Diagnostic ability of a 22G Franseen needle in endoscopic ultrasound‑guided fine needle aspiration of subepithelial 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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Mo1358 Efficacy of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Rectal and Colonic Subepithelial Lesions

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.535 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB406

Author(s):

Ko Watanabe ◽

Takuto Hikichi ◽

Tadayuki Takagi ◽

Masaki Sato ◽

Rei Suzuki ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle ◽

Subepithelial Lesions

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

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.234.eug ◽

2014 ◽

Vol 23 (4) ◽

pp. 405-412 ◽

Cited By ~ 23

Author(s):

Kazuya Akahoshi ◽

Masafumi Oya ◽

Tadashi Koga ◽

Hidenobu Koga ◽

Yasuaki Motomura ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Submucosal Tumor ◽

Needle Aspiration ◽

Clinical Usefulness ◽

Ultrasound Guided ◽

High Power Field ◽

Early Management ◽

Fine Needle ◽

Subepithelial Lesions

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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Tu1390 The Combination of Pancreatic Juice Cytology With Endoscopic Ultrasound-Guided Fine-Needle Aspiration Biopsy Raised the Diagnostic Ability for Pancreatic Tumor

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.03.871 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB523

Author(s):

Kazuya Matsumoto ◽

Kenichi Harada ◽

Yohei Takeda ◽

Takumi Onoyama ◽

Kazuo Yashima ◽

...

Keyword(s):

Pancreatic Juice ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Pancreatic Tumor ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Diagnostic Ability ◽

Fine Needle ◽

Pancreatic Juice Cytology

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Su1298 Reevaluation of Diagnostic Ability of Fluorescence Cytology Using 5-Aminolevulinic Acid During Endoscopic Ultrasound-Guided Fine Needle Aspiration for Pancreatobiliary Lesions

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.872 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB342

Author(s):

Tsukasa Ikeura ◽

Makoto Takaoka ◽

Kazushige Uchida ◽

Masaaki Shimatani ◽

Hideaki Miyoshi ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Aminolevulinic Acid ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Diagnostic Ability ◽

Fine Needle

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Usefulness of endoscopic ultrasound-guided fine needle aspiration for splenic parenchyma in patients suspected of having primary splenic malignant lymphoma

Endoscopy International Open ◽

10.1055/a-1287-9577 ◽

2021 ◽

Vol 09 (01) ◽

pp. E96-E101

Author(s):

Fumitaka Niiya ◽

Yuichi Takano ◽

Tetsushi Azami ◽

Takahiro Kobayashi ◽

Naotaka Maruoka ◽

...

Keyword(s):

Malignant Lymphoma ◽

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Diagnostic Ability ◽

Fine Needle ◽

Splenic Parenchyma ◽

Neoplastic Lesions ◽

Clinical Background

Abstract Background and study aims The diagnosis of malignant lymphoma (ML) is sometimes difficult, especially in patients with primary splenic malignant lymphomas (psML) which have no lymph nodes capable of acting as the biopsy target. We carried out endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for “splenic parenchyma” in patients suspected of having a psML, even without any obvious neoplastic lesions in the spleen. Patients and methods A retrospective study using medical records was conducted of eight patients suspected of having a psML that received EUS-FNA for the splenic parenchyma between January 2016 and January 2019. Data analyzed included clinical background, EUS-FNA procedure (puncture needle/route), diagnostic ability (pathological/flow cytometry [FCM]), and complications. Results EUS-FNA was performed from the stomach in all eight cases, and no patients had complications. As a result of splenic parenchymal biopsy found on EUS-FNA, 75 % of patients (6/8) were histologically diagnosed with MLs, monoclonality of B-cells was identified in all cases (8/8) with FCM, and all patients (8/8) were definitively diagnosed with psMLs. Conclusion EUS-FNA for “splenic parenchyma” is useful for patients with spML, even if they have no obvious neoplastic lesions in the spleen.

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