Rescue Endoscopic Ultrasound (EUS)-Guided Trucut Biopsy Following  Suboptimal EUS-Guided Fine Needle Aspiration for Mediastinal Lesions

조창민; Mohammad Al-Haddad; Julia K. LeBlanc; Stuart Sherman; Lee McHenry; John DeWitt

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자료유형: 학술저널

저자정보: 조창민 Mohammad Al-Haddad Julia K. LeBlanc Stuart Sherman Lee McHenry John DeWitt

저널정보: 거트앤리버 발행위원회 Gut and Liver Gut and Liver 제7권 제2호

발행연도: 2013.1

수록면: 150 - 156 (7page)

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Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and Trucut biopsy (TCB) are sensitive techniques for diagnosing mediastinal lesions, but it is unclear how either one or both should be used to obtain a pathologic diagnosis. The objective of our study was to evaluate whether EUS-TCB impacts the diagnosis of mediastinal lesions after the initial on-site review of EUS-FNA specimen suggests a suboptimal result. Methods: We enrolled consecutive patients with mediastinal lesions who underwent EUS-TCB during the same procedure if the initial EUS-FNA demonstrated an inadequate FNA sample or suggested that histopathology was required for diagnosis. Diagnostic accuracies between procedures were compared as the main outcome. Results: Twenty-seven patients (14 men; median age, 56 years; range, 19 to 82 years) underwent EUS-FNA and EUS-TCB to evaluate a mediastinal lymphadenopathy or mass (n=17), to determine the cancer stage (n=3) or to exclude tumor recurrence or metastasis (n=7). The overall diagnostic accuracies of EUS-FNA and EUS-TCB were 78% and 67%, respectively (p=0.375). The combined diagnostic accuracy of EUS-FNA plus EUS-TCB was 82%. In six patients with nondiagnostic EUS-FNA, EUS-TCB provided a final diagnosis in one patient (17%). Conclusions: In the current series of patients with mediastinal masses or adenopathy, the administration of EUS-TCB following suboptimal results for the onsite cytology review did not increase the diagnostic yield.

#Endoscopic ultrasound #Endoscopic ultrasound-guided fine needle aspiration #Endoscopic ultrasound-guided Trucut biopsy #Mediastinum

참고문헌 (22)

참고문헌 신청

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