Clinical Usefulness of Endoscopic Ultrasound-Guided Fine Needle Aspiration for Gastric Subepithelial Lesions Smaller than 2 cm

Background & Aims: There is no evidence of postoperative metastasis of gastric gastrointestinal stromal tumors (GISTs) smaller than 2 cm. The aim of this study was to evaluate the clinical usefulness of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) smaller than 2 cm.Patients and methods: Using a prospectively maintained EUS-FNA database, 90 consecutive EUS-FNAs of gastric hypoechoic solid SELs smaller than 2 cm diagnosed by EUS were evaluated retrospectively. The reference standards for the final diagnosis were surgery (n=44) and/or clinical follow-up (n=46) using esophagogastroduodenoscopy (EGD), CT, and/or ultrasonography (US). Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.Results: The diagnostic rate of EUS-FNA for gastric hypoechoic solid SELs smaller than 2 cm was 73% (66/90). Histological diagnosis of EUS-FNA showed 47 (52%) malignant SELs (44 GISTs, 1 glomus tumor, 1 SEL like cancer, and 1 malignant lymphoma), 19 (21%) benign SELs (14 leiomyomas, 4 ectopic pancreas, and 1 neurinoma), and 24 (27%) indeterminate SELs. In 44 surgically resected cases, the diagnostic accuracy of EUS-FNA using immunohistochemical analysis was 98% (43/44). There were no complications. Appropriate 5 out of 66 SELs (98%) diagnosed by definitive EUS-FNA. After surgery, there was no recurrence of malignant SELs.Conclusions: EUS-FNA is an accurate and safe method in the pre-therapeutic diagnosis of gastric SELs smaller than 2 cm. EUS-FNA for gastric SELs smaller than 2 cm is a promising way to permit early management of patients with gastric SELs including GIST.Abbreviations: EGD: esophagogastroduodenoscopy; EUS: endoscopic ultrasonography; EUS-FNA:endoscopic ultrasound-guided fine needle aspiration; GIST: gastrointestinal stromal tumor; HPF: high power field; SEL: subepithelial lesion; SMT: submucosal tumor.

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Huge hemothorax caused by endoscopic ultrasound-guided fine-needle aspiration of a submucosal tumor of the gastric fornix

Endoscopy ◽

10.1055/s-0034-1391259 ◽

2015 ◽

Vol 47 (S 01) ◽

pp. E69-E70

Author(s):

Hiroshi Kawakami ◽

Masaki Kuwatani ◽

Kimitoshi Kubo ◽

Yoshimasa Kubota ◽

Kazumichi Kawakubo ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Submucosal Tumor ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle

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Endoscopic ultrasound-guided fine-needle aspiration skill acquisition of gastrointestinal submucosal tumor by trainee endoscopists: A pilot study

Endoscopic Ultrasound ◽

10.4103/2303-9027.183970 ◽

2016 ◽

Vol 5 (3) ◽

pp. 157 ◽

Cited By ~ 7

Author(s):

Keiko Niimi ◽

Osamu Goto ◽

Kazumichi Kawakubo ◽

Yousuke Nakai ◽

Chihiro Minatsuki ◽

...

Keyword(s):

Pilot Study ◽

Skill Acquisition ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Submucosal Tumor ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle

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ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION FOR SUBEPITHELIAL LESIONS: A SINGLE CENTRE EXPERIENCE

10.1055/s-0040-1705007 ◽

2020 ◽

Author(s):

M João ◽

L Elvas ◽

D Brito ◽

M Areia ◽

S Alves ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Single Centre ◽

Fine Needle ◽

Single Centre Experience ◽

Subepithelial Lesions

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A Pilot Randomized Crossover Trial of Wet Suction and Conventional Techniques of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Upper Gastrointestinal Subepithelial Lesions

Gastroenterology Research and Practice ◽

10.1155/2021/4913107 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Mika Takasumi ◽

Takuto Hikichi ◽

Minami Hashimoto ◽

Jun Nakamura ◽

Tsunetaka Kato ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Crossover Trial ◽

Final Diagnosis ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle ◽

Randomized Crossover Trial ◽

Subepithelial Lesions ◽

Solid Lesions

Background and Aim. A wet suction technique (“wet” technique) has been developed to improve the quality of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for sampling various solid lesions. However, no studies have reported on the wet technique for EUS-FNA for gastrointestinal (GI) subepithelial lesions (SELs). We conducted a pilot randomized crossover trial to explore whether the wet technique could be useful with regard to tissue adequacy of upper GI-SELs (UGI-SELs) compared to the conventional EUS-FNA technique (“dry” technique). Methods. Twenty-six patients with UGI-SELs indicated for EUS-FNA were randomly assigned to the dry-first arm using the dry technique for the first two passes or the wet-first arm using the wet technique for the first two passes using a cross-over design with a ratio of 1 : 1. The primary endpoint was the cellularity score of the EUS-FNA specimens rated on a 4-point scale (0-3). The secondary endpoints were the factors influencing cellularity in each suction technique. Results. The mean cellularity score was 1.65 ± 1.20 for the wet technique and 2.00 ± 0.98 for the dry technique ( p = 0.068 ). Logistic regression analysis showed that higher cellularity may be related to the final diagnosis of gastrointestinal stromal tumors in the dry technique and the SEL location in the upper stomach in the wet technique. Conclusion. The wet EUS-FNA technique failed to show a potential for improved cellularity of specimens compared to the dry technique for UGI-SELs.

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