ABSTRACT
Endoscopic ultrasound-guided fine needle aspiration (EUS-guided FNA) is a highly sensitive and specific method for diagnosing pancreatic masses. Alternatively, EUS-guided needle core biopsies (NCB) have also been introduced. We sought to determine efficacies of pancreatic EUS-guided FNAs and NCBs. Records of consecutive EUS-guided FNAs received over a 24-mo-period were reviewed. Cases with concurrent NCBs were selected for the study. The diagnoses from the two modalities were compared and designated concordant (CC) or discordant (DC). Of 252 cases, 52 had concurrent NCBs. The final diagnoses included primary and secondary tumors. Of the 52 cases, 29/52 (55.8%) were CC and 23/52 (44.2%) were DC. The sensitivities for FNAs and NCBs were 95.0% and 67.6%, respectively. Both modalities were 100% specific. Direct comparison between EUS-guided FNAs and NCBs demonstrated that the former are more sensitive for diagnosing pancreatic neoplasms, both primaries and metastases. There was no correlation between CC/DC cases and type of neoplasm.
Subject(s)
Biopsy, Fine-Needle/methods , Endosonography/methods , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Humans , Pancreatic Neoplasms/surgery , Predictive Value of Tests , Reproducibility of Results , Retrospective StudiesABSTRACT
CD138 (Syndecan-1) is a transmembrane heparan sulfate proteoglycan present on the surface of plasma cells and epithelial cells. CD138 is also expressed in some hematopoietic neoplasms and has recently been observed in carcinomas. We characterized CD138 expression in cell-block preparations of fluids/effusions, focusing on the distinction between carcinoma and mesothelioma. One hundred formalin-fixed, paraffin-embedded cell-block sections of fluids/effusions consisting of 58 metastatic carcinomas, 24 mesotheliomas, 11 reactive mesothelial cell proliferations, 3 lymphomas, 3 metastatic sarcomas, and 1 metastatic melanoma were stained with a monoclonal antibody against CD138. CD138 staining was observed in 32/58 (55%) metastatic carcinomas and 2/24 (8%) mesotheliomas; all reactive mesothelial cells, lymphomas, sarcomas, and melanoma were negative. CD138 is a highly specific marker in the differential diagnosis of carcinoma vs. mesothelioma. Distinct membranous staining without background staining of most inflammatory cells makes CD138 an ideal marker for cell-block preparations of fluids/effusions. It should be an integral component of the epithelial-mesothelial antibody panel.
