Through-the-needle microforceps biopsy: a powerful tool but for selected patients
Stefano Francesco Crinò
Abstract
Pancreatic cystic lesions (PCLs) are a common incidental finding on cross-sectional imaging, with a prevalence of 13.5 % that increases with age [1]. Despite very low progression to pancreatic cancer [2], the spectrum of pathology ranges from benign lesions to invasive neoplasms, and the possible threat of cancer is a looming fear for both patients and physicians. Endoscopic ultrasound (EUS) is indicated when clinical or radiological features of concern mean the lesion is considered for surgical resection or when the patient's management dramatically changes according to the cyst histological subtype [3]. However, cyst morphology is often non-specific and "traditional" cystic fluid analyses (i. e. carcinoembryonic antigen [CEA] and cytology) obtained through EUS-guided fine-needle aspiration (EUS-FNA) have low accuracy in differentiating mucinous vs. non-mucinous lesions, and in defining the nature of the cyst [3].