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• W2094239631 abstract "Background: Determining the etiology of GI tract submucosal lesions can be difficult. EUS may help distinguish certain lesions based on imaging characteristics. But, EUS alone does not provide tissue diagnosis, and some lesions, such as GI stromal tumors (GISTs) and leiomyomas, appear similar on imaging. EUS-FNA provides a method for histologic sampling, but data on EUS-FNA yield for submucosal lesions are limited. Aim: To assess the diagnostic yield and accuracy of EUS-FNA in characterizing submucosal lesions in the upper GI tract. Methods: We reviewed medical records to identify all patients undergoing EUS-FNA for submucosal, intramural, solid-appearing lesions of the upper GI tract. The following data were recorded: patient characteristics, EUS findings, pathology results, and surgical findings. Data were analyzed to determine the diagnostic yield and accuracy of EUS-FNA. Results: EUS-FNA was performed for 66 solid-appearing, intramural upper GI tract lesions in 65 patients over a 4-year period. Mean patient age was 66 years, and about one-half were male (51%). Lesions were located in the esophagus (n = 7), stomach (n = 55), or duodenum (4). By EUS, most lesions were hypoechoic (92%), and measured <20 mm (n = 22), 21-30 mm (n = 16), 31-40 mm (n = 18), or >40 mm (n = 10). Most originated in the muscularis propria by EUS (83%), and had smooth borders (94%). EUS-FNA based cytologic diagnosis was obtained in 45 of 66 (68%). The yield was higher for gastric (75%) as compared to esophageal (43%) or duodenal submucosal lesions (25%). Yield was lower for lesions <20 mm (45%) as compared to lesions >20 mm (80%). EUS-FNA diagnoses included: GIST (56%), leiomyoma (9%), carcinoma (2%), and non-diagnostic (32%). Diagnosis of GIST was based on histology and c-kit staining. Based on final pathology from surgical (15) or endoscopic (4) resection of lesions, EUS-FNA provided a correct diagnosis in 13 of 19 cases (68%), and was non-diagnostic in 6. EUS-FNA correctly diagnosed 10 of 13 (77%) GISTs (sample was insufficient in 3). There were no resection-proven, false positive EUS-FNA diagnoses. Performance characteristics for EUS-FNA in diagnosing GISTs were: sensitivity 77%, specificity 100%, positive predictive value 100%, negative predictive value 67%, and accuracy 84%. One EUS-FNA complication occurred: mild hemorrhage at FNA puncture site that was immediately recognized and treated endoscopically. Conclusion: EUS-FNA is a safe and useful tool to ascertain the etiology of submucosal, intramural lesions in the upper GI tract. It provides high yield in sampling submucosal lesions, and may be a practical and accurate method to diagnose GISTs." @default.
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• W2094239631 date "2008-04-01" @default.
• W2094239631 modified "2023-10-14" @default.
• W2094239631 title "Yield of Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA) in Diagnosing Submucosal Lesions of the Upper GI Tract" @default.
• W2094239631 doi "https://doi.org/10.1016/j.gie.2008.03.554" @default.
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