title: Performance and clinical role of endoscopic ultrasound fine needle aspiration for diagnosing gastrointestinal intramural lesions.
abstract: OBJECTIVE
  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.
authors: Division of Gastroenterology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Hea Jung
authors: HJ
authors: Sung
authors: Yu Kyung
authors: YK
authors: Cho
authors: Eun Young
authors: EY
authors: Park
authors: Sung Jin
authors: SJ
authors: Moon
authors: Chul Hyun
authors: CH
authors: Lim
authors: Jin Su
authors: JS
authors: Kim
authors: Jae Myung
authors: JM
authors: Park
authors: In Seok
authors: IS
authors: Lee
authors: Sang Woo
authors: SW
authors: Kim
authors: Myung-Gyu
authors: MG
authors: Choi
authors: Kyu Yong
authors: KY
authors: Choi
keywords: Accuracy; Endoscopic ultrasound-guided fine needle aspiration; Extraintestinal mass; Intramural mass; Yield