title: Endoscopic ultrasound-guided fine-needle aspiration of lesions near the aortoiliac bifurcation via an upper gastrointestinal approach.
abstract: OBJECTIVE
  Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is widely used to investigate posterior mediastinal and upper abdominal lesions. Previously, we noticed that the aortoiliac bifurcation can be visualized by transduodenal EUS scanning, and the surrounding area might be a potential target for EUS-guided FNA. This study aimed to determine the feasibility of using EUS-guided FNA to study lesions near the aortoiliac bifurcation via the upper gastrointestinal approach.
  
  
  METHODS
  This study was a prospective pilot study of consecutive patients with a lesion of unknown origin near the aortoiliac bifurcation.
  
  
  RESULTS
  EUS-guided FNA was used in six patients. The aortoiliac bifurcation was visible from the inferior duodenal angle in all patients; however, the lesions could be visualized in only five patients (3 via the transduodenal approach, and 2 via the transgastric approach). In one patient with a lesion on the left side, the lesion could not be visualized by either the transgastric or transduodenal approach. In the other five patients, EUS-guided FNA was successful, and FNA specimens were adequate for histopathological assessment. The diagnoses were lymphoma (n = 3), plasmacytoma (n = 1), and neurinoma (n = 1). All lymphoma cases were subclassified as diffuse large B-cell lymphoma (n = 2) or grade 2 follicular lymphoma (n = 1). No complications were observed.
  
  
  CONCLUSIONS
  The aortoiliac bifurcation was visible in all patients by transduodenal EUS scanning. FNA of the legions near the aortoiliac bifurcation was possible in five of six patients by using either the transgastric or transduodenal approach.
authors: First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
authors: Shinpei
authors: S
authors: Doi
authors: Ichiro
authors: I
authors: Yasuda
authors: Masanori
authors: M
authors: Nakashima
authors: Junji
authors: J
authors: Kawaguchi
authors: Takahiro
authors: T
authors: Yamauchi
authors: Takuji
authors: T
authors: Iwashita
authors: Katsuhisa
authors: K
authors: Toda
authors: Seiji
authors: S
authors: Adachi
authors: Masahito
authors: M
authors: Shimizu
authors: Hisashi
authors: H
authors: Tsurumi
authors: Hisataka
authors: H
authors: Moriwaki