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EUS guided fine needle aspiration

Rahul Pannala, Karyn M Hallberg-Wallace, Amber L Smith, Aziza Nassar, Jun Zhang, Matthew Zarka, Jordan P Reynolds, Longwen Chen
INTRODUCTION: The increasing use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology to examine pancreatic neoplasms has led to an increase in the diagnosis of metastases to the pancreas. Renal cell carcinoma (RCC) is the most common metastasis to the pancreas. Our study examines 33 cases of metastatic RCC to the pancreas sampled by EUS-FNA from four large tertiary care hospitals. MATERIALS AND METHODS: We searched the cytopathology database for RCC metastatic to the pancreas diagnosed by EUS-FNA from January 2005 to January 2015...
2016: CytoJournal
Masayuki Shibata, Hiroyuki Matsubayashi, Akiko Todaka, Hanako Kurai, Naoyuki Tsutsumi, Keiko Sasaki, Hiroyuki Ono
A 75-year-old Japanese man was referred to our hospital to undergo the examination of an enlarged peripancreatic lymph node. Computed tomography (CT) showed a lymph node 47 mm in size that was located above the pancreas head and beneath the liver. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the enlarged lymph node was performed, and an immunohistological examination of the sample confirmed a histological diagnosis of neuroendocrine carcinoma (NEC). The patient refused treatment with chemotherapy and instead chose to undergo observation...
2016: Internal Medicine
Nikhil Sonthalia, Samit S Jain, Ravindra G Surude, Vinay B Pawar, Suhas Udgirkar, Pravin M Rathi
Esophageal squamous cell carcinoma (ESCC) is the commonest primary malignant esophageal tumor, which typically presents as endoscopically visible surface mucosal ulcerations, irregularities, or polyploidal masses. We here report a rare case of primary ESCC with completely intramural growth under a normal looking intact nondysplastic surface squamous epithelium disguising as a submucosal tumor. Upper gastrointestinal endoscopy-guided mucosal biopsy was negative for malignancy. Endoscopic ultrasound (EUS) revealed a heteroechoic solid mass originating from the muscularis propria of the distal esophagus...
2016: Clinical Medicine Insights. Gastroenterology
Raffaele Manta, Elisabetta Nardi, Nico Pagano, Claudio Ricci, Mariano Sica, Danilo Castellani, Helga Bertani, Micaela Piccoli, Barbara Mullineris, Alberto Tringali, Francesco Marini, Ugo Germani, Vincenzo Villanacci, Riccardo Casadei, Massimiliano Mutignani, Rita Conigliaro, Gabrio Bassotti, Angelo Zullo
BACKGROUND AND AIMS: Diagnosis of pancreatic neuroendocrine tumors (p-NETs) is frequently challenging. We describe a large series of patients with p-NETs in whom both pre-operative Computed Tomography (CT) and Endoscopic Ultrasonography (EUS) were performed. METHODS: This was a retrospective analysis of prospectively collected sporadic p-NET cases. All patients underwent both standard multidetector CT study and EUS with fine-needle aspiration (FNA). The final histological diagnosis was achieved on a post-surgical specimen...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Hany Sakr, Michael Cruise, Prabhleen Chahal, Claudiu Cotta, James Cook, Sricharan Chalikonda, Steven Rosenblatt, Fatima Hamadeh, Omar Al-Nourhji, Charles D Sturgis
Anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK+ LBCL) is a rare distinct type of non-Hodgkin's lymphoma that arises in association with alterations of the ALK gene. This distinct disease entity is typically associated with an aggressive clinical course and appears in light microscopic preparations as a monomorphic population of large, immunoblast-like cells. In this report, we describe a case of ALK+ LBCL diagnosed by transgastric endoscopic ultrasound-guided fine needle aspiration (EUS FNA) of splenic hilar lymph nodes...
September 30, 2016: Diagnostic Cytopathology
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Masaru Ueki, Norimasa Miura, Hajime Isomoto
Pancreatic cancer is the fifth leading cause of cancer death and has the lowest survival rate of any solid cancer. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is currently capable of providing a cytopathological diagnosis of pancreatic malignancies with a higher diagnostic power, with a sensitivity and specificity of 85%-89% and 98%-99%, compared to pancreatic juice cytology (PJC), whose sensitivity and specificity are only 33.3%-93% and 83.3%-100%. However, EUS-FNA is not effective in the cases of carcinoma in situ and minimally invasive carcinoma because both are undetectable by endoscopic ultrasonography, although PJC is able to detect them...
September 15, 2016: World Journal of Gastrointestinal Oncology
J Dušková, T Krechler, M Dvořák
OBJECTIVE: To evaluate the efficacy and the learning curve of the endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) diagnostics of pancreatic lesions over 8 years (2007-2014). MATERIAL AND METHODS: EUS-FNAB using a Linear Echoendoscope Olympus was performed in 531 patients, mostly without rapid on-site evaluation (ROSE). Smears plus cytoblock sections were used routinely. Immunocytochemistry was utilised as indicated. RESULTS: The average, satisfactory sampling rate increased from the 61...
September 23, 2016: Cytopathology: Official Journal of the British Society for Clinical Cytology
Narendra Choudhary, Rinkesh Kumar Bansal, Rajesh Puri, Rajiv Ranjan Singh, Mukesh Nasa, Vinit Shah, Haimanti Sarin, Mridula Guleria, Sanjiv Saigal, Neeraj Saraf, Randhir Sud, Arvinder S Soin
BACKGROUND AND AIMS: Etiologic diagnosis of pyrexia of unknown origin is important in patients with cirrhosis for optimal management and to prevent flare up of infectious disease after liver transplantation. However, there is very limited literature available on this subject. The present study aimed to examine the safety and impact of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) in patients with cirrhosis. METHODS: The study was conducted between January 2014 and January 2016 at a tertiary care center...
September 2016: Endoscopy International Open
Robert A Mitchell, Dylan Stanger, Constantin Shuster, Jennifer Telford, Eric Lam, Robert Enns
Background. There is a high incidence of inconclusive cytopathology at initial EUS-FNA (endoscopic ultrasound-guided fine-needle aspiration) for suspected malignant pancreatic lesions. To obtain appropriate preoperative or palliative chemotherapy for pancreatic cancer, definitive cytopathology is often required. The utility of repeat EUS-FNA is not well established. Methods. A retrospective cohort study was conducted evaluating the yield of repeat EUS-FNA in determining a cytological diagnosis in patients who had undergone a prior EUS-FNA for diagnosis of suspected malignant pancreatic lesions with inconclusive cytopathology...
2016: Canadian Journal of Gastroenterology & Hepatology
Shigeru Horiguchi, Hironari Kato, Hidenori Shiraha, Koichiro Tsutsumi, Naoki Yamamoto, Kazuyuki Matsumoto, Takeshi Tomoda, Daisuke Uchida, Yutaka Akimoto, Syou Mizukawa, Takehiro Tanaka, Koichi Ichimura, Akinobu Takaki, Takahito Yagi, Hiroyuki Okada
BACKGROUND AND AIM: Pathological grading is important in defining the therapeutic strategy in pancreatic neuroendocrine neoplasm (PNEN), but is difficult for unresectable cases. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is useful in the diagnosis of PNEN, but its usefulness for pathological grading is not well established. No studies have examined the diagnostic ability of dynamic computed tomography (CT) for pathological grading of PNEN. We investigated the usefulness of EUS-FNA and dynamic CT in the diagnosis and pathological grading of PNEN...
September 16, 2016: Journal of Gastroenterology and Hepatology
Katrina Collins, Tinera Buckley, Kevin Anderson, Michael Karasik, Saverio Ligato
Perivascular epithelioid cell tumors (PEComas) of the pancreas are extremely rare mesenchymal tumors and to our knowledge, only 17 cases have been reported in the English literature to date. We report our experience with a new case of primary pancreatic PEComa diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) complemented by tissue cell block and immunohistochemistry. The patient was a 54-year-old female whose chief complaint was intermittent severe right upper quadrant abdominal pain...
September 15, 2016: Diagnostic Cytopathology
Se Hun Oh, Jong Kyun Lee, Kyu Taek Lee, Kwang Hyuck Lee, Young Sik Woo, Dong Hyo Noh
Background/Aims: The objective of this study was to investigate the value of cyst fluid carcinoembryonic antigen (CEA) in combination with cytology and viscosity for the differential diagnosis of pancreatic cysts. Methods: We retrospectively reviewed our data for patients who underwent endoscopic ultrasound guided fine needle aspiration (EUS-FNA) and cyst fluid analysis. We investigated the sensitivity, specificity and accuracy of the combination of cyst fluid CEA, cytology and viscosity testing...
September 9, 2016: Gut and Liver
Marc Giovannini, Fabrice Caillol, Geneviève Monges, Flora Poizat, Anne-Isabelle Lemaistre, Bertrand Pujol, Damien Lucidarme, Laurent Palazzo, Bertrand Napoléon
BACKGROUND AND STUDY AIMS: The differential diagnosis of solid pancreatic masses by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently suboptimal in centers that are not equipped with rapid on-site evaluation. Needle-based confocal laser endomicroscopy (nCLE) enables real-time in vivo microscopic imaging during endoscopy. This study aimed to describe nCLE interpretation criteria for the characterization of pancreatic masses, with histopathological correlation, and to perform the first validation of these criteria...
October 2016: Endoscopy
Rawad Mounzer, Roy Yen, Carrie Marshall, Sharon Sams, Sanjana Mehrotra, Mohamed Sherif Said, Joshua C Obuch, Brian Brauer, Augustin Attwell, Norio Fukami, Raj Shah, Stuart Amateau, Matthew Hall, Lindsay Hosford, Robert Wilson, Amit Rastogi, Sachin Wani
BACKGROUND AND AIMS: Endoscopic ultrasound with fine needle aspiration (EUS-FNA) has become the standard of care in the evaluation of solid pancreatic lesions. Limited data exist on interobserver agreement (IOA) among cytopathologists in assessing solid pancreatic EUS-FNA specimens. This study aimed to evaluate IOA among cytopathologists in assessing EUS-FNA cytology specimens of solid pancreatic lesions using a novel standardized scoring system and to assess individual clinical and cytologic predictors of IOA...
July 2016: Endoscopy International Open
Akane Yamabe, Atsushi Irisawa, Goro Shibukawa, Koki Hoshi, Mariko Fujisawa, Ryo Igarashi, Ai Sato, Takumi Maki, Hiroshi Hojo
We report on a 75-year-old man who was admitted due to pancreatic cystic lesion accompanied by a solid mass with liver metastasis. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed on the solid mass, and pathological findings revealed the lesion to be an adenocarcinoma diagnosed as intraductal papillary mucinous carcinoma (IPMC). Approximately 3 months after, a cystic subepithelial lesion appeared in the posterior gastric wall where the EUS-FNA had been performed. We performed EUS-FNA again, which revealed that the cystic mass was IPMC with pathology similar to the original lesion...
July 2016: Endoscopy International Open
Bartosz Adamowicz, Thibaut Manière, Vincent Déry, Étienne Désilets
Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain). Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions...
2016: Case Reports in Medicine
Tetsuhide Ito, Susumu Hijioka, Toshihiko Masui, Atsuko Kasajima, Yuji Nakamoto, Noritoshi Kobayashi, Izumi Komoto, Masayuki Hijioka, Lingaku Lee, Hisato Igarashi, Robert Thomas Jensen, Masayuki Imamura
Several new developments have occurred in the field of pancreatic neuroendocrine neoplasm (PNEN) recently in Japan. First, the utility of chromogranin A (CgA), useful for the diagnosis and monitoring of the treatment response of neuroendocrine neoplasm (NEN), has been demonstrated in Japan. For PNEN diagnosis and treatment, grading and correct histological diagnosis according to the WHO 2010 classification is important. Regarding the histological diagnosis, the advent of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has enabled correct pathological diagnosis and suitable treatment for the affected tissue...
August 18, 2016: Journal of Gastroenterology
Junpei Sasajima, Jiro Uehara, Takuma Goto, Shugo Fujibayashi, Kazuya Koizumi, Yusuke Mizukami, Akemi Ishida-Yamamoto, Mikihiro Fujiya, Toshikatsu Okumura
BACKGROUND: Pancreatic involvement of angiosarcoma is extremely rare. METHODS: We herein report a rare case of angiosarcoma associated with chronic lymphedema (Stewart-Treves syndrome) with pancreatic metastasis that was diagnosed using endoscopic ultrasound (EUS)/fine needle aspiration (FNA). RESULTS: A 43-year-old woman with a history of radical hysterectomy with bilateral inguinal lymphadenectomy and chemoradiotherapy for cervical cancer 15 years prior noticed the presence of erythematous indurative plaques on her right femoral region, where chronic lymphedema had developed...
August 2016: Medicine (Baltimore)
Allison R Schulman, Christopher C Thompson, Robert Odze, Walter W Chan, Marvin Ryou
BACKGROUND AND AIMS: EUS-guided liver biopsy using fine-needle aspiration (FNA) and more recently fine-needle biopsy (FNB) needles has been reported with discrepant diagnostic accuracy. This may in part be due to differences in methodology. We aimed (1) to compare liver histologic yields of 4 EUS-based needles and 2 percutaneous needles (2) to identify optimal number of needle passes and suction. METHODS: Six needle types were tested on human cadaveric tissue: one 19-G FNA, one existing19-G FNB, one novel 19-G FNB, one 22-G FNB and two 18-G percutaneous needles (18-G1 and 18-G2)...
August 13, 2016: Gastrointestinal Endoscopy
Ryo Igarashi, Atsushi Irisawa, Goro Shibukawa, Akane Yamabe, Mariko Fujisawa, Ai Sato, Takumi Maki, Noriyuki Arakawa, Yoshitsugu Yoshida, Shogo Yamamoto, Tsunehiko Ikeda
Eosinophilic esophagitis (EoE) is diagnosed by microscopic findings of eosinophilic infiltration into the squamous epithelium. In contrast, another disease concept termed "eosinophilic esophageal myositis (EoEM)" has been proposed, whereby there is eosinophilic infiltration into the muscularis propria instead. A 60-year-old man was referred to our hospital for chest pain, dysphagia, and several episodes of esophageal food impaction. Although EoE was suspected based on clinical features, biopsy specimens showed no mucosal eosinophilic infiltration...
October 2016: Clinical Journal of Gastroenterology
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