Endoscopic ultrasound-guided fine-needle aspiration biopsy of XXXX : histological and cytological assessment.

@entity1 @entity82 @entity548 @entity96 @entity5 @entity843 @entity409 @entity117 @entity1003 @entity2286 @entity356
BACKGROUND AND STUDY AIMS: EUS-guided fine-needle aspiration biopsy (EUS-FNA) is used increasingly for the diagnosis of mediastinal, biliopancreatic, and @entity356 . However, little is known about EUS-FNA in hepatic lesions and the best method for tissue analysis. We assessed EUS-FNA combined with histological and cytological evaluation in selected @entity1 . @entity1 AND METHODS: 41 @entity1 (66 +/- 7 years) were prospectively studied, 33 of whom had clinical findings suggestive of @entity409 . Selection for EUS-FNA was based on an increased risk of @entity548 from percutaneous biopsy ( @entity1003 , @entity82 , @entity843 , @entity117 intake; n = 15), presence of small @entity96 < 2 cm (n = 12), or @entity409 found incidentally (n = 14). Transgastric EUS-FNA of lesions located in accessible liver segments was performed using the Hitachi FG-34UX longitudinal echo endoscope and a 22-G aspiration needle. Specimens were submitted separately for standard cytological and histological evaluation. In the case of @entity5 , findings at surgery with histological examination, endoscopy, or computed tomography (CT)-guided biopsy of the primary @entity5 served as reference results (n = 33), while in benign disorders, a combination of imaging studies (Magnetic Resonance Tomography <MRT>, scintigraphy) and the clinical follow-up, as summarized in the physician's report, was used as reference. RESULTS: EUS-FNA provided appropriate biopsy specimens in 40/41 @entity1 . It was not possible to aspirate sufficient material in one @entity1 . On average, 1.4 needle passes were necessary to obtain sufficient amounts of tissue. With regard to @entity5 , the combination of histological and cytological examination had a sensitivity of 94%, specificity of 100%, negative predictive value (NPV) of 78%, and positive predictive value ( @entity2286 ) of 100%. Tissue diagnoses were in agreement in 27/41 @entity1 (65%). In the remaining @entity1 , only the cytological examination identified six lesions correctly, while the histological assessment was correct in another seven @entity1 . Malignant lesions were correctly identified by cytology in 24/33 (73%) @entity1 , while histology alone was diagnostic for @entity5 in 27/33 (82%) @entity1 . When both modalities were combined, 31 out of 33- @entity5 (94%) were correctly diagnosed. Minor complications occurred in two @entity1 and consisted of self-limiting local @entity548 . CONCLUSIONS: EUS-FNA of @entity96 is a powerful, reliable, and safe procedure for the diagnosis of @entity409 . Optimal diagnostic results are achieved by combining cytological with histological assessment. Hence, EUS-FNA is an alternative to percutaneous biopsy, particularly in @entity1 at risk of @entity548 or with small lesions of the liver.
