Performance and clinical role of endoscopic ultrasound fine needle aspiration for diagnosing gastrointestinal intramural lesions

Clinical Endoscopy
Hea Jung SungKyu Yong Choi

Abstract

We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions. Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging. Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology. EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was ...Continue Reading

References

Jul 3, 2002·Human Pathology·Christopher D M FletcherSharon W Weiss
Jul 28, 2005·Gastrointestinal Endoscopy·Joo Ha HwangMichael B Kimmey
Apr 28, 2009·Gastrointestinal Endoscopy·Katherine M HodaDouglas O Faigel
Feb 23, 2010·Gastrointestinal Endoscopy·Cetin KaracaWilliam Brugge
Mar 17, 2010·Gastrointestinal Endoscopy·Mohamed A MekkyVikram Bhatia
May 18, 2010·Journal of the National Comprehensive Cancer Network : JNCCN·George D DemetriJeffrey D Wayne

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BETA
biopsy
surgical resection

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