The Role of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Lesions

Since Vilmann et al.[1] reported their results with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), EUS-FNA has been spread as a good diagnostic tool for gastrointestinal and perigastrointestinal lesions such as gastrointestinal submucosal tumors, pancreatic lesions, abdominal and mediastinal lymphadenopathies, ascites, and adrenal lesions.[2] EUS-FNA of pancreatic lesions is especially important because of its high diagnostic yield.[3] However, to achieve good specimens, we should consider many issues such as the selection of needle size, necessity of stylet and suction, number of strokes and passes, presence of the on-site cytopathologist, and so on. Additionally, when we puncture pancreatic cystic lesions, we should consider not only pathological evaluation but also fluid analysis.[4] Some of these issues are still controversial although there are many articles about them. Recently, EUS-guided, through-the-needle confocal laser-induced endomicroscopy and cystoscopy for pancreatic cystic neoplasms have been reported.[5] In this way, EUS-FNA will be developed and its use will spread all the more. Jani et al.[6] reviewed the present status of EUS-FNA of pancreatic lesions systematically. This review is one of good guides to EUS-FNA, and we can get a lot of information from their article.