EUS-Guided Tissue Acquisition Of GI Subepithelial Lesions With Macroscopic On-Site Evaluation (MOSE): Adequacy With FNA And FNB Needles

Aims EUS imaging, even if coupled with FNA, has a suboptimal accuracy in diagnosing subepithelial lesions; to increase the performance of EUS-guided tissue acquisition the use of FNB needles, or the addition of macroscopic (MOSE) or microscopic (ROSE) evaluation of the specimen have been proposed. The aim of this study is to compare the adequacy of FNA with MOSE and FNB with MOSE in this setting.

Methods We retrospectively divided our cases in two groups according to the technique used. In the FNA group the target lesion was punctured with a cytological needle and the specimen was smeared on slides and macroscopically assessed; if needed, additional needle passes were done till five slides showed some whitish granular or thread-like material. In the FNB group an histological needle of any type was used and one or more needle passes were done till at least 2 cm of tissue cores, overall, were acquired. We compared the final microscopic adequacy and the needle passes effected when using the two techniques.

Results 60 lesions, 6 in the esophagus, 38 in the stomach, 8 in the duodenum and 8 in the rectum were studied. FNA was adequate in 18 out of 22 (81.8 %) cases after a mean of 3.2 needle passes. FNB was adequate in 30 out of 38 (78.9 %) cases after a mean of 2.1 needle passes (p < 0.05). The final diagnoses were 8 adenocarcinoma, 3 squamous carcinoma, 16 GIST, 4 leiomyoma, 4 NET, 3 lipoma, 1 pancreatic rest, 1 psammosarcoma, 1 Schwannoma, 1 glomus tumor, 1 Brunneroma, 5 normal submucosal cells without atypias, 12 non diagnostic.

Conclusions The presurgical diagnosis of GI subepithelial lesions is challenging but the endosonographer can increase his performance using FNB needles and MOSE, that could represent a fast and cheap alternative to ROSE.

Citation Togliani T, Pilati S. eP402 EUS-GUIDED TISSUE ACQUISITION OF GI SUBEPITHELIAL LESIONS WITH MACROSCOPIC ON-SITE EVALUATION (MOSE): ADEQUACY WITH FNA AND FNB NEEDLES. Endoscopy 2021; 53: S228.

Publication History

Article published online:
19 March 2021