title: Usefulness of endoscopic ultrasound-guided sampling using core biopsy needle as a percutaneous biopsy rescue for diagnosis of solid liver mass: Combined histological-cytological analysis.
abstract: OBJECTIVE
  Endoscopic ultrasound (EUS)-guided fine needle aspiration (EUS-FNA) is one of the alternative methods for tissue sampling of liver solid mass. However, the diagnostic efficacy using cytology alone was limited. In this study, we evaluate the diagnostic accuracy of EUS-guided fine needle biopsy (EUS-FNB) as a percutaneous biopsy rescue for liver solid mass.
  
  
  METHODS
  The EUS-FNB using core biopsy needle for liver solid mass was performed prospectively for patients who were failure to acquire a tissue or achieve a diagnosis using percutaneous liver biopsy. The primary outcome was the diagnostic accuracy of EUS-FNB for malignancy and specific tumor type. The secondary outcomes were the median numbers of passes required to establish a diagnosis, the proportions of patients in whom immunohistochemical (IHC) stain was possible and obtained adequate specimen, and safety of EUS-FNB.
  
  
  RESULTS
  Twenty-one patients (12 women; mean age, 63 years [range, 37-81]) underwent EUS-FNB for solid liver masses. The median number of needle passes was 2.0 (range, 1-5). On-site cytology and cytology with Papanicolaou stain showed malignancy in 16 patients (76.2%) and 17 patients (81.0%), respectively. In histology with HE stain, 19 patients (90.5%) were diagnosed malignancy and optimal to IHC stain. The overall diagnostic accuracy for malignancy and specific tumor type were 90.5% and 85.7%, respectively. No complications were seen.
  
  
  CONCLUSIONS
  EUS-FNB with core biopsy needle for solid liver mass may be helpful in the management of patients who are unable to diagnose using percutaneous liver biopsy.
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Yun Nah
authors: YN
authors: Lee
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Jong Ho
authors: JH
authors: Moon
authors: Department of Pathology, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Hee Kyung
authors: HK
authors: Kim
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Hyun Jong
authors: HJ
authors: Choi
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Moon Han
authors: MH
authors: Choi
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Dong Choon
authors: DC
authors: Kim
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Tae Hee
authors: TH
authors: Lee
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Tae Hoon
authors: TH
authors: Lee
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Sang-Woo
authors: SW
authors: Cha
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Sang Gyune
authors: SG
authors: Kim
authors: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea.
authors: Young Seok
authors: YS
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D016591:Histocytological Preparation Techniques / Q000379:methods*; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
keywords: cancer of liver; core needle biopsy; endoscopic ultrasound-guided fine needle aspiration