Factors affecting the diagnostic accuracy of endoscopic ultrasonography‐guided fine‐needle aspiration (EUS‐FNA) for upper gastrointestinal submucosal or extraluminal solid mass lesions

Liang, Rong; Kida, Mitsuhiro; Yamauchi, Hiroshi; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Kikuchi, Hidehiko; Watanabe, Maya; Inoue, Hiroshi; Koizumi, Wasaburo

doi:10.1111/j.1443-1661.2012.01243.x

Cited by 57 publications

(47 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This technique obtains more adequate specimens than does biopsy with upper gastrointestinal endoscopy. Rong et al [5] reported that the diagnostic accuracy of EUS-FNAB for submucosal tumors was 85.2 % [5]. However, as in our case, EUS-FNAB does not always allow for a definitive pathological diagnosis.…”

Section: Discussionmentioning

confidence: 52%

See 1 more Smart Citation

Resection of an esophageal schwannoma with thoracoscopic surgery: a case report

et al. 2016

View full text Add to dashboard Cite

BackgroundEsophageal schwannomas are rare primary submucosal esophageal tumors. We herein report a case of an esophageal schwannoma that was difficult to diagnose.Case presentationA 39-year-old woman presented with chief complaints of difficulty swallowing and epigastric pain. Enhanced computed tomography of her chest revealed a tumor mass at the upper thoracic esophagus with internal heterogeneity. 18-Fluorodeoxyglucose positron emission tomography/computed tomography showed a hypermetabolic appearance matching the tumor mass; the accumulation had a maximum standardized uptake value of 5.5. We performed endoscopic ultrasound-guided fine-needle aspiration biopsy under general anesthesia, but the small specimens obtained prevented a definitive diagnosis. Thoracoscopic esophagectomy was performed due to the large size of the tumor, suspicion of its malignant potential, and the patient’s symptoms. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture in the proper muscle layer. Immunohistochemical studies showed S100 protein positivity and the absence of CD34 and c-kit. We diagnosed the tumor as a benign schwannoma.ConclusionsWe herein report a relatively rare case of schwannoma of the esophagus that was diagnosed with difficulty.

show abstract

Section: Discussionmentioning

confidence: 52%

“…The most common histological type is leiomyoma; the incidence of schwannoma among benign tumors is low [1–5]. Esophageal schwannomas are difficult to definitively diagnose by biopsy because they are located in the submucosal tissue.…”

Section: Introductionmentioning

confidence: 99%

Resection of an esophageal schwannoma with thoracoscopic surgery: a case report

et al. 2016

View full text Add to dashboard Cite

show abstract

“…EUS-FNA for gastric infiltrative tumors can be used to acquire cytology findings, but for large tissue specimens for histopathology analysis, with the disadvantages of difficult operations, long time and high expenses, the positive finding rate is still undesirable[14-16]. Al-Haddad et al[17] reported that the sensitivity, specificity and accuracy rates of EUS-FNA in the diagnosis of lymphoma were 80%-87%, 92%-93%, and 83%-89%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided cutting of holes and deep biopsy for diagnosis of gastric infiltrative tumors and gastrointestinal submucosal tumors using a novel vertical diathermic loop

Liu¹,

Yang²

2017

WJG

View full text Add to dashboard Cite

AIMTo report on a more accurate diagnostic possibility offered by endoscopic ultrasound-guided cutting of holes and deep biopsy (EUS-CHDB) for pathologic diagnosis of gastric infiltrative tumors and gastrointestinal submucosal tumors.METHODSTen consecutive patients who were suspected of having gastric invasive tumors or gastrointestinal submucosal tumors underwent EUS-CHDB with a novel vertical diathermic loop. We reviewed their medical data and analysed the effectiveness and safety of this new method. The final diagnosis was based on the surgical pathology or clinical/imaging follow-up.RESULTSEUS-CHDB was performed successfully in all the ten patients. Neither severe haemorrhage nor perforation occurred in any patient. Among the ten patients, there were three cases of gastric linitis plastica, one case of gastric lymphoma, five cases of gastrointestinal stromal tumors (GISTs), and only one case of chronic non-atrophic gastritis. That is, nine (90%) of the cases treated by EUS-CHDB showed positive findings.CONCLUSIONEUS-CHDB may be a technically feasible and safe option for patients with gastric infiltrative tumors or gastrointestinal submucosal tumors. EUS-CHDB may be used as a remedial or even preferred biopsy method for submucosal lesions.

show abstract

“…Needle diameter has not been definitively shown to significantly impact the diagnostic accuracy of EUS-FNA for subepithelial lesions [32,33], but 25-gauge needles may more easily puncture small, mobile lesions, as well as those within or adjacent to the duodenum when the scope tip may be acutely angulated.…”

Section: Endoscopic Ultrasound-guided Fine Needle Aspirationmentioning

confidence: 99%