title: Endoscopic ultrasound-guided fine needle aspiration of pleural and ascitic fluid.
abstract: Endoscopic ultrasound (EUS) has been established as an important modality for staging gastrointestinal malignancies. We have previously described the new technique of EUS-guided fine needle aspiration (FNA) in diagnosing submucosal and extraluminal tumors and lymph nodes. We now report the novel application of EUS and EUS-guided FNA in diagnosing malignant ascites and malignant pleural effusion in two patients with gastric carcinoma. In the first patient, CT did not detect any effusion or ascites. EUS-guided FNA diagnosed cytologically that both fluids were malignant, thereby precluding surgery. The second patient had a small pleural effusion on CT that was not detected on the chest x-ray. EUS-guided FNA made the cytological diagnosis of recurrent adenocarcinoma in the pleural fluid. These two cases demonstrate for the first time that EUS combined with EUS-guided FNA can be used for the diagnosis of malignant pleural or ascitic fluid in patients with gastrointestinal malignancies and might further extend the staging capabilities of EUS.
authors: University of California, Irvine, Medical Center, Orange.
authors: K J
authors: KJ
authors: Chang
authors: C G
authors: CG
authors: Albers
authors: P
authors: P
authors: Nguyen
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology / Q000473:pathology*; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000209:etiology / Q000473:pathology*; D013274:Stomach Neoplasms / Q000150:complications*; D013906:Thoracoscopy; D014463:Ultrasonography