Clin Endosc.  2013 Sep;46(5):441-444.

Endoscopic Ultrasound-Fine Needle Aspiration versus Core Biopsy for the Diagnosis of Subepithelial Tumors

• Webb K
• Hwang JH

Abstract

Subepithelial lesions are frequently encountered and remain a diagnostic challenge. Imaging of subepithelial lesions using endoscopic ultrasound (EUS) can be helpful in narrowing the differential diagnosis of the lesion; however, definitive diagnosis typically requires tissue. Many methods for acquiring tissue exist including EUS-guided fine needle aspiration, Trucut biopsy, and fine needle biopsy. Obtaining adequate tissue is important for cytologic and histologic exams including immunohistochemical stains, thus a great deal of effort has been made to increase tissue acquisition in order to improve diagnostic yield in subepithelial lesions.

Keyword

Endosonography; Subepithelial masses; Endoscopic ultrasound-guided fine needle aspiration; Endoscopic ultrasound-guided core needle biopsy

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Coloring Agents
Diagnosis, Differential
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Needles
Coloring Agents

Figure

• 

  Fig. 1 Endoscopic ultrasound imaging of the gastrointestinal tract wall. White arrows point to the corresponding histologic structures and echogenicity: 1) superficial mucosa (hyperechoic); 2) deep mucosa (hypoechoic); 3) submucosa (hyperechoic); 4) muscularis propria (hypoechoic); 5) serosa and subserosal fat (hyperechoic). (a) Subepithelial tumor continuous with the muscularis propria layer.

• 

  Fig. 2 Comparison of fine needle aspiration (FNA) and core biopsy samples. (A) FNA sample obtained with a 19-gauge needle. (B) Core biopsy sample obtained with a 19-gauge ProCore (Cook Endoscopy) needle (H&E stain, ×40).

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