ENDOSONOGRAPHICALLY GUIDED FINE-NEEDLE ASPIRATION PUNCTURE OF PARAESOPHAGOGASTRIC MASS LESIONS - PRELIMINARY-RESULTS

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.