PREOPERATIVE AND INTRAOPERATIVE FINE NEEDLE ASPIRATION CYTOLOGY OF PANCREATIC LESIONS

The aim of the present study was to describe our experience from 1976 through 1988 with fine needle aspiration (FNA) cytology of pancreatic lesions in 90 patients. Fine needle aspirations were performed preoperatively under ultrasound guidance (USG) in 46 patients, under computed tomographic guidance (CTG) in seven patients, and intraoperatively in 37 patients. Based on histologic, cytologic, and clinical findings, final diagnoses were reached in 80 patients, of whom 62 had malignant pancreatic disease (MPD) and 18 had benign pancreatic disease (BPD). The accuracy of cytologic diagnoses was verified by histologic, cytologic, and clinical findings. In 62 patients with MPD, the cytologic findings suggested malignancy in 54 patients, suspected malignancy in five, and did not reveal malignancy in three patients. Among 18 patients with BPD, all of the cytologic findings were reported as benign. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for intraoperative FNA cytologic results were 96%, 100%, 100%, 91%, and 97%, respectively, and for USG FNA cytologic results were 94%, 100%, 100%, 78%, and 95%, respectively. No complications followed the procedure. Conclusions: Both transabdominal percutaneous imaging-guided and intraoperative FNA cytology of pancreatic lesions are simple, safe, and highly accurate methods in differentiation of benign from malignant pancreatic lesions.