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.