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© 2004 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 23:1141-1150 • 0278-4297

Endoscopic Sonographically Guided Fine-Needle Aspiration Yield in Submucosal Tumors of the Gastrointestinal Tract

Vitor Arantes, MD, Roberto Logroño, MD, Sohaib Faruqi, MD, Ijaz Ahmed, MD, Irving Waxman, MD and Manoop S. Bhutani, MD

Center for Endoscopic Ultrasound, Department of Medicine (V.A., S.F., I.A., I.W., M.S.B.), and Department of Pathology (R.L.), University of Texas Medical Branch, Galveston, Texas USA.

Address correspondence and reprint requests to Manoop S. Bhutani, MD, Center for Endoscopic Ultrasound, University of Texas Medical Branch, 4.106 McCullough, Galveston, TX 77555-0764 USA. E-mail: msbhutan{at}utmb.edu.

Objective. To study the yield of endoscopic ultrasonographically guided fine-needle aspiration cytologic examination in the diagnosis of submucosal masses. Methods. From 1999 to 2003, 10 patients underwent ultrasonographically guided fine-needle aspiration for the cytologic diagnosis of submucosal masses in our institution. The endoscopic ultrasonography records and the cytology database were consulted, and the reports were analyzed, as were slide material and the technical aspects related to these procedures. All procedures were performed under conscious sedation and cardiorespiratory monitoring on an outpatient basis. Ten patients (4 men and 6 women; mean age, 60.8 years) were studied. Results. Eight lesions were located in the stomach, and 2 were located in the esophagus, with a mean diameter of 3.3 cm. An experienced cytopathologist was present on-site during all procedures for assessment of adequacy and preliminary cytologic examination. Cytologic diagnoses were obtained in 8 cases as follows: 6 gastrointestinal stromal tumors, 1 organizing submucosal hematoma, and 1 low-grade mucosa-associated lymphoid tissue–associated lymphoma. Two cases consisted of scant gastric epithelium only and were considered nondiagnostic. The cytologic diagnoses guided further clinical treatment. Conclusions. Ultrasonographically guided fine-needle aspiration with cytopathologic analysis has a high accuracy rate (80%) for diagnosing submucosal lesions. These findings potentially affect clinical decision making.

Key Words: endoscopic ultrasonography • fineneedle aspiration • submucosal tumors

Abbreviations: EUS, endoscopic ultrasonography • EUS-FNA, endoscopic ultrasonographically guided fine-needle aspiration • GIST, gastrointestinal stromal tumor • SMT, submucosal tumor




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