Journal of Ultrasound in Medicine, Vol 17, Issue 12 739-742, Copyright © 1998 by American Institute of Ultrasound in Medicine
Ultrasonographically guided percutaneous biopsy of gastric, small bowel, and colonic abnormalities: efficacy and safety
B. W. Carson, J. A. Brown and P. L. Cooperberg
Department of Radiology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
The purposes of this study were to evaluate the efficacy of sonographically
guided percutaneous biopsy of gastric and bowel lesions and to document any
associated complications. A retrospective review of all patients undergoing
ultrasonographically guided biopsy of gastric, small bowel, or colonic
lesions was performed. Cases were evaluated for size of lesion, location,
efficacy in obtaining a diagnostic specimen, and any procedure-related
complications. A total of 46 biopsies were performed in 44 patients over a
6 year period. Fifteen gastric, four duodenal, seven small bowel, 16 right
colonic, and two left colonic lesions were identified. Histologic diagnosis
included 20 adenocarcinomas, seven lymphomas, 10 mesenchymal tumors, and
two cases of candidal enteritis. In 18 (41%) patients the initial
fine-needle aspirate was negative, although 10 of these patients
subsequently underwent ultrasonographically guided core biopsy with a
diagnosis of neoplasm established in all 10. Two patients with an initial
negative result on fine-needle aspiration underwent repeat aspiration,
demonstrating malignancy. Two additional false-negative aspirates were
obtained; these patients did not undergo repeat biopsy but were
subsequently found to have lymphoma. Two of the patients with aspirates
that were negative for malignancy were believed to have inflammatory
changes secondary to pancreatitis. One patient was lost to follow-up
evaluation. No complications were recorded. Percutaneous fine-needle
aspiration of gastric and bowel lesions is a simple and safe procedure and
may be particularly useful with poor candidates for endoscopy or for
lesions that are difficult or impossible to reach endoscopically.
Diagnostic yield is high, particularly in documenting malignancy, although
in suspected stromal tumors a core biopsy often is required.
