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Sung Jin Moon 1 Article
Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions
Hea Jung Sung, Yu Kyung Cho, Eun Young Park, Sung Jin Moon, Chul Hyun Lim, Jin Su Kim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Myung-Gyu Choi, Kyu Yong Choi
Clin Endosc 2013;46(6):627-632.   Published online November 19, 2013
DOI: https://doi.org/10.5946/ce.2013.46.6.627
AbstractAbstract PDFPubReaderePub
Background/Aims

We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions.

Methods

Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging.

Results

Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology.

Conclusions

EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.

Citations

Citations to this article as recorded by  
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  • Diagnosis of Gastric Subepithelial Tumor: Focusing on Endoscopic Ultrasonography
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  • Endoscopic Ultrasound-Guided Fine Needle Biopsy without Rapid On-Site Cytologic Examination: A Time to Change the Paradigm?
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    Clinical Endoscopy.2014; 47(3): 207.     CrossRef
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