Indications de la ponction-biopsie à l’aiguille fine sous écho-endoscopie (EUS-FNA) dans Les kystes pancréatiques
Indications of EUS-FNA in pancreatic cysts
Pancreatic cysts encompass a wide spectrum of histology, including inflammatory (pseudocyst), benign (simple cyst, serous cystadenoma), premalignant and malignant lesions (intraductal papillary mutinous tumor, mutinous cystadenoma and cystadenocarcinoma).
EUS is a valuable tool for characterizing pancreatic cysts in order to establish indications for surgical operation or, on the other hand, follow up. EUS features of each kind of pancreatic cystic lesion are described in detail. However, EUS features are not very accurate in differentiating between malignant and nonmalignant pancreatic cysts and interobserver agreement is dismal. For this reason, the use of EUS-FNA has been advocated to increase diagnostic accuracy. In this respect, a combination of cytologic examination and assay of tumoral biomarkers in the cystic fluid seems to provide the best diagnostic yield.
P. FUSAROLI, Stefania MALTONI, G. CALETTI
cytology, endoscopic ultrasonography (EUS), fine needle aspiration (FNA), pancreatic cyst, tumoral biomarkers