title: Fluorescence cytology with 5-aminolevulinic acid in EUS-guided FNA as a method for differentiating between malignant and benign lesions (with video).
abstract: BACKGROUND
  EUS-guided FNA (EUS-FNA) has been increasingly performed to obtain specimens for the pathological evaluation of patients with GI and pancreaticobiliary masses as well as lymphadenopathies of unknown origin. Photodynamic diagnosis by using 5-aminolebulinic acid (ALA) has been reported to be useful for enabling the visual differentiation between malignant and normal tissue in various cancers.
  
  
  OBJECTIVE
  To evaluate the diagnostic accuracy of fluorescence cytology with ALA in EUS-FNA.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  A single center.
  
  
  METHODS
  A total of 28 consecutive patients who underwent EUS-FNA for the pathological diagnosis of a pancreaticobiliary mass lesion or intra-abdominal lymphadenopathy of unknown origin.
  
  
  METHODS
  Patients were orally administered ALA 3 to 6 hours before EUS-FNA. The sample was obtained via EUS-FNA for fluorescence cytology and conventional cytology. A single gastroenterologist performed the fluorescence cytology by using fluorescence microscopy after the procedure, independently of the conventional cytology by pathologists.
  
  
  METHODS
  The accuracy of fluorescence cytology with ALA in the differentiation between benign and malignant lesions by comparing the results of fluorescence cytology with the final diagnosis.
  
  
  RESULTS
  Of the 28 patients included in the study, 22 were considered as having malignant lesions and 6 patients as having benign lesions. Fluorescence cytology could correctly discriminate between benign and malignant lesions in all patients. Therefore, both the sensitivity and specificity of fluorescence cytology were 100% in our study.
  
  
  CONCLUSIONS
  Fluorescence cytology was performed by only 1 gastroenterologist with a small number of patients.
  
  
  CONCLUSIONS
  Fluorescence cytology with ALA in EUS-FNA may be an effective and simple method for differentiating between benign and malignant lesions.
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Tsukasa
authors: T
authors: Ikeura
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Makoto
authors: M
authors: Takaoka
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Kazushige
authors: K
authors: Uchida
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Masaaki
authors: M
authors: Shimatani
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Hideaki
authors: H
authors: Miyoshi
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Kota
authors: K
authors: Kato
authors: Department of Pathology, Kansai Medical University, Hirakata Hospital, Osaka, Japan.
authors: Chisato
authors: C
authors: Ohe
authors: Department of Pathology, Kansai Medical University, Hirakata Hospital, Osaka, Japan.
authors: Yoshiko
authors: Y
authors: Uemura
authors: Department of Surgery, Kansai Medical University, Osaka, Japan.
authors: Masaki
authors: M
authors: Kaibori
authors: Department of Surgery, Kansai Medical University, Osaka, Japan.
authors: A-Hon
authors: AH
authors: Kwon
authors: The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors: Kazuichi
authors: K
authors: Okazaki
mesh_terms: D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D003584:Cytological Techniques / Q000295:instrumentation / Q000379:methods*; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D005453:Fluorescence; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011446:Prospective Studies
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid