M. Wegener et al., ENDOSONOGRAPHICALLY GUIDED FINE-NEEDLE ASPIRATION PUNCTURE OF PARAESOPHAGOGASTRIC MASS LESIONS - PRELIMINARY-RESULTS, Endoscopy, 26(7), 1994, pp. 586-591
Mass lesions adjacent to the gastroesophageal wall can be visualized i
n detail by endoscopic ultrasonography. However, in many patients tiss
ue diagnosis of these mass lesions is urgently required. We evaluated
the efficiency of transmural fine-needle aspiration puncture guided by
endosonography for cytological confirmation of such mass lesions. End
osonographically guided transmural fine-needle aspiration (EUS-guided
FNA) puncture was performed in 12 patients with extrinsic mass lesions
adjacent to the gastro-esophageal wall. In seven patients a malignant
tumor and in four patients a benign lesion, were identified by EUS-gu
ided FNA puncture, while in one patient no diagnostic tissue specimen
could be obtained. No complications were observed. The cytological res
ult of a malignant lesion was confirmed in six patients either by auto
psy (n = 3), resection of tumor metastasis (n = 1) or by demonstration
of a local recurrence of a previously histopathologically diagnosed c
arcinoma (n = 2), while the benign cytological results in four patient
s were confirmed by a follow-up period of at least 13 months (n = 3) a
nd appropriate diagnostic tests (n = 1). It is concluded that EUS-guid
ed FNA puncture is an efficient diagnostic technique for the assessmen
t of malignancy and tissue diagnosis of extrinsic paragastroesophageal
mass lesions. An important precondition for the successful performanc
e of transmural EUS-guided FNA puncture is the application of endosono
graphic transducers with longitudinal scanning in the axis of the endo
scope.