Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions.
- Author:
Hea Jung SUNG
1
;
Yu Kyung CHO
;
Eun Young PARK
;
Sung Jin MOON
;
Chul Hyun LIM
;
Jin Su KIM
;
Jae Myung PARK
;
In Seok LEE
;
Sang Woo KIM
;
Myung Gyu CHOI
;
Kyu Yong CHOI
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. ykcho@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Accuracy;
Endoscopic ultrasound-guided fine needle aspiration;
Extraintestinal mass;
Intramural mass;
Yield
- MeSH:
Biopsy, Fine-Needle*;
Diagnosis;
Diagnostic Errors;
Duodenum;
Endoscopic Ultrasound-Guided Fine Needle Aspiration;
Esophagus;
Follow-Up Studies;
Humans;
Judgment;
Stomach;
Ultrasonography*
- From:Clinical Endoscopy
2013;46(6):627-632
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions. METHODS: Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging. RESULTS: Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology. CONCLUSIONS: EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.
