scholarly journals Tissue acquisition for diagnosis of proximal biliary lesions using endoscopic ultrasound-guided fine-needle aspiration.

JMS SKIMS ◽  
2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Vikas Singla ◽  
Ravi Daswani ◽  
Anil Arora ◽  
Kusum Verma ◽  
Mandhir Kumar ◽  
...  

Objectives: To report the diagnostic yield and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS FNA) for the evaluation of proximal bile duct lesions. Materials and methods: A retrospective analysis of data of the patients, who had undergone EUS for proximal bile duct lesions was done. FNA was performed from either the bile duct mass, enlarged node, or liver lesions. Outcome measures were the diagnostic yield of EUS FNA and adverse events. Results: From April 2011 to August 2018, 147 patients with suspected proximal bile duct malignancy underwent EUS. Mass lesion was seen in 133 (90.47%) patients. FNA was performed in 125 (85.03%) patients. The final diagnosis in patients undergoing EUS FNA was malignancy in 118, benign disease in six, and one patient was lost to follow up. EUS FNA confirmed the diagnosis in 103/118 patients with malignancy (sensitivity 87.28%); was false negative in 15/118 cases with malignancy, and was truly negative in all the six patients with benign disease (specificity 100%). Positive predictive value, negative predictive value, and the accuracy of EUS FNA were 100%, 28.57%, 87.90% respectively. No serious adverse event was reported, five patients had self-limiting pain. Conclusion: EUS FNA is a sensitive tool for the evaluation of proximal bile duct lesions. Low negative predictive value warrants further evaluation in patients with non-malignant findings on cytology.

Endoscopy ◽  
2004 ◽  
Vol 36 (8) ◽  
pp. 715-719 ◽  
Author(s):  
M. F. Byrne ◽  
H. Gerke ◽  
R. M. Mitchell ◽  
H. L. Stiffler ◽  
K. McGrath ◽  
...  

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Cecilia Curvale ◽  
Ignacio Málaga ◽  
Paloma Rojas Saunero ◽  
Viviana Tassi ◽  
Enrique Martins ◽  
...  

Differential diagnosis of pancreatic masses is challenging. The endoscopic ultrasound-guided fine-needle aspiration method with the highest diagnostic yield has not been established. It was realized a prospective, randomized, double-blind study of the endoscopic ultrasound-guided fine-needle aspiration in solid lesions of the pancreas to compare and evaluate diagnostic yield and aspirate quality between wet and pull technique. Forty-one patients were enrolled. The wet technique presented a sensitivity, a specificity, a positive and negative predictive value, and a diagnostic accuracy of 58.3%, 100%, 100%, 25% and 63.4%, respectively. In the capillary technique they were: 75%, 100%, 100%, 35.7% and 78.1%, respectively. Comparing the diagnostic yield between both techniques, there was no statistically significant difference (McNemar’s test p = 0.388). Regarding the cellularity of the specimen, both in cytology and the cell block samples, no significant difference was observed between the techniques (p = 0.84 and 0.61, respectively). With respect to contaminating blood in the specimen, there was no difference in cytology samples (p = 0.89) and no difference in cell block samples (p = 0.08). The suitability of cytology samples for diagnosis was similar in both techniques (wet = 57.5% and capillary = 56.7%, p = 0.94) and there was no difference in cell block samples (wet = 75% and capillary = 66.1%, p = 0.38). In this study we did not observe differences in diagnostic yield or sample quality. Since both techniques are effective, we suggest the simultaneous and alternate use of both methods.


2007 ◽  
Vol 65 (5) ◽  
pp. AB102
Author(s):  
Enrique Vazquez-Sequeiros ◽  
Daniel Boixeda-Miquel ◽  
Jose Ramon Foruny-Olcina ◽  
Diego Juzgado-Lucas ◽  
Victor Moreira-Vicente ◽  
...  

2017 ◽  
Vol 46 (4) ◽  
pp. 293-298 ◽  
Author(s):  
Sambit K. Mohanty ◽  
Dinesh Pradhan ◽  
Shivani Sharma ◽  
Anurag Sharma ◽  
Niharika Patnaik ◽  
...  

2015 ◽  
Vol 59 (4) ◽  
pp. 305-310 ◽  
Author(s):  
Kate O'Connor ◽  
Danny G. Cheriyan ◽  
Hector H. Li-Chang ◽  
Steven E. Kalloger ◽  
John Garrett ◽  
...  

Background: Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is the preferred method for biopsying the gastrointestinal tract, and rapid on-site cytological evaluation is considered standard practice. Our institution does not perform on-site evaluation; this study analyzes our overall diagnostic yield, accuracy, and incidence of nondiagnostic cases to determine the validity of this strategy. Design: Data encompassing clinical information, procedural records, and cytological assessment were analyzed for gastrointestinal EUS-FNA procedures (n = 85) performed at Vancouver General Hospital from January 2012 to January 2013. We compared our results with those of studies that had on-site evaluation and studies that did not have on-site evaluation. Results: Eighty-five biopsies were performed in 78 patients, from sites that included the pancreas, the stomach, the duodenum, lymph nodes, and retroperitoneal masses. Malignancies were diagnosed in 45 (53%) biopsies, while 24 (29%) encompassed benign entities. Suspicious and atypical results were recorded in 8 (9%) and 6 (7%) cases, respectively. Only 2 (2%) cases received a cytological diagnosis of ‘nondiagnostic'. Our overall accuracy was 72%, our diagnostic yield was 98%, and our nondiagnostic rate was 2%. Our results did not significantly differ from those of studies that did have on-site evaluation. Conclusion: Our study highlights that adequate diagnostic accuracy can be achieved without on-site evaluation.


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