Expanding the horizons of endoscopic ultrasound: diagnosis of non-digestive pathologies

Abstract

Endoscopic ultrasound (EUS) is mainly used for the evaluation and sampling of mediastinal and abdominal lymph nodes, luminal and submucosal lesions of the upper and lower gastrointestinal tract, as well as in the diagnostic approach for pancreatic, biliary and liver disease. However, several non-digestive pathologies may be encountered as well, expanding the diagnostic potential of EUS. In this article, we present nine examples of extra-digestive abnormalities detected by means of EUS, including pathologies of the thyroid gland, mediastinal and abdominal vessels, lungs, kidney and the urinary bladder. The purpose of this article is to review the capabilities of EUS beyond routine evaluation of gastrointestinal organs.

Dysphagia aortica: Emerging role of endoscopic ultrasound (with videos)

“…The role of transesophageal echocardiography in assessing the thoracic aortic disorders is described by cardiologists and the role of EUS in differentiating mediastinal masses and has been described by gastroenterologists. [ 5 11 12 13 14 ] The role of EUS in the setting of dysphagia with hematemesis, which is a clinical emergency, has been less recognized due to the lack of generalized availability of EUS. This series illustrates the role of simultaneous EUS with EGD in diagnosing this catastrophic condition, thus minimizing the time lag for definitive surgical management.…”

EUS of the neck: A comprehensive anatomical reference for the staging of head and neck cancer (with videos)

“…[9101112] Little information is available regarding the use of EUS and EUS-FNA aspiration cytology (EUS-FNAC) to stage tumors in the head and neck region. [131415] No specific probe has been developed for EUS evaluation of the head and neck region. [1617] EUS with the help of a modified probe has shown results superior to CT and MRI in the assessment of laryngeal cancer.…”

Imaging of spaces of neck and mediastinum by endoscopic ultrasound

“…[ 6 ] Proper staging of diseased lymph nodes at different stations is possible by computed tomography (CT), positron emission tomography (PET), and PET-CT.[ 4 7 ] Ultrasonography (US) also assumes importance in the routine diagnosis, treatment, and follow-up of diseases of the head, neck, and chest. [ 8 9 10 11 ] Imaging of hollow organs by endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration cytology (FNAC) has improved accuracy in the assessment of local lymph node metastases in malignancies of the neck, esophagus, and lung when compared with CT.[ 12 13 14 ] Currently, EUS is increasingly used in the evaluation of metastatic disease, posttreatment assessment, and the detection of recurrent disease, and it offers a distinct advantage in EUS-FNAC of lymph nodes or masses that are not accessible to CT.[ 15 16 17 ]…”