| The additional value of EUS-guided Tru-cut biopsy to EUS-guided FNA in patients with mediastinal lesions. | |
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MedLine Citation:
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PMID: 19249038 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article Date: 2009-02-26 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 69 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-04 Completed Date: 2009-08-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 1045-51 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, St Antonius Hospital, Nieuwegein, the Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Biopsy, Needle / instrumentation* Diagnosis, Differential Endosonography* Female Granuloma / pathology, ultrasonography* Humans Lymph Nodes / pathology Male 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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