CT-Guided Percutaneous Needle Biopsy in Patients with Suspected Retroperitoneal Fibrosis: A Retrospective Cohort Study

Koike, Yuya; Matsui, Shinobu; Takase, Koichiro; Tannai, Hiromitsu

doi:10.1007/s00270-019-02266-x

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Moreover, unlike CT-guided biopsy, EUS-FNA/FNB does not expose the patient to additional radiation. Our two cases demonstrate that the biopsy procedure was relatively fast (approximately 25 and 20 minutes) when compared to a retrospective study by Koike et al [5], who reported a mean time of 31.5 min ± 13.2 for CT-guided biopsies in patients with suspected RPF.…”

Section: Discussionsupporting

confidence: 40%

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Role of transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of retroperitoneal fibrosis (Ormond’s disease)

2023

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Background Retroperitoneal fibrosis (RPF), often referred to as Ormond’s disease when it is of idiopathic origin, is a rare disease characterized by the presence of inflammatory infiltrates and periaortic masses in the retroperitoneum. For a definite diagnosis, a biopsy and subsequent pathological examination is required. Currently accepted methods for retroperitoneal biopsy include open, laparoscopic, or CT-guided approaches. However, transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of RPF has attracted only little attention in the literature. Case Reports We report two male patient cases who presented with leukocytosis, elevated C-reactive protein, and a suspicious retroperitoneal mass of unknown origin on computed tomography. One patient also reported left lower quadrant pain, whereas the other patient suffered from back pain and weight loss. In both patients, idiopathic RPF was successfully diagnosed by using transduodenal EUS-FNA/FNB with 22- and 20-gauge aspiration needles. Histopathology revealed dense lymphocytic infiltrates and fibrosis. The procedures lasted approximately 25 and 20 minutes, respectively, and in both patients no serious adverse events occurred. Treatment included steroid therapy and administration of Azathioprine. Conclusion We demonstrate that using EUS-FNA/FNB to diagnose RPF is a feasible, fast, and safe method, which should always be considered as a first-line diagnostic modality. Hence, this case report emphasizes that gastrointestinal endoscopists are likely to play an important role in the setting of suspected RPF.

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Section: Discussionsupporting

confidence: 40%

“…Initial detection of a suspicious mass is often done by using computed tomography (CT), or magnetic resonance imaging (MRI) [2,3]. Subsequent tissue sampling for histologic confirmation is commonly performed via modalities such as CT-guided, laparoscopic, or open biopsy [4,5]. However, these modalities entail some disadvantages.…”

Section: Introductionmentioning

confidence: 99%

Role of transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of retroperitoneal fibrosis (Ormond’s disease)

2023

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“…Der Hybridbildgebung, sowohl mit der FDG-PET/CT als auch der FDG-PET/MRT, kommt somit im Rahmen der Bildgebung der RPF eine spezielle Rolle zu, da sie sich exzellent zur Quantifizierung und Vorhersage eines Therapieansprechens eignet, entsprechende Anpassungen der medikamentösen Therapie zulässt und potenziell frühere Entfernungen von etwaigem Fremdmaterial wie Stents und Kathetern ermöglicht [3,35] Abgrenzung zu maligner Genese Einer der wichtigsten Herausforderungen an die bildgebende Diagnostik ist die Differenzierung gegenüber anderen, vor allem inflammatorischen und malignen Erkrankungen des Retroperitoneums. Die CT-gesteuerte histologische Sicherung der Fibrose vor Einleitung einer medikamentösen Therapie ist eine sichere Methode, wird aber weiterhin kontrovers diskutiert [36]. Insbesondere die Differenzierung gegenüber malignen Erkrankungen wird von Befürwortern der histologischen Sicherung ins Feld geführt, wobei vor allem Klinik und Labor in Zusammenschau mit einer präzisen Bildgebung, welche interdisziplinär diskutiert werden sollte, Malignome in den wohl meisten Fällen ausschließen können (▶ Abb.…”

Section: Hybridbildgebungunclassified

Retroperitoneal Fibrosis and its Differential Diagnoses: The Role of Radiological Imaging

Peisen

Thaiss

Ekert

et al. 2020

Rofo

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Background Retroperitoneal fibrosis is a rare disease with an incidence of 0–1/100 000 inhabitants per year and is associated with chronic inflammatory fibrosis of the retroperitoneum and the abdominal aorta. This article sheds light on the role of radiological imaging in retroperitoneal fibrosis, names various differential diagnoses and provides an overview of drug and surgical treatment options. Methods A literature search for the keywords “retroperitoneal fibrosis” and “Ormond’s disease” was carried out in the PubMed database between January 1, 1995 and December 31, 2019 (n = 1806). Mainly original papers were selected, but also reviews, in English and German language, with a focus on publications in the last 10 years, without excluding older publications that the authors believe are relevant to the topic discussed in the review (n = 40). Results and Conclusion Ormond’s disease is a rare but important differential diagnosis for nonspecific back and flank pain. Imaging diagnostics using CT or MRI show a retroperitoneal mass, which must be differentiated from lymphoma, sarcoma, multiple myeloma and Erdheim-Chester disease. Patients have an excellent prognosis under adequate therapy. FDG-PET/CT or FDG-PET/MRT should be considered as potential modalities, as hybrid imaging can evaluate both the morphological changes and the inflammation. Key Points: Citation Format

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“…Retroperitoneal biopsy is usually performed via open, laparoscopic, and CT‐guided approaches 5 . CT‐guided percutaneous needle biopsy of the retroperitoneal lesion is less invasive and is the preferred choice but is considered technically challenging because of the extensive depth of the lesions and their proximity to vital structures such as vessels and ureters 6 . A recent study demonstrated that EUS‐FNB was useful for the histological diagnosis of type 1 autoimmune pancreatitis in IgG4‐related disease 7 .…”

Section: Figurementioning

confidence: 99%

“…5 CTguided percutaneous needle biopsy of the retroperitoneal lesion is less invasive and is the preferred choice but is considered technically challenging because of the extensive depth of the lesions and their proximity to vital structures such as vessels and ureters. 6 A recent study demonstrated that EUS-FNB was useful for the histological diagnosis of type 1 autoimmune pancreatitis in IgG4-related disease. 7 Furthermore, the latest prospective study on the diagnosis of type 1 autoimmune pancreatitis demonstrated that the diagnostic accuracy of 22-gauge Franseen needles was higher than that of 20-gauge forward-bevel needles.…”

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confidence: 99%

Idiopathic retroperitoneal fibrosis diagnosed by endoscopic ultrasonography‐guided fine‐needle biopsy

et al. 2020

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We demonstrate a case, in which endoscopic ultrasonography‐guided fine‐needle biopsy (EUS‐FNB) was useful for determining the diagnosis of lesions of retroperitoneal fibrosis. In our case, accessing the retroperitoneal lesions by conventional percutaneous biopsy procedures was not feasible due to the difficulty of avoiding the inferior vena cava and ureter. We believe that our case demonstrates a unique approach for performing histological analysis in a challenging case.

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CT-Guided Percutaneous Needle Biopsy in Patients with Suspected Retroperitoneal Fibrosis: A Retrospective Cohort Study

Cited by 6 publications

References 11 publications

Role of transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of retroperitoneal fibrosis (Ormond’s disease)

Role of transduodenal endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) for diagnosis of retroperitoneal fibrosis (Ormond’s disease)

Retroperitoneal Fibrosis and its Differential Diagnoses: The Role of Radiological Imaging

Idiopathic retroperitoneal fibrosis diagnosed by endoscopic ultrasonography‐guided fine‐needle biopsy

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