative results following FNAC with only one false negative result of histological biopsy. However, there was sampling bias in favour of histology in each of the five patients with negative FNAC and positive histology; two had metastatic disease and three had histology repeated because the initial frozen section was negative. Two major complications may have resulted from the histological biopsy procedure. It is concluded that fine needle aspiration cytology is the ideal method of biopsying pancreatic lesions because of the inherent risk of complications following histological biopsy.