Malignant cell contamination may lead to false-positive findings at endosonographic fine needle aspiration for tumor staging

Wilson T.-Y. Kwong; Walter J. Coyle; Farnaz Hasteh; Michael R. Peterson; Thomas J. Savides; Mary L. Krinsky

doi:10.1055/s-0033-1358922

Endoscopy, Table of Contents

Endoscopy 2014; 46(02): 149-152
DOI: 10.1055/s-0033-1358922

Innovations and brief communications

Malignant cell contamination may lead to false-positive findings at endosonographic fine needle aspiration for tumor staging

Wilson T.-Y. Kwong

¹Division of Gastroenterology University of California San Diego, La Jolla, California, USA

³Division of Gastroenterology Veterans Affairs Medical Center, La Jolla, California, USA

,

Walter J. Coyle

⁴Division of Gastroenterology Scripps Clinic, La Jolla, California, USA

,

Farnaz Hasteh

²Department of Pathology University of California San Diego, La Jolla, California, USA

,

Michael R. Peterson

²Department of Pathology University of California San Diego, La Jolla, California, USA

,

Thomas J. Savides

¹Division of Gastroenterology University of California San Diego, La Jolla, California, USA

,

Mary L. Krinsky

¹Division of Gastroenterology University of California San Diego, La Jolla, California, USA

³Division of Gastroenterology Veterans Affairs Medical Center, La Jolla, California, USA

› Author Affiliations

Abstract

Background and study aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of lymph nodes is used for staging of gastrointestinal malignancies. False-positive rates of 5 % – 7 % are not well understood. Elements of EUS examinations that contribute to false-positive cytological findings were investigated.

Patients and methods: 13 patients undergoing EUS staging of gastrointestinal luminal malignancy were consecutively enrolled together with 3 patients with extraluminal tumors (pancreas, lung) defined as controls. After EUS, cellular debris and fluid were collected from the FNA needle catheter, instrument channel, and endoscope tip for cytologic and histologic investigation.

Results: 6 of 13 patients (46 %) had malignant cells contaminating the FNA needle catheter, instrument channel, or endoscope tip. Malignant cells were present in the instrument channel in 5 cases (38 %), exterior tip of echoendoscope in 4 (31 %) and needle catheter in 2 (15 %).

Conclusions: Echoendoscopes used for FNA in patients with luminal tumors are at risk for malignant cell contamination of the instrument channel, FNA needle catheter, and echoendoscope tip. FNA needle contamination can contribute to false-positive findings.

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References

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