Neural ganglia visualized by endoscopic ultrasound

OBJECTIVES: To describe visualization of gastrointestinal neural ganglia by endoscopic ultrasound (EUS). METHODS: We retrospectively identified patients in whom neural ganglia were visualized during EUS and the diagnosis of ganglion confirmed by EUS guided fine needle aspiration (FNA) cytology. RESULTS: Ten patients were identified. Celiac ganglia were visualized in nine, and a perirectal ganglion was visualized in one. Ganglia appeared as discrete hypoechoic structures, often with associated hypoechoic threads that may represent neural rami. Aspiration of ganglia yielded scant material and caused transient pain. Ganglia were best visualized with linear array echoendoscopes. Celiac ganglia (but not the perirectal ganglion) were retrospectively identified on computed tomography scans. CONCLUSIONS: Gastrointestinal neural ganglia can be imaged by EUS and their identity confirmed by EUS FNA.