ENDOSCOPIC ULTRASOUND-GUIDED REAL-TIME FINE-NEEDLE ASPIRATION - CLINICOPATHOLOGICAL FEATURES OF 60 PATIENTS

Diagnosis of lesions of the gastrointestinal tract and adjacent struct ures is possible using an imaging modality, endoscopic ultrasonography (EUS). Fine-needle aspiration (FNA) is a suitable and cost-effective technique Sor obtaining cytohistologic material to confirm the diagnos is. EUS is capable of both characterizing the lesion and then guiding the FNA under real-rime (RT) ultrasound guidance rising a through-the- scope needle aspiration system. The goal of this study was to determin e the diagnostic accuracy of this technique and to describe the clinic opathologic features. Sixty patients underwent EUS-guided RTFNA of 64 lesions, including pancreas (n = 45), periluminal lymph nodes (n = 12) , mediastinal and retroperitoneal masses (n = 4), and hepatobiliary ma sses (It = 3). Follow-up data were obtained by surgery, histopathology , or clinical course. Thirty-one lesions were malignant, eight were at ypical/ suspicious, 16 were non-neoplastic, and nine were non-diagnost ic. Of the 55 lesions with sufficient material for interpretation, 54 had follow-up confirmation of the RTFNA diagnosis. The calculated sens itivity and specificity Sor malignancy was 90% and 100%, respectively Diagnostic accuracy for malignancy was excellent Sor gastrointestinal associated lymph nodes (100%), mediastinal and retroperitoneal masses (100%), somewhat less so for pancreatic tumors (94%), and pool for hep atobiliary lesions (33%) EUS-guided RTFNA is accurate for sampling sma ll gastrointestinal tract-associated lesions. EUS-guided RTFNA should be considered as a procedure of choice in selected patients when the r esults will influence management decisions. (C) 1998 Wiley-Liss,Inc.