title: Usefulness of endoscopic ultrasound-guided fine-needle aspiration with a forward-viewing and curved linear-array echoendoscope for small gastrointestinal subepithelial lesions.
abstract: OBJECTIVE
  It is difficult to perform endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of small gastrointestinal (GI) subepithelial lesions (SELs) approximately 10 mm in diameter. This study was undertaken to evaluate the feasibility, safety, and diagnostic ability of EUS-FNA with a forward-viewing and curved linear-array echoendoscope (FVCLA-ES) that has a cap for small SELs.
  
  
  METHODS
  The study enrolled 8 patients who had small upper GI SELs approximately 10 mm in diameter. To fix the SELs during FNA, a cap device was attached to the scope tip.
  
  
  RESULTS
  The mean (standard deviation [SD]) diameter of the SELs was 10.6 mm (2.94). Even small lesions were well targeted for FNA when the FVCLA-ES with a cap device was used. The mean (SD) number of passes was 4.6 (1.59). Adequate samples were obtained from 7 patients (87.5 %) - in 6 (75 %) for cytology and in 4 (50 %) for histologic examination with immunohistochemical (IHC) staining. No complication occurred. Gastrointestinal stromal tumor (GIST) in 2 patients and leiomyoma in 2 patients were definitively diagnosed with IHC staining.
  
  
  CONCLUSIONS
  EUS-FNA with an FVCLA-ES that has a cap device is feasible and safe. This technique is expected to contribute to histologic diagnosis, even in small SELs.
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Yamabe
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.affiliation: Department of Gastroenterology, Hepatology and Nutrition Unit, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Manoop S
authors.initials: MS
authors.lastname: Bhutani
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Shibukawa
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Koh
authors.initials: K
authors.lastname: Imbe
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Hoshi
authors.affiliation: Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Igarashi