Background and Study Aims: The aims of this study were: firstly, to determine the usefulness of endoscopic ultrasound-guided
fine-needle aspiration (EUS-FNA) in obtaining tissue diagnosis of intramural and extraintestinal
lesions; secondly, to assess the immediate, acute, and 30-day complications in these
patients; and thirdly, to assess the impact of the tissue diagnoses on patient management.Patients and Methods: All EUS-FNAs of extraintestinal mass lesions and intramural gastrointestinal tumors
over a 26-month period were evaluated prospectively. The reference standards for the
final diagnosis were surgery (n = 20), repeat imaging (n = 12), clinical follow-up
(n = 4), or death from disease (n = 2). Four patients were lost to follow-up.Results: Forty-two consecutive patients (24 men, 18 women; mean age 59.7 years) underwent
EUS-FNA of extraintestinal mass lesions and intramural gastrointestinal tumors. Previous
attempts at tissue diagnosis had failed in 52.4 % of the patients. The EUS-FNA cytological
diagnoses included: 17 gastrointestinal stromal tumors, five esophageal cancers, five
rectal cancers, one bronchogenic cyst, one foregut duplication cyst, and 13 other
miscellaneous diagnoses. The mean number of passes needed to reach a diagnosis was
3.9 (± 2.2). The mean follow-up period was 13.1 months. The sensitivity, specificity,
positive predictive value, negative predictive value, and accuracy of EUS-FNA of extraintestinal
and intramural tumors were 97 %, 100 %, 100 %, 90 %, and 98 %, respectively. No major
complications were encountered.Conclusions: EUS-FNA is a safe and accurate method that can provide a tissue diagnosis in intramural
and extraintestinal mass lesions, especially when other modalities have failed. EUS-FNA
significantly affects the management of patients by allowing them to be allocated
to appropriate treatment and by avoiding the need for more invasive procedures to
obtain tissue diagnosis.
References
eloubeidi@uab.edu
