Tissue processing of endoscopic ultrasound-guided fine-needle aspiration specimens from solid pancreatic lesions.

IF 1.9 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Journal of Medical Ultrasonics Pub Date : 2024-04-01 Epub Date: 2023-12-05 DOI:10.1007/s10396-023-01387-8
Kenji Notohara, Kaori Nakamura
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引用次数: 0

Abstract

Now that tissue cores can be obtained using fine-needle biopsy (FNB) needles, the ways tissues are handled for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) are changing. Direct smear, touch smear of core tissues, and centrifugation have been used for cytological examinations, and liquid-based cytology (LBC), which allows immunostaining and genetic tests that use residual samples, is emerging as an alternative. We emphasize that liquid cytology (Cytospin™ cytology and LBC) is still important, because it enables the diagnosis of pancreatic ductal adenocarcinoma (PDAC) when cancerous cells are scarce in specimens. Cell blocks are being replaced by core tissues obtained via FNB needles. Recent reports indicate that rapid on-site evaluation (ROSE) is not necessary when FNB needles are used, and macroscopic on-site evaluation is used to evaluate specimen adequacy. Macroscopic findings of specimens are helpful in the diagnostic workup and for clarifying specimen-handling methods. In addition to the red strings and white cores observed in PDAC, mixed red and white strings, gray tissues, and gelatinous tissues are observed. Gray (necrotic) tissues and gelatinous (mucus) tissues are more suitable than histology for cell block or cytological processing. Tumor cells in neuroendocrine tumors (NETs) are numerous in red strings but cannot be observed macroscopically. ROSE might thus be necessary for lesions that may be NETs. Core tissues can be used for genetic tests, such as those used for KRAS mutations and comprehensive genomic profiling. Cytological materials, including slides and LBC specimens, can also be genetic test materials.

Abstract Image

内镜超声引导下胰腺实体病变细针穿刺标本的组织处理。
现在可以使用细针活检(FNB)针获取组织核心,内窥镜超声引导下细针抽吸术(EUS-FNA)处理组织的方式也在发生变化。细胞学检查一直采用直接涂片、核心组织触摸涂片和离心法,而液基细胞学(LBC)作为一种替代方法正在兴起,它可以利用残留样本进行免疫染色和基因检测。我们强调液基细胞学(Cytospin™细胞学和液基细胞学)仍然很重要,因为当标本中癌细胞稀少时,液基细胞学可以诊断胰腺导管腺癌(PDAC)。细胞块正被通过 FNB 针获取的核心组织所取代。最近的报告显示,使用 FNB 针时无需进行快速现场评估(ROSE),而采用宏观现场评估来评价标本是否充分。标本的宏观检查结果有助于诊断工作和明确标本处理方法。除了在 PDAC 中观察到的红串和白核,还可观察到红白混合串、灰色组织和胶状组织。灰色(坏死)组织和胶状(粘液)组织比组织学更适合细胞块或细胞学处理。神经内分泌瘤(NET)中的肿瘤细胞在红线中数量众多,但无法进行宏观观察。因此,对于可能是 NET 的病变,ROSE 可能是必要的。核心组织可用于基因检测,如用于检测 KRAS 突变和综合基因组图谱。细胞学材料,包括切片和 LBC 标本,也可作为基因检测材料。
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来源期刊
CiteScore
3.30
自引率
11.10%
发文量
102
审稿时长
>12 weeks
期刊介绍: The Journal of Medical Ultrasonics is the official journal of the Japan Society of Ultrasonics in Medicine. The main purpose of the journal is to provide forum for the publication of papers documenting recent advances and new developments in the entire field of ultrasound in medicine and biology, encompassing both the medical and the engineering aspects of the science.The journal welcomes original articles, review articles, images, and letters to the editor.The journal also provides state-of-the-art information such as announcements from the boards and the committees of the society.
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