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EUS-guided FNA of pancreatic metastases: a multicenter experience.

Publication ,  Journal Article
DeWitt, J; Jowell, P; Leblanc, J; McHenry, L; McGreevy, K; Cramer, H; Volmar, K; Sherman, S; Gress, F
Published in: Gastrointest Endosc
May 2005

BACKGROUND: Metastatic lesions of the pancreas are a rare but important cause of focal pancreatic lesions. The purpose of this study is to describe the EUS features, cytologic diagnoses, and clinical impact of a cohort of patients with pancreatic metastases diagnosed by EUS-guided FNA (EUS-FNA). METHODS: Over a 6-year period, in a retrospective, multicenter study, patients had the diagnosis of pancreatic metastases confirmed with EUS-FNA. All examinations were performed by one of 5 experienced endosonographers. The EUS and the clinical findings of pancreatic metastases were compared with those of a cohort with primary pancreatic malignancy. RESULTS: Thirty-seven patients with possible metastases were identified, and 13 were excluded because of diagnostic uncertainty. The remaining 24 underwent EUS-FNA (mean passes 4.1) of a pancreatic mass without complications. Diagnoses included metastases from primary kidney (10), skin (6), lung (4), colon (2), liver (1), and stomach (1) cancer. In 4 (17%), 16 (67%), and 24 (100%) patients, EUS-FNA provided the initial diagnosis of malignancy, tumor recurrence, and pancreatic metastases, respectively. Four (17%) metastases initially were discovered by EUS after negative (n = 3) or inconclusive (n = 1) CT scans. Compared with primary cancer, pancreatic metastases were more likely to have well-defined margins (46% vs. 4%) compared with irregular (94% vs. 54%; p < 0.0001) margins. No statistically significant difference between the two populations was noted for tumor size, echogenicity, consistency, location, lesion number, or number of FNA passes performed. CONCLUSIONS: Pancreatic metastases are an important cause of focal pancreatic lesions and may occasionally be discovered during EUS examination after previously negative or inconclusive CT. Use of immunocytochemistry, when available, may help to confirm a suspected diagnosis. These lesions are more likely to have well-defined EUS margins compared with primary pancreatic cancer.

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Published In

Gastrointest Endosc

DOI

ISSN

0016-5107

Publication Date

May 2005

Volume

61

Issue

6

Start / End Page

689 / 696

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Reproducibility of Results
  • Pancreatic Neoplasms
  • Neoplasm Metastasis
  • Middle Aged
  • Male
  • Humans
  • Gastroenterology & Hepatology
  • Follow-Up Studies
 

Citation

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DeWitt, J., Jowell, P., Leblanc, J., McHenry, L., McGreevy, K., Cramer, H., … Gress, F. (2005). EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointest Endosc, 61(6), 689–696. https://doi.org/10.1016/s0016-5107(05)00287-7
DeWitt, John, Paul Jowell, Julia Leblanc, Lee McHenry, Kathleen McGreevy, Harvey Cramer, Keith Volmar, Stuart Sherman, and Frank Gress. “EUS-guided FNA of pancreatic metastases: a multicenter experience.Gastrointest Endosc 61, no. 6 (May 2005): 689–96. https://doi.org/10.1016/s0016-5107(05)00287-7.
DeWitt J, Jowell P, Leblanc J, McHenry L, McGreevy K, Cramer H, et al. EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointest Endosc. 2005 May;61(6):689–96.
DeWitt, John, et al. “EUS-guided FNA of pancreatic metastases: a multicenter experience.Gastrointest Endosc, vol. 61, no. 6, May 2005, pp. 689–96. Pubmed, doi:10.1016/s0016-5107(05)00287-7.
DeWitt J, Jowell P, Leblanc J, McHenry L, McGreevy K, Cramer H, Volmar K, Sherman S, Gress F. EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointest Endosc. 2005 May;61(6):689–696.
Journal cover image

Published In

Gastrointest Endosc

DOI

ISSN

0016-5107

Publication Date

May 2005

Volume

61

Issue

6

Start / End Page

689 / 696

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Reproducibility of Results
  • Pancreatic Neoplasms
  • Neoplasm Metastasis
  • Middle Aged
  • Male
  • Humans
  • Gastroenterology & Hepatology
  • Follow-Up Studies