Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using a 20-Gauge Menghini Needle with a Lateral Forward Bevel and a 22-Gauge Franseen Needle: A Single-Center Large Cohort Study

Abstract

Background/Aims: Several fine-needle biopsy (FNB) needles are available for endoscopic ultrasound (EUS)-guided tissue acquisition. However, there is disagreement on which type of needle has the best diagnostic yield. The aim of this study was to compare the performance and safety of two commonly used EUS-FNB needles. Methods: We retrospectively analyzed consecutive patients who underwent EUS-FNB between June 2016 and March 2020 in our hospital. Two types of needles were evaluated: a 20-gauge Menghini needle with a lateral forward bevel and a 22-gauge Franseen needle. Rapid on-site evaluation was performed in all the cases. A multivariate analysis was performed to clarify the negative predictive factors for obtaining a histological diagnosis. Propensity score matching was performed to compare the diagnostic yields of these two needles. Results: We analyzed 666 patients and 690 lesions. The overall diagnostic rate of histology alone was 88.8%, and the overall adverse event rate was 1.5%. Transduodenal access and small lesions (≤2 cm) were identified as negative predictive factors for obtaining a histological diagnosis. After propensity score matching, 482 lesions were analyzed. The diagnostic accuracy rates of histology in the M and F needle groups were 89.2% and 88.8%, respectively (p=1.00). Conclusions: Both the needles showed high diagnostic yield, and no significant difference in performance was observed between the two. Clin Endosc 2021 Mar 4. [Epub ahead of print]

Pancreatic follicular lymphoma: a report of two cases and literature review

“…While we successfully reached a diagnosis in Case 1 after a single EUS-FNA session, Case 2 could not be diagnosed despite obtaining satisfactory samples in 16 EUS-FNA passes during three different sessions over a course of 6 months. Diagnosis could not be reached in Case 2 despite using both Menghini needles and Franseen needles, both of which have high diagnostic yield [24,25]. Repeated CD10 negativity was the key factor precluding the diagnosis of PPFL.…”

Primary Pancreatic Lymphoma: Endosonography-Guided Tissue Acquisition Diagnosis

“…Obtaining more tissue fragments allows adequate histological examination with routine staining, along with the use of auxiliary methods such as immunohistochemistry, genetic and molecular tests. For flow cytometry (FC), the collected material is sent fresh in an appropriate transport liquid [12]. Precise diagnosis helps in early chemotherapy treatment, improving the prognosis of the disease [4,5].…”

Diagnostic Yield of Serial Pancreatic Juice Aspiration Cytologic Examination With Brush Cytology for Pancreatic Ductal Stenosis

“…Pancreatic masses visualized on EUS can be further evaluated by EUS-guided fine-needle aspiration (EUS-FNA). [4][5][6] The sensitivity, specificity, and accuracy of EUS-FNA for pancreatic lesions smaller than 2 cm are 80% to 92%, 100%, and 82% to 93%, respectively. 7,8 However, EUS-FNA cannot be performed when no mass can be visualized by EUS.…”

“…Endoscopic ultrasound (EUS) is often used to evaluate pancreatic duct (PD) caliber changes, pancreatic cystic lesions, or localized PD stenosis detected by abdominal ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). Pancreatic masses visualized on EUS can be further evaluated by EUS-guided fine-needle aspiration (EUS-FNA) 4–6 . The sensitivity, specificity, and accuracy of EUS-FNA for pancreatic lesions smaller than 2 cm are 80% to 92%, 100%, and 82% to 93%, respectively 7,8 .…”