Document Detail

The additional value of EUS-guided Tru-cut biopsy to EUS-guided FNA in patients with mediastinal lesions.
MedLine Citation:
PMID:  19249038     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: EUS-guided FNA is a sensitive method to obtain cytologic specimens from solid lesions in close proximity to the GI tract. Although FNA provides cells for analysis, large-caliber Tru-cut biopsy (EUS-TCB) needles obtain samples that can be used for additional histopathologic analysis. We assessed the additional diagnostic yield of EUS-TCB in patients with solid mediastinal lesions in whom EUS-FNA was performed. PATIENTS AND DESIGN: In the period from July 2003 to July 2007, all patients with mediastinal lesions accessible to EUS-FNA and EUS-TCB were evaluated. In all patients, a mean of 3 passes of EUS-FNA was followed by EUS-TCB. Cytologic and histologic specimens were evaluated by 2 pathologists blinded for patient condition. A final diagnosis was obtained by combining all information present (EUS-FNA and EUS-TCB results, mediastinoscopy, bronchoscopy [if performed], and other investigations). RESULTS: The diagnostic accuracy of EUS-FNA, EUS-TCB, and the combination of both techniques was 93%, 90%, and 98%, respectively (not significant). In EUS-FNA-negative patients, EUS-TCB provided a final diagnosis in an additional 3 patients (5%). Malignant disease found by EUS-FNA could be specified by EUS-TCB in 15 patients (25% of patients). The granulomatous disease established by cytologic samples of clinically suspected tuberculosis could be specified by EUS-TCB in 2 patients (3%). In 1 patient (2%), both FNA and TCB were inconclusive. LIMITATIONS: Retrospective study. CONCLUSIONS: The diagnostic yield of EUS-FNA and EUS-TCB is comparable. We recommend limiting the use of EUS-TCB to specific cases in which EUS-FNA is not conclusive.
Lieke P V Berger; Robert C H Scheffer; Bas L A M Weusten; Cees A Seldenrijk; Peter C de Bruin; Robin Timmer; Mark F J Stolk
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Publication Detail:
Type:  Journal Article     Date:  2009-02-26
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  69     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-04     Completed Date:  2009-08-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1045-51     Citation Subset:  IM    
Department of Gastroenterology, St Antonius Hospital, Nieuwegein, the Netherlands.
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MeSH Terms
Aged, 80 and over
Biopsy, Needle / instrumentation*
Diagnosis, Differential
Granuloma / pathology,  ultrasonography*
Lymph Nodes / pathology
Mediastinal Diseases / pathology*,  ultrasonography*
Mediastinal Neoplasms / pathology*,  ultrasonography*
Middle Aged
Observer Variation
Predictive Value of Tests
Sarcoidosis / pathology,  ultrasonography
Ultrasonography, Interventional*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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