Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) in non-gastrointestinal (GI) disorders: A multicenter assessment on accuracy and therapeutic guidance

M. F. Catalano, B. Hoffman, M. Bhutani, W. Wassef, E. Erickson, J. Scheiman, G. Aliperti, J. Van Dam, C. Nguyen, N. Harada, M. Wiersema

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Abstract

EUS guided FNA has increased the diagnostic capability of endosonography with respect to GI pathology. The role of FNA in non-GI disorders using EUS guidance has received little attention in the literature in limited numbers. AIM: To evaluate the diagnostic accuracy and impact on Rx of EUS guided FNA in a variety of non-GI disorders. METHODS: 142 pts (85M, 57F, age 27-81) underwent EUS guided FNA at 10 tertiary centers. Final diagnosis was available in all pts using EUS FNA, "other" biopsy method, surgery, and long-term f/u. EUS guided FNA was classified under 8 disease categories: 1) Mediastinal lymph (LN) node (primary pulmonary process), 1A-benign/ infections, 1B-malignant pulmonary, 1C-malignant mediastinal (lymphoma, mets, etc); 2) Mediastinal mass (thymoma, thyroid, etc.); 3) Prostate; 4) Ovarian; 5) Adrenal; 6) Kidney; 7) Intra-abdominal mass (non-GI); 8) Intra-abdominal LN (non-GI). Indications for EUS guided FNA included abnormal x-ray 56, LN staging of known malignancy (lung, ovarian, etc.) 61, unexplained symptoms 5. RESULTS: EUS FNA was successful in establishing a tissue diagnosis in 123 of 142 pts (87%). It was helpful in directing subsequent Rx and/or guiding further testing in 116 of 142 pts (82%). Number of FNA passes/pt ranged from 1-9 (mean 3.6). Complications were rare and included 2 episodes of infection Rx with antibiotics and 1 chest pain. DISEASE CATEGORY (No.) EUS FNA RESULTS FINAL DX ESTABLISHED ACCURACY EUS No. (%) EUS FNA ON RX IMPACT BEN MALIG INAD SUSP FNA OTHER SURG F/U 1A - (9) 7 0 2 0 5 2 2 0 7 (78) 7 1B - (88) 29 55 1 3 75 5 8 0 80 (91) 78 1C - (9) 3 6 0 0 6 1 1 1 7 (78) 6 2 - (5) 3 1 1 0 4 0 0 1 4 (80) 3 3 - (4) 1 3 0 0 4 0 0 0 4 (100) 4 4 - (2) 2 0 0 0 2 0 0 0 2 (100) 2 5 - (3) 1 2 0 0 3 0 0 0 3 (100) 3 6 - (4) 0 4 0 0 4 0 0 0 4 (100) 4 7 - (16) 6 7 0 3 12 0 3 1 10 (63) 9 8 - (2) 1 0 0 1 0 1 1 0 0 0 CONCLUSIONS: EUS guided FNA in a variety of non-GI disease is accurate, safe and assists in guiding subsequent Rx in the vast majority of cases. Promising areas include FNA of mediastinal LN/masses in primary pulmonary disease and intra-abdominal lesions, particularly perirectal disease.

Original languageEnglish (US)
Pages (from-to)AB26
JournalGastrointestinal endoscopy
Volume45
Issue number4
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Catalano, M. F., Hoffman, B., Bhutani, M., Wassef, W., Erickson, E., Scheiman, J., Aliperti, G., Van Dam, J., Nguyen, C., Harada, N., & Wiersema, M. (1997). Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) in non-gastrointestinal (GI) disorders: A multicenter assessment on accuracy and therapeutic guidance. Gastrointestinal endoscopy, 45(4), AB26.