Original ArticleOptimal number of EUS-guided fine needle passes needed to obtain a correct diagnosis
Section snippets
Study design
This prospective study was performed at a tertiary referral center. The study cohort consisted of consecutive patients who presented for EUS-FNA of a lesion suspected to be malignant. The following data were collected for each patient: demographic information; symptoms; medical, surgical, social, and family history; indication for EUS; and results of previous pertinent diagnostic tests. In our experience, between one and 6 EUS-guided fine needle passes are required to make a diagnosis of
Results
Over a 6-month period, 95 consecutive patients (50 men, 45 women; mean age 62 years, range 16-92 years) underwent EUS-FNA, for diagnosis or staging, of 95 sites: pancreas (33), lymph node (43), and miscellaneous (19) (Table 1). The miscellaneous group included lesions of the mediastinum, esophagus, stomach, duodenum, adrenal gland, periportal region, porta hepatis, spleen, and rectum. There were no aspirations of ascitic fluid, pleural fluid, or liver. The median number of FNA passes required
Discussion
The aim of the present study was to determine the optimal number of EUS-guided fine needle passes required to reach a diagnosis with certainty. An optimal number would be particularly useful in institutions in which the assistance of a cytopathologist or cytotechnician is not available during EUS-FNA. FNA of lesions arising in the breast, the thyroid, and the lung is non-diagnostic in up to 32% of cases because of scant cellularity when on-site interpretation is unavailable. These specimens, in
References (20)
- et al.
Randomized controlled trial of EUS-guided fine needle aspiration techniques for the detection of malignant lymphadenopathy
Gastrointest Endosc
(2001) - et al.
The clinical utility of endoscopic ultrasound-guided fine needle aspiration in the diagnosis and staging of pancreatic carcinoma
Gastrointest Endosc
(1997) - et al.
Endoscopic ultrasound-guided fine needle aspiration biopsy using linear array and radial scanning endosonography
Gastrointest Endosc
(1997) - et al.
Endosonography-guided fine needle aspiration biopsy: diagnostic accuracy and complication assessment
Gastroenterology
(1997) - et al.
Endoscopic ultrasonography-guided fine-needle aspiration biopsy of lesions in the upper gastrointestinal tract
Gastrointest Endosc
(1995) - et al.
Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies
Gastrointest Endosc
(2000) - et al.
Triple-tissue sampling at ERCP in malignant biliary obstruction
Gastrointest Endosc
(2000) - et al.
Diagnosis of recurrent rectal carcinoma by EUS-guided fine-needle aspiration
Gastrointest Endosc
(2000) - et al.
Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (FNA) of liver lesions
Gastrointest Endosc
(1999) - et al.
Endosonographic features predictive of lymph node metastasis
Gastrointest Endosc
(1994)
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