Pancreatic biopsy

Pancreatic biopsy — is the collection of a tissue sample from the gland for detailed pathomorphological examination. Since the organ is located deep in the abdominal cavity, the material is usually taken under ultrasound, CT or endoscopic ultrasound guidance (EUS-FNA). This study is a crucial step in the diagnosis, allowing to distinguish benign cysts and chronic inflammation from pancreatic cancer.

Research objective: The main task is morphological verification of the nature of the detected neoplasm. The histological conclusion allows the oncologist or surgeon to determine whether the patient requires radical surgery or whether conservative treatment and observation can be limited.

What does the pathologist evaluate:

• Cellular composition: search for atypical cells characteristic of adenocarcinoma or neuroendocrine tumors.

• Parenchyma structure: detection of signs of chronic pancreatitis, fibrosis or atrophy of gland tissues.

• Type of cystic formations: differentiation of serous, mucinous cysts and their potential for malignancy (degeneration into cancer).

• Presence of inflammatory infiltration: assessment of the activity of the inflammatory process and its impact on tissues.

Clinical significance: An accurate diagnosis obtained through biopsy prevents unnecessary complex surgeries and allows for the appointment of targeted chemotherapy. In cases of neuroendocrine tumors, histology helps determine the degree of their aggressiveness (G1, G2, G3), which is critically important for the prognosis of patient survival.

When is it prescribed:

• detection of tumor-like formations in the pancreas using CT or MRI;

• the need to confirm the diagnosis before starting chemotherapy or radiotherapy;

• differential diagnosis between pseudotumorous pancreatitis and cancer;

• assessment of the nature of pancreatic cysts with a high risk of malignancy.