Application of electron microscopy on image-guided fine needle aspiration cytology from pancreatic masses

Abstract EN

Fine needle aspiration cytology (FNAC) is a cost effective diagnostic procedure when compared to surgical biopsy.

Electron microscopy enhances the cost effectiveness of the FNAC procedure by being able to render a more accurate diagnosis in complex cases.

The aim of this work is to determine whether the electron microscopic examination of the aspirate improves the preoperative cytological diagnosis of pancreatic lesions.

This study comprised 30 cases of pancreatic masses that were subjected to trans abdominal ultra-solography (U/S) guided aspiration biopsy.

Part of the aspirate was processed to be examined by electron microscopy.

In benign cases examined (8 cases), the FNAC material was either insufficient for further electron microscopic examination (2 cases), or did not add more reliable information (6 cases).

In malignant cases, however, (22 cases), electron microscopy was very important to specify the type of pancreatic carcinoma.

It confirmed the diagnosis of 17cases of ductal carcinoma diagnosed by FNAC as well as one case of actioner cell carcinoma.

It changed the diagnosis of 2 cases of actioner cell carcinoma diagnosed by FNAC to ductal carcinoma.

Also, it changed the diagnosis of one case from spindle cell sarcoma diagnosed by FNAC to sarcomatoid variant of ductal carcinoma.

In the remaining case, the EM was inconclusive as the aspirated material revealed only necrotic material without viable cells.