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EUS guided fine needle aspiration

Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Robert Hawes, Shyam Varadarajulu
BACKGROUND & AIMS: Outcomes of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) evaluation vary with technique, needles, and methods of specimen evaluation. We performed a direct comparison of diagnostic yields of EUS-FNA samples collected using different gauge needles (22- vs 25-gauge), with or without suction. METHODS: We performed a randomized controlled study of 352 patients with suspected pancreatic masses, referred for EUS-FNA at a tertiary referral center...
March 10, 2018: Clinical Gastroenterology and Hepatology
Vincent P Groot, Sameer S Thakker, Georgios Gemenetzis, Michaël Noë, Ammar A Javed, Richard A Burkhart, Behnoud B Noveiry, John L Cameron, Matthew J Weiss, Christopher J VandenBussche, Elliot K Fishman, Ralph H Hruban, Christopher L Wolfgang, Anne Marie Lennon, Jin He
BACKGROUND: Lymphoepithelial cysts (LECs) are rare pancreatic cystic lesions. Since LECs are benign, preoperative diagnosis is important to differentiate from a cystic neoplasm and avoid unnecessary surgery. The aim of this study was to identify clinical, radiographic and cytopathologic features associated with LECs. METHODS: A retrospective review was performed of patients diagnosed with LEC between 1995 and 2017 at our hospital. Clinicopathologic and radiographic imaging features were documented...
March 9, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
David L Diehl, Shaffer R S Mok, Harshit S Khara, Amitpal S Johal, H Lester Kirchner, Fan Lin
Background and study aims:  Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) or biopsy (FNB) is an indispensable diagnostic tool. Improvements in needling technique have led to increasing tissue yields. Blood clogging of the needle can cause difficulties with specimen handling and stylet passage, which improves when the needle is primed with heparin before use. However, the effect of heparin on cytology, histology or immunochemistry (IHC) of FNA and FNB specimens is unknown...
March 2018: Endoscopy International Open
Yoon Suk Lee, Nam-Hoon Kim, Jun Hyuk Son, Jung Wook Kim, Won Ki Bae, Kyung-Ah Kim, June Sung Lee
Autoimmune pancreatitis (AIP) is a distinct subtype of pancreatitis, which is classified into type 1 and 2 based on the clinicopathological features. According to the international consensus diagnostic criteria, pancreas resection or core biopsy specimens are recommended to make an accurate histological evaluation. However, the usefulness of endoscopic ultrasonography (EUS) guided fine needle aspiration (FNA) for histological evaluation has also been reported. Furthermore, the simultaneous presentation of type 2 AIP and Crohn's disease (CD) is very rare, especially in the Asian population...
March 9, 2018: Internal Medicine
Michael J Levy, Benjamin R Kipp, Dragana Milosevic, Amber R Schneider, Jesse S Voss, Rajeswari Avula, Sarah E Kerr, Michael R Henry, Edward Highsmith, Minetta C Liu, Ferga C Gleeson
BACKGROUND & AIMS: Cellular and nuclear material from tumors disseminates into the bloodstream (tumoremia), but it is not clear whether medical procedures cause release of this material or contribute to formation of metastases. We performed a prospective study of blood samples from patients with pancreatic adenocarcinoma (PDAC) to determine whether endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) associates with markers of tumoremia. METHODS: We obtained peripheral blood from 104 patients (35 with PDAC) before and after EUS-FNA of primary tumors; blood samples from 69 healthy individuals were used as controls...
March 8, 2018: Clinical Gastroenterology and Hepatology
Juri Ikemoto, Keiji Hanada, Tomoyuki Minami, Akihito Okazaki, Tomoyuki Abe, Hironobu Amano, Shuji Yonehara
OBJECTIVES: Most patients with pancreatic cancer (PC) demonstrate recurrences in the form of metastatic disease. We prospectively evaluated recurrence in PC cases diagnosed at an early stage. METHODS: Thirty cases of PC stage 0 or IA were prospectively followed for at least 1 year after initial surgery. We performed blood tests and contrast-enhanced computed tomography (CT) every 3 to 6 months. Endoscopic ultrasonography (EUS) was performed if CT revealed abnormal findings in the remnant pancreas (RP)...
April 2018: Pancreas
Omer Basar, Osman Yuksel, Dennis Yang, Jason Samarasena, David Forcione, Christopher J DiMaio, Mihir S Wagh, Kenneth Chang, Brenna Casey, Carlos Fernandez-Del Castillo, Martha B Pitman, William R Brugge
BACKGROUND AND AIM: The tissue acquisition and diagnostic yield of cyst fluid cytology is low-to-moderate and rarely provides a specific diagnosis. The aim of this study was to compare the tissue acquisition and diagnostic tissue yield of micro-forceps biopsy (MFB) with cyst fluid cytology. PATIENTS AND METHODS: The data of 42 patients, whose cysts were aspirated by EUS-guided fine needle aspiration (EUS-FNA) and then biopsied with MFB device in this multicenter study, were collected...
March 3, 2018: Gastrointestinal Endoscopy
Takayasu Ito, Masahide Oki, Hideo Saka, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka
A 71-year-old man, who had received long-term oxygen therapy for respiratory failure caused by chronic obstructive pulmonary disease, had an enlarged mediastinal lymph node for one year. As his lung function was poor, we tried performing endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure ventilation for diagnosis but could not obtain sufficient specimens. Later, we performed an endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) using a transesophageal approach...
May 2018: Respirology Case Reports
Santosh Tummidi, Kanchan Kothari, Pragati Sathe, Mona Agnihotri, Gwendolyn Fernandes, Leena Naik, Aleena Jain, Rachana Chaturvedi
BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become increasingly popular for the diagnosis and staging of gastrointestinal diseases and peri-gastrointestinal lesions. The application of FNA/Brush has dramatically expanded the clinical utility of EUS. AIMS AND OBJECTIVE: To evaluate the diagnostic accuracy, study the spectrum of lesions encountered in EUS-FNAC/brush cytology of gastrointestinal and peri-gastrointestinal lesions. MATERIALS AND METHODS: Total of 124 patients during the period from August 2015 to November 2016 was included in the study...
March 5, 2018: Diagnostic Cytopathology
Yoko Sekita-Hatakeyama, Takeshi Nishikawa, Mao Takeuchi, Kouhei Morita, Maiko Takeda, Kinta Hatakeyama, Tokiko Nakai, Tomoko Uchiyama, Hiroe Itami, Tomomi Fujii, Akira Mitoro, Masayuki Sho, Chiho Ohbayashi
BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) technology is widely used for the diagnosis of pancreatic masses. However, in some cases, inadequate tissue volume or difficulty of morphological diagnosis are constraining factors for adequate cytopathological evaluation. K-ras mutation is the most frequently acquired genetic abnormality, occurring in approximately 90% of all patients with pancreatic ductal adenocarcinoma (PDAC). In the present study, the clinical utility of residual liquid-based cytology (LBC) specimens obtained using EUS-FNA for K-ras mutation analysis was evaluated...
2018: PloS One
Marina Suzuki, Kazuteru Hatanaka, Hajime Hirata, Kazuharu Suzuki, Masayoshi Ono, Taiki Kudo, Yoshiya Yamamoto, Hirohito Naruse, Noriyuki Yokoyama
A 50-year-old woman was diagnosed with dermatomyositis at the department of neurology in our hospital; she then received steroid pulse therapy. A positron emission computed tomography(PET-CT)revealed swollen lymph nodes near the aorta and in the left inguinal region. She presented at our institution for examination to determine the cause of her lymphadenopathy, but the primary site of the carcinoma was unknown. A histopathological examination of the lymph node specimen obtained using endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA)revealed a moderately to poorly differentiated adenocarcinoma...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Abhinav Koul, Anand C Baxi, Ruilian Shang, Xianmei Meng, Lianyong Li, Steven A Keilin, Field F Willingham, Qiang Cai
Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has become the preferred method to diagnose pancreatic masses due to its minimally invasive approach and diagnostic accuracy. Many studies have shown that rapid on-site evaluation (ROSE) improves diagnostic yield by 10-30%; however, more recent studies have demonstrated effective diagnostic accuracy rates without ROSE. Our study aims to examine whether the current standard of performing ROSE after each FNA pass adds diagnostic value during EUS-guided FNA of pancreatic masses...
February 2018: Gastroenterology Report
Ivan Chebib, Emily Albanese, Aristana Scourtas, Martha B Pitman
BACKGROUND: Inspissated cyst fluid may be identified on pancreatic cyst aspiration cytology. We report on the cytomorphologic characteristics of inspissated cyst fluid on EUS-FNA of pancreatic cysts and correlate this finding with histopathology or multimodal (cytology, cyst fluid analysis, molecular pathology, imaging) classification of cyst type. METHODS: The department archives were searched for pancreatic cyst fine-needle aspiration biopsies that contained dessicated, crystalline or inspissated material on cytologic preparations...
February 24, 2018: Diagnostic Cytopathology
Takuji Iwashita, Yousuke Nakai, Tsuyoshi Mukai, Osamu Togawa, Saburo Matsubara, Yuichiro Hatano, Akira Hara, Mariko Tanaka, Junji Shibahara, Masashi Fukayama, Hiroyuki Isayama, Ichiro Yasuda
BACKGROUND: The necessity of histological analysis is increasing. A 19-gauge histology needle (PC19) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has recently been developed and has shown high yields of tissue acquisition and histological diagnosis. AIMS: To compare the histological diagnostic yield in single-pass EUS-FNA for solid lesions using PC19 and a standard 19-gauge needle (EC19). PATIENTS AND METHODS: Consecutive patients with solid lesions were enrolled and underwent one pass with each of PC19 and EC19 for EUS-FNA with the randomized order of the needles...
February 21, 2018: Digestive Diseases and Sciences
Diogo Turiani Hourneaux De Moura, Martin Coronel, Danielle Azevedo Chacon, Ryan Tanigawa, Dalton M Chaves, Sérgio E Matuguma, Marcos E Lera Dos Santos, José Jukemura, Eduardo Guimarâes Hourneaux De Moura
Pancreatic cancer is the second most common malignancy of the gastrointestinal tract in the US, and adenocarcinoma has been identified as the most common type of pancreatic cancer. Different types of pancreatic cancers have been classified: adenocarcinoma, ductal adenosquamous carcinoma, solid pseudopapillary tumors, endocrine neoplasms, acinar cell carcinoma, squamous cell carcinoma, cystic tumors, primary lymphoma of the pancreas, and metastatic lesions of the pancreas. Adenosquamous carcinoma is extremely rare, behave in a very aggressive way and is responsible for the 1 to 4% of the pancreatic exocrine neoplastic lesions...
October 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Stefano Francesco Crinò, Maria Cristina Conti Bellocchi, Laura Bernardoni, Erminia Manfrin, Alice Parisi, Antonio Amodio, Nicolò De Pretis, Luca Frulloni, Armando Gabbrielli
BACKGROUND: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation. METHODS: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Margaret G Keane, Mayur Kumar, Natascha Cieplik, Douglas Thorburn, Gavin J Johnson, George J Webster, Michael H Chapman, Keith J Lindley, Stephen P Pereira
BACKGROUND: In adults ERCP and endoscopic ultrasound (EUS) are standard methods of evaluating and treating many hepatopancreaticobiliary (HPB) conditions. HPB disease is being diagnosed with increasing frequency in children but information about role of ERCP and EUS and their outcomes in this population remain limited. Therefore the aims of this study were to describe the paediatric ERCP and EUS experience from a large tertiary referral HPB centre, and to systematically compare outcomes with those of other published series...
February 9, 2018: BMC Pediatrics
Antonio Z Gimeno Garcia, Jose R Aparicio, Angel Barturen, Miguel Moreno, David Nicolas-Perez, Enrique Quintero
BACKGROUND: Differentiation between benign and malignant portal vein thrombosis (PVT) in the setting of a hepatocellular carcinoma (HCC) is of paramount importance. Histological analysis is usually not carried out because of potential severe side effects of the percutaneous approach. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) may be safer and may guide the clinical management of patients with HCC. OBJECTIVE: To describe the feasibility of the EUS-FNA in a series of patients with HCC and PVT...
April 2018: European Journal of Gastroenterology & Hepatology
Kazumichi Kawakubo, Kei Yane, Kazunori Eto, Hirotoshi Ishiwatari, Nobuyuki Ehira, Shin Haba, Ryusuke Matsumoto, Keisuke Shinada, Hiroaki Yamato, Taiki Kudo, Manabu Onodera, Toshinori Okuda, Yoko Taya-Abe, Shuhei Kawahata, Kimitoshi Kubo, Yoshimasa Kubota, Masaki Kuwatani, Hiroshi Kawakami, Akio Katanuma, Michihiro Ono, Tsuyoshi Hayashi, Minoru Uebayashi, Naoya Sakamto
Background/Aims: Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrombotic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. Methods: Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study...
February 8, 2018: Gut and Liver
Jae Min Lee, Hong Sik Lee, Jong Jin Hyun, Jung Min Lee, In Kyung Yoo, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim
Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016...
February 8, 2018: Gut and Liver
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