The findings from the initial testing by EUS-FNA is suspicion of the slower growing, less aggressive pancreatic neuroendocrine tumor (PNET) based only on microscopic examination of the cellular morphology. To make a definitive diagnosis requires immunohistochemical (IHC) staining to determine what clusters of proteins are on the surface of the neoplasm. Each cell type has unique combinations of staining patters and the interpretation of which stains are positive and negative on a cell is how the definitive cell type is made. The report noted the biopsy material obtained was insufficient to use for the IHC and will need to be repeated.

For diagnosing diseases of the pancreas, it is best done at a high-volume center with a Hepatobiliary department and pancreas program. The patient should consider going to an NCI designated center of excellence or a National Neuroendocrine Foundation recommended comprehensive cancer center. These medical centers have a higher level of expertise and skills in doing an EUS, making a diagnosis and determining the most appropriate treatment.

CENTERS OF EXCELLENCE
https://www.cancer.gov/research/infrastructure/cancer-centers/find
https://pancreasfoundation.org/patient-resources/npf-centers-of-excellence/
https://netrf.org/