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Sinh thiết, chọc tế bào khối tụy và quanh tụy

Khối ở tuỵ và quanh tuỵ là tổn thương thường được phát hiện qua nhiều phương pháp chẩn đoán hình ảnh khác nhau và hầu hết trong số đó đều cần lấy tế bào học hoặc sinh thiết làm mô bệnh học. Hai phương pháp thường dùng là FNA qua siêu âm nội soi và sinh thiết qua da bằng cách tiếp cận tổn thương qua các tạng lân cận. | SINH THIẾT CHỌC TẾ BÀO KHỐI TỤY DIỄN ĐÀN VÀ QUANH TỤY Ultrasound-guided fine needle aspiration and MEDICAL FORUM core needle biopsy for pancreatic neoplasms and surrounding-pancreatic neoplasms Nguyễn Thị Khơi Nguyễn Thị Thu Thảo Ngô Lê Lâm Vũ Đăng Lưu Phạm Minh Thông SUMMARY Solid pancreatic or peripancreatic lesions are common diseases . All most of them need to pathology diagnosis. provides an alternative pathway for adequate specimen acquisition. Because of the deep retroperitoneal location we usually use endoscopic ultrasound EUS -guided fine needle aspiration FNA or inderect percutaneous core needle biopsy CNB . Both of them have disadvantages on their own. the sensitivity and specificity of EUS-guided FNA EUS-FNA for pancreatic neoplasms has were 85 and 98 respectively and The complication rate of EUS-FNA is approximately 1 2 1 . However one limitation related to this technique is that it often only provides a cytologic specimen with scant cellularity and lack of histologic architecture which restrains us from making a complete tissue analysis for diagnosis and grade differentiation. the sensitivity and specificity of inderect percutaneous CNB for pancreatic neoplasms has were 90 4 and 92 respectively 2 overcome the disadvantages of EUS-FNA 3 . But it is relatively risky and difficult especially for those who do not have much experience. Reaching through the liver spleen and kidneys increases the risk of bleeding. Approaching through the stomach and intestine the incidence of complications can reach 15.3 4 5 including infection peritonitis and gastrointestinal perforation. Access through the gallbladder has a high risk of cholestatic and cholecystitis 4 . Derect percutaneous CNB FNA is a new technique which can make good the risks of two technique before. In this review we will present some cases of FNA and biopsy of solid pancreatic or peripancreatic lesions by direct access approach thereby showing about techniques diagnostic effectiveness as well as .