title: Prospective evaluation of new 22 gauge endoscopic ultrasound core needle using capillary sampling with stylet slow-pull technique for intra-abdominal solid masses.
abstract: OBJECTIVE
  The aim of this study was to evaluate the adequacy and diagnostic yield of the histologic core obtained with a 22 G endoscopic ultrasound histology needle using capillary sampling with stylet slow-pull technique without on-site cytopathologist.
  
  
  BACKGROUND
  No standard technique for new EUS histology needle has been established.
  
  
  METHODS
  A total of 125 consecutive patients with intra-abdominal solid masses were enrolled prospectively between October 2011 and March 2013. EUS-guided fine needle biopsy (EUS-FNB) with a 22 G histology needle using capillary sampling with stylet slow-pull technique was performed.
  
  
  RESULTS
  A total of 133 EUS-FNB procedures targeting the pancreas, lymph node, retroperitoneal mass, ampulla of Vater, gallbladder, common bile duct, duodenum, and liver were performed in 125 patients. EUS-FNB was technically feasible in all cases, and a visible core was obtained in 128 cases (96%). Histologic core specimens suitable for pathologic assessment were reported in 111 cases (83%). There were no procedure-related adverse events. According to the determinants of malignancy with EUS-FNB, the sensitivity, specificity, positive and negative predictive values, and accuracy were 85%, 98%, 99%, 77%, and 89%, respectively. In addition, histologic architecture with or without immunohistochemical staining of the core biopsy specimens was useful for pathologic confirmation in 101 cases (76%).
  
  
  CONCLUSIONS
  A 22 G EUS-FNB using capillary sampling with stylet slow-pull technique showed a high diagnostic yield and histologic core acquisition for the histologic diagnosis of various intra-abdominal masses without an on-site cytopathologist. Furthermore, a histologic core with or without immunohistochemical staining was helpful for clinical decision making in 76% of the intra-abdominal solid masses.
authors.affiliation: *Department of Internal Medicine, Division of Gastroenterology †Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul ‡Department of Gastroenterology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Paik
authors.forename: Yangsoon
authors.initials: Y
authors.lastname: Park
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Park
authors.forename: Seung-Mo
authors.initials: SM
authors.lastname: Hong
authors.forename: Byung Uk
authors.initials: BU
authors.lastname: Lee
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Seo
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
mesh_terms: D000008:Abdominal Neoplasms / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004067:Digestive System Neoplasms / Q000473:pathology*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009339:Needles; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D057188:Workflow; D055815:Young Adult