Pancreatic sampling by endoscopic ultrasound-guided fine-needle aspiration and needle biopsy from the cytopathology perspective

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become the criterion-standard tool for preoperative diagnosis and staging of various lesions in the pancreas and has demonstrated good diagnostic accuracy, sensitivity, and specificity with few adverse complications. However, there are several limitations to the diagnostic ability of EUS-FNA specimens, one of which includes the frequent lack of tissue architecture or adequate cellular material to perform ancillary studies for definitive diagnosis. These specific limitations have led to an increased interest in developing a variety of different needle devices for EUS-guided histologic sampling beyond the conventional FNA needle, including core-needle biopsy (eg, Trucut Quick-Core) and fine-needle biopsy (EchoTip ProCore) devices. The goal of this review is to evaluate these new types of needle biopsies with an emphasis on how these devices have impacted cytopathology and the pathological evaluation of the pancreas.