Читать книгу Pancreatic Tumors - Группа авторов - Страница 42

Factors influencing the diagnostic yield of a lesion include the location, size, nature of the lesion (solid, cystic, or firm), and the type and the size of the needle used for aspiration. Needle types with different tip designs that have been introduced for solid masses include the EchoTip ProCore^® HD Ultrasound (Cook Medical, Bloomington, IN), Shark core^TM FNB Exchange (Medtronic, Minneapolis, MN), and the AcquireTM (Boston Scientific, Marlborough, MA). These newer-generation EUS-FNA biopsy needles help obtain small histopathology specimens from pancreatic solid masses (Fig. 4). For pancreatic cystic masses the Moray micro forceps have been used. These needles not only improve the tissue yield compared to FNA, but also significantly reduce the number of passes and provide a larger amount of cellularity for diagnostic accuracy and ancillary studies. In our experience, material obtained from these newer-generation needles, depending on the gauge of the needle used and the experience of the laboratory, is best processed using cell blocks as the biopsies are fragile and fragment easily.