Endoscopic ultrasound-guided fine needle aspiration of pancreatic carcinoma

Endoscopic ultrasound (EUS) is reported to be the single best modality for visualizing small pancreatic carcinomas. Whereas tissue diagnosis by fine needle aspiration (FNA) can be performed with computed tomography (CT) or transabdominal ultrasound guidance, the diagnostic accuracy is limited by the ability of these modalities to visualize the lesion. Real time EUS-guided fine needle aspiration has recently been reported as a new diagnostic modality. The application of EUS-guided FNA in the diagnosis of small pancreatic carcinoma has not been reported. We present a case in which transduodenal EUS-guided FNA was successful in establishing a definitive tissue diagnosis of pancreatic carcinoma in a 1.6-cm lesion in the head of the pancreas. This case along with a review of the literature highlights the great potential of this new modality in the diagnosis of pancreatic carcinoma.