Endoscopic ultrasound guided fine needle aspiration of non-pancreatic lesions: an institutional experience.
BACKGROUND
Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) has proven to be an effective diagnostic modality for the detection and staging of pancreatic malignancies. In recent years EUS-FNA has also been used to diagnose lesions of non-pancreatic sites such as structures in close proximity to the gut wall within the mediastinum, abdomen, pelvis and retro-peritoneum.


OBJECTIVE
To evaluate experience with EUS-FNA of non-pancreatic sites at a large university medical centre.


METHODS
The study cohort included 234 patients who underwent EUS-FNA of 246 lesions in non-pancreatic sites (122 peri-pancreatic and coeliac lymph nodes; 9 peri-pancreatic masses; other sites: mediastinum 12, gastric 25, liver 27, oesophagus 17, duodenum/colon/rectum 15, retro-peritoneum 8, lung 7, miscellaneous 4).


RESULTS
The cytology diagnoses were classified as non-neoplastic/reactive in 82 (33%), atypical/suspicious for malignancy in 25 (10%), malignant in 86 (35%) and non-diagnostic in 53 (22%) cases. Surgical pathology follow-up was available in 75 (31%) cases. Excluding the non-diagnostic cases there were 7 false negative and 3 false positive cases. The sensitivity, specificity and positive predictive value of EUS-FNA in the diagnosis of lesions of non-pancreatic sites was 92%, 98% and 97%, respectively.


CONCLUSIONS
EUS-FNA can be effectively used as a diagnostic modality in the diagnosis of lesions from non-pancreatic sites.
Anand
Dipti
D
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
Barroeta
Julieta E
JE
Gupta
Prabodh K
PK
Kochman
Michael
M
Baloch
Zubair W
ZW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D004067:Digestive System Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*