Сytomorphological diagnosis of metastatic lesions to the pancreas
Authors: A.A. Mikhetko, O.V. Ivko
Objectives: to evaluate the effectiveness of the cytological method in the diagnosis of metastatic lesions of the pancreas.
Material and methods. We analyzed 249 biopsies performed on an outpatient basis over 4 years (2016–2019) at the Petrov National Medical Research Center of Oncology in 242 patients (11 cystic and 231 solid pancreatic tumors). In 139 cases, percutaneous trepan biopsy (TB) was performed by 18G needle under ultrasound control, with collecting material for cytological and histological examination, and in 110 cases – fine needle aspiration biopsy under endosonography (EUS-tab) by EndoFlex and Boston Sientific 22 G needles. Results. Our study presents the results of 249 pancreatic biopsies, from 116 men and 126 women, 15–89 years old (average age 60,5 years). The material for cytological research was found informative in 245 (98,39%) of 249 biopsies. Malignant process in cytological and (or) histological examination was established in 186 (76,86%) of 242 patients. Metastatic lesions of the pancreas were diagnosed in 17 of our patients – this is 7,02% of all pathology and 9,13% of malignant tumors of the pancreas: in 6 patients, the material was obtained using TB, in 11 – using EUS-tab. In 16 of 17 cases with pancreatic metastases, cytological examination correctly established the malignant process, and in 12 cases the nosological form of the tumor was determined. Immunocytochemical examination (ICC) was performed in 9 cases.
Conclusion. Among secondary pancreatic tumors, the most common are metastases of clear-cell renal cell carcinoma, colorectal cancer, and breast cancer. The cytological method, supplemented by the ICC study, is an accurate and safe diagnostic method for metastatic pancreatic lesions.