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. 2021 May-Jun;10(3):207-213.
doi: 10.4103/EUS-D-20-00174.

Histopathological evaluation of needle tract seeding caused by EUS-fine-needle biopsy based on resected specimens from patients with solid pancreatic masses: An analysis of 73 consecutive cases

Ryosuke Nakatsubo  1 , Kenjiro Yamamoto  1 , Takao Itoi  1 , Atsushi Sofuni  1 , Takayoshi Tsuchiya  1 , Kentaro Ishii  1 , Reina Tanaka  1 , Ryosuke Tonozuka  1 , Shuntaro Mukai  1 , Kazumasa Nagai  1 , Hiroshi Yamaguchi  2 , Yuichi Nagakawa  3
Affiliations

Histopathological evaluation of needle tract seeding caused by EUS-fine-needle biopsy based on resected specimens from patients with solid pancreatic masses: An analysis of 73 consecutive cases

Ryosuke Nakatsubo et al. Endosc Ultrasound. 2021 May-Jun.

Abstract

Background and objectives: EUS-guided fine-needle biopsy (EUS-FNB) is considered a safe and useful method for preoperative diagnosis of resectable solid pancreatic masses. However, needle tract seeding (NTS) after EUS-FNB has recently been reported, which may affect long-term outcome. The aim of this study was to evaluate NTS after EUS-FNB.

Materials and methods: We reviewed 73 resected cases that underwent preoperative EUS-FNB for a pancreatic tumor from April 2014 to March 2016 and evaluated the utility and adverse events of EUS-FNB based on consecutively resected pathological specimens.

Results: The final diagnoses were pancreatic ductal adenocarcinoma (n = 67), neuroendocrine neoplasm (n = 5), and acinar cell carcinoma (n = 1). The diagnostic accuracy of preoperative EUS-FNB was 98.6%. Clinical adverse events were observed in 4.1% of cases (bleeding, n = 2; acute pancreatitis, n = 1) and abnormal pathological findings in 4.1% (NTS, n = 2; acute focal pancreatitis, n = 1).

Conclusions: Although EUS-FNB is useful for preoperative diagnosis of pancreatic tumors, we may need to reconsider the risk of NTS and use of EUS-FNB in patients with a resectable solid pancreatic mass unless the tract itself is planned to be resected.

Keywords: EUS-fine-needle biopsy; needle tract seeding; pancreatic cancer.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Case 1: (a) Cross-section of the fixed excised specimen. The largest diameter of the tumor was 60 mm and it was localized in the pancreas. (b) Histopathological findings in the resected specimen. Necrotic tissue was scattered in the pancreatic parenchyma (arrow). (c) Adenocarcinoma was located in the muscle layer of the duodenum separate from the primary tumor. (d) Schema showing the location of the puncture route and needle tract seeding (red ball)
Figure 2
Figure 2
Case 2: (a) Cross-section of the fixed excised specimen. The largest diameter of the tumor was 140 mm. (b) Histopathological findings in the resected specimen. Acinar cell carcinoma was observed in the muscle layer of the stomach at a site distal from the primary tumor (arrow). (c) Magnification of Figure 2b. (d) Schema showing the location of the puncture route and needle tract seeding (red ball)
See this image and copyright information in PMC

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