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Cytojournal. 2011;8:7. doi: 10.4103/1742-6413.79779. Epub 2011 Apr 21.

Endoscopic ultrasound-guided fine-needle aspiration of metastases to the pancreas: A study of 25 cases.

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  • 1Department of Pathology, University of Pittsburgh Medical Center, S-417 BST, 200 Lothrop Street, Pittsburgh, PA 15261.

Abstract

BACKGROUND:

Metastases to the pancreas are an uncommon cause of pancreatic masses seen on endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The purpose of this study is to retrospectively review the cytomorphology, clinical findings, and results of ancillary studies in a large series of these unusual cases.

MATERIALS AND METHODS:

We searched our institution's pathology database for EUS-guided FNAs of the pancreas that were diagnostic of metastatic tumor over a 5-year period. The final cytologic diagnosis, results of ancillary studies, corresponding histological material, and clinical follow-up data were reviewed in these cases.

RESULTS:

A total of 1172 pancreatic EUS-guided FNAs were identified, of which 25 cases (2.1%) had a confirmed diagnosis of a pancreatic metastasis. This included 12 (48%) cases of renal cell carcinoma, 3 (12%) melanomas, 3 (12%) small cell carcinomas, and 7 (28%) other malignancies. In these metastatic tumors involving the pancreas, 20 (80%) of the lesions were solitary. Four (16%) cases had no prior history of malignancy. The average time to diagnosis of pancreatic metastasis was 5.3 years. Immunohistochemistry and special stains were performed in 22 (88%) and 9 (36%) cases, respectively.

CONCLUSIONS:

Our data shows that although metastases to the pancreas are rare, they can present as a solitary mass many years after the primary malignancy is diagnosed and can even be the first manifestation of an extrapancreatic primary in a small number of cases. It is important to consider the possibility of a metastatic lesion in the pancreas because this may require a different management than a primary pancreatic tumor.

KEYWORDS:

Cytology; endoscopic ultrasound-guided fine-needle aspiration; pancreatic metastases

PMID:
21713016
[PubMed]
PMCID:
PMC3119417
Free PMC Article

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