AI Article Synopsis
- EUS-guided Fine Needle Aspiration (FNA) is a method for obtaining cell samples from solid lesions near the gastrointestinal tract, while larger Tru-cut biopsy (EUS-TCB) needles provide samples for deeper analysis.* -
- A study assessed the effectiveness of these two techniques in diagnosing solid mediastinal lesions, finding that while both had high diagnostic accuracy (EUS-FNA at 93% and EUS-TCB at 90%), the combination of both improved accuracy to 98%.* -
- The findings suggest that EUS-FNA and EUS-TCB provide similar diagnostic yields, with EUS-TCB offering additional information in certain cases, leading to recommendations for its use only when EUS
Article Abstract
Background And Objective: EUS-guided FNA is a sensitive method to obtain cytologic specimens from solid lesions in close proximity to the GI tract. Although FNA provides cells for analysis, large-caliber Tru-cut biopsy (EUS-TCB) needles obtain samples that can be used for additional histopathologic analysis. We assessed the additional diagnostic yield of EUS-TCB in patients with solid mediastinal lesions in whom EUS-FNA was performed.
Patients And Design: In the period from July 2003 to July 2007, all patients with mediastinal lesions accessible to EUS-FNA and EUS-TCB were evaluated. In all patients, a mean of 3 passes of EUS-FNA was followed by EUS-TCB. Cytologic and histologic specimens were evaluated by 2 pathologists blinded for patient condition. A final diagnosis was obtained by combining all information present (EUS-FNA and EUS-TCB results, mediastinoscopy, bronchoscopy [if performed], and other investigations).
Results: The diagnostic accuracy of EUS-FNA, EUS-TCB, and the combination of both techniques was 93%, 90%, and 98%, respectively (not significant). In EUS-FNA-negative patients, EUS-TCB provided a final diagnosis in an additional 3 patients (5%). Malignant disease found by EUS-FNA could be specified by EUS-TCB in 15 patients (25% of patients). The granulomatous disease established by cytologic samples of clinically suspected tuberculosis could be specified by EUS-TCB in 2 patients (3%). In 1 patient (2%), both FNA and TCB were inconclusive.
Limitations: Retrospective study.
Conclusions: The diagnostic yield of EUS-FNA and EUS-TCB is comparable. We recommend limiting the use of EUS-TCB to specific cases in which EUS-FNA is not conclusive.
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| http://dx.doi.org/10.1016/j.gie.2008.09.034 | DOI Listing |
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