Clin Endosc.  2013 Jul;46(4):379-383.

Concordance of Endoscopic Ultrasonography-Guided Fine Needle Aspiration Diagnosis with the Final Diagnosis in Subepithelial Lesions

Affiliations
  • 1Division of Gastroenterology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. dr_erkan799@yahoo.com
  • 2Department of General Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
  • 3Division of Gastroenterology, University of Bezmi Alem Faculty of Medicine, Istanbul, Turkey.

Abstract

BACKGROUND/AIMS
In this study we aimed to determine the rate of concordance of endoscopic ultrasonography (EUS)-guided fine needle aspiration (FNA) diagnosis with the final diagnosis obtained by surgery or endoscopic resection and follow-up in upper gastrointestinal subepithelial lesions.
METHODS
We retrospectively studied patients with subepithelial lesions who underwent EUS at our center from 2007 to 2011.
RESULTS
We had a final diagnosis in 67 patients (mean age+/-SD, 51.23+/-12.48 years; 23 [34.3%] female, 44 [65.6%] male). EUS-FNA was performed in all of the patients. On-site pathology was not performed. In nine of the patients, the obtained material which was obtained was insufficient. The cytologic examination was benign in 31 and malignant in 27 of the patients. Based on the final diagnosis, the EUS-FNA had a sensitivity of 96%, a specificity of 100%, and a diagnostic yield of 85%.
CONCLUSIONS
The diagnostic yield of EUS-FNA, in the absence of the on-site cytopathologist, is feasible for the diagnosis of subepithelial lesions of the upper gastrointestinal system.

Keyword

Endosonography; Biopsy, fine-needle; Subepithelial lesion

MeSH Terms

Biopsy, Fine-Needle
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Female
Follow-Up Studies
Humans
Retrospective Studies
Sensitivity and Specificity

Figure

  • Fig. 1 Flow chart showing diagnostic methods used in the study. FNA, fine needle aspiration.


Reference

1. Hedenbro JL, Ekelund M, Wetterberg P. Endoscopic diagnosis of submucosal gastric lesions. The results after routine endoscopy. Surg Endosc. 1991; 5:20–23. PMID: 1871670.
2. Nesje LB, Laerum OD, Svanes K, Ødegaard S. Subepithelial masses of the gastrointestinal tract evaluated by endoscopic ultrasonography. Eur J Ultrasound. 2002; 15:45–54. PMID: 12044852.
Article
3. Caletti GC, Brocchi E, Ferrari A, et al. Guillotine needle biopsy as a supplement to endosonography in the diagnosis of gastric submucosal tumors. Endoscopy. 1991; 23:251–254. PMID: 1743123.
Article
4. Buscarini E, Stasi MD, Rossi S, et al. Endosonographic diagnosis of submucosal upper gastrointestinal tract lesions and large fold gastropathies by catheter ultrasound probe. Gastrointest Endosc. 1999; 49:184–191. PMID: 9925696.
Article
5. Stelow EB, Stanley MW, Mallery S, Lai R, Linzie BM, Bardales RH. Endoscopic ultrasound-guided fine-needle aspiration findings of gastrointestinal leiomyomas and gastrointestinal stromal tumors. Am J Clin Pathol. 2003; 119:703–708. PMID: 12760289.
Article
6. Wiersema MJ, Wiersema LM, Khusro Q, Cramer HM, Tao LC. Combined endosonography and fine-needle aspiration cytology in the evaluation of gastrointestinal lesions. Gastrointest Endosc. 1994; 40(2 Pt 1):199–206. PMID: 8013822.
Article
7. Vander Noot MR 3rd, Eloubeidi MA, Chen VK, et al. Diagnosis of gastrointestinal tract lesions by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer. 2004; 102:157–163. PMID: 15211474.
Article
8. Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010; 71:913–919. PMID: 20226456.
Article
9. Watson RR, Binmoeller KF, Hamerski CM, et al. Yield and performance characteristics of endoscopic ultrasound-guided fine needle aspiration for diagnosing upper GI tract stromal tumors. Dig Dis Sci. 2011; 56:1757–1762. PMID: 21360279.
Article
10. Sepe PS, Moparty B, Pitman MB, Saltzman JR, Brugge WR. EUS-guided FNA for the diagnosis of GI stromal cell tumors: sensitivity and cytologic yield. Gastrointest Endosc. 2009; 70:254–261. PMID: 19482280.
Article
11. Hoda KM, Rodriguez SA, Faigel DO. EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc. 2009; 69:1218–1223. PMID: 19394006.
Article
12. Ando N, Goto H, Niwa Y, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc. 2002; 55:37–43. PMID: 11756912.
Article
13. Kojima T, Takahashi H, Parra-Blanco A, Kohsen K, Fujita R. Diagnosis of submucosal tumor of the upper GI tract by endoscopic resection. Gastrointest Endosc. 1999; 50:516–522. PMID: 10502173.
Article
14. Gu M, Ghafari S, Nguyen PT, Lin F. Cytologic diagnosis of gastrointestinal stromal tumors of the stomach by endoscopic ultrasound-guided fine-needle aspiration biopsy: cytomorphologic and immunohistochemical study of 12 cases. Diagn Cytopathol. 2001; 25:343–350. PMID: 11747229.
Article
15. Wehrmann T, Martchenko K, Nakamura M, Riphaus A, Stergiou N. Endoscopic resection of submucosal esophageal tumors: a prospective case series. Endoscopy. 2004; 36:802–807. PMID: 15326575.
Article
16. Fritscher-Ravens A, Sriram PV, Bobrowski C, et al. Mediastinal lymphadenopathy in patients with or without previous malignancy: EUS-FNA-based differential cytodiagnosis in 153 patients. Am J Gastroenterol. 2000; 95:2278–2284. PMID: 11007229.
Article
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