Differentiation of benign from malignant pancreatic masses by endoscopic ultrasound

Paul L. Baron, Lars E. Abakken, David J. Cole, Margaret B. LeVeen, Lisa F. Baron, Donna M. Daniel, John T. Cunningham, Robert H. Hawes, David B. Adams, Brenda J. Hoffman

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Background: It is often difficult to determine whether a mass in the pancreas is benign or malignant. The goal was to evaluate whether endoscopic ultrasound (EUS) can reliably establish whether a mass is benign or malignant. Methods: One hundred five patients with possible pancreatic tumors were referred for EUS. Those who were found to have a lesion suspicious for carcinoma and did not have a known malignancy also underwent EUS-guided FNA. Results: A mass suspicious for cancer was identified in 73 patients, whereas inflammatory changes or a normal pancreas was noted in 32 patients. Four of the latter 32 patients were subsequently found to have cancer. EUS-guided FNA was performed on 47 of the 73 patients with a suspicious mass and was read as cancer in 27 patients, atypia in 10 patients, and benign in 10 patients. All 10 patients with atypia were subsequently confirmed to have cancer, and 6 of the 10 patients with a benign FNA were proved to have a tumor at surgery. EUS could differentiate the lesion as malignant with a sensitivity of 95%, specificity 88%, positive predictive value 95%, and negative predictive value 88%. Conclusions: Radial array EUS is helpful in supporting or refuting a diagnosis of cancer in a patient with a pancreatic mass. Although EUS-guided FNA can confirm the diagnosis, a negative FNA should not preclude exploration when clinically indicated. Published by Lippincott-Raven Publishers

Original languageEnglish (US)
Pages (from-to)639-643
Number of pages5
JournalAnnals of Surgical Oncology
Volume4
Issue number8
DOIs
StatePublished - Dec 1997

Keywords

  • Cytology
  • Endoscopic ultrasonography
  • Pancreatic cancer
  • Pancreatitis

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Baron, P. L., Abakken, L. E., Cole, D. J., LeVeen, M. B., Baron, L. F., Daniel, D. M., Cunningham, J. T., Hawes, R. H., Adams, D. B., & Hoffman, B. J. (1997). Differentiation of benign from malignant pancreatic masses by endoscopic ultrasound. Annals of Surgical Oncology, 4(8), 639-643. https://doi.org/10.1007/BF02303748