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My approach to pancreatic fine needle aspiration
  1. Gladwyn Leiman
  1. Correspondence to:
    Dr G Leiman
    Fletcher Allen Health Care, Pathology Department ACC-EP2-154, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA; gladwyn.leiman{at}vtmednet.org

Abstract

Pancreatic fine needle aspiration cytopathology has earned a reputation as a rapid, safe, accurate and cost-beneficial modality of investigation of pancreatic mass lesion. Optimal results can be expected only if these procedures are undertaken regularly in gastroenterology departments processing large numbers of patients; occasional aspirators cannot exploit the technique to full potential. Professional teams following a dedicated approach to patient selection and management develop requisite expertise over time. Cytodiagnosis rests as much on morphological examination as on the milieu in which is it practised, and as much on sample quality as on cellular criteria. This article focuses attention on specimen handling, with particular reference to rapid on-site evaluation. The significance of particular cytodiagnoses in patient care is evaluated, and tumour types that may be encountered are enumerated and illustrated.

  • EUS, endoscopic ultrasound
  • FNA, fine needle aspiration
  • IPMT, intraductal papillary mucinous tumour
  • MCT, mucinous cystic tumour

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Footnotes

  • Published Online First 12 May 2006

  • Competing interests: None declared.