Can FNA be performed for solid pancreatic masses completely surrounded by the bowel?
- If a skinny needle (< 20 gauge) is used and the lesion is solid, any organ, including the stomach, small bowel, and colon, can be traversed. Antibiotic coverage is recommended for procedures through the bowel.
- Major blood vessels should be avoided.
- The diagnosis of pancreatic adenocarcinoma often can be established by cytopathologic examination alone; a negative result must be interpreted with caution and assumed to be a sampling error until proved otherwise.