الفهرس 
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Abstract
Pancreatic lesions specifically the malignant ones have been estimated to be one of the leading causes of cancer death worldwide.
In a patient who presents with a newly diagnosed pancreatic mass, the role of imaging is to assess if the patient is considered surgically resectable. This aspect of the evaluation is divided into detection, localization and characterization of the mass as benign versus malignant, evaluation of adjacent vasculature and the presence or absence of metastases for the purpose of resectability.
In patients with unresectable tumors, the role of imaging will be to list the sites of metastases in addition to vascular involvement. Post treatment evaluation in patients, who have had surgery for pancreatic neoplasms, is to assess for recurrence. In patients who are unresectable, treatment response of the primary tumor and metastatic sites is assessed as a part of post treatment imaging.
Ultrasound (US), multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) can help to do the right diagnosis.
Options for tissue acquisition include CT or MRI, ultrasound guided percutaneous biopsy, brush cytology at endoscopic retrograde cholangio-pancreatography (ERCP), open biopsy at surgery or endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) or fine needle biopsy (FNB). Of these techniques EUS-FNA/FNB has emerged as the most accurate.
Complementary and a combination of helical/multidetector CT with EUS seems to be the best approach for accurate staging and diagnosis of tumor resectability. ERCP has a limited role in staging of pancreatic and biliary cancers.
Nowadays EUS is well established as an important tool in clinical practice. from purely diagnostic imaging, it has progressed to include tissue acquisition, which provided the basis for therapeutic procedures. Even as interventional EUS developed, there has been ongoing progress in EUS diagnostic capabilities due to improved imaging systems. EUS is well established for differentiation of subepithelial lesions, for T-staging of luminal gastrointestinal and pancreaticobiliary malignancies, for differentiation of benign pancreaticobiliary disorders and for diagnostic tissue acquisition, which can be achieved by EUS-guided fine needle aspiration or by EUS-guided fine needle biopsy using dedicated biopsy needles.
The present study had been carried out to detect the accuracy of EUS in diagnosing pancreatic lesions, 63 EUS were carried out. Of these patients, 63 underwent FNA of a mass lesion that was seen at the time of EUS. The mean age of these patients was 55.43 ± 13.55 years. And 52.4 % of the patients were female.
According to EUS evaluation for all the studied cases, 60 patients (95.2%) of the lesions were located in pancreas; three patients (4.8 %) had ampullary lesions.
Among the studied 63 cases EUS-FNA diagnosed 15 benign lesions and 35 malignant lesions (23.8% and 55.6% respectively) , 13 cases of neuroendocrine tumors (20.6%) were diagnosed, 53 solid lesions and 10 cystic lesions (84.1% and 15.8% respectively), these proves the ability of EUS and EUS FNA for detection and diagnosis different pancreatic lesions with different pathology.