Syed Z. Ali, MD, FRCPath, FIAC

Director, Division of Cytopathology Johns Hopkins University School of Medicine Baltimore, Maryland

Improved imaging techniques and the introduction of endoscopic ultrasound guidance has resulted in significantly better detection of pancreatic masses. Clinical and radiological examinations cannot reliably distinguish benign/inflammatory pancreatic disease from carcinoma, the latter being one of the most lethal human malignancy. Therefore, an accurate pre-operative diagnosis is crucial for optimal and timely patient management. The lecture will focus on diagnostic issues of practical importance and will describe the potential pitfalls and limitations leading to erroneous diagnosis on EUS-guided FNA of this difficult anatomic site. The importance of a multidisciplinary approach when dealing with pancreatic FNA will be highlighted as well as the clinical implications of cytologic interpretations. Emphasis will be placed on the role of ancillary studies particularly immunostaining in difficult to classify pancreatic tumors. Mimics of cancers such as chronic pancreatitis will be particularly discussed to avoid misdiagnoses. Morphologic challenges relating to cystic pancreatic lesions will also be presented. The presentation will also include a discussion on the new standardized terminology and nomenclature for pancreatobiliary cytology.

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