Endoscopic ultrasound -guided biopsy

Larsen SS, Krasnik M, Vilmann P, et al. Endoscopic ultrasound guided biopsy of mediastinal lesions has a major impact on patient management. Thorax 2002 57(2) 98-103. 

Vander Noot MR III, Eloubeidi MA, Chen VK et al (2004) Diagnosis of gastrointestinal tract lesions by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer 102 157-163... 

Vilmann P, Krasnik M, Larsen SS, et al. Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy a combined approach in the evaluation of mediastinal lesions. Endoscopy 2005 37(9) 833-839. 

The diagnosis of carcinoid and submucosal tumors by endoscopy or barium contrast studies is not easy since these tumors are usually covered with a normal mucosal layer. To determine the main portion of the wall stratification in the gastrointestinal wall in which the tumors lie is the most important part of diagnostic imaging of submucosal tumors. For this purpose, endoscopic ultrasound (BUS), including the use of an EUS-guided fine-needle aspiration biopsy (FNA), is the best choice (Arantes et al. 2004 Vandernoot et... 

Fig. 24.7. Ultrasound-guided fine-needle biopsy with a cutting needle in a case of endoscopically negative biopsies. The needle tip is clearly visible in hypoechoic gastric wall (arrow). Final diagnosis gastric adenocarcinoma...

The indications to the procedure were impossibility to perform endoscopy in 8 cases, non-diagnostic endoscopic biopsies in 20 cases (Fig. 24.7), and endo-scopically inaccessible lesion in 6 cases (Fig. 24.8). No complications occurred and the procedure was well tolerated in all patients however, an alternative approach to diagnosis of gastrointestinal diseases may be needed in some cases. In particular when the lesion is clearly visible at ultrasound, US-guided FNB could be considered a simple, rapid, relatively non-invasive and accurate procedure. 

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