Aim: Endoscopic ultrasound (EUS) has become an indispensable method for diagnosis in gastroenterology and new indications for EUS continue to emerge. However, there are limited data regarding the accuracy of EUS-guided biopsy of hepatic focal lesions. The aim of this study was to assess the diagnostic yield of EUS-guided fine needle aspiration (FNA) of focal liver lesions.Material and methods: We conducted a prospective study in which patients with focal liver lesions, detected by transabdominal ultrasound and computed tomography or magnetic resonance imaging, underwent EUS-guided FNA to determine the diagnostic yield of the procedure.Results: In 47/48 of patients, the results of EUS-FNA were positive for malignancy, while in one case the acquired fragment was insufficient for appropriate histological analysis. Diagnostic yield was 0.98. In 83% of the cases biopsies were taken from the left lobe and in 17% from the right lobe with the same technical success rate. The most common diagnosis was metastatic adenocarcinoma of the pancreas (26% cases) followed by cholangiocarcinoma (17% cases). Concurrent sampling of other sites in addition to the liver and/or primary tumor was realized in 35% of the cases, with results that correlated with the liver biopsy and with the primary tumor biopsy. We reported no immediate or long-term complications in any of the patients.Conclusions: EUS guided fine needle aspiration/biopsy of focal liver lesions is safe, provides a very high diagnostic accuracy and should not be considered only as a rescue method after failure of percutaneous guided biopsies.
Endoscopic ultrasonography (EUS) has become an indispensable method for diagnosis and therapeutic procedures in gastroenterology. As experience with this technique grows, new indications continue to emerge. Due to the vicinity of the transducer to the liver, endoscopic ultrasonography provides detailed images of the liver segments and its vascular and biliary structures. Endosonographers have made an effort to define a clinical role for endoscopic ultrasound in liver diseases; however, not much is known about endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in hepatic focal lesions. This review summarizes the available evidence regarding the usefulness of endoscopic ultrasound-guided fine needle aspiration in patients with focal liver lesions.
Aims: There are few data on the use of endoscopic ultrasound (EUS) for the biopsy of suspected malignant lesions of the lung. The main objective of this study was to evaluate the performance of transesophageal EUS fine needle aspiration (EUSFNA) for the diagnosis of paraesophageal lung tumors and also for the confirmation of metastatic sites of lung cancer during the same procedure.Material and methods: We performed a retrospective study in a tertiary care unit including 19 patientswith paraesophageal lung tumors referred to our department for a lung biopsy. Transesophageal EUS-FNA was performed using a linear echoendoscope and 22G needles.Results: In all 19 patients with suspected lung tumors the confirmation of the malignant disease was achieved. Pathological examination revealed 16 cases of non-small cell lung cancers, 2 small cell lung cancers and one case of lung metastases. Diagnostic yield of lung EUS-FNA was 1, with no post-procedural complications. In 7 cases, we performed also biopsies of suspected metastasis and all biopsies revealed the same histopathological type as the primary tumor.Conclusions: Our study supports the use of this minimally invasive technique for paraesophageally locatedlung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield.
Background/Aim: Endoscopic ultrasound (EUS)guided liver tumor biopsy has some advantages over the percutaneous and surgical route and, in many cases, should be preferred. The aim of this study was to evaluate the role of EUS-fine needle aspiration (FNA) in the diagnosis of liver tumors with an emphasis on its diagnostic accuracy and histological quality of the acquired specimen. Patients and Methods: We followed 30 consecutive patients who underwent liver tumor biopsy using EUS guidance. Tissue was acquired using a 22-gauge FNA needle. Results: In 97% of patients, the results of EUS-FNA were adequate for diagnosis. In one case, the pathologist recommended a repeat biopsy. The acquired specimen was a core fragment in 81% of cases while in 19% of cases the specimen was fragmented and subsequently used as a cell block. No complications were reported. Conclusion: EUS-FNA is characterized by a high success rate on the acquisition of good-quality tissue specimens, a low rate of complications, and decreased patient discomfort. This procedure should be especially considered in the case of liver lesions that are inaccessible via the percutaneous route or when concurrent biopsies are required for accurate diagnosis. Patients and MethodsThirty patients who underwent liver tumor biopsy assisted by EUS guidance were followed between March 2020 and March 2021. The 890 This article is freely accessible online.
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