EUS-guided FNA for the diagnosis of gallbladder masses.
BACKGROUND
Gallbladder masses can be identified endosongraphically, but FNA for cytologic diagnosis is not routine. This is a review of our experience with EUS-guided FNA of gallbladder masses.


METHODS
Records of patients undergoing EUS were reviewed to identify cases in which FNA of the gallbladder was performed. Reports of EUS procedures, EUS images, cytology results, and clinical records were reviewed.


METHODS
Six cases were identified. The final diagnosis was gallbladder carcinoma in 5 and xanthogranulomatous cholecystitis in one. In each case, EUS revealed a hypoechoic mass within the gallbladder wall or gallbladder lumen. Gallbladder wall calcification was observed in 3 of the 5 cases of carcinoma. FNA yielded a specimen that was positive (n = 3) or raised a suspicion (n = 1) for adenocarcinoma in 4 of the 5 proven malignancies. FNA of regional lymph nodes demonstrated metastatic adenocarcinoma in 2 cases. FNA was negative for malignancy in the case of xanthogranulomatous cholecystitis and one case of proven carcinoma. There were no complications.


CONCLUSIONS
EUS-guided FNA of gallbladder masses is safe and can provide a definitive diagnosis of malignancy. Gallbladder carcinoma appears endosonographically as a hypoechoic mass and may be associated with focal wall calcifications.
Jacobson
Brian C
BC
Section of Gastroenterology, Boston University Medical Center, Massachusetts 02118, USA.
Pitman
Martha B
MB
Brugge
William R
WR
D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D002763:Cholecystectomy / Q000379:methods; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity