Abstract
Mass lesions adjacent to the gastroesophageal wall can be visualized in detail by
endoscopic ultrasonography. However, in many patients tissue diagnosis of these mass
lesions is urgently required. We evaluated the efficiency of transmural fine-needle
aspiration puncture guided by endosonography for cytological confirmation of such
mass lesions. Endosonographically guided transmural fine-needle aspiration (EUS-guided
FNA) puncture was performed in 12 patients with extrinsic mass lesions adjacent to
the gastro-esophageal wall. In seven patients a malignant tumor and in four patients
a benign lesion, were identified by EUS-guided FNA puncture, while in one patient
no diagnostic tissue specimen could be obtained. No complications were observed. The
cytological result of a malignant lesion was confirmed in six patients either by autopsy
(n = 3), resection of tumor metastasis (n = 1) or by demonstration of a local recurrence
of a previously histopathologically diagnosed carcinoma (n = 2), while the benign
cytological results in four patients were confirmed by a follow-up period of at least
13 months (n = 3) and appropriate diagnostic tests (n = 1). It is concluded that EUS-guided
FNA puncture is an efficient diagnostic technique for the assessment of malignancy
and tissue diagnosis of extrinsic paragastroesophageal mass lesions. An important
precondition for the successful performance of transmural EUS-guided FNA puncture
is the application of endosonographic transducers with longitudinal scanning in the
axis of the endoscope.
