Diagnosis of pancreatic lesions by percutaneous aspiration biopsy

Fifteen patients suspected of having pancreatic disease were studied by transabdominal percutaneous fine needle aspiration biopsy guided by computed tomography. Ten patients had aspirates positive for carcinoma: seven had clinically advanced disease, and the diagnostic procedure spared them laparotomy; two patients underwent laparotomy for choledochoduodenostomy; and one underwent exploratory laparotomy resulting in pancreatoduodenectomy. Four aspirates were negative for malignancy, but one patient was found ultimately to have carcinoma. One specimen was unsatisfactory. We conclude that transabdominal percutaneous fine needle aspiration cytology is a safe and simple procedure for distinguishing benign from malignant lesions. There were no complications from the procedure. We experienced no false positives and one false negative.