Endoscopic ultrasound-guided fine needle aspiration: How to obtain a core biopsy?

Fuccio, Lorenzo; Larghi, Alberto

doi:10.4103/2303-9027.123011

Cited by 25 publications

(9 citation statements)

References 60 publications

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“…Second, ROSE was not performed in this study. The sensitivity of EUS-FNA is known to depend on the availability of an on-site cytopathology assessment, which has been clearly demonstrated to significantly influence both the diagnostic accuracy and the proportions of indeterminate and unsatisfactory samples [17, 18]. However, as we could confirm the presence of white/tan tissue macroscopically in most samples obtained using the Franseen needle, this method may overcome this limitation and reduce the necessity of ROSE.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

Ishikawa

Kawashima

Ohno

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims. Several studies have shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a Franseen needle for histological assessment. However, studies focusing on pancreatic diseases are limited and the safety of this method has not been well assessed. We aimed to assess the current status and issues of EUS-FNB in the diagnosis of pancreatic diseases. Materials and Methods. We retrospectively reviewed 87 consecutive EUS-FNB specimens using either a 22-gauge Franseen needle (Group A, N = 51) or a conventional 22-gauge fine-needle aspiration needle (Group B, N = 36) for pancreatic diseases, and the diagnostic accuracy and safety were compared. Final diagnoses were obtained based on surgical pathology or a minimum six-month clinical follow-up. Results. Although the diagnostic accuracy for malignancy was 96.1% in Group A versus 88.9% in Group B, with no statistically significant difference (P = 0.19), the median sample area was significantly larger in Group A (4.07 versus 1.31mm2, P < 0.0001). There were no differences between the two needles in the locations from which the specimens were obtained. Adverse events occurred in one case (2%) in Group A (mild pancreatitis) and none in Group B with no statistical significance (P = 0.586). Although there was no case of bleeding defined as adverse events, 2 cases in Group A showed active bleeding during the procedure with increase in the echo-free space, which required CT scanning to rule out extravasation. Eventually, the bleeding stopped spontaneously. Conclusions. Given its guaranteed ability to obtain core specimens and comparable safety, and although the risk of bleeding should be kept in mind, EUS-FNB using a Franseen needle is likely to become a standard procedure for obtaining pancreatic tissue in the near future.

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Section: Discussionmentioning

confidence: 99%

Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

Ishikawa

Kawashima

Ohno

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

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“…In a review paper by Larghi and Fuccio [7] , the performance of EUS biopsy by a 19-G needle in 12 studies had a cumulative technical success and a diagnostic accuracy above 90%. Yasuda et al [8] demonstrated that 88% of the 152 patients diagnosed with lymphoma were able to be classified in accordance with the World Health Organization (WHO) system.…”

Section: Introductionmentioning

confidence: 99%

Flexible 19-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle: First Experience

Tyan

Patel²,

Czarnecka³

et al. 2017

Respiration

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Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established first-line invasive modality for mediastinal lymph node staging in lung cancer patients and in the diagnostic workup of patients with mediastinal adenopathy. With the current 21- and 22-gauge (G) EBUS-TBNA needles, the procedure can be limited by the degree of flexibility in the needle and the size of the lumen in tissue acquisition. Objective: We report our initial experience with a first-generation flexible 19-G EBUS-TBNA (Flex 19G; Olympus Respiratory America, Redmond, WA, USA) needle with regards to efficacy and safety. Methods: The Flex 19G EBUS-TBNA needle was used in 47 selected patients with enlarged hilar and/or mediastinal lymphadenopathy at 3 centers. The standard Olympus EBUS scope with a 2.2-mm working channel was used in all cases. Results: The diagnostic yield of the Flex 19G needle according to clinical cytopathology reports was 89% (42/47). The diagnosis and their respective diagnostic yield with the Flex 19G EBUS-TBNA needle were malignancy 24/27 (89%), sarcoidosis 13/14 (93%), and reactive lymph node hyperplasia 5/6 (83%). The mean short axis of the sampled lymph nodes was 19 ± 9 mm. No complications occurred except for 1 instance of moderate bleeding, which did not require intervention beyond suctioning and subsequently resolved. All 13 patients diagnosed with adenocarcinoma by the 19-G needle had sufficient tissue for genetic testing. Conclusion: EBUS-TBNA using the first-generation Flex 19G needle is feasible and safe with promising diagnostic yield while providing a greater degree of flexion with the Olympus EBUS scope. Additional clinical evaluations are warranted.

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“…[ 13 ] Therefore, EUS-guided tissue acquisition can be a useful diagnostic method when a core biopsy tissue is necessary for a pathological confirmation. [ 14 15 ] In the present case, based on the EUS-FNA cytology findings, other tumors demonstrating dispersed plasmacytoid cell patterns, such as pancreatic neuroendocrine tumor, melanoma, and lymphoma with plasmacytic differentiation, could be considered in the differential diagnosis. Additional immunostaining using the FNAB specimen was helpful in confirming the diagnosis.…”

Section: Discussionmentioning

confidence: 92%

Extramedullary plasmacytoma mimicking pancreatic cancer: A case report and literature review

et al. 2017

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Pancreatic adenocarcinoma may account for more than 80% of all pancreatic neoplasms. Occasionally, other rare tumors such as lymphoma, metastatic tumor, and solid pseudopapillary neoplasm can be considered in the differential diagnosis. We report the case of an 82-year-old man with a pancreatic solid mass. This case suggests that endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) with biopsy, that is, EUS-FNA is recommended in the differential diagnosis of the pancreatic solid mass apart from pancreatic adenocarcinoma. In particular, the histologic core obtained by EUS-guided biopsy is helpful for the immunostaining of molecular markers to confirm the final diagnosis.

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Endoscopic ultrasound-guided fine needle aspiration: How to obtain a core biopsy?

Cited by 25 publications

References 60 publications

Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

Flexible 19-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle: First Experience

Extramedullary plasmacytoma mimicking pancreatic cancer: A case report and literature review

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