Efficacy and safety of Endoscopic Ultrasound guided fine needle aspiration biopsy (EUS FNAB) in gastrointestinal and mediastinal disease

Background: Management of GI malignancy is determined by accurate staging (TNM) using CT, MRI and PET. These modalities have limitations with regard to tumour stage, local extension and the differentiation of benign and malignant adenopathy, which may be overcome by EUS / EUS FNAB. Aim: To assess the technical success, the diagnostic yield and complications of EUS FNAB. Method: 61 patients were referred for EUS FNAB for the evaluation of suspected or confirmed upper gastrointestinal, pancreaticobiliary and mediastinal malignancy. All patients had CT / MRI evaluation of disease prior to EUS FNAB. Results: Tissue was acquired in 97% (59/61) of cases with an average of 2 needle passes. Diagnostic yield was 84% (51/61) – Table 1. Mediastinal nodes / mass 21 Pancreatic mass, nodes, ascites 31 GI Tract primary lesions 9 Transient chest pain occurred in 2 patients following mediastinal biopsy. Nodal and ascitic fluid FNAB significantly upstaged disease and influenced management. Conclusion: EUS FNAB is a safe and effective modality for tissue diagnosis of upper gastrointestinal and thoracic benign and malignant disease.