Ultrasonically guided puncture of solid pancreatic mass lesions

Ultrasound scanning in combination with ultrasonically guided fine needle aspiration biopsy is a well established method in the evaluation of patients with suspected pancreatic cancer. Fine needle puncture should be performed when a solid mass lesion is outlined by ultrasound. The dynamic scanning technique provides the best identification of the biopsy needle during its insertion. In a series 203 patients including 126 with malignant mass lesions of the pancreas or malignant periampullary tumors from a 10 yr period, false negative cytological diagnoses occurred in 24%. Two false positive cytological diagnoses occurred in patients with chronic pancreatitis. The technique is most valuable in the demonstration of cancer of the pancreas or of the periampullary region (pVpos = 98%) but less valuable in the exclusion of malignancy (pVneg = 69%).