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EUS-guided Trucut biopsy

2005; Elsevier BV; Volume: 62; Issue: 3 Linguagem: Inglês

10.1016/j.gie.2005.04.044

1097-6779

Michael J. Levy, Maurits J. Wiersema,

Neuroendocrine Tumor Research Advances

EUS is a sensitive method for evaluating intra- and extraintestinal mass lesions and peri-intestinal lymphadenopathy. 1 Chang K.J. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) in the USA. Endoscopy. 1998; 30: A159-A160 PubMed Google Scholar , 2 Rosch T. Endoscopic ultrasonography. Br J Surg. 1997; 84: 1329-1331 Crossref PubMed Scopus (26) Google Scholar , 3 Hawes R.H. Endoscopic ultrasound. Gastrointest Endosc Clin N Am. 2000; 10 (viii): 161-174 PubMed Google Scholar EUS-guided FNA (EUS-FNA) may be performed at the same time as the diagnostic examination and offers a diagnostic accuracy of 60% to 90%, depending on the site. 4 Wiersema M.J. Vilmann P. Giovannini M. Chang K.J. Wiersema L.M. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997; 112: 1087-1095 Abstract Full Text PDF PubMed Scopus (1074) Google Scholar , 5 Gress F.G. Hawes R.H. Savides T.J. Ikenberry S.O. Lehman G.A. Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosonography. Gastrointest Endosc. 1997; 45: 243-250 Abstract Full Text Full Text PDF PubMed Scopus (375) Google Scholar , 6 Gress F. Gottlieb K. Sherman S. Lehman G. Endoscopic ultrasonography-guided fine-needle aspiration biopsy of suspected pancreatic cancer. Ann Intern Med. 2001; 134: 459-464 Crossref PubMed Scopus (295) Google Scholar However, several limitations arise with EUS-FNA. When available, adequacy assessment can reduce the number of biopsies; however, assistance often is restricted because of staffing issues. In addition, cytologic interpretation is hampered by the presence of blood and benign epithelial cells. Furthermore, tumors that are well differentiated or contain substantial desmoplasia are more difficult to diagnose when using cytology alone. 4 Wiersema M.J. Vilmann P. Giovannini M. Chang K.J. Wiersema L.M. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997; 112: 1087-1095 Abstract Full Text PDF PubMed Scopus (1074) Google Scholar Finally, EUS-FNA typically yields a small biopsy sample and destroys the tissue architecture, thereby limiting the diagnostic sensitivity for lesions such as GI stromal tumors and lymphomas. 4 Wiersema M.J. Vilmann P. Giovannini M. Chang K.J. Wiersema L.M. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997; 112: 1087-1095 Abstract Full Text PDF PubMed Scopus (1074) Google Scholar , 7 Ribeiro A. Vazquez-Sequeiros E. Wiersema L.M. Wang K.K. Clain J.E. Wiersema M.J. EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma. Gastrointest Endosc. 2001; 53: 485-491 Abstract Full Text Full Text PDF PubMed Scopus (182) Google Scholar , 8 Erickson R.A. Sayage-Rabie L. Beissner R.S. Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies. Gastrointest Endosc. 2000; 51: 184-190 Abstract Full Text Full Text PDF PubMed Scopus (351) Google Scholar